Fluctuating BG levels

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MelissaF DAFNE Graduate
South West Essex PCT
56 posts

Hi guys,

Can anyone help?

I've been fairly good with my diet over the last few months and my BG results have been pretty stable (for me) and fairly predictable using the DAFNE guidelines. I've been using around 4-5 units of BI (Lantus) in the evening to get a good waking reading and stable daytime levels. This is working with a pretty controlled diet though.

However, at the weekend, I had a bit of a blowout for 48 hours. I went to stay with friends and ended up eating an awful lot of "bad food". Predictably, my BG levels shot up and I haven't been able to bring them back down again as I can't work out what my BI levels should be. As my waking readings were shocking, I ended up raising BI from 5 to 7-8. They're currently on 8 and I've been waking with readings of around 13-18. I tested at 3am last night to try and work out if hypos were involved at all. I went to sleep on a reading of 11.5, took 1.5 units of QA to correct that and 8 units of BI and, at 3am, my reading was 7.1 which I was quite pleased with. However, when I woke it was 14.6. I wondered if this was because my BG levels had dropped from 3am and I had gone hypo and my body was reacting to that.

However, when I tested mid morning, my levels after breakfast had gone to 7.8 which again I was happy with. But, testing before lunch, they had risen to 13.0, even though I hadn't had any carbs. This would imply to me that my background insulin levels are too low and my BG levels are only reacting to the QA.

Can anyone help please? Novorapidboi - you're usually good on this sort of thing!

Many thanks,

Melissa

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,800 posts

What time do you normally get up at?

The first impressions would be Dawn Phenomenon, normal levels at 3 am, high when waking, back down once fuel and insulin for breakfast has been given.......

I think more background testing is needed, I asked if you had done any in the other thread.... Wink

You really need to NOT correct before bed when basal testing so as to eliminate the QA variable, then always remember the 3 am as well......if your really high, correct and do the test another night....

I couldn't say for sure but I wouldn't of expected you to go low after a 7.1 at 3 am, but its not impossible.....

So just go through the steps methodically, establish what you BI dose is doing overnight, adjust accordingly.....then move on to the daytime, with carb free or missed meals....

Unfortunate with Lantus there is no flexibility for varying BI needs from day to night. You can split the dose though, its just personally I feel its no use and Levemir would be better, I am bias though........

What is interesting is that this has all happened after lots of carbs over the weekend, which is not the usual behavior. So this reaction may only be a temporary one and you may find your BI needs return to normal soon.

In the meantime, get testing....... Very Happy

MelissaF DAFNE Graduate
South West Essex PCT
56 posts

Hi NRB,

I usually get up around 07.00 but this varies according to my shifts at work.

I think that you're right and the problem definitely lies with my BI - I just wouldn't have thought that I would have needed to make this level of adjustment to it after 24 hours of "naughtiness". Oh well, that will teach me.

I did try Levemir for a period of about 5 months but it didn't suit me at all. I'm just one of those people who suit Lantus better. I know that we're in the minority but I have found a fair few others.

And, in answer to your post on my other thread, yes I am incredibly sensitive to insulin which I guess isn't necessarily a bad thing after 24 years of diabetes but it does make for a fair amount of yo-yo-ing with my sugar levels which can make life harder!

Thanks for the advice - much appreciated as always.

M

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,800 posts

Rising at 7 or close to that time would suggest dawn phenomenon due to their being only a few hours between the 3am test and waking.......

I wouldn't of though that you would need to adjust so much because of your food filled weekend either......how extreme was it? The liver releases a steady a stream of glucose which wouldn't change dramatically just because you were eating lots. Your resistance to insulin may have been upped a few notches if your eating habits over the weekend were not controlled well and high sugars followed, that may be the explanation..........

If Lantus works better then I totally agree. You would expect folk on little amounts of basal, and who are relatively sensitive to work well with Lantus, me however, I need lots, 64 units in total, 28 in the morning, 36 at night....... Smile

If your really sensitive and are experiencing hypos because of it, a pump is in order..............has this been mentioned/offered. How many hypos do you have in a week?

The pleasure is all mine, honestly.............. Wink