Type 1 diabetic mums & mums to be damn that dawn phenomenon!

[SpottyTeacakes]

New thread ladies

[RueDeWakening]

New thread started! Come on over and join the fun...

[RueDeWakening]

Hoping - yes, you can have loads of different basal rates over the day. I run about 5 at the mo, midnight till 2.30 (change basal 2 hrs prior to when you want the impact so this change is for dp). Then it changes again at 8am, 2pm, and 7pm.

You can also have more than one pattern set up, eg I have one for pre- and post-ovulation as my sugars are affected by my cycle.

[Hopingforno2]

Thanks bona and rue I will def speak about it when I eventually get an appt! I don't expect it to be like an easy option or anything I just am fed up with inj loads and being constantly worried what my bg is. So can a pump be set then for a basal rate till say 4am then be increased without having to wake up?

ginger yes I did a few times however mine was tested via my meter so I knew the level and that if it was above 0.6 to call but yes a pint of water and insulin usually worked. I was also told that u might have ketones in the morning due to fasting and eating would help.

[Gingerbreadpixie]

Hi all. I over-corrected a hypo last night and ended up with between + and ++ ketones. I phoned my hospital birth centre and was on the verge of going in at 4am when they suddenly the insulin/water thing worked and they came down again. Did anyone else get ketones in pregnancy? I was really quite scared. :(

[BonaDea]

Hoping - dp is one of the things a pump really would be great for. You can just make sure you're getting much more insulin from say 3/4 am...

Spotty poor you

[BonaDea]

Hang on a minute - not sure how a pump gives any more freedom eating wise? Maybe compared to the old mixed insulin where you had to eat to the Insulin not the other way around. But now with basal bolus insulin (novo and levemir) you don't have to eat if you don't want to. In that sense I don't believe there is any difference. You still have to figure out what you're eating and dial up the correct dose, no? If you're not eating dont take any extra.

Hoping there is no separate long acting insulin. The pump releases tiny amounts of insulin (at a level you set) throughout the day and night to mimic the pancreas. You then just dial up a higher dose for covering meals

I definitely think you should discuss with your doc but it isn't going to be a magic bullet - you will still need to carb count and calculate meal time insulins...

[dieciocho]

Yes, we need a new thread, but not sure how!

Poor spotty.

Yes, that's the evil dawn p. hoping, I hate it and can't see what to do about it.

[Hopingforno2]

Have watched my bg rise from 6.9 at 4.15am to 10.2 at 5.15am dp hitting hard and looks like the cause of high morning readings ive been taking 3u at 3-4am but didnt to see what happened incase I was putting myself hypo then bouncing back but no ive taken a correction now see how that is in a few hours

also we r near the thread limit anyone know how to set up new one and link it??

[Hopingforno2]

spotty you poor thing my levels get mucked up too when im ill I hope you start to feel better soon

[SpottyTeacakes]

I'm soooo ill. Levels in the 20s despite regularly injecting 8u and haven't eaten anything since yesterday breakfast

[Hopingforno2]

thanks rue just had a very quick scan of the ones you mentioned the tubless one says its completely waterproof and has a built in bg meter? Mind you so does the veo but then myb im looking at their newest ones.

Shall have to try and get my dsn tommorow again she was supposed to call me with an appt Monday but didnt and only got her answering machine

[RueDeWakening]

I had a cgm as a loan from my clinic for 5 days to get an overview on blood levels - was interesting but couldn't access readings till DSN downloaded them. DSN said it costs them something like £50 per use, which explains why they don't hand them out to all and sundry!

Pump def worth it long term, much more stable and much more freedom re eating - once basal (long term) levels are stable it's completely up to you whether you eat or not it took me quite a while to adjust! Once you're on the pump you don't do any injections at all unless you need to correct if the tubing blocks (happened to me about 4 or 5 times in 9 years, and even then I normally change my set (the tubing etc) and correct that way). Your pump gives you a background level every hour (a tiny amount given every few minutes, like a pancreas would do) that you programme in, and you tell it how much carb you're eating so it can give a bolus when you eat.

My eyes got worse on the pump because I had a very rapid improvement in Hba1c, eyes like the status quo and advice now is to manage improvements slowly so as not to be affected in the same way.

My pump (the VEO) technically can connect to a CGM, but since the NHS won't fund one for me yet I've not tried it. Not sure what the others can do though, I've not checked. You should be able to choose which pump you want to use once you're approved, but in practise most centres have a particular brand that they use and are most familiar with, and you'd be strongly encouraged to use that.

[Hopingforno2]

Thanks bona and diec
rue thanks for the info sounds like it would be hard initially but worth it long term? When you went on to pump did u feel it gave u more freedom eating wise?and most importantly better more stablr bg? Also have seen an accu check one that is if im reading correctly also a bg monitor tho im guessing u dont get to choose one u would like? Stupid question but you still inj long acting right? Also rue did you say ur eyes got worse when you went on to pump?

Can/have any of you ever had a loan of a cgm for a few weeks to help you figure out whats going on?

