T1 diabetics thread

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PositronicRay

Original Poster:

27,088 posts

184 months

Tuesday 17th March 2020
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jimmsy said:
For bringing down sugar levels when you have a cold/virus raising them is to increase the background by 50%, rather than more fast acting. If you’re on a 12 hour or less background this is easier, if you’re on a once a day like Lantus then it can be more difficult. Works well for me though. You can also do a brisk walk to increase your body’s insulin sensitivity, around 30 minutes does the trick, as long as you feel well enough!
Good tip.

I'm always worried about overdoing it though.

PositronicRay

Original Poster:

27,088 posts

184 months

Tuesday 17th March 2020
quotequote all
dirty doug said:
T1 49yo

watching & reading at the mo.

currently still working at work but contingencies currently being ironed out for WFH

to gym or not to gym though now that is the question...?
I probably wouldn't go to the gym, but maybe some running or walking.

PositronicRay

Original Poster:

27,088 posts

184 months

Wednesday 18th March 2020
quotequote all
Now this is the daft thing. Libre freestyle CGM authorised 2 months ago, but need to wait for training (due Fri this week)

Lady calls, due to C19 training cancelled, not to worry I'll email you the presentation. Any probs just call.


If so simple they could have done this months ago. Will C19 mean we work smarter?

PositronicRay

Original Poster:

27,088 posts

184 months

Sunday 22nd March 2020
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My freestyle is up and running, what a great bit of kit.

The screen is a bit small on the reader is awkward, and the diary seems limited. TCurrently using a food diary on my android tablet and transferring data manually. (I don't have a smart phone.

What do you folks do?

PositronicRay

Original Poster:

27,088 posts

184 months

Thursday 2nd April 2020
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mike9009 said:
Feirny said:
i4got said:
Feirny said:
So we’re on the list of people to self isolate for 12 weeks then. I’ll 100% be doing it as my immune system isn’t great as it is.
Have you see a definitive list of those impacted? Is it available online? TIA
I don't know if it's online yet, I've been informed by my mother who works for the NHS in a senior capacity.
When the guidance was first announced it was clear that diabetics should isolate for 12 weeks. I clearly remember discussing with two T1 colleagues and my T2 boss about this.

Now, there seems to be no mention of diabetics being at risk anymore in government guidance. I presume/ assume the initial guidance was incorrect. Anyone have any more info on this? Are the stats for diabetics much the same as the general population in terms of susceptibility to complications of COVID-19?

TIA
We're not on the official vulnerability list. But no doubt diabetics have a reduced immune system. I was surprised to learn that statically T2, suffered more, perhaps due to other underlying health issues.

I'm keeping my head down, even if I catch something minor it can really knock me about. Often unexplained high blood sugars are my 1st symptom.

I feel a little guilty, fit and healthy but using the volunteer group to fetch meds, rather than helping. The way I look at it better one person goes for 6 scripts, than 6 people collecting one each.

Our local volunteers are brilliant. I'm sure they get satisfaction from helping, but also like the opportunity to get out and about.

PositronicRay

Original Poster:

27,088 posts

184 months

Sunday 31st May 2020
quotequote all
I've been using the freestyle libre since mid March. Apart from one dodgy sensor (replaced quickly by Abbot) all is good.

It gives me a much greater understanding of what's going on, tighter control, and less "yoyoing" over correction.

Average glucose reading down from 10.1 to 8.8 mmol/l, est hb1c down to 54 mmol/mol, for yrs it's hovered around 62-64.
I had a call from the diabetic nurse, she was monitoring my results remotely, spooky but fantastic too.

I'm fairly insulin sensitive around 1/20 (insulin to carbs) daytime, 1/15 evenings. Typically 100-120g carbs per day, so some meals I find myself having to make a call between 1 or 2 units, sometimes skipping insulin completely. Invariably a difficult one, often resulting in correction a few hrs later.

I think the solution would be a pump or 1/2 unit insulin pen.

PositronicRay

Original Poster:

27,088 posts

184 months

Thursday 18th June 2020
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mike9009 said:
I have just been given Freestyle Libre, I will pick it up on Friday.

