How to optimize my glycosilada and avoid insulin peaks

Hello!

I just entered the forum, so as "rookie" my message is duplicated (also in the "I am new" section).As it is a consultation, I include it here, for those who want to lend me a hand and give me some advice on how to improve my values ​​and avoid the peaks:

I debuted in the DM1 9 years ago (with 36) and this has been my itinerary since then:

1A.- Treaty only with basal insulin (Levemir) + Diet !!(despite being quite thin) and with an endocrinologist who resisted believing that he had type 1 diabetes.
2A.- Treaty with Levemir (for me it meant: Very abrupt hypoglycemia) and Novorapid.And this time with the support of the team of a day hospital.So far I had good glycosylated values.
3A.- Supported by the same team but with a phase in which I neglected my controls.My glycosiladas were always between 8-9.I continued with Levemir and Novorapid.
4th.- Finally, I have been able to have my glycosylated between 6.9-7.2 approx.The improvement came in part because of the change of basal insulin (I went from a lesspress to Lantus).By having my hypoglycemia, I gave greater confidence to insulin and increased my motivation when controls.

At present: I think I have reached a point where my control is better than ever.However, and now that I have a routine, and therefore it does not imply a great effort I would like to optimize these values, since when you enter this forum, I have discovered that these values ​​are good, but they could be better !!!;) Anyway, I have been pleasantly surprised to see that enough forerosy have a glycosilada of 6. I would like to know how you get it;)

Soon I have an appointment with my endocrinologist and I would like to take an active part and propose..

So you can help me give you a little more information:

- I inject every night Lantus (24/25/26).That is, adjust if necessary.
- For each food injectorpid (according to HC intake).A ration of HC goes up about 50 sugar (I need an insulin unit)

In the morning I get up with good values ​​(between 70-90).However, where I see that I can improve the controls is just after meals.Both after breakfast, and sometimes after lunch and dinner.If I control after an hour of the intake, I realize that I am about 190. Then I get almost always well to the next meal, but it seems to me that if I control this peak I could improve my glycosiladas.

For example: in the morning Breakfast 100 gr.of bread with some jam (really very little and with little sugar content) and butter.I inject 5 you of Novorapid.After an hour I usually be about 190. After three hours, however, I sometimes need to take half banana to reach food time since sometimes I already have a slight hypoglycemia.

I usually eat with each of the meals a piece of fruit.I think this peak could be due to fruit.But I would like to know if there is any way to reduce the beak without giving up eating fruit.

Insulin inject just at the time of starting food.That is, I do not postpone it.

Does anyone come up with an idea?

Thank you!!

Welcome!!
Try to put the insulin for a while before eating, about 15-20 minutes as you see.
All the best!

Hi Laire:

Thank you so much.I think I rushed a little yesterday exposing my doubts since then I saw in the forum that other users had exposed the same.I will start with this little correction, surely this will already be a small improvement.I will tell you.Greetings!!

Can anyone also tell me what values ​​would be considered "normal" for a DM1 one-two hours after eating?Because sometimes it happened to me that when I go to the doctor and controls my sugar one-two hours after eating, he seems too much everything that is above 170. Yesterday instead, in the forum, I read other opinions.
I live in Germany;I don't know if doctors can have other criteria ...

If you want to improve the glycemia curves because you do not wear a continuous meter, even if it is only a month or two to see how they are and so be able to adjust everything better?

Fresstyle for 60 euros can help you a lot and many endocrine let you try (paying).

Yesterday I was reading a little about continuous meters ... however I do not understand what the basic difference with the pump is.What I saw is that social security in Germany does not cover them ... I will continue reading.Maybe find a link where basic differences are explained ...

eriantha said:
yesterday I was reading a little about continuous meters ... however I do not understand what is the basic difference with the pump.What I saw is that social security in Germany does not cover them ... I will continue reading.Maybe find a link where basic differences are explained ...

It has absolutely nothing to do with a pump with a continuous meter.

The pump is only like having an insulin syringe always attached to the body and that you control with a remote control or programming it.A continuous meter instead is a sensor under the skin that measures every minute to how much you are from glucose.Not only does it give you the value but it gives you a graph with the blood sugar curve all day.

That helps you know how the different insulins act, as quickly assimilated by the hydrates of the different meals, the peaks and the descents that with a normal meter escape you.And obviously it is much better than the advice we can give you or the tontocrine.

