Is my doctor doing well?

Hello everyone
I've been with diabetes for about 12 years and I've always been quite controlled.
I've been with my current and all perfect endocrine for about 5 years (because it was easy to control the insulin)
A month ago, for some unknown reason, they gave me several fat hypos for days (two of them ended up in the emergency room because I could not overcome them even though I was conscious and everything, thankfully)
My endocrine decided to lower my insulin radically and go back to adapt it little by little so that it would not happen again
When I managed to return to normal I put the same as before the hypos less 2/4 units at each meal
Well, it turns out that now that same endocrine believes that it cannot be, that I cannot get so quickly and I must put more lantus
So now I sulked 22 of Lantus in the morning and 16 at night (before I click me 18 and 16)
And practically I don't get fast, only if you have to correct a fat hyper
This causes me to happen with hypers two or three hours after the food but since I wear a lot of lantus when it comes to snack, before dinner and when I get up I have good or even slight hypos.
Luckily I have no ketone bodies despite hypers (which are usually spending 3 or 4 hours a day with 300) I guess because I have a lot of basal do not come out
It does not make me funny to have those hyperglycemia, although it is true that with the hypos it happened much worse this does not seem to me a feasible solution to avoid them.
Does this happen to any more?Do you think the new treatment that the doctor has put me?Should I change my endocrine despite taking many years with this?

Although I find it very daring to judge this from here, I think that uploading a lot and lowering the rapid is the best way to have an unstable profile.Intuitively it seems that it is safer because "the hypos are produced by the rapid", but imagine that after breakfast you are 300 and only because of the effect of slow casualties up to 115 at 14, which is your usual time to eat.Then you eat and you get fast.Imagine that one day for whatever you do not start until eating until 4 pm.Theoretically there is a danger that you are still low and make a hypo for the slow.

You say you get 22 from Lantus.How much do you usually get total throughout the day?In theory, the slow one should be 40-50% of the total dose and the rapid 50-60% of the total dose (unless a very low carbohydrate diet is made, which is not recommended either).

Anyway, you can try to let the "scare" pass, both for you and your doctor, and maybe little by little the quick is raising and lowering the slow.

endocrinaantinewage said:
Although it seems very daring to judge this from here, I think that up the slow and lowering the rapid is the best way to have an unstable profile.Intuitively it seems that it is safer because "the hypos are produced by the rapid", but imagine that after breakfast you are 300 and only because of the effect of slow casualties up to 115 at 14, which is your usual time to eat.Then you eat and you get fast.Imagine that one day for whatever you do not start until eating until 4 pm.Theoretically there is a danger that you are still low and make a hypo for the slow.

You say you get 22 from Lantus.How much do you usually get total throughout the day?In theory, the slow one should be 40-50% of the total dose and the rapid 50-60% of the total dose (unless a very low carbohydrate diet is made, which is not recommended either).

Anyway, you can try to let the "scare" pass, both for you and your doctor, and maybe little by little the quick is raising and lowering the slow.

Quickly I get (according to the glucose I have before eating)
If I have 80 or early hypoglycemia
If I have between 90/100 and 200 between 2 and 6 according to the hydrates you are going to eat
If I have more than 200 I put 8

In my seem a bit weird because formerly the rapid was fixed 10/12-16/18-14/16 (breakfast-cena) and varied a little alone if I ate a little more or a little less that day that day

And these days, for example, what total daily average are you getting quickly?If you are putting for example 4 U at each meal and eat 3 times a day, it would be 12 u/day (then, a priori, it seems quick for 22 u of slow)

At breakfast I do not usually wear because I dawn with 80 and breakfast little, but before eating I have 100 and a lot touching the 200 and I get 8 and at dinner it depends but I usually get a little more normal and put on 4 or 6.
The problem is that at the time of the snack (three hours after eating approx) I have 300 but an hour and a half later I am 90-100 so that despite having hypers I can do nothing more to wait because if I put me morefast as you say would give me hypoglycemia

What is the 2H-Postdesayuno value, after having breakfast without fast, even if it is little food?And the 2H postcomida?

It is striking that you go down from 300 to 90 in an hour and a half.It seems that in that section of the day there is basal.But we would have to see what happens between the postcena and the predesayuno and between the postdesayuno and the predominate.

I am going to tell you an average of my glucose measures since I am like this, so that it is clearer:
When I get up (predesayuno) 85
Breakfast a glass of milk or a glass of juice without fast insulin
2 hours later 170
Before eating 220
How "normal" (I have not measured the rations for many years but as the same amount of HC that I have eaten since I was regulated by diabetes years ago
Fast insulin: 8
2 hours after eating 300
Around 7 in the afternoon if I went out to walk 80 and go down, I have to snack so that I do not give me a hiccup
If I have not moved from house 170, not getting
Before dinner whether I have decking as if no 155
Before going to bed (more than two hours after dinner) 280 and I go to bed like this, without correcting myself
I also started clicking at 5 and 7 in the morning to see what is happening and I get off stable throughout the night without having anything quick (5 in the morning I am 160 and at 7 120)

Thanks for the data so detailed and well explained.I am more supported by the initial hypothesis than plenty of plenty of and foul (of course always with the reserves that can be evaluated in a medium like this).I think that for serious hypoglycemia your doctor was scared and that is why the guideline changed you (which is understandable to some extent, nobody likes to think that their patient can stay around a serious hypoglycemia).If you take these controls I think you will see what happens and little by little it will adjust you.

Thank you very much for your opinion.On Thursday I have an appointment with him and see what he tells me.The problem is that he told me that if I saw that I had to be correcting with the fast by hypers what I would do would be even more slow because it seems better method and I do not see it very clear about the truth ...
Let's see if on Thursday changes mind

You are welcome :-)

With correcting with fast, do you mean you have to wear 8 before eating instead of 4 because you are 200?Man, the solution to avoid that is to raise the slow as long as the pattern of climbing between the post and the next pre is given throughout the day.But in your case, it seems that it only occurs in the morning (which you go from 170 postdesayuno to 220 precomm recent).The rest of the day, it seems that you go down alone: ​​from 300 post -compromised to 155 predemn (even reaching 80 in the afternoon if you are going to walk) and from 280 postcens 85 Predesayuno ... It seems to me that it is quite clear.

That goes well on Thursday, and if you want you tell us what you have decided :-)