{'en': 'Horrible increases between hours', 'es': 'Subidas horribles entre horas'} Image

Horrible increases between hours

Tyler's profile photo   02/19/2017 1:04 p.m.

Very good to everyone,

For some time, I am in a situation that is going crazy.I get a lot of glucose between hours, that is, among the post-pandarial of a meal, to the control of before the next meal.

For example, one day I wake up at 93, I click 5 from the novorapid, and two hours later I am 139. So far everything is fine.But later, at noon, without having eaten anything in the morning, I look at myself and I am 235.

Another case, another day I was in 123 two hours after eating, and before dinner, and despite having exercised that afternoon, I am 210.

Yesterday afternoon, after eating, 161. Before dinner, 300.

I don't know what to do anymore, I exercise absolutely every day, but I can't help these climbs.And it is something constant.I have thought about which insulin fails, but if the post-pandals do well, it is that the fast is well adjusted, right?And I deduce the toujeo that too, since I usually wake up normal, and at night I lowers me a lot, and if I put more I am at the limit of hypoglycemia.

I have had a visit with my endocrine and my educator, and I have adjusted the calculator to recommend me faster, but I think it does not go there, since with faster I will have descents later.

It is as if the toujeo does not work during the day, or here there is an X factor that escapes me and is destroying the control.

It is crazy because in the end there is no way to have a single good day, and I am constantly exercising like a donkey so that it does not rise so much, and then I find that the fast of each meal I have to descend that value, so thatThen between hours I get up again.

Not as anything between hours or drink anything other than water or infusions with saccharin.

Has anyone else happened or knows what may be happening?

(Sorry for the tocho, but I had to explain it clearly).I'm desperate and I'm going crazy, really.

Tyler's profile photo
Tyler
02/19/2017 1:04 p.m.

DM1 desde 2015 | Accu - Chek Aviva Expert | Fiasp + Toujeo

  

Hi @tyler,

Tell you that some happen to me and it is a bit disconcerting and desperate.
And as it is said a lot in this forum, and it is totally true, it is a matter of testing, because each diabetic we are a world and still there will always be files x that we will not know how to explain.
However, what I would do would be, to upload the toujeo.You have the fast calculated.As I tell you it has happened to me lately and
Another thing, it is logical that glycemia lowers you at night, since as you say you do a lot of sport.
Maybe also what you have to do if you get on slow insulin, be to adjust rations and insulin at dinner ... to avoid down at night.
Ahh, and true, look at the blood glucose before doing sports, and that when we have more than 200 it is not good to exercise, because the only thing we achieve is the rebound effect, and perhaps it is what happened to you, so whatAccounts

Well I hope I have helped you a Pokito;)

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RAKE
02/19/2017 6:15 p.m.

DM1 desde 1992, con 9 añitos; Tresiba 10, Apidra en función de HC
Freestyle Libre

  

And if you increase the toujeo and do not exercise so much?
And if you put the toujeo in the morning or at noon and increase it a bit?
I am sorry to read you, because I trusted that that insulin was better than Lantus ..
It will have to be studying how to adjust it. My lantus cost me a year, until we changed the schedule in the morning and increased the dose.

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Regina
02/19/2017 6:20 p.m.

Hija de 35 años , diabética desde los 5. Glico: normalmente de 6 , pero 6,7 la última ( 6,2 marcaba el Free)
Fiasp: 4- 4- 3 Toujeo: 20

  

When the glucose uploads between hours it is usually due to lack of basal ... I would also upload the basal as the companions advise you ... Keep in mind that you may have to go down quickly after that change ... it is likely that at nightt lower more because of the exercise than for insulin itself ... you will have to look for balance .... greetings

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ranty
02/19/2017 10:19 p.m.
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As far as Toujeo and Tresiba are similar, my daughter was changing Lantus for Tresiba a few months ago, at first it was crazy, it happened to us, so we started to rise slowly and down quickly.
And another possible explanation, my daughter gets quickly on all meals, makes five daily meals.One day, lunch at home was left, his control at lunchtime was good, and since he was not going to lunch, he did not get fast, because he arrived at eating with 300. Before my surprise I consulted him with his endo,And he told me that when he skipped a meal, his body needed that glucose that he had not ingested and that his body began to release the glucose of his reserves to replace that fault, and not administering insulin, because hyper of championship.From there, he told us, the importance of making the five daily meals.

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RocioLlinares
02/20/2017 6:16 p.m.

Mamá de María. 15 años. Diagnósticada 05/06/2015
Humalog
Tresiba
@RocioLlinares
Última hemo 6,1

  

I sometimes pass my daughter that postpandrial has it within the limits and rise long after two hours of control ... Try to get the fast during or at the end of eating.