I did not push for the Libre, in fact it was 'almost' pushed on me. During lockdown, I have been having more frequent hypos. I get very good signals, even at night. However I have yoyo'ed a bit after each hypo. Oddly, my HBa1C is the best it has ever been.... (Equiv to 7.4).

I am also changing my 'basal' insulin from Humilin I at the same time - so it might be quite an interesting time having been using the same insulin and control for 25years. The specialist I spoke to, said he was amazed my control was so good with the 'whacky' insulin doses I am using. My current Humilin I is about 25% of my total daily insulin intake - typically he says it ought to be around 50%.....

Time will tell....

Just sharing, so I can get some advice in a couple of weeks smile
I hope you get on with it. Its given me greater confidence, so I'm not over correcting whilst out walking. My hypo awareness has dropped right off in recent yrs.

I've now dropped my basal from 18 to 12 units in stages. Certainly feels more stable, equates to just under 50%.

I love the stats and targets produced, not sure of my interpretation though. The really cool thing is remote monitoring from the DN. Call them, and they'll make recommendations based on accurate information on the screen in front of them.

ETA I now have a 1/2 unit pen. Good for making minor adjustments.

Edited by PositronicRay on Thursday 18th June 08:31

PositronicRay

Original Poster:

27,088 posts

184 months

Friday 19th June 2020
quotequote all
The thing is everyone's different, no formulas, even day to day my regime varies. Typically 150g of carbs per day.

A couple of really cool things re the libre. If I wear it on my left arm, my wife can check my BS whilst on the road.

Some winter days invariably finds me soaking wet, togged up in gloves and waterproofs, on an exposed site, blowing a hoolie, horizontal rain and sleet, head to toe in mud.

This season I'll be able to pop the libre reader in a sandwich bag, glucose reading taken still gloved up.

PositronicRay

Original Poster:

27,088 posts

184 months

Saturday 20th June 2020
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mike9009 said:
Well, I have had the Libre on for about 24 hours. It is scary!

Occasionally, before Libre, I had been going low during the night, waking up, having a boost and then fine in the morning.

Last night, first time with Libre, I was running between 5 and 6 most the night. At about 5:30AM, I went hypo, didn't wake and by the time I awoke my blood sugar had recovered to normal. Then through this morning my blood sugar just kept climbing (upto 15), it looks like the same trajectory from the hypo at 530AM. By lunchtime back to normal, with no insulin, other than normal breakfast dose. I wonder whether this has been happening far more frequently than I realise....

Tonight will be interesting. I am desperately trying to do things 'normally' and resisting what Libre is telling me......

Appreciate any insights, but I know I will be talking to my specialist about this....
Before libre I didn't realise what my night time glucose levels were like. Before bed 10 breakfast 4-5 stable I thought, except it'd been soaring to 15+ in the small hours before plummeting.

3 months on I'm starting to get the basal/bolus ratio right. The danger is getting obsessed and trying to micro manage.

A 1/2 unit pen helps, I'm sure an insulin pump would too.



PositronicRay

Original Poster:

27,088 posts

184 months

Tuesday 23rd June 2020
quotequote all
Chilly for June said:
Wasn't aware of 1/2 shot pen, who manufacturer them?

I have been using libre for 6 months now. Really does help with staying in top of levels. My A1c has never been lower sinve being diagnosed.

I find that my blood sugar can stay steady all night then if I get up at say 6am for the toilet and go back to bed my sugar can go from 6 up to 14 very by 8:30 when I get up. Tend to get this most mornings haven't ate anything so can't quite understand it.

Have started taking insulin at 6 to cancel out the rise but annoying none the less
Manufactured by novo nordisk, probably developed for children but really helps me fine tune.

Google Dawn phenomenon.

I find that when I'm adjusting my basal, it takes a week for it to settle. (clinics reckon a couple of days)

Now on 12u basal (Lantus) down from 18u a couple of months ago.

