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Bouncing of Blood sugar
I am type 2 diabeteic patient. Due to skipping meal, I developed adrenaline stress and by diamicron  metformin
But blood sugar was never high. Doctor gave me Lantus and Humalog. It was working well for a year. Then blood was becoming high, Doctor gave me LEVEMIR. If I take 10 units of humalog, after two hours sugar drops 4 points, I think this is the right dose for humalog for what I eat. I eat 60 gram Carb every meal. But 3 hours, sugar tries to go low, but insead, it bounces back and proceede to values and I start to feel hypo,  though I never see sugar 9. It is not hypo value, why sugar bounces up, why feel shaky, fear etc. I use LEVIMIR as base insulin. Why body is obstructing sugar to low, and why it gives hypo feeling.

Can any body me the reason and how to overcome this situation? My sugar is going high now.

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60 gr is a lot of carbs/meal  (for me, I keep it under 20gr)

Have you herd about the law of small numbers?

if you eat small amount of carbs, you use small amount of insulin, you have small BG swings.

you might need Apidra Insulin it is faster than Humalog (might help with the 3 hour low)

Or your timing on the insulin is off, might have to take sooner before eating so its running out as your BG drops  Before 3 hours

when your BG drops too far your liver will dump glucose to raise BG but it over does it
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Thank you for your answer
Yesterday night, before going to bed, blood pressure was not high. It was very close to 100/60. I was hesitating to take 300mg Avapro(BP medicine)
I took 22 unit of Levimir at bed time. At 4am, I woke up. measure the pressure , it was 165/100. I took 150gm Avapro. My sugar was 8.1mmol. I got up from bed, sit down quietly for 10 minutes. BP became OK. I went to bed again, and got up at 6. BG was 9.4. I want to bring morning sugar to 6or 7. I am facing a very unstable situation in blood pressure and sugar and these two are working against each other

After 3 hours of eating, no humalog is there, but why I feel shaky and then BG starts increasing? Though sugar is not low.

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Humalog lasts 3 hours in me.

What was your BG number when you felt "shaky"

Could be a "false Hypo"  you body is used to high BG numbers, when it gets a number that is normal your body thinks it is to low because it thinks normal is 9 so 4 feels low.
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Is there any way to stop this false hypo and dumping of sugars by liver?

Do you have any idea about Levimir ? Does it lower sugar in day time?

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Getting used to lower BG is the cure for a False hypo

Levimir last 24 hours so yes it works in the day.

you need to keep an ACCURATE  Log, you need to test before bed, when you get up, before you eat, then 1 hour after 2 hours after  and any time you feel wrong.  

time      BG test        carbs eaten       insulin used

do all that and you should see a pattern develop.  just guessing and testing willy nilly, will get you willy nilly info.
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I was trying to bring the morning sugar to 7 mmol. Yestarday night and day before night , I took 24 units of Levimir at 10 pm, In both the days, I woke up at 4 am, sugar was 8.1 and 8.4, I went to wash room and go to bed again, I measured at while in bed it was 9.4 and 9.9, I ate a cookie, it went down 1 point. How can I bring down BG to 7, How can I stop the liver dumping.
I am giving you yestarday's history.
AT 4 am I woke up, sugar was 8.1, went to washroom. Went to bed again,, got up at 6am, sugar is 9.4.
I ate, 45 gram of brown rice + Cabbage + 15 gramm of milk(1cup) +2 spoon of olive oil.
I took 11 unit of HUmalog, Sugar 8 am is 10.4 but 11.9 at 10 am, Then I walked to bring it down. Before eating at 11am it was 9.3 at 1 pm it 10.6, before super at 5 pm it was 9.7, I was taking 1 cookie at 3 and 4 pm at 7 pm 11.1, it was going high, I walked brought down to 9.4 at 10 pm and the 24 units of levimir
I took 10 units of humalog before lunch and 11 units of humalg befor super.
I have lot of anxiety.

MATIN
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Anxety can raise BG

looks to me like you need more insulin and less carbs.
your not matching the carbs with insulin thats why your high at 2 hours.  stop eating cookies for snacks (if they are the same thing as what I call a cookie), find a low carb snack to eat.

Your 2 hour post eating BG should be almost the same as your pre-eating BG in its hi you need more fast insulin and or less carbs.

carbs raise BG


Metforman helps with DP by slowing the livers ability to dump sugar.and it helps with insulin resistance
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Actually my complicacy was not eating sufficiently in 2009, Metformin and Diamicron created stress on adrenaline. Metformin harmed me, I do not know, it is OK to take metformin  in this situation?

I am afraid of increasing more insulin, if body does not allow to lower, then it will bounce and make it higher.
If sugar goes low but not too low, and not bouncing, I can tolerate that.
But if it bounces, I cannot go lower.

Sugar increase is not that high. 9 to 13. I like to come within 7 to 11
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I cant tell you if it is safe to take met (im not an MD)

I can say you have a meter and you test are you going low (lower than 3.8)  that is low, if your not going low then you need more insulin to bring your numbers down you are still too high.

every time your BG is over 7.8 you are doing damage to your body.  so 11 is way to high.
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How many times you eat with 20g Carb. How many times a day including snack? How much protein you eat every day? It would be better for me, if I could eat every three hours maintaining uniform BG. Please suggest me a meal planning. Do you have any idea about tyramine rich food?
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I eat 3 times a day
breakfast   eggs & bacon, coffee

lunch sandwich made with low carb bread ~18 carbs

dinner   meat and salad or vegies

snacks any number of low carb

NO rice, pasta (except shirataki noodles  0 carbs), potato limited fruit.
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Can I ask one more question?

I am taking 22 units of levimir at bed time.

The number "22", does it depend on bed time sugar?

Will 22 units of levimir be same for both  bed time sugar 7 and 10?
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That depends;  the amount of levimir depends on your fasting BG  IE 6 hours of no food you should be around 5 to 6  if your higher add 2 IU every third day till your fasting comes down.

***  for some people Levimir does not last 24 hours,  for them they split the does 12 hours apart IE 11 IU in the morning and 11 IU in the evening
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Please explain me clearly once again. I could not understand yet. Last time I eat at 5 pm. Take 11 unit of humalog, I go to bed at 10 pm to 10-30pm.
Sugar remains then 10 to 10.5. I do not eat any more. If I walk and able to make it down to 8.5, then I drink 2 ounces of skim milk at bed time. If right amount levimir is taken, how much should be fasting BG.

I am very confused with the behaviour of levimir with me. If I take 23 unit of levimir, I awoke at 4 am and see sugar is 8, but blood pressure up, the if I seat or get up, I get 9 to 9.5, sugar increases.

Probably I cannot go to 5 and 6 as fasting sugar, I have adrenal weakness, I may not tolerate that. I am 65 years old

Please explain two terms you mentioned:  a.   Fasting BG   b. 6 hours of no food.

Yesterday night, I brought to 7 by walking, I woke up at 4pm, sugar was 9, pressure did not increase. I gave only 18 units of levimir.

I feel worse in the morning, specially at 8:30, cortisol releasing time.

I tried only 4 units in the morning and 20 units in the night. 12 hours apart. But blood pressure become high. I stopped it.

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Insulin does not effect blood pressure.

fasting is fasting no food or drink (except water) for 6 to 8 hours sometimes MDs want to see 12 hours no food or drink except water.

If correct levimir dosage is when your fasting BG is between 3.8 and 5.5

7 is too high so is 9  
test before you eat dinner COUNT THE CARBS YOU WILL EAT!! take your fast insulin. eat dinner, test 2 hours after you eat your BG should be the same as before dinner. if its higher than before dinner eat less carbs OR take more insulin.  repeat next time you eat.

I am not an MD

But proper BG levels are better for your body than high BG who says you cant have NORMAL BG with "adrenal weakness"

You should see an Endocrinologist (diabetes specialist MD)
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I am about 1 and 1/2 month with high BG, as insulin or food tries to lower BG, blood pressure tends  to increase. I ate at 11am, hence no humalog is present in my body,Now time is 3-30pm,  sugar is 10.5, I ate a chicken leg, I am feeling shaky, blood pressure increased, and sugar went down to 9. Due to lack of food, sugar was going up, liver was dumping, chicken leg helped to stop dumping.  As soon as sugar will be stabilized, blood pressure will be stabilized. My problem was due to skipping meal, I must have to eat every three hours, atleast a little . But sugar is increasing for that too. I need more insulin, Levemir. I do not know  how I cope with the opposing forces of blood pressure and sugar decrease. My body will have to be habituated, so that it does not declare emergency, and excite liver and adrenals for dumping of sugar and increase of pressure. Now I am starting to believe that, meat can do that job. Three time carb and vegetable and three times meat. I will try it from tomorrow.




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why is there no humalog because you eat at 11:00?  If all you eat is a chicken leg you dont need humalog.

I am confused  you eat , take insulin  measure BG with no plan and get unknown results.