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mariah14
02/20/2017 9:04 p.m.
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@"Rociollinares" to me that explanation that gave you the end of the five meals sounds a little to the Chinese story.Precisely the freedom that flat insulins should give is to eat at the time you want and not make more than three meals, unless they give you hypos ..
The function of a flat basal insulin is

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Regina
02/20/2017 9:50 p.m.

Hija de 35 años , diabética desde los 5. Glico: normalmente de 6 , pero 6,7 la última ( 6,2 marcaba el Free)
Fiasp: 4- 4- 3 Toujeo: 20

  

If you do a lot of exercise, I think it is not good for your body, or for anyone, to make only three meals, be so many hours without eating;What comments @"Rociollinares" does not seem at all a "Chinese story", so I know my body, for what I have read and for what they have told me various endocrine.

Exercise mobilizes metabolism to achieve the necessary energy for that exercise;If there is not enough glucose to feed the body, the liver will segregate it while.As in our body with diabetes, insulin is not secreted that leads that glucose to the muscles and heart, blood glucose increases.

The liver can segregate glucose, and in fact it does, on many different occasions, to maintain adequate metabolic balance.Only in people with diabetes the orchestra that maintains glycemia levels in very tight values, does not work, because one of the elements is not available whenever necessary (insulin).And doing the work of a whole metabolic system from the outside, as we do, is extremely difficult, because our body is of an extraordinary complexity, which escapes our rational and controlling mind (which cannot control so many variables at the same time) That is the one that consciously decides what we do, what we eat, the exercise, the injected insulin ...

Here some basic articles, at the informative level, of the subject, that comment on the segregation of glucose:
https:/5liver-and-el -azucar-in-sang/

Link

regina said:
@"sprinkle" that explanation that gave you the end of the five meals sounds a bit to the Chinese story.Precisely the freedom that flat insulins should give is to eat at the time you want and not make more than three meals, unless they give you hypos ..
The function of a flat basal insulin is

We are asking science for something that still cannot come;Those should are utopian, for now.It is evident that the complexity of which he spoke before prevents that from the outside we can control absolutely everything so that our body works as we want at all times.That is far away.Although we approach from time to time, and to very small steps, with all our scientific knowledge and advances;Although flat insulins help us in the task :-)

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imara
02/21/2017 9:44 a.m.
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It has also happened to me and the endocrine took the lantus and I went to less than to put it in two doses I can better control the basal.With a single dose of Lantus it was more difficult for me to adjust between meals.
I make 5 meals more or less, except for the days I have insulin resistance that does not lower me or double the rapid.Nor exercise like yesterday ... I left home with 180 and returned home with 165 after two hours of bicycle.

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Ruthbia
02/21/2017 12:53 p.m.

Lada enero 2015.
Uso Toujeo y Novorapid.

  

I apologize for not saying anything before.Thanks to everyone for the answers, they are very varied and sure that all are very useful.

I have discovered that when I get the fast on my leg, being slower absorption, it keeps me somewhat better between hours, although it should not be abused with the puncture area ...

I sign out what you say, I still do not walk perfect and I will have to continue investigating and rehearsing ... Thank you again!

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Tyler
02/14/2018 12:25 a.m.

DM1 desde 2015 | Accu - Chek Aviva Expert | Fiasp + Toujeo

  

Look also if you eat hydrates mixed with fat.Fat causes part of the hydrates to be absorbed later and you give you a beak at 3 or 4 hours.It happens with meals like the pizza that has a lot of hydrate and a lot of fat.In those cases you have to get an extra fast at 2 or 3 hours.

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Yessica_A
02/14/2018 10:01 a.m.

DM1 desde 2003 | Toujeo + Humalog | FreeStyle 2 | HbA1c 5.5

  

Thanks Yesssica, the truth is that I do not abuse them ... at most a small pizza a week and a hamburger every so often, always made at home.And always light cheese.

I usually blame the basal, but with what I get dawn, once again with downturn, that's why I don't upload it.:-?And sometimes it seems that I have to lie high to avoid that descent.So on the one hand it seems that I lack basal, and on the other I think I have left over.I am a bit disaster, time passes and I do not learn.= D>

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Tyler
02/14/2018 6:38 p.m.

DM1 desde 2015 | Accu - Chek Aviva Expert | Fiasp + Toujeo

  

Have you proven that you have no busts in the areas where you click?Something similar happened to me a few months ago and it ended up being that;Without realizing it, I punctured me in an area where I had some packages, so insulin did not carry out the effect.And of course, they gave me up every two.I had very uncontrolled.

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Alb85
02/14/2018 9:56 p.m.

