Change resistance

Good chic@s,

I wanted to ask you above all about your experiences ...

I debuted with type1 almost 20 years ago and my treatment has always been since then the "same insulins" since my glyc usually around 6-6.5

Lately because of the confinement or call it X, I am getting worse and the endocrine has recommended me totally changing the pattern to some style, 24h basal insulin of 24h + fast insulin in meals with the counting of rations and such.

The case is .... do you see this change to positive?As you can understand something that I have already very well known and now this radical change welcomes me but the nurse told me that the matter would greatly improve ...

Greetings and encouragement to all.

I forgot to say that the insulins I use are mixtures humalog mix 25, mix 50 and a quick one that does not mix

I believe that although at first the change is cost you better.Before there were 24 -hour basal ones, we used mixtures and the change to those of 24h (and more modern such as Toujeo and Tresiba) is another world.It will give you a lot of flexibility, you can adapt the insulin doses to what you eat, change food schedules, even skip any if you don't feel like eating someday.And you can eat what you want at each meal, without fixed hydrates.If one day you want fillet and salad and if another dish pasts you with adapting the insulin you already have it.You just need to count the hydrates well and know your insulin/ration ratio.You can also better adapt to changes in your lifestyle.If you go from more to less physical activity, adapt the slow and voila.

At first it may seem crazy but it is worth the change.Surely the controls and you can adapt the medication to your life and not vice versa.I recommend 100%.
I started many years ago with Lantus and Apidra and La Lantus and it was a change to much better and that Lantus had his problems (he did not cover well 24h and had a more action peak).When Toujeo came out, the endocrine was changing because it was flatter and covered the 24h and it was another important improvement.The fast now uses humalog because it has half units and allows me to better adapt the dose.
Now without eating I keep totally flat and when I only have to calculate the fast I need for that meal.It is much more flexible.If one day instead of eating at 2 they give me 4 in the afternoon there is no problem of descents or ups.And one day like late and much and I don't feel like dinner because I don't ceno and it also remains stable all night.Every day like what I feel like without having to adjust the hydrates, adjust the insulin to the food and not vice versa.
It is true that I do low diet in hydrates but because I find it easier to manage the meals, but if one day I want to eat a paella or a piece of cake I can do it by putting more insulin.With mixture insulins it is a disaster if one day you eat many more hydrates than another.

Well thanks for the comment,

Right now my biggest problem is that if I want to do something in the style, today breakfast a bread and tomorrow an oatmeal or simply a coffee is a very fat bundle because not having basal, for me .. Do not eat does not imply notGet insulin (and give repair because you think you fall in hiccups by not eating) ... and I give you an example.

The morning movement that I have now .... Alba Emproper ... get up with 210 ... and I have already proven with the sensor that from 4 am, begins to climb the face ..

If I drink only a coffee I have to put 8-10 units of Mix50 and still it costs that it goes down and for example if I like a molecAlthough I eat a peak of 210 to 260 post breakfast then I get well to food .. They are things that I understand that with the basal it would be better.

Yes, all that accounts will be better with basal 24h and fast.You also have the option to make corrections if you are high.If, for example, you get up as you say in 210 you would have to put correction to lower those 210 say to 100 (you will have to see how much low of insulin to calculate it) plus the corresponding insulin than what you go to breakfast (you calculate the rations and multiplicationby your ratio that is the amount of insulin you need for 1 ration).With the mix 50 of those 10 units 5 they will be quick and the other 5 slow ones that could give hypoglycemia hours later.With the normal fast if you need 5 for correction + breakfast you put on those 5 and at most it takes effect up to 4 hours later (the normal of the rapids is that they make the peak at the time of putting it and from 2 hours nowThey have little effect).You take away the risk of having hypoglycemia later.And between hours I would already have covered with the basal 24 hours.
If one day for example you do not feel like breakfast then you would not wear quickly and if you have breakfast more quantity or you get up high dose but that does not affect you hours later.With yours Mix 50 the part that has slowly gives you hypoglycemia many hours later because I think it has an effect of about 12 hours.

And the effect of dawn is the same is partly because you don't have much basal at that time, with a 24 hours you can control it better.The effect of dawn is not always controlled but in many cases yes.
You have to change the chip of how to manage it but then everything is easier and gives you more flexibility.And all this ratios and counting hydrates is to get a few days and quickly catch it.Go reading on the subject to be prepared to the next consultation and thus the endocrine can better explain things to you.
You can start with this article of the Diabetes Foundation you have all this explained:

Link

But if you want to look for more, look for the following:

"Count hydrates"
"Insulin sensitivity factor"
"insulin ratio"

And then on the Diabetes Foundation page you also have a carbohydrate table that come very well to count rations.

OK, thanks a lot

Many years ago I changed and would never return to mixed, what slavery!
The changes cost, but it will be worth it.

Good chic@s,

After a week of adjustment based on trial and error I have managed to improve the tir a barbarity.

The passing of mixtures to basal+fast is like going from making a master to a basic course .... incredible.

One of the things that I have improved is the Alba effect ... before I had no way to control it .. dawn with 170-220 on average for years ... and now I am getting up with 90-120.

My particular question in case anyone knows ... is that breakfast is costing me a lot to control it I explain ...

I like to have breakfast of bread (100g, approx 50HC net) with a coffee and the theme is that I am using 6ud of Humalog (fast) and I have rebound effects.

that is ... I get up with 120 .. I climb up to 220.230 and just at the time it gives me a downturn up to 140 approx, then climb a little and already stays over 160 until it goes down gradually until you reach lunch with 130-140-140.