I explained how to make a chart and how and when to test.  fill in the chart to see how it works.

STOP stressing it will raise BG
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231441 tn?1333896366
I recommend the book, Think Like a Pancreas.

If you blood sugars are too high then you need to increase your insulin doses.

Levimir is your background insulin.  It shoudl keep your blood sugars stable, even if you don't eat.  You need to do something called "basal" testing to work out the correct dose.

Humalog is your fast acting insulin and should prevent your blood sugar rising high after you eat.  Humalog can also be used to 'correct' blood sugars that are too hihg.   You need to have a carb;Insulin ratio worked out.  This is usually worked out by trial and error and is indivicual.  Often people start off with a ratio of 1 unit of Humalog to 20 g of carbs and then adjust from there.

If you are eating low carb, then you will also probably need to dose for protein (about 50% of the insulin needed for carbs).  ie. something likee 1 unit of humalog for 40 g of protein (but you need to fine tune this for yourself).

Testing and monitoring and adjusting insulin based on the blood sugar results will allow you to have better control of your blood sugar.

But you also need to control what you eat, particularly the carbs.
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Can you please explain the situation:
I took 300gm Avapro before bed(BP medicin)
Bed time Sugar 10.8, took 20 units of Levimir at 11pm.
2-20 am Sugar  8.8 got up & went to washroom
4-20 am sugar 9.2
6am       sugar 10.1
While sitting, blood seemed low, but after taking Levimir, went to bed and blood pressure was 135/77/64
I ate brown rice 150gm brown rice by weight, 1 cup of cooked cabbage @ 2 ounce of milk I took 10 u nit of humalog at 6am. 8am sugar is 11.7
At 9 am humalog will finish, and it it will increase.

Yestarday before eating at 5am. sugar was 10, took 12 unit of humalog , sugar was 9.3 after 2 hours(7pm), at 9 pm it was 12, I walked 15 minute to bring down and it was 10.8 before bed..

Please give me suggestion

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But  I have adrenal fatigue. It has been done by metformine, while i was not eating sufficiently . I had hypoglycemia, But I did not see low sugar in my meter. Emergency could not catch it, because liver dumped it imediately

Harbalists say to take lot of vitamins and minerals to recover adrenal. Harbalists say, eat  whole grain carbs very limited amount. I cannot eat white rice, any kind white, or anything with high glycemic index. I cannot eat white rice, it gives me very absurd feelings because of adrenal. They suggest to eat lot of protein.. BUt probably, MDs do not believe in vitamin theory

Can I take high dose vitamin C and B5.?  Some people take vitamin and minerals for adult over 50. Are all those OK with insulin? I understood your insulin fixation concept. Thanks
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3 pm  now I feel bad, I see my sugar is 9.8, why I am feeling bad? Then I ate a little meat. Within a moment, sugar went down to 9. I must have to give food after three hours, otherwise I feel bad, I described it as a hypoglycemia, shaking. Due to skipping meal problem, body still remembers it, and demand food, if I do not eat then i feel bad and sugar bounces.  I need a food, that I can eat every two hours but sugar will not  increase that much. I could do it with nuts, but I cann0t eat nuts, because I am reactive to tyramine rich food. I cannot eat protein, other than animal protein. If I could in this way body used to forget this issue. If I eat protein, sugar increased before bed time, because it releases sugar later Please suggest me what can I eat. I will have to eat 3 pm and 9 pm
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"I ate brown rice 150gm brown rice by weight, 1 cup of cooked cabbage @ 2 ounce of milk I took 10 u nit of humalog at 6am. 8am sugar is 11.7
At 9 am humalog will finish, and it it will increase.
"
you tell me

insulin lowers BG,  carbs raise BG...   your BG went up by 17%  and you say will continue to rise.  insulin lowers BG if your BG continues to rise you might need what is called a wave bolas some when you eat and some later.

Insulin lowers BG

you need to find your I/C ratio (insulin/carb)  and your how much each IU on humalog will brings down your BG when you dont eat.

Suppersally gave you some good advice.

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231441 tn?1333896366
Hello,

your blood sugars are high.  Because your body is used to being high you will feel low, even you aren't. B ut damage is happening so you need to bring your sugars down.  I'll put my comments in capitals below


Bed time Sugar 10.8 (194.4), took 20 units of Levimir (LONG ACTING) at 11pm.
(WITH BLOOD SUGAR AT 158 YOU PROBABLY SHOULD HAVE TAKEN HUMALOG - YOU NEED TO WORK OUT THE APPROPRIATE CORRECTION DOSE TO CORRECT FOR THE HIGH).

2-20 am Sugar  8.8 (158.4 STILL HIGH)got up & went to washroom

4-20 am sugar 9.2  (165.5 STILL HIGH AND RISING - PROBABLY DAWN PHENOMENON)

6am       sugar 10.1  (181.8 THIS IS A VERY HIGH FASTING.  OPTIMAL FASTING IS 80 - 95 RANGE.)

While sitting, blood seemed low, but after taking Levimir, went to bed and blood pressure was 135/77/64

I ate brown rice 150gm brown rice by weight, 1 cup of cooked cabbage @ 2 ounce of milk I took 10 u nit of humalog at 6am. 8am sugar is 11.7 (210 AFTER EATING.  THIS TELLS ME THAT YOUR HUMALOG DOSE WAS PROBABLY SLIGHTLY LESS THAN YOU NEEDED).

At 9 am humalog will finish, and it it will increase.

Yestarday before eating at 5am. sugar was 10 (180 ), took 12 unit of humalog , sugar was 9.3 after 2 hours(7pm) (THE 12 UNITS OF HUMALOG DID COVER YOUR FOOD REASONABLY - AS YOUR WERE 10 BEFORE EATING AND 9.3 AFTER), at 9 pm it was 12, I walked 15 minute to bring down and it was 10.8 before bed..

TWO COMMENTS:
1. Your basal insulin dose (levemir) appears too low, as your background blood sugar is always high.  I would recommend that you work with your doctor to increase your levemir dose such that you can get your base blood sugar levels down to a more normal level.  

That may need to be done over a period of days to weeks.  You may want to try splitting the levemir into 2 doses 12 hours apart as some people find this gives better coverage.  So, if you take 22 units then take 11 units each 12 hours apart.

Then you would increase (with your Dr. supervision) your levemir by probably 1 unit per dose every 3 - 5 days until you get your fasting numbers on target (ideally 80 - 95 range - though your dr. may set a slightly higher number).  Your before eating numbers should also be in this 80 - 95 range.  Increase only slowly and once you get close to target make adjustments even more slowly.

Your humalog is then used to cover what you eat and to prevent you going high from the food that you eat.  It seems that your humalog dosing is reaonable - you are fairly close in numbers before and 2 hours after eating.  I would not be changing your humalog dose at this time.

however, you do need to work out how to do a correction of high blood sugars using humalog.  For me, 1 unit of humalog will drop my blood sugar by 2.2 points.   So if I am say 9 and wanted to be 7 I would take 1 unit of humalog.

btw the coversion between numbers is 18.

Hope this helps.

Strongly recommend the book "think like a pancreas". See if you can get it from your library or find it in a bookshop.

The levemir is not dosed based on your blood sugar at the time of dosing.  It is based on your fasting blood sugar and your before eating blood sguars (assuing that your humalog dose is sufficient and you are not going terribly high after meals - which you could if your humalog is not enough).

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231441 tn?1333896366
you will cause even more adrenal stress by having blood sugars all over the place.  So please do work on getting yoru blood sugars more stable and lower.

In your numbers for the targets:

Fasting ideally: 4.4 - 5.3
2 hours Post eating: < 6.6 (or maximum 7.7) - but also should not be lower than 4.4.

You will need to bring your sugars down slowly as you will feel hypo with normal numbers at the beginning.

Please be careful. While your nubmers are too high, we also don't want you to be going low.  This means you need to eat on a regular schedule, test frequently and be consistent with exercise and activities.  If you are more activce than usual you may need to eat a bit more / test blood sugar.

Please do also work with your Dr.  But be an educated patient.  Diabetes is nto something our Dr. can manage for us. We need to manage it for ourselves.

Hope this helps.
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I am in a very complicated situation:
a. Stress: Stress is giving me increase in sugar. Driving car also keeping me on high

b. Blood pressure: Though it is normally OK, I am tyramine sensitive. There are some foods, we eat I suddenly wake up, it gives blood pressure  and heart rate high.

I was trying to increase levemir. I  increased one unit yestarday night to 24
But suddenly I wake up,  heart rate went to 100, pressure to 148/78, After two minute, it was Ok. probably I ate some tyramine rich food,  After a while  Blood pressure increased to 155/88, but OK after 3 minutes. Then I slept for six hours, I wake at 4 am, Sugar was 9.5, at 6AM 10.7


No improvement. I am worried about blood pressure increase,If I  I increase the levemir  dose,

I am increasing Humalog too. I took 14 unit humalog, at 6am, after two hours it it 12.4, at 9 it was 11.4, I gave a ride to my, sugar increased to 12,5 and is not dropping. I feel worse at 12.5
I can give more humalog, it be  good or not, without decreasing the morning sugar

I will give 24 units of levemir to day night again. Let me see blood pressure is OK or not.