[RueDeWakening]

Hoping you need your consultant/doctor onside to get a pump - but if they decide there is clinical need for one, your local PCT or whatever they are not CAN NOT refuse you one on the grounds of cost. NICE guidelines rule!

Re carb counting, there's an online DAFNE course that anyone can sign up for, developed by the Bournemouth team who are pro-pump - you can find it here but anyone can sign up and do it. Carbs and Cals also has an iPhone app that's pretty good, I have that but not the book.

Re getting pumps wet - they are all splashproof, but not waterproof. You disconnect it and can leave it unattached for around an hour with no ill effects, after an hour you'd need to make up your lost basal when you reattach it. When it's disconnected, the pump and tubing comes off, and it leaves behind the sticky tape bit and a plastic connector bit that the tube clips back onto. The tubing all needs replacing every 3 days max or you run the risk of infection at the site, you do this yourself (it's fiddly but easy when you get the hang of it, much like injections!).

My pump is a Minimed Veo, there are Animas ones that are waterproof I think, and the Omnipod type one attaches to you with no tubing but I've never seen one in use so not sure how that works (though I know you give insulin via a remote control).

[BonaDea]

Good plan hoping! And you're right a few fasting mornings and afternoons will help you figure it out.

As Diec says things can also take a while to register particularly whole grain stuff.

[Hopingforno2]

diec you may be right but my 10s have been pre breakfast(I feed my 2 dc before having mine)after like 6 readings at around 4-5am!?

[Hopingforno2]

Ok so have discovered my scales don't work which shows how much I use them have however used my cwls&carb book and written down what it says in there for a few of my meals and found inside it my ratios from ages ago shall start off with them and see how it goes

[dieciocho]

Good advice from bona as usual.
Also hoping, bear in mind that bran flakes probably take a while to get into your system, so your bg may well still be registering their effect 2 or 3 hrs later. I get the same problem with oatcakes, they take forever to get into my bloodstream.
That should account for your 10.2 at 9am.
I get a big drop before lunch too. Do you have a mid-morning snack?

[Hopingforno2]

Thanks bona your right dinnerwise and breakfast I tend to rotate between a few of the same things lunch mon-fri too will admit to eating out on weekends diabetes is feeling like a ft occupation!and think id need to try a fasting day/s to try and find out about my long acting but dont it cant be right as if I skip dinner I go high

[BonaDea]

Hoping maybe you should go back to basics a bit with carb counting and ratios.

On carb counting, if you are like me the reality is that you tend to eat the same types of things every week. Often the same one or two breakfasts, a few lunch options and maybe 6-10 dinners you rotate. Go to the bother of properly working out the carbs in those meals (either from packets or using the Internet to work out the carbs in the ingredients- you will have to weigh things). This is a pain but honestly you are going to go round in circles otherwise.

When you have worked out your carbs for your meal, if you are not confident on your ratios, start with 1:1 (1u insulin for each 10g carbs). This is a good starting point and if you end up high or low you can adjust the ratio.

Finally you need to make sure your long acting is right. Remember, the job of levemir is just to keep you stable in the background not to bring you up or down. So, if your dose is right and you start the day at 7 then eat nothing til lunch you should still be 7.

I totally get how you feel and we all get like that. But you just need to take this thing by the horns. Don't know about pump funding in your area but usually you need to be able to demonstrate you know what you're doing with carbs and dose adjustment (and that it still isn't stable).

Xxxx

[Hopingforno2]

bona not overly confident right now no tbhb ive never been very good at it ive always estimated what to take based on current bg and what im about to eat tho I dont count carbs or not properly anyway however I did do a 2 session carb counting thing at the beginning of my pregnancy and was close when estimating the plate things, not even sure id be a candidate for one if they are even available in my area im told its a bit of a postcode lottery? Im just so fed up right now I need to reduce carbs in my diet but feel so rubbish when I do and hate it sorry im ranting having a bit of a why me and all I keep thinking'I just want to be normal and my only worry be if food will make me fat'

[BonaDea]

Hoping - the pumps are not permanently attached so you would just unhook it for a shower (the needle part stays in).

I think pumps take a lot of initial work. You would still need to carb count and calculate your ratios. Whst are your ratios right now? Are you confident in carb counting and working out your ratios?

[Hopingforno2]

diec just what id usually have bran flakes last week I was having to reduce breakfast insulin as I was going low pre lunch!susoect im going to have same problems today checked at 5.30am I was 6.1 now at almost 9am 10.2?? I cant work out ratios they seem to keep changing.

I remeber rue saying she is on a pump but cant think if any of you other ladies are? Not even sure if id be able to get one but is it easy to use? I looked at one online and was confused when it said that it could handle getting wet cant they all?how do u get washed otherwise?

[dieciocho]

What did you eat for breakfast hoping? Have you worked out your ratios for each time of day/each meal time?

[Hopingforno2]

Double f**k was 10 when I had breakfast this morning(later than usual) so had an extra cpl of units been entertaining ds and looking after ellie all morning just went to eat 14.5???!!! What am I doing wrong? Feeling really down about it now ketones also at 1.3 so must be high all morning I could cry