PositronicRay

Original Poster:

27,088 posts

184 months

Tuesday 23rd June 2020
quotequote all
Some basal is designed for a split dose, I take Lantus once a day at bedtime.

I tried splitting the dose but it didn't help with control, I was relying too much on the basal and not Bolusing enough. I found I was playing catch up all day. I'm still taking the same total units, (basal v bolus) but a more sensible split.

40yrs since diagnosis, everyday is still a school day, you'd have thought I'd have it cracked by now!

Edited by PositronicRay on Tuesday 23 June 12:55

PositronicRay

Original Poster:

27,088 posts

184 months

Friday 3rd July 2020
quotequote all
Just had my first HbA1c level since libre

Down from 64 in Jan to 53 mmol/mol now.

Yeh. biggrin

As the man said "you can't manage what you can't measure"

PositronicRay

Original Poster:

27,088 posts

184 months

Saturday 4th July 2020
quotequote all
mike9009 said:
PositronicRay said:
Just had my first HbA1c level since libre

Down from 64 in Jan to 53 mmol/mol now.

Yeh. biggrin

As the man said "you can't manage what you can't measure"
Great work! How does your actual HbA1C match with what Libre predicts?

I have been on Libre for two weeks now, with predicted HbA1C of 52. My last actual Hb1AC was 58 in May - just interested in the correlation....
The estimated value correlated well with the actual. I've a telephone appointment with my consultant on Friday. Keen to discuss a pump.

I'm also interested in this https://miaomiao.cool/ self funding though. The watch with a warning would be great while working in the Forest, and a display on the phone for long distance driving. I'm kinda surprised Abbot haven't developed a similar thing.

I'm going to dragged kicking and screaming into the 21st C.

PositronicRay

Original Poster:

27,088 posts

184 months

Saturday 25th July 2020
quotequote all
Well it's been a funny old week.

I've moved from novarapid to humalog. Faster acting so still working things out, running too high, but overcompensating so also hypos.

I've increased my basal, a couple of units, hoping to have the balance cracked in the next few days.

PositronicRay

Original Poster:

27,088 posts

184 months

Sunday 26th July 2020
quotequote all
Chilly for June said:
mike9009 said:
PositronicRay said:
Well it's been a funny old week.

I've moved from novarapid to humalog. Faster acting so still working things out, running too high, but overcompensating so also hypos.

I've increased my basal, a couple of units, hoping to have the balance cracked in the next few days.
I am on Humalog and have been for years (prior to that Actrapid). Humalog feels quite controllable, but I need to inject about 20 minutes before eating which is not what the 'sales' blurb says and not always possible with my lifestyle....

I have recently moved from Humilin I to Tresiba which feels much better. Libre is putting my HBA1C at about 6.7 which is unheard of for me.
What is the reason for the change in insulin?

When I was in America last year I ended up running out of insulin just before we came home. Long story short ended up getting one pen to tide me over. I think it was a Lily brand. Anyway ate a massive meal carbs etc and took this new pen, it had my blood well under 7 two hours after. It was almost as if my body liked having the change from Novo rapid.

Went straight back to Novo when I got home so no further details but it did make me think what are these drugs we constantly pump into our body capable of and does the body get used to them and stop reacting well to them?
I wanted a faster insulin, high spikes then low BS before meals with nova rapid.

I'm preferring that it's in, does the job and out again.

PositronicRay

Original Poster:

27,088 posts

184 months

Monday 27th July 2020
quotequote all
Chilly for June said:
PositronicRay said:
Chilly for June said:
mike9009 said:
PositronicRay said:
Well it's been a funny old week.

I've moved from novarapid to humalog. Faster acting so still working things out, running too high, but overcompensating so also hypos.

I've increased my basal, a couple of units, hoping to have the balance cracked in the next few days.
I am on Humalog and have been for years (prior to that Actrapid). Humalog feels quite controllable, but I need to inject about 20 minutes before eating which is not what the 'sales' blurb says and not always possible with my lifestyle....

I have recently moved from Humilin I to Tresiba which feels much better. Libre is putting my HBA1C at about 6.7 which is unheard of for me.
What is the reason for the change in insulin?