Suppose before before lunch sugar is 12.5, whaever i eat, can be covered by 10 units, and I add more 6 units more to makes 12.5 less 9mmol?
Among 12.5 some are from liver.









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Can you please explain me some pecuiliar result.  To day morning sugar at 6am was 10.7
To reduce it to 8, I took 14 unit humalog
After 2 hours  12.4
Before 11am Lunch it is again 12.5 (I dive car) I gave more insulin to bring it down to 8  : 16 units humalog,
After 2 hours again 12.5
at pm  again 12.5, how come, why it is same? it should be less.  Then I ate a little chicken, and 10 minutes after I measure again it is 11.

I am not feeling well too. It means I have given more insulin than the food  requires that I ate. . I believe 11 is the actual amount required to compensate.  I understand, if I give more humalog  than the requirement it helps  bouncing, and bouncing will give abnormal feeling and harm the adrenals. I can give mo r e humalog if I eat more carb, Otherwise not.  

Please comment on my inference.

I took Lantus and Humalog a year. Sugar came down 6 to 9. Though all numbers were told by ENDO. Probably I took more humalog than required.
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I am really thankful to Medhelp and its members, especially Diabetes86 and super_sally888 for rwesponding to my question.

I was almost hopeles and was thinking too much negative about myself. Now I have hope that I can manage myself. I got courage that there are  some people are with me.

There are really some good people in this world, who come forward to help. The simple mistake made by me has put me in complex world. I hope that I will be able to come  out  from this problem. At the start  of taking insulin I should have been known with the Med help support . Thanks everbody
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I know of no connection between levemir and BP

what was your BG when you where not feeling well?

stress an raise BG

"I am not feeling well too. It means I have given more insulin than the food  requires that I ate.
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If you took too much insulin your BG would be low,  below 4

Again you talk about high BG stress but NOT what you eat.  some foods raise BG VERY high. WHAT DO YOU EAT.

yes I am yelling at you
your before lunch is 12.5
you drive a car stress raises BG

2 hours after eating your BG is again 12.5   you DONT SAY WHAT YOU EAT for linch.

again 12.5 to 11 is within tha acuracy of the meeter.  meening in reality your BG could be the same for both tests but the meter is giving the errer..  your meter has a 20% error (at least in the us)

another point I have not mentiond do you wash your hands befor each test?  I once tested (4.0), eat a hamberger for lunch and then tested again as I eat more potato than I intended.  MY BG had gone up to 10.1  I panicked and took insulin to cover.  I then realized there is no way my BG could raise that much from food in 15 minutes.  I washed my hands and re tested, my BG was actually 4.5  and I had too much insulin because I had injected extra....   anyways i had catchup on my fingers from the hamburger and while I wiped my hands I did not wash them so my high reading was from catchup.
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Hello,

please get the book "Think like a pancreas" and study it and use the information in it.

Levemir should not increase your blood pressure.  But stress and anxiety can.  

Your very high blood sugar is going to cause you complications.  What is your correction factor?  How many units of insulin does it take to bring your blood sugar down by say 20 points. But you can only test this properly AFTER you've adjusted your levemir and have your non-eating (basal) blood sugar stable. Becuase for now the humalog is replacing too low basal insulin.

1-2 unit increase in levemir is not going to make a big change in anthing considering you already take 22 units.  But still you need to increase slowly over a period of days - weeks.   I think it is anxiety that made your feel bad.

Please consider to split the levemir into 2 doses, each of 11 units. Then increase by 1 - 2 units per dose every few days until your blood sugars come down.
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have faced  three type low symptoms:
1.  One day , I see sugar is very high
      I took humalog, waiting to reduce to some extent and went to bed just
      to relax. Probably i was feeling sleepy, I started feeling shaky. Sugar
      was 4 in my meter. I drink pop.
2.   That time, I was not taking Lantus or Levimir then. In a transition from
       switching from Lantus to Levimir.  To combat high sugar, I took 18
       units of Humalog. After an hour, I started feeling shaky. But sugar in
       my meater was 12. I ate some sugar, sugar in the meter was 10 then.
      As I was taking more carb, it was more going down. After that sugar
      started to increase. I do not think so that meter is not giving good result.

The incidence I was describing to you was that, before eating sugar was 10 and I took 12 unit of  Humalog. I was driving, but I was not feeling well, I was feeling headache and restless, probaly it was adrenaling fatigue. I was panicking. But was sugar 12.7. After 3 hours of eating, still sugar was showing 12.7. Then I ate a little chicken, sugar droppd to 10. This is unexplainabe situation to me.

3. Sugar is not low yet, 7 or 6, I was feeling little restless. Probably it was trying to go further low. Most of the cases  I tried to tolerate.

Why my simple problem became complicated?  I was feeling shaky, eye blurriness in 2009. But sugar is not low in the meter, Why I was panicking then?
I visited 5 emergencies of 5 renound hospitals in episodes. Why I have palpitation? I asked them , is it low sugar.?  They said no. Because I was in need of food, as medicine is inside. It may not show low sugar in the meter.. No body understood. It was late to withdraw Diamicron and Metformin.

Every dody understands, sugar is high, give more insulin.  I am shaky to give more humalog due to this odd experiences

I eat same food, three times a day, 6 , 11 and 5
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I took 24 units Levimir  yesterday night.

I took 24 units  of levimir and slept at 10 pm. I woke up at 4am, sugar was 8.9. I was in the bed until 5-45am, but getting up sugar became 10 again

I will increase to 26 units to nights. Let me see what happens.

Let me see a good value in the morning and observe the stability of my pressure, then I will try to use two times.

My Endo also suggested to increase Levimir gradually.

I feel burning in my body, is it lack of sufficien base insulin?
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4 is a good number  why drink pop?

of corce you are shaky at 4 your body is used to 10 and 12 so 4 feels low.

you are NOT low untill you drop below 3.8  

"Why my simple problem became complicated?  I was feeling shaky, eye blurriness in 2009. But sugar is not low in the meter, Why I was panicking then?
I visited 5 emergencies of 5 renound hospitals in episodes. Why I have palpitation? I asked them , is it low sugar.?  They said no. Because I was in need of food, as medicine is inside. It may not show low sugar in the meter.. No body understood. It was late to withdraw Diamicron and Metformin. "

If your BG was good you do NOT need more BG you do not need more carbs  maybe food yes but not carbs that raise BG.

maybe you panicking easy.  that does not meen you need higher BG.  high BG will give all kinds of problems.  once used to high BG you body will not like normal BG untill it gets used to it.

STOP EATING CARBOHYDRATES when your BG IS HIGH

read think like a pancreas and using insulin  Those books will help
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Your blood sugars are very high.

You need to reduce them slowly.  If you increased to 24 units last night, I would recommend you maintain this dose for 2 more days and then increase to 26 units which you should maintain for 3 days before increasing again until your fasting blood sugars come to target - an intial good target would be around 5.5 (please also check this with your Dr - it sounds like he is also giving you the same instruction that we are mentioning here).  

It could take you a few weeks to get down to.  DO not try to do this in just a day or two - reducing blood sugars too quickly when they are so high can cause other problems - particularly with your eyes).

This doesn't mean you shouldn't bring your sugars down, just you have to approach this slow and steady.

As mentioned please try splitting the dose into 2 doses 12 hours apart.  Ie. 13 units/dose.

The burning may be caused by your chronic high blood sugars.  Neuropathy.  The best way to treat this is by getting blood sugars consistent and stable and closer to normal.

Reduce your carbs.  This is super critical. IF you are low, you must only take a small amount of carb.  5 - 10 g.  You would just want to bring your sugars up a little, not make yourself high.

Please get and read the recommended book. Think Like a Pancreas.  You have to help yourself by being and active and educated patient.
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I took 26 units I took 26 units. I getup at 4:30am. sugar came down to 7.8. I was lying down in the bed. At 6 am I got up, It was 9.7 again like other days. I cannot understand the situation. I told my doctor about my adrenal weakness. I will go to lab just 8 am to give blood . Now 6am, another 2 hours I cannot eat or take insulin.

I will not increase more than 26 units for a week. Let me see if I can make it stable.

I eat last at 5pm.  Sugar was at bed time was 10. Do you think that, I should eat a little before going to bed?

Even in the evening time, as the time goes, sugar increases gradually, if I eat, it decreases a little.  
In the morning time, I have basal in my body, why it cannot stop raising?
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Maybe i didnt make myself clear  BG goes up in the AM its your bodys way of getting ready for the day.  Its called DP (Dawn Phenomenon).