My fear is that if I upload the fast I see myself at risk of hypo in that abrupt descent ... and I would also like to avoid a rush up and down peak in a matter of 1h-1h: 30m

Any idea?

Right now my treatment is: Smile:

Toujeo: 34ud at breakfast
Humalog: 6-4-3 (the ratio is approx (1, 1.3, 1)

The same trying with FIASP?There are people who are doing very well to avoid these peaks.Greetings and congratulations on change.

@marine
Maybe it is not a suggestion that you want to continue but I would consider changing breakfast.

The bread mollet are very fast carbohydrates and I would say that not very healthy.I understand that it is rich but I would consider leaving it.Maybe if you put olive oil and add ham a little delay it.
All the best

nigiri said:
equal testing with fiasp?There are people who are doing very well to avoid these peaks.Greetings and congratulations on change.

I even know that insulin, I will investigate to see how and thank you!

jldiazdel said:
@marine
Maybe it is not a suggestion that you want to continue but I would consider changing breakfast.

The bread mollet are very fast carbohydrates and I would say that not very healthy.I understand that it is rich but I would consider leaving it.Maybe if you put olive oil and add ham a little delay it.
GREETING

I understand you, but it is the only whim that I give myself in the day and I don't want to be a slave ... you have to try to make diabetes attach to us and not contrary and eye that although I say this I am rather the opposite.

I have not commented that the Mollet does not go alone .. yes .. made it serrano ham and oil or some fat to slow the absorption but before, when I used the humalog mix 50, the peak was not so sharp and the only thing that could come to meTo happen it will happen to me with the amount of slow 50% and a little before lunch I had to eat something or have coffee to correct a possible hypo.

The issue is that, if the basal is correct and I have that ratio of 1ud for 1 ration of HC ... why that double bounce ... It also happens to change the area of ​​the puncture to a slower like the legs but that is that it is that it is that it is thatI do not do it because there is how if I did nothing ... it's incredible ...

@jldiazdel already out of curiosity, what do you usually have breakfast?

@marine
I breakfast a bit weird!

I have made about 15 breakfast chips all between 3 to 4 be, well what you call rations.So I don't get bored.Every morning I choose a different one.But everything that I get cares about and use my tables and annotations and so I really take the amount of planned carbohydrates.In my chips I already put the amount of grams that I have to take from each product and sumo the rations.

In general they are whole grains, oat flakes, oat bran, with normal yogurt or soy yogurt or Skyr.I add nuts (4 or 5), and/or flax seeds and/or pumpkin pipes.And then a ration or a half of fruit.I then take a large cup of very soft coffee I do with natural coffee (I make it before).

There is no need to say that there are mornings that everything goes like silk and other mornings that are a disaster!And carbohydrates fall short and others that at 2 h half I have to put an insulin correction (these cases are few fortunately).But on average I am quite under control.The truth is that apart from the discipline of controlling what I take, without the sensor I would not do it!

@jldiazdel That is the subject, "I have a little weird breakfast"

Before all this in Covid, I was very assiduous to stay with my friends to breakfast and in a bar you cannot ask for that kind of breakfast and eye ... is that the breakfast I tell you I see it very healthy removing the theme of whatprocessed or not, whatever bread.

The case, that what I like is ... have normalized if I am in street how much insulin put me if I like that similar bread in the bar and not walk that day as crazy because I do not know how my body will react.

Before it was the one that made me tortillas with extra and oats ... typical Gym diets and others with his handful of nuts too and others ... but in the end one also ends up tired.

Therefore, without being abusing with meals that we know they are "dangerous" such as pizza or pasta ... Well, I hit that morning whim.

We also tend to demonize hydrates and what we should try to know is to control them.

All the best!And thanks for answering.

I understand you !!

All the best

@Marine I do not use it but I know it is an ultra -granted insulin, surely there is some thread in the forum on it so that you take a look.All the best.

@Marine What you can do is click between 15 to 30 minutes before breakfast according to glycemia and the trend and with that you give time to the action of insulin avoiding the glycemic peak and even the same you need some less insulin

Carlos70 said:
@marine what you can do is click between 15 to 30 minutes before breakfast according to glycemia and the trend and with that you give time to the action of insulin avoiding the glucemic peakAnd even you need some less insulin

Good, I explain something better because I think I haven't done it well.

I expose the detailed case:

-I get up at 7:30 with 90.Breakfast, I wait about 20min and I see that there is when it begins to rise over 140 and there I put the fast insulin .. blood glucose continues to rise to 220 at 8:30 am and at that time I see that quick insulin begins to act andI find myself about 9:30 am with glycemia in 130 ....

my fear which is?Well, I hope those 20min post breakfast of a hypoglycemia because then about 10: 00-10: 30 the blood glucose rises again and stays over 150.

I put other summarized cases ...

-If I get up with 120, I do the same but shorte

-If 1ud 1ud quickly, the peak is greater ... rises to 250 or there and then arrived at lunch time to 200.

That is why I say and summarize, that I see myself a little juggling with the abrupt entrance in the action of the rapThat in a few minutes what I have had breakfast will act.

@marine, the beak after breakfast is the most difficult to remove, sometimes it is good to distribute breakfast in two shots ...
But if it is a short duration peak and the glucosilada goes well, you can be calm.