When I was in America last year I ended up running out of insulin just before we came home. Long story short ended up getting one pen to tide me over. I think it was a Lily brand. Anyway ate a massive meal carbs etc and took this new pen, it had my blood well under 7 two hours after. It was almost as if my body liked having the change from Novo rapid.

Went straight back to Novo when I got home so no further details but it did make me think what are these drugs we constantly pump into our body capable of and does the body get used to them and stop reacting well to them?
I wanted a faster insulin, high spikes then low BS before meals with nova rapid.

I'm preferring that it's in, does the job and out again.
Be really interested to hear your thoughts in a week or so when you have gotten used to it. Always looking for better ways to control.

Do you guys still only inject in your arms, thighs and stomach?
I'm about a week in.

Nova rapid was active for so long it was difficult to correct between meals. Also I think it was in my system for so long it was masking a low bolus dose. I've increased that to 14u.

To maintain a decent level with with nova rapid I was injecting, waiting until BS dropped to 5 then chomping fruit pastilles to maintain sub 10 until the next meal. Or huge spike 15-18 then slowly dropping to around 4-5 before the next meal.

Now after a couple of hours it's back in range, sub 10 and (by and large) flat lines. Less variability.

I'm a little paranoid when it starts going high, and take a correction dose between meals. With novarapid I'd just wait and correct at my next meal time.

Stomach and 1/2u pens.

I'm still campaigning for a pump.

PositronicRay

Original Poster:

27,088 posts

184 months

Friday 31st July 2020
quotequote all
mike9009 said:
Chilly for June said:
Be really interested to hear your thoughts in a week or so when you have gotten used to it. Always looking for better ways to control.

Do you guys still only inject in your arms, thighs and stomach?
I only inject in my thighs, rotating region on a daily basis. When I was a kid I was encouraged to inject in my stomach, arm and calves. Injecting in my calf and stomach gave me a cramp-like pains.

Very occasionally I will inject in my stomach, which I have read will help absorb the insulin more quickly. No about you??
Sorry for the late reply.

I found fatty lumps forming on my thighs, arms and buttocks. So gave those up. I only use my midriff now, even around the sides, anywhere I can find some spare flab.

I haven't noticed any absorpstion problems, but maybe sometimes I just put it down to one of those days! I have been warned about injecting into muscle, apparently insulin gets into the system much more quickly.

2 weeks into humalog and I'm getting a handle on it, more time in target (up to 74%) lower sugars and lower variability so pretty pleased. Hypos have increased so I'm going to peg back the basal again.


ETA

It was so much simpler 40yrs ago! I was hypo aware, no testing, glass syringes with 12 needles (like horse needles they were) per month. 2 injections per day, mixing cloudy and clear insulin in the syringe as you went.

Edited by PositronicRay on Friday 31st July 12:11

PositronicRay

Original Poster:

27,088 posts

184 months

Monday 7th September 2020
quotequote all
I've just been approved for an omnipod. I won't miss 6 injections per day!

Looking forward to a time when pumps link properly to CGM.

PositronicRay

Original Poster:

27,088 posts

184 months

Wednesday 9th September 2020
quotequote all
Arun_D said:
Having been started on Libre in November, I was realy happy to see my HbA1C drop from 68 to 54 after 3 months usage.

Expecting I've throttle back a little over lockdown, and seeing a slight rise in the estimated level in the app, I was pleasantly surprised to be told I've dropped down further in my latest blood test, now 53. The lowest I've been in about 12years, since just after my diagnosis.

Not a big drop, granted ,but I'll happily take it since I was expecting a worse result than before!

Now looking at tighter control with faster acting insulin or one of the systems to turn the Libre into a proper CGM.
Yes similar hb1ac, getting obsessed by time in target. Around 66%.

PositronicRay

Original Poster:

27,088 posts

184 months

Saturday 24th October 2020
quotequote all
Omnipod arrived biggrin

Zoom meeting next week with rep and DN for introduction and training.