Im getting tired of this you dont listen... WHAT DID YOU EAT  (COUNT THR CARBS

you dont listen.insulin lowers BG 10 is too high means you need more insulin.

untill you keep an ACURATE record of

TIME, CARBS, INSULIN,  BG BEFORE you eat  BG 1 HOUR after you eat and 2 HOURS after you eat.
I have nothing further to say.
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If your sugar is 10 (180) it is too high and you shouldn't eat.

If you must eat, then only eat some protein and no carbs at all.

Your sugar is continuing to rise because your basal insulin (Levemir) is still not at a high enough dose.  When your basal insulin is correctly dosed your blood sugar should be fairly stable and not continue to rise throughout the day.

Please read through this thread and the advice given and take it to heart.  It will help.
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I have some problem, that I cannot understand. Because my sugar is high, I need more insulin or less carb. But some times I do not understand the behaviour of insulin and I feel discouraged to use more insulin.

et me describe the whole situation. Yesterday night, bed time sugar was 9.7. I took 25 unit of levemir. At 3 am sugar was 7.7, 3:30am: 7.9. Then I took one thin slice of cookie in the idea that, body has enough energy to start the day. Morning after getting up was 8.4. It improved, atleast it did not go to 10 again.
The n I took 13 unit humalog and ate 150 gram brown rice cooked and 2 ounce of skim milk (about 40 gram carb)
Sugar after 1 hour was 8.2, Close to two hour, I started to feel shaky , My eyes are blurry. I thought that, sugar is going down to 7. But it was 9.2. Then why I was shaking? May be two reasons, I do not know
a. Smogi effect, sugar went to low, but bounced to high
b. 8 am is the cortisol releasing time, I might have any trouble their.
Ultimately, I could not go to 7, It will make high before lunch. Is it better to use more humalog, I am confused
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Yesterday night, bed time sugar was 9.7. I took 25 unit of levemir. At 3 am sugar was 7.7, 3:30am: 7.9.

0.2 is within the error of your meter  meaning its thame reading

Then I took one thin slice of cookie in the idea that, body has enough energy to start the day.

Clearly you do NOT UNDERSTAND the role of carbs  If your BG was 7.9 it is already too high WHY DO YOU EAT ANOTHER COOKY?????  IT WILL ONLY RAISE BG HIGHER!!!!


Morning after getting up was 8.4. It improved, atleast it did not go to 10 again.
The n I took 13 unit humalog and ate 150 gram brown rice cooked and 2 ounce of skim milk (about 40 gram carb)
Sugar after 1 hour was 8.2, Close to two hour,

That is good your insulin matched your carbs and you had stable  but high BG

I started to feel shaky , My eyes are blurry. I thought that, sugar is going down to 7. But it was 9.2. Then why I was shaking?   a rpid change in BG (up or down) can give you the same feeling as going low

May be two reasons, I do not know
a. Smogi effect, sugar went to low, but bounced to high
b. 8 am is the cortisol releasing time, I might have any trouble their.
Ultimately, I could not go to 7, It will make high before lunch. Is it better to use more humalog, I am confused

You have to get your BG lower  at a BG of 7  you will with time go blind.  loose your feet 7 is too high.

your novalog is countering your carbs just fine.  I think your  levemir is to little. (your fasting BG is too high.

STOP EATING COOKIES when your BG is HIGH.
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231441 tn?1333896366
Diabetes 86 is correct.

Your Humalog dosing seems reasonable and fairly closely matching your food.

Your levemir is still too low. Keep adjusting / increasing it slowly.

If you wake up and your blood sugar is 7, you should eat eggs and not a biscuit.  Ie. If your blood sugar is high don't eat carbs.

Keep working at it.
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To day morning, sugar was 9.1. I am in doubt that I took 25 unit of levimir last night. . Probably, there was not sufficient insulin. in the cartig   However I took 13 units humalog before eating in the morning, sugar after 2 hours 9.6 (8am), at 10 am came to 7.4, I was shaking, but at 11 am it came up to 8.6 . Egg gives more sugar to me. I added one egg in my lunch, but sugar raised to 10.7, about 2 points than expected. But still my body js  is shaking
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Eggs do not raise BG  rising BG could mean you did not take your Levimir.  wait till tonight to take it.  Do NOT take it now.

AGAIN what did you eat for lunch (how many carbs).  did you take humalog before lunch (how much)?

I dont know about the shaking you could have other problems.  
Rabidly changing BG can cause that, but it does not look like you have that ether.  

If its not from a broken meter then I do know its not from low BG

Check your meter against one at the MD or drug store
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I must change some of my posts.  I am in error about BG being too nigh

As long as you dont go over 7.7 (in the us thats 140) on a regular bases you will be OK

a 7.4 is a fine number for for after eating or AM (when BG tends to be high due to DP)

Eggs do not raise BG
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I am giving you all the data of to day
6 AM - 9.1   Rice 150gm by weight about 40 gram Carb 13 unit humalog
8 AM -9.6   10 am-7.7

11 am  Before eating 8.6  Rice  180 gram by weight +`1 egg +Vegetable
1 pm =10.7    3-14 pm 10.1       3.53 - 7.8    Feeling shaky and blurry, 13 unit humalog

Before 5 probably it might increase, but why I do not know

Probably there is a quick fall towards the end.  I believe

How ever last two month I was alwayes above 10. For this I may feel shaky.  Any way, sugar goes around 7 atleast for some time.

I have some food allergies due to adrenaline weak ness, I cannot take caffine and plant protein. Fruit etc. As it improves, it will accept
To day is the first day, I see 7 in my meter

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I bought the book THINK LIKE PANCREAS
In page 132  it says from bed time to wake up time, if sugar is  up or down  1.7 mmol/l , basal unit quantity is ok, if it is up more than that, increase 10 percent and if it is  down more than that, then decrease it 10 percent, test it again.

Now how much must be bed time sugar?  If it is 10 then more than 1.7  drop is rather less. Then why should I reduce the dose?

Yesterday night, I increased Levemir to 26. At bed time it was 8.8, but I drink 2 ounce milk. But at 4 am  it was 8.8 and at 6 am , 1 more unit increased due to dawn phenomenon. Then no good result from increasing 1 unit.

Please explain me the situation.

After eating and taking humalog, if I see after one hour sugar is high and walk within home it  dcreases considerably. If I sit down, it seems, it does not want to decrease.

Please explain the effect of walking on sugar up and down. When I should walk, when I should not.

Please explain me, for testing correct basal dose, how should be the bed time sugar, should I eat some snack then or not.

I am not successful in fixing basal dose. My weight is 90 Kg. It should be beteween 18 to 45 units. But I am using only 26 units




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I cannot understand my situation.   Sugar was 9 in my meter before eating  at 11 am. I took 13 unit humalog,  after half an hour I was feeling blurry, I was thinking it is lowering, I am not in habit of staying 8 or 9 and for this, I am feeling hypo. But it was 13 in my meter, how come? It was not high sugar symptom. I think sugar was going low, but body did not tolerate that low and it bounced and showed high sugar. I have to reduce humalog dose I think. Due to this confusing situation, I cannot lower sugar, cannot fix the proper dose. It might be the reason that, insuline is reducing sugar first, but food releasing sugar later. Bouncing increases blood pressure
I am in hopeless situation, Sugar went high now by bouncing, I ate only 150 gram rice +Vegetable+ Chicken leg

Humalog dose is confusing me. I am at a loss
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Yesterday night, I took 26 unit of Levemir, but I did not see good result in the morning. But now it has come down to 7. Do I need to lower Humalog dose? To night I will keep bed time sugar 10(as standard comparator for morning sugar) and take 26 unit Levemir and no bed time snack. I will see how much it goes down in the morning.

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Yesterday night, I took 26 unit of Levemir, but I did not see good result in the morning. But now it has come down to 7. Do I need to lower Humalog dose? To night I will keep bed time sugar 10(as standard comparator for morning sugar) and take 26 unit Levemir and no bed time snack. I will see how much it goes down in the morning.

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231441 tn?1333896366
Hello,

your questions are confusing me.

1. target fasting / sleeping blood sugar should not be 10.  It should be in the range of 5.5 - 7.  

2. The book is trying to guide you that your sugars should be stable over night.

3. I highly recommend you try slitting the levemir into 2 (13 units each dose) to give you a more stable base insulin.

4.  "Yesterday night, I increased Levemir to 26. At bed time it was 8.8, but I drink 2 ounce milk. But at 4 am  it was 8.8 and at 6 am".

This is good.  Your blood sugar is stable overnight (even though it is too high), before dp hits.  See how it is the next 2 nights.   If you are typically waking at 4 am, you could try a small dose of humalog (try 1 unit first and only increase cautiously) to try to counter the DP.


5.  "After eating and taking humalog, if I see after one hour sugar is high and walk within home it  dcreases considerably. If I sit down, it seems, it does not want to decrease".

exercise burns sugar.  It also reduces insulin resistance which you, as a type 2 have.  Ideally you will walkk 30 minutes after every meal.  This is an excellent way to help your management.