Have you looked at if the freestyle is distributed in Germany?

Thanks for the explanation.I just arrived at the freestyle link in Germany ( Link think this will clarify the doubts.
So the main advantage of the continuous meter, is it not having to prick your finger?Controlling the results of the meter, would it be the same as checking the mobile?What is the cost of maintenance of the meter?

Thank you,

The main advantage is precisely to see the peaks, as quickly goes up and even when after a meal, be able to better adjust insulin and food.Know how you are without having to click ... although from time to time you will have to prick your fingers to ensure that the device works correctly.Some sensors come out better than others.

In Spain the device is worth 50 euros.The sensors are worth 60 and last 14 days each.

Thanks Sherpa.It would also be an option to take it two weeks of the test to monitor my body reactions a bit during those days and according to the different activity of the week, to see what moments are the "critics" and how to improve them ...
I have seen that 60 euros are also worth here.
I will continue to investigate.
*****************
At the moment the breakfast experiment to click 10 minutes before has not worked at all, although on weekends it is not perhaps the best day to do so.I have started breakfast with 70 sugar in my blood and I have given myself 8 novorapid.At two hours I was with 210. Normally the weekend I give him a little more insulin fast because the change of rhythm affects me and always breakfast more, different and I do not leave directly from home and Ando.I think today I fell short.But well ... this is something that I must test ... since each person is a world ...
I go to try tomorrow, with the rhythm of work and the usual breakfast, to see how it works ...

Hi Laire and Sherpa41:

Tell you that after continuing to read in the forum, I have seen that insulin resistance in the morning is not rare in DM1.At the moment and after experiencing two days anticipating insulin up to 20-30 minutes before breakfast, the results are more than satisfactory.Actually, I'm surprised.I get up well (between 70-80), breakfast and my postpandral at two hours is between 120-145 (at least these two days).Until arriving at the time of the food I have to take a banana between 12 and 13 hours.
The fact is that I would normally have seemed little "correct" to do so, and I would even have felt with bad conscience.But after reading here that many Foreros save the issue of insulin peaks in the morning in this way, because I feel relieved and also sure to do it well.Today I have gone to the doctor and my HB1C is at 7.2.Therefore, I don't have a fantastic value.But my trust is that if I improve the problem I had in the morning, my next results will be better.Again, thanks for the tips !!

I am very happy that I have improved!It also happened to me and I solved it that way.It also happens to me that glucose begins to rise to me nothing but I lift him, even if I have not eaten anything.I had no idea until I tried a CGM and I could see in the graphic as I was going up from the moment I woke up when I had not yet had breakfast yet.

That is because of the effect of cortisol, which goes up (it does not rise to me, it shoots me !!) When we wake up

As a gala, it happens to me, it is typical of the mornings.The only way I have is to prick the insulin at least half an hour before breakfast.One has to get up more, but it is what there is

Telling you that normally, everyone after an hour will give a lot of glucose in a measurement.Keep in mind that the effect of insulin is trying to correct the peak, but normal, is to be measured after 3 hours, once the greatest effect of insulin lasts.The problem of measuring before, is that it can give you as you say 170, to think that you are high and correct.Mistake.

Besides, not only the diabetics have those peaks.Control made on a birthday, 30 minutes after eating the cake and giving 2 non -diabetic people 135 and 145. The pancreas corrects the blood glucose once.;)

Hello again...
Anyway I think there are two options:
- One that would be to accept that during the first two hours we were around 170 (or more) and wait for insulin to do the peak over three hours >> This is what I have been doing in recent years thinking that there were no possibilitiesto improve it.
- The second option, since I have proven that it is possible, that it is to avoid this peak in the morning, clicking before and even giving me a Més de Insulina unit.And to arrive at the time of food without hypos, compensate with a banana or a cookie.And it is really working.
- And the icing I think would be to get the CGM, at least for a while, to be able to see the values ​​continuously and from there draw conclusions to correct.
- And in my case, I now have to improve the corrections on the weekend, since the change of rhythm (getting up two hours later) also affects me.

Anyway, it is nice to see that the thing has improved, because until now it had fallen into a spiral of resignation with regard to the issue of morning values.It also gives me a little penalty that the idea has not left the doctor, although I appreciate him very much and in general I am very happy with him, and of course ... I also have sad not to have consulted the forum before :) ..