6.  "Sugar was 9 in my meter before eating  at 11 am. I took 13 unit humalog,  after half an hour I was feeling blurry, I was thinking it is lowering, I am not in habit of staying 8 or 9 and for this, I am feeling hypo. But it was 13 in my meter, how come?"

Did you recheck that it was 13?  
What did you eat?  Without you telling us this it is hard to comment.
Unless you didn't eat, it is unlikely that it was a rebound.
You must eat within a few minutes of taking humalog.  It is fast acting insulin, meant to counter food.

Rapidly swinging blood sugar - high or low - can have similar symptoms.

Should you reduce your humalog?  No.  Your blood sugars are still too high.

Don't take 1 event as evidence you can't lower your sugar. You can and must if you want to avoid a horrible host of diabetic complications.  Slow and steady.

Please study the book.



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Super_sally888

Thank you

you are much more elaquint than I am.
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231441 tn?1333896366
Thank you! :)

We are both trying to give sound advice to Matin34.  Hope it can be of benefit to him and he can use it to get his blood sugars under better control.
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You both are giving me good advice. It works too but I could not implement it for two major obstacles.

a.  After giving humalog, I eat within 10 to 15 minutes. But some times if it is more than 11 units, after 40 minutes,  I feel shaky, feeling that it is going too low, but in the meter, it is not low. rather high, but it should not be so high in 40 minutes, I eat only brown rice. I think after giving humalog, body goes in emergency, and some times increases blood pressure and it in turn increases blood sugar. Probably I should take humalog after eating.
b. Blood pressure increases  as blood sugar goes to normal, Even some times, after pushing insulin ,pressure goes high

Before going to bed I take blood pressure medication, push levemir

Yestarday evening sugar came down to 7, I was glad, at 5 am I ate, reduced humalog to 11 in place of 13, but after 2 hours, it was 10. I walked 10 minutes, it came down to 9. But at 10 body was shaking, means sugar was coming down, but it bounced to 9 again. Blood pressure increased.

To day morning I got 9.8 again. I was taking insulin only in the abdomen. Yestaerday, I took Levemir on right thigh, humalog in the left thigh.

I could not make effective  use of the pattern of sugar to take decision.
Anxiety is also factor for sugar and pressure increase.

Please continue talking, it gives me courage

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You both are giving me good advice. It works too but I could not implement it for two major obstacles.

a.  After giving humalog, I eat within 10 to 15 minutes. But some times if it is more than 11 units, after 40 minutes,  I feel shaky, feeling that it is going too low, but in the meter, it is not low. rather high, but it should not be so high in 40 minutes, I eat only brown rice. I think after giving humalog, body goes in emergency, and some times increases blood pressure and it in turn increases blood sugar. Probably I should take humalog after eating.


You might have to take the humalog 15 to 20 minutes before eating.  Humalog had a curve to how it works the curve need to match the food ( in your case rice which is a very fast BG riser. yes even brown rice)  I think you get shaky when your BG is high.


b. Blood pressure increases  as blood sugar goes to normal, Even some times, after pushing insulin ,pressure goes high

Before going to bed I take blood pressure medication, push levemir

Yestarday evening sugar came down to 7, I was glad, at 5 am I ate, reduced humalog to 11 in place of 13, but after 2 hours, it was 10. I walked 10 minutes, it came down to 9. But at 10 body was shaking, means sugar was coming down, but it bounced to 9 again. Blood pressure increased.

Why reduce the humalog?  humalog is for the food, did you eat less?

To day morning I got 9.8 again. I was taking insulin only in the abdomen. Yestaerday, I took Levemir on right thigh, humalog in the left thigh.

I could not make effective  use of the pattern of sugar to take decision.
Anxiety is also factor for sugar and pressure increase.

Please continue talking, it gives me courage


cold you NOT change EVERYTHING all the time makes it diffacult to figure out.

eat the same thing take the same insulin for 2 days.
ILL SAY IT AGAIN
time          carbs eaten      insulin taken       BG reading    how you feel


test  -AM,  before you eat, 1 hour after, 2 hours after.  bed time  give me those numbers and we can help you
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If bed time sugar is 5.5 - 7 , will it not be reduced by LEVEMIR at night, to become lower than 5.5?  It is not clear to me.
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LEVEMIR is a hod steddy insulin  humalog is a lowering insulin.

If popper dosing LEVEMIR will not allow BG to rise

you cant figure out how it works by changing everything every day.

Novalog is NOT causing a bounce in BG in 40 minits

that is caused by your food getting into your BG before the novalog.  

Take the novalog 20 minutes before eating.
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Do you have any idea about reactive hypoglycemia. I  had psuedo hypoglycemia at the start of the problem. It was like reactive hypoglycamia. In my case, it was not real but sugar used try to go below 10, but fall quickly  and then and there bounced back to higher value. I feel two times, at near 10 or 10:30an another at 4:30. It is not real hypo but it drops a little then bounces back to higher value. Some times at 10 pm.

To stop it I started eating every three hours, after 4 week it will sop. But I cannot  eat every three hours now,  PLEASE GIVE ME SOME IDEA how I can get rid off
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231441 tn?1333896366
1.  You are not having real reactive hypoglycemia.  Your blood sugars are high.  You feel low at relatively lower value just becuase you are not used to it.  Also rapid changes in blood sugar can make you feel bad.

2. Humalog should be taken before meals - 15 - 20 minutes before.  If you are going high at 40 minutes it is becuase rice is easily digestible and the sugar from the rice is hitting before the humalog can cover it.  Do not take the humalog after (only before).   Try taking it 5 minutes earlier and hopefully the peak of the humalog will then better match the peak of the sugar being digested.

I can recommend that you split the humalog into a number of injections and inject at different sites to give a more predictable absorption.  The recommendation is for not more than 6 units/ injection.  So if you will take 10 units of humalog to cover food then you should inject 6 units in one spot and 4 units in another.   IF you take 13 units, then do one injection of 6 units and 1 of 7.

ALso recommendation to avoid injecting into legs.  The absorption can be uneven.

I could also recommend that you increase your consumption of vegetables (other than potato or corn which are very high carb) and maybe decrease the rice consumption a little.  If you  reduce how much carb you eat your blood sugar should be easier to control.

if you need to snack, your snack should be very low carb.  Ie. eggs, a small amount of peanuts.  Otherwise you will also need to add humalog to cover he snacks.

2. Levemir should stop you going high over night (and keep your blood sugar stable).    I think your humalog dosing is reasonable from what you have explained, but you need to increase the levemir dose  (1 -2 unit increase every 3 days) until your blood sugars are on target and stable (particularly when you don't eat).  Please do what I said and split it into 2 daily dosesf (50% morning and 50% at night about 12 hours apart).

Keep working on it.  You must make small changes gradually.  Your target it to keep your blood sugars under 7.7 at all times and the close to 5, the better.  But this will take time and you'll have to gradually work out what works for you.
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"Yestarday evening sugar came down to 7, I was glad, at 5 am I ate, reduced humalog to 11 in place of 13, but after 2 hours, it was 10. I walked 10 minutes, it came down to 9. But at 10 body was shaking, means sugar was coming down, but it bounced to 9 again. Blood pressure increased"

You should not have reduced your humalog.  Why did you reduce?  With blood sugar of 7 you should have taken your normal dose of humalog to cover the food you ate.

I think you should also do breathing and meditation exercises to calm yourserlf when you are feeling stressed or that your blood pressure is hihg.  it does sound that you have a problem with anxiety.  This can be also addressed by breathing / meditation / other means to calm yourself.
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March 18, 2013 11 am before eating 10.6
Humalog 13 unit at 11am
Eating at 11-15am
150gram brown rice(35 gram carb) + 1 cup cooked Cabbage + 2 chicken leg+ 2 spoon of Olive oil
Filling little shaky
Sugar at 11-30   10.2
1 PM  10.8, 2 PM  9.7, 3 PM 9.7
4 pm 9.7 4: 4: 45    9.2    Blood pressure increased Reactive hypo
5 PM    9.7
Took 13 unit Humalog,   Eat same  food at 5-15 pm
Sugar at 6  12.8 (HOW COME)   probably continued bouncing and increased sugar OR No Levemir present in the body
7 pm 12       8pm   10.7
Bed time sugar 10.4
Took Levemir 25 units, Morning sugar 9.8.

How can I drop morning sugar, how can I drop bed time sugar?
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If the purpose of  levemir just keep sugar steady the probably I do no need it more increased dose. Yesterday bed time sugar was 10.4, Morning sugar 9.5.  Only one unit difference.

After 2 hours 9.5 , before lunch 9.5   after lunch 11 before super 10.
I  followed your 20 minutes late theory in the morning and super. but before lunch  I  did only 10 mintes theory, Other, those 2 values would have been below 10. I believe sugar is fairly stabilized during the day and night. Hence I do not need to increase humalog or Levemir. Only any how if I can make bed time sugar 7, then morning sugar would 6. Is it right ?
PLease advice me. I do not like to take more basal insulin if not required.

If humalog does not make bed time sugar 9, I will make it 9 by walking within home. Then I will compare with morning sugar.
I took 25 units of levemir yesterday bed time at 10.30 pm and 1 unit at 10:30 am in the morning

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No, I could not do that
Yesterday before supper sugar was 10, after 2 hours 10.3. But at 8:30 I was feeling sleepy,  a sudden jerk, sugar bounced to 12.8. THen I eat a very small piece of chicken, sugar came down to 10.6. Then walked within home, came down to 9. But at bed time I see again 11.6. I slept 11 pm to 4 :15 am. At 4am sugar is 9.5 and at 6am  it is 9.2

I believe I need Lvemir at 11am more. Yesterday I took only one unit. Should I in crease one more unit?  Then total will be 27 unit
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Before when I took 24 or 22 units of Levemir at bed time I  got 7.7, 8 morning sugar, But now giving 25 or 26 is not giving 7 or 8

Morning to 5 pm, sugar is remaining fairly within 9 and 10 but after 5pm it is going to 12, with the same food and same 13 unit humalog.

It is very confusing. Shall I start testing again from 22 units?

I have lot of anxity, because of lot bad experiences. Will be OK to take anxiety medicine?

I have an appointment with psychiatrist doctor to-morrow.
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Taking humalog and waitng for 20 minutes, I start feeling hypo. though sugar is already 10. In 20 minutes it reduced to 9.5 only. However it helps to  keep lower. Whole day I will feel hypo if I do like that. But sugar will remain stable between 9 to 10 upto 5 pm. But after that it will come 10 and 11.
I have given one unit Levemir at 11am and took 25 units of levemir yesterday night.
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How many eggs you eat every day?
How  is your cholesterol level. Do you believe that whole egg increases cholesterol?
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I just came off snow plowing for last 2 days

Ill get back to you
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231441 tn?1333896366
I'be been out at a convention these few days and no internet.  Anyway, I'll answer now.

You said "feeling little shaky
Sugar at 11-30   10.2
1 PM  10.8, 2 PM  9.7, 3 PM 9.7
4 pm 9.7 4: 4: 45    9.2    Blood pressure increased Reactive hypo'.

I don't see any evidence of reactive hypo in these numbers. Bood sugar ranged from 9.2 - 10.8. This is fairly stable - though still way high.  I would say what you felt was anxiety and not to do with your blood sugars.  

You need more levemir. Even though your sugars are fairly stable they are still far too high. All of your blood sugar readings should be below 7.7.

Increase the levemir to 28 units. Split your dose in 14 units morning and 14 at night. (you will probably have to continue to increase a few more times before you'll get to your target).

Your afternoon higher readings may be because your levemir is already wearing off. Effective action is about 20 hrs rather than 24 hours - this is why I am asking you to split the dose (aside from just increasing it).

Other cause is that you may be more sensitive to carbs later in the day than in the morning. Some people need to use different carb:insulin ratio at different times of the day.

Ie. Same breakfast lunch and dinner with 40g carbs, but may need 16 units (C:I ratio 1:4) at breakfast, 12 units at dinner (C:I ratio 1:3) , 8 units at dinner (C:I ratio 1:2). Alternative is you eat less carbs at dinner.

Then your poast a few hours ago.

You say you are feeling hypo at 9.5.  That is only becuase you are used to being high.  9.5 is still very high.  If you maintain your blood sugars at a lower level then your body will get used to it and you will not feel hypo at these more normal numbers.

As such high numbers will give you complications, it would be best if you just try to tolerate feeling hypo, becuase you really aren't hypo - if you test and you are 9 you KNOW you are not hypo.  THen you should just try to relax and tolerate it.  Then in a week or so you will not feel like this any more and you can work to further bring your numbers down to a more reasonable level.
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Yesterday night, before super 8 (I walked in the mall), 2 hour after super 10.3, did not bounce, at bed time 8.5
I took 20 units Levemir instead of 25.
Sugar at 2:15 am  7.6 but at 5:36 it was 8.2   . At 6:12 after getting up 8.6.
Why sugar went up from 2:15 to 5:36. Should I have  reduce the Levemir dose or increase the Levemir dose? I will increase to 2 units of Levemir at 11am to day
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BG changes all the time it will never be a constant number. 7.6 to 8.4 is less than 10% change  so what?
BUT you need to have it lower below 7.7 ALL the time


WHY did you take less Levimir? your BG was too high at 8.2

Have you ever had a BG under 3.8 below that is hypo not at 7.0 not at 6.0
we go over the same thing over and over.

have you kept a log of

TIME       BG           Carbs       insulin         comment
7:00        6.5                                                wake up (fasting AM)
8:00                                      14 Lantus        1/2 my daily lantus
8:30                                       3.3 Apidra    intend to eat 10 gr carbs
8:45                         10gr                         2 eggs, low carb toast
9:45        7.5                                             this means I did not take enough fast insulin

10:55      6.9
11:45      7.1                           6.5 IU            1.5 IU for the high BG and 5 for the lunch carbs

12:05                         20gr                         Lunch 2 slices low carb bread, fish

1:00        6.5                                               BG came down

Note the width of the post is not sufficient to prevent text wrapping

Keep a log like that
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This is the insulin that works for me, NOT suggesting you use MY insulin doses YOUR insulin need are different
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My family doctor ( not the ENDO)wants to give me low dose celexa 10 mg, low dose anxiety medicine. But I am not in favour of taking anxiety medicine with insulin   Should patient with insulin take anxiety medicine?
What is the general trend?
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Md MD wanted to put me on them too   But I never started them.

you do have a lot of anxiety between BG and driving.

the thing to check on is weather it will raise BG

go to the google search bar and enter celexa
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Now levimir working in the evening. No bouncing. At bed time sugar comes to 8 or 8.5. I gave 3 units in the morning. As Levemir starts working, should we reduce humalog? I use to give 13 units. But after giving that I starting shaky but stressed too. I believe reducing one unit humalog and increasing Levemir is the best way. I think.
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If your after eating BG is similar to your before eating BG then your Novalog does is correct.
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In order to have bouncing of BG you first have to go low.  have you had any reading under  3.8.......   NO so you have not bounced you simply have HIGH BG.  

It is good that your average numbers are coming down.  you are still high.  untill you are under 7.8  ALL the time you are too high.

Keep at it.
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PI cannot match with you. You say that humalog quantity should be such that. Before eating and after two hours reading should be same. In my case whatever I eat , could be covered by 13 units of humalog. As I was increasing Levemir and the same times I give 13 units, my body starts shaking at high value and the  sugar bounces to higher value. This bouncing  makes blood pressure high, body starts shaking again

Now my idea is that, humalog is getting force of  levemir. Hence we will have to decrease humalog quantity. Probably this is cause of blood pressure  in my case.  Probably you will not believe it. You will think, if there is more humalog sugar will go below 4 mmol/l  and make you hypo. But in my case it is bouncing and giving me pressure rise
Am I right?
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No


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Have made a chart as I exampled?

Do you MIX the novalog and Levimir in the same sareng (spelling)?

Do you inject them in the same spot?

if no to both, then they do NOT interferer with each other, they have separate effects on BG
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I GIVE HUMALOG  IN LEFT SIDE OF STOMAC, I GIVE LEVIMIR IN RIGHT SIDE  OF STOMAC

IF IT IS WRONG TELL ME IMMEDIATELY WHERE SHOULD I INJECT
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LEVEMIR AND HUMALOG ARE TWO DIFFERENT PENS. INSULIN IS NOT MIXED
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You are doing it correct.  where are you getting the idea that "humalog is getting force of  levemir."

Angsiaty will raise both BG and BP, its NOT the insulin.  

you need to stop coming up with "Ideas" and do good record keeping for 2 days.  

Then look at the chart and use it to come up with how carbs and insulin effect BG.
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Taking insulin 20 minutes before eating was not a good idea for me. It gave me, body shaking, blood pressure rise.

I could not take proper dose for that. It was giving dissimilar result due to blood pressure rise and bouncing.

Now I am trying to walk after each meal.
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Taking insulin 20 minutes before eating was not a good idea for me. It gave me, body shaking, blood pressure rise.

What was your BG then?

I know of NO one that has BP issues with insulin.  


I dont know where you are getting this "bouncing" from  In order to have a liver dump you first have to go low,  where is your low BG reading?  where is your chart?

I think most of the problems you are having are anxiety related, that will raise BP and BG
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BG was same as before, or may be .05 mmol less, But after BP rise, BG rises one point more. I start shaking in that high value, I feel shortness of breath.  However, I take Humalog just after eating. I do not face any problem.  In my case hormone is still unbanced, when sugar tries to go low, hormone instructs liver to dump before it goes really low. That was my problem, while started complications. I visited 5 hospital emegecies , but  none was able to discover that it was hypoglycemia due to adrenaline stress. That stress was made by Metformin. My family doctor understood after one month, but already it made complicated  Blood pressure rise due to  anxiety, may be maximum 160, not more than that. Not only you , even doctor does not want to believe that.

However it will be hard for  me to make you understand,

I have a question to you, I like to walk.  There is is a circle of homes near my home. If I walk around the circle, it takes 15 minutes. I like to walk two times. If I walk 2 times, 3 mmol sugar is reduced.  If I take 13 units , it brings back the starting number. If I take insulin with 9, after two hours it becomes 9 again. Now I am 9 and eight ranges. I eat at 5 pm, after eating I like to start walking. How much Humalog should I take? I like to do that for improving heart health
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Did you just say if you take 13 units your BG goes back to your pre meal number.  then take 13 units.

Walking is good.

9 is to high
every time your BG is over 7.7 your body is being damaged by high BG  so keep working on getting it lower.

I have helped all I can, I am not an MD make a chart it will show you how to make it work.
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Whatever you told is right. I have a friend in USA. He also says that. He has no problem. But I have extra problems.. Hypotension, if I walk, blood pressure goes low, heart rate high, sugar increases quickly, falls quickly.

Body does not allow to go lower, blood pressure increases, specially at night, then it makes high.  

Levemir dose is not  clear to me.  Day before yesterday, I took 20 units, I got 8 in the morning. But I took BP medicine at bed time. Yesterday at bed time BP was low, I was hesitate to take BP medicine. I took 23 units of levemir. 2 in day time, 21 in night. at 3am, I woke up, body was shaking, sugar was 8.7. BP was slightly high.
Whole thing is unclear to me. Why it did not come lower? Is it that it went low, the bounced? Somogi effect? Or I am not habituated to remain lower, for this body is shaking? Or sugar is trying to go lower, body is not allowing, in resposne to that, increasing the pressure?

My  friend in USA says he takes 18 unit lantus if bed time sugar is high, but 15 unit if sugar is lower
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Maybe the shaking is NOT from BG


I need a chart  (as I showed you to make) to help you further.  
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What brand of Glucaose meter you are using? My meter might have the trouble. I  use one touch ultra 2 (Blue). I have three of those. I brought one from the company recently. I think it is not good. I have three of them. Each one gives the variable result. Please  reply as soon as possible. Name the good brand
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March 18
Before lunch : 10.6   After Lunch : 10.8    Before Sper: 9.5 After Super 12:5
Bed Time : 10.4    Humalog all 13,  Levemir  25 units
March 19
Before Breakfast: 9.8 After nreak fast 9.5 After Lunch 11 Before Super 10
After super 10.3  Bed time 11.6 one unit levimir at 11am Levemir 25 Humalog all 13
March 20
Before breakfast 9.2 After breakfast 11.7    Before Lunch 9.9  After lunch 8.9 before super 10.3 bed time 8.5 Levemir at 11am 3 units night 20units
March 23
Before breakfast 10 After breakfast 10 Humalog 12 Bfore Lunch 10 After lunch 11.4 Humalog 13  Before super 8.3 HUmalog 12 After super 12 Bed time 9.3 Levemir 11am 3 units, night  levemir 18

March 24
Before breakfast 8.6 11 unit humalog after breakfast 10.5 before lunch 10.5 humalog 12 after lunch 9.7 (walking) Before super 8.9 humalog 12 after super 7 by walking Bed time 8.9 levemir 1 unit at 11am 19 unit levemir at bed time
March 25
Before break fast 8 humalog 11 after breakfast 10.1 before lunch 13 unit humalog after lunch 8.2 (walked)  Before super 9.2 after supr 7 by walking, humalog12  Drink little milk bed time 9.2 one unit humalog at 11am 2 unit levemir 21 unit at bed time
March 26
Before  breakfast 9.2 13 unit humalog After break fast 12.2 (not feeling well) Before lunch 10.7
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I did the lunch, before lunch sugar was 10.7. After eating I started feel shaky, I see sugar dropped to 9.3, Then I gave 13 units of humalog in left side and 2 unit of levimir in right side.

This is new symptom

Please give me an initial planning,  Just after eating does sugar drops to every body?
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I am continuing my information, yesterday after 2 hours of lunch sugar was 8.7 before super 6.5, ate and gave 13 unit of humalog, but added 2 ounce of milk in super, sugar increased to 9.9 after 2 hours. took 18 units of Levemir at bed time. Bed time sugar 8.9. To day before breakfast 8.4

My idea is that, if sugar is  7 at bed time, I will have to take 18 units of Levemir.  But I will have to take BP medicine at night. If I do not take it, sugar tries go low and pressure increases to 150/80/70, this increases sugar in turn
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Going out Ill check in tonight
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Do you eat the SAME NUMBER of carbs every day at each meal?

Remember carbs raise BG

Some nights you take 25 IU of levamir and other nights 18 IU .

STOP DOING THAT!!!
how can you see how your body reacts to insulin if your always changing it.  I cant tell ...   take 12 IU each night and 12 IU each morning space the AM and the PM times about 12 hours apart. do this for 3 days.  If your AM and PM BG are even but above 7.0 THEN up your AM and PM does of levimir by 1 IU each  (13 IU AM and 13 IU  PM)  for 3 days  do this until ether your AM or PM is under 7.0    

If your AM numbers are consistently higher than your PM numbers increase your PM levimir by 1 IU every 3rd day until am and PL are about even.

remember BG is NEVER constant  so sorta close is good
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I should give  insulin, 2" beyon the buttock, if errobeously, if I give within 2 "
how much harm might be?

Yesterday night, I took 18 units levemir, I got 8.4 in the morning. I see if I take more than 18, it gives higher value at bed time. I wii gradually increase morning levemir, and decrease nighjt dose.

To day I took humalog on thigh, 13 unit, after 2 hours it should come to 8.4 back, but after 2 hours 11.8, next 1/2 hour 13.5, next half hour 11.5.  is this fall and rise normal/

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I give up

AM 8.4 is too high why reduce nightime Levimir?

I KEEP SAYING  carbs raise BG  and asking how many carbs you eat  all you tell me how much insulin you take and you keep chainging it.  (as you should based on how many carbs you eat)

how can you figure out the correct does for your carbs, when you dont know how many carbs you eat (Dont tell me).  as far as I can see you change things willynilly and get willy nilly BG numbers and want us to help...................  WELL WE CANT
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Please do not be annoyed. Probably I am doing some thing wrong, that is why I am getting dissimilar results and unusual symptoms.

Humalog is a short acting, I am giving on the leftt side of stomach.
Levemir is long acting, I am giving on the right side of stomach, specially 2 units I give in day time. Will it not interfare with short acting? Probably it .  is infaring, with blood pressure.  

Should I give long acting LEVEMIR completely in a different place such as thigh?  I do not know.  Please let me know immediately.

I  am facing some unusual symptom, for which I cannot increase the dose,

Please reply it as soon as possible. I understood, how to decide  doses but not courageous to increase the dose. My ENDO is on vacation and will come back on tuesday, it will be too late.  Or otherwise I will give Levemir at night on thigh
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231441 tn?1333896366
You can take levemir on thigh or tummy or whereever you have fat.

Yes, you inject each insulin in a different spot.

You should be rotating insulin injection sites, ie. not using exactly the same site every time.

Please follow the advice given.  keep the dose of insulin steady.  Do not change all the time.

Please read the previous messages - we have already said the same thing many times over.  We cannot help if you don't help yourself.

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Still I did not get answer of my question. I am giving 13 units of humalog at 11 am on left side of the tummy and  2 units of levemir on the right side. Probably it is interfaring each other. Am I right or not?  Night time there is no humalog there, I might give Levemir on the tummy on right side then. Or should I select completely different site for levemir and Humalog?

I am facing some unusual symptoms. I have to understand.  I gave 18 units on right thigh yesterday night. But it did not work that well. Bed time sugar was 8.5 but morning sugar was 10. But thigh in outer side does not have that much fat.

Please I am not understanding injection sites. Please make understand.

Yesterday night
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From yesterday I am taking Levemir on back of the upper arms. It is better than thigh. I decided not take levemir and Humalog on the same site.

I took three units of  Levemir at 11 am and 18 units at night
Yesterday morning sugar 10, 13 unit humalog  after 2 hours 11.2  before lunch 8.8 14 unit humalog after 2 hours 9.2 before super 7.6, after 2 hours 7.  Foods are same every time  I ate some chicken at night in a party. Bed time sugar 9.  Morning sugar to day  8.7 but increased to 9.7 after getting up.

AS per your advice, I will  make this base and will not change it  except manipulating levemir at night. Let me try  19+3 units of levemir
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AS per your advice, I will  make this base and will not change it  except manipulating levemir at night.

STOP DOING THAT

Keep your Levimir the same every day

your meal insulin is close to optimal as your BG before and after are close.

but your fasting BG is still to hi but somewhat stable.  
please take the same levimir for 3 days.

BG changes all the time that is normal change of 1 pt is not significant and will happen frequently.  however what is significant is BG hovering in the 9 and 10 area.

the two insulin do NOT interact with each other.

the thighs are NOT a good place to inject as insulan absorption can very.  The belly is the best place to inject.

inject at least 50 mm away from last injection sight .
inject novalog at least 50 mm away from levimir site.
stay 50 mm away from belly button
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I will take 3 days 3 unit Levemir at at 10:45 am
Can I take this levemir on the right side  2" away from belly button to wards right?    Please answer   Yes ?  No?    
Remember I will take Humalog on left side at 11:30am. Is OK?  Yes? No?

I will take Levemir 18 unit   3 days at bed time 10:30 pm  On right side 2" away from belly button, Is it OK?   Yes? No? Last Humalog will on 6 PM. at that time  there will be no humalog present in the body
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I will take 3 days 3 unit Levemir at at 10:45 am
Can I take this levemir on the right side  2" away from belly button to wards right?    

Yes
Remember I will take Humalog on left side at 11:30am. Is OK?

YES

I will take Levemir 18 unit   3 days at bed time 10:30 pm  On right side 2" away from belly button,
NO
that is the same place you took your AM shot. each shot should be 2" away from last shot.
Move each shot 2 " further to the side, do this 4 times then go back to the belly button move UP 2 inch above the first shot and do 4 more shots in a row towards your side.

Last Humalog will on 6 PM. at that time  there will be no humalog present in the body  OK

see this Picture (copy and past into your brouser

http://www.google.com/imgres?imgurl=http://www.ivf.com/images/hep.jpg&imgrefurl=http://www.ivf.com/immune.html&h=1316&w=1800&sz=211&tbnid=PnV9hBm6gebarM:&tbnh=85&tbnw=116&zoom=1&usg=__AFhPUOOgtfkszWUvamD0_hAXlGU=&docid=XhoXF7HAvNBFHM&sa=X&ei=UYxYUYL4G6nI0QHLvYHQDw&ved=0CDgQ9QEwAA&dur=2238

one sot in each square until all squares used then go back to start.
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I have seen those pictures are confusing. One pictures says, Back of the upper arm. One picture says front of the upper arms. are both the two are correct? One picture says furthest corner of belly. But to day I gave humalog 6" away to  left side from button, it did not work that well. How far we can go to left or righ of the belly?  6 inches or more from button?.
One picture says two row above button and below.  4 inches up and 4 inhes down from button.
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Insulin needs to be interjected into fat. Any place with fat works some places work better than others.

Injecting into muscle makes the insulin work fast. and runs out fast and can damage muscle.

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I should have asked this to start with.

What do you want to accomplish with your BG?
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I have drawn a picture on a paper  with a hole in the middle. First draw a square 2" both the sides and up and down .Then draw 12 points each 2" away from each other on left and right side of the no injection zone closer to belly button. . The last point will be  atleast 6.5"  away from belly button. Keeping the hole of paper on belly button, I find the injection point. I started injecting one after the other. If I  could attach here you could  see

I have only one hesitation.  Taking 3 units of Levimir on the right and Humalog in the left, almost in closer time. 10:30 am and 11 am. Though the points are at least 4" away. It might interfare because of same  site

March 29
Morning  8.4  After break fast  11.8  Before lunch  10 After Lunch 10 after bouncing, ate a very little meat ,came down to 8.6 before supper 9.5 after supper 9.5 Bed time 8.5  Levemir 2 in morning 18 night  Humalog 13

March 30
Morning 10 after breakfast 11.2  humalog 13 before lunch 8.8 humalog 14 after lunch 9.2 before super 7.6 humalog 13 after supper 7 Bed time 9
Levemir 3 morning 18 night

May 31
Morning 8.7 bounced to 9.7  humalog 13 after breakfaST 12.6 BEFORE LUNCH 10.1 HUMALOG 14 AFTER LUNCH 10.2 BEFORE SUPPER 7.6 AFTER SUPER   11.2(added a little milk) Bed time 7.8  Levemir 3 and 18

April 1
4 am    8.6 got up went to wash room at 6 am 10, ate a little meat, came down to 8.6. 13unit humalog after 2 hours 11.4

Probably if I could eat a little at bed time, would be better.

Bouncing is a problem now.  
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STOP with the bouncing.  your NOT bounciong

BG changes all the time goes up goes down no bouncing.

If injected in different places the insulin WILL NOT INTERACT  stop werering about that

your mornings are constantly in the high 8.X   and night BG is a little better than morning but still high increase your bed time Levimir to 20.

You need to know how many carbs you eat at breakfast.  Is it always the number of carbs?  
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I eat the same food every time. 159 gram by weight brown rice, One cup cookedcabbage One piece chicken leg. But morning time sugar increases quickly with same unit insulin it gives more sugar.

Do you take vitamins or mineral supplements ?
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a lot of people are more carb sensitive in the morning, meaning  the same amount of carbs will raise BG more in the AM than eating that same thing in the PM

you are eating a LOT of carbs.  that makes it difficult to regulate BG.

Later we will address your Bolus regime in more depth your pretty good now, when your before meal and after meal are similar BG readings. lets stick with tuning in your Basel for now.
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If I reduce carb, I have to increase something, shall I increase more protein?  

Probably there is some problem in injecting in the belly. Probably quick absorption creates some odd feeling. I injected 19 units of levemir, I was feeling bad.  Next day  sugar was higher.

Yesterday night, I took 18 units in the leg. Morning sugar 8.9, Humalog 12 after 1 hour 12.3, after 2 hours 10.1

FRom now I will take levemir in the thigh, not in abdomen
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If you decrease carb you need to decrease novalog too or you will go low.

for now leave  the carbs and novalog alone.

How long (Days) had you taken Levimir in the belly?
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I am taking levemir one and half month. Day time may be 10 days.
Normally I used to take in the belly. Day time levemir injection does not increase blood pressure. But humalog did 2 times, probably due to closer to belly button injection or long time waiting after taking injection.

Day before yesterday after taking levemir 19 unit just after 2" away from belly button, I was feeling burning in the body.

I have odd feelings, I have anxiety for symptoms.
When I have no levemir, or lantus, end of january, I uised to try to control with humalog only. That time I used to feel body burning.

If I could convince that, levemir and humalog  have no side effect for me
I could reduce some worriness.

Before eating, I take humalog then I eat. AS sugar increases, I feel tigtness of chest, eye gets blurry, why?
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Before eating, I take humalog then I eat. AS sugar increases, I feel tightness of chest, eye gets blurry, why?

Anxiety and your BG is changing a lot when you eat.

The ONLY side effect from insulin is low BG.  Insulin is a natural hormone that your body makes (just not enough of it, which is why you inject it to make up for your bodys shortfall)


I am taking levemir one and half month. Day time may be 10 days.
Normally I used to take in the belly.
So 1 time you feel bad, so you move injection site... How can you figure out something if you change it all the time?

Day time levemir injection does not increase blood pressure. But humalog did 2 times, NO you BP goes up from anxiety not from insulin.

you NEED to read 2 books Think Like a Pancreas by Gary Scheiner and Using Insulin by John Walsh)
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231441 tn?1333896366
Hello,

Diabetes86 is giving you great advice.

Insulin is more consistently absorbed from belly than from the thigh.  The activity of muscles in the thigh can change how insulin is absorbed.

Stop worrying about interaction of insulins.  They do not interact.

Stop worrying about the injection site.  You can use your belly and hips.  Just rotate the sites as described and discussed.

Stop worrying about effect of insulin on blood pressure.  It doesn't have any effect.

Write these "stop worrying" comments down and look at them any time you start to feel anxious.

You are feeling bad because your sugars are very high - such high blood sugars can also cause burning sensations.  You will feel better once your sugars become lower and more consistent.

Keep your diet and the humalog the same for now.  We want to help you to adjust your basal (levemir) to get your base blood sugars lower.  

Please continue to increase your Levemir.  I would recommend a 2 unit increase in both the morning and night time doses. Maintain this increase for 3 days.  Then do a further increase of 2 units for both the morning and night time dose.  Continue to keep us updated with what happens.
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Yesterday morning 8.9 after 2 hours with 12 ubut of humalog 10.1 before lunch 10.6 after 2 hours 8.7 before super 7.7  13 units humalog after super 10.3 bed time 8.7 the  ate some chicken made high 9.7

At bed time I took 19 unit(increased 1 unit) in the thigh. I slept at 10:30pm got up at 5:30am, I see body is burning, sugar is same 9.7, blood pressure increased.

For these reason I cannot increase the dose of levimir. I am worrying too much, that is true.
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I see body is burning, sugar is same 9.7, blood pressure increased.

For these reason I cannot increase the dose of levimir. I am worrying too much, that is true.

those reasons are NOT from insulin.
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