- 32 años. Diabético Tipo 1 desde los 9 años.
- Tratamiento:
Tresiba (14 unidades)
Humalog (según actividad, glucosa, comida...)
- Mediciones: Accu-chek aviva y Freestyle libre

  

Hi ALB 85
I have improved a lot, since the head of Cabezra takes me, today for example before eating 96, then at two hours 125, it seems good to me, that with the capillary, but with
Freestyle, I get 158 ​​or 33 points of difference with the capillary, is it normal?
I beg you to tell me something, thanks
Greetings

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DiabetesForo
02/15/2018 5:29 p.m.
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I get a lot of glucose between hours, that is, among the post-pandarial of a meal, to the control of before the next meal.For example, one day I wake up at 93, I click 5 from the novorapid, and two hours later I am 139. So far everything is fine.But later, at noon, without having eaten anything in the morning, I look at myself and I am 235.
This can effectively say that you lack basal during the day.Now, Toujeo insulin once a day and lasts all day.And it is difficult to play by changing it because its profile is even more flat than the Lantus (Lantus releases more insulin during the first 12 hours than during the last 12 hours).Once this explained, it may be that you lack basal during the day because you really lack insulin or because you do something for your body to be very resistant during those hours.Or because your body simply has very different basal needs depending on the time of the day.The very intense exercise, by releasing counter -regulatory hormones, of stress (catecholamines, cortisol, GH ...) can cause hyperglycemia because the insulin that you have guided for a normal day, cannot counteract those stress hormones.And as they say in some comments, it can cause an increase in insulin sensitivity many hours later (for example at night), and therefore the insulin that you have guided can be excessive for that situation.

And the toujeo deduce that too, since I usually wake up normal, and at night I low
With this, it can be said that "there" basal insulin during the night (perhaps because of the late effect of intense exercise, or perhaps because you need less basal insulin during the night than during the day)

It is as if the toujeo does not work during the day, or here there is an X factor that escapes me and "it is destroying the control.
Just, the conclusion is correct.

It is crazy because in the end there is no way to have a single good day, and I am constantly exercising like a donkey so that it does not rise so much, and then I find that the rapid of each meal I have to descend that value, so that later between hours I get up again.
What I commented before, the very intense exercise can cause hyperglycemia shortly after, and late hypoglycemia.

(forgiveness for billet, but I had to explain it clearly).I'm desperate and I'm going crazy, really.
You have explained it very well, of book, and it is no billet.

What happens to you happens many times in type 1 diabetics.

What would I do?
Try to see how your profile goes in a more "basal" situation, that is, with less physical activity.If you exercise light, or without exercise, the profile is still reproduced that lowers you a lot between the postcena and the predesayuno (touching the hypo, as you seem to comment), and yet it still goes up to you a lot between the post -desayuno and the predominate, andBetween the post -composition and the predem, we have a problem with the toujeo insulin.Could it be that before, if you carried Lantus, this would not happen to you, or were it less accentuated?I say it because it would make sense, since the lantus, set in the morning, makes more effect during the day than during the night, which would better cover the interprandial periods (especially that of the afternoon) and would make less effect during theNight-Moving, avoiding the tendency to predesayuno hypoglycemia.If before the change to Toujeo you were better, it would be worth trying with Lantus again (in the morning).If you improve at all, great.And if it continues to look at basal at night and miss during the day, another option would be to change to two doses of Levemir (in which you can already put more in the morning and less at night, to adapt to your profile).

If doing onemore leisurely life, the profile is resolved, we already know the cause (intense exercise).In that case, you could play with fast insulins.Or even, if you always exercise in the afternoon, change the rapid of noon for regular insulin (the actrapid of a lifetime), which would give you an "extra basal" during the afternoon, although this is not the most optimal, becauseThe postprandial peak of food would escape us a little.In any case, the influence of being half an hour at 250 after eating is probably less than being 200.

There are thousands, one of which, of course, could be the pump.

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EndocrinaAntiNewAge
02/15/2018 5:37 p.m.
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alb85 said:
Have you proven that you have no packages in the areas where you click?Something similar happened to me a few months ago and it ended up being that;Without realizing it, I punctured me in an area where I had some packages, so insulin did not carry out the effect.And of course, they gave me up every two.I had very uncontrolled.

I do not have packages that the area is quite smooth and that the content of the units between good.Although it is what I say, I have to watch with not abusing the same area ... which is then many years.

endocrinaantinewage said:
I get the glucose a lot between hours, that is, among the post-pandarial of a meal, until the control of before the next meal.For example, one day I wake up at 93, I click 5 from the novorapid, and two hours later I am 139. So far everything is fine.But later, at noon, without having eaten anything in the morning, I look at myself and I am 235.
This can effectively say that you lack basal during the day.Now, Toujeo insulin once a day and lasts all day.And it is difficult to play by changing it because its profile is even more flat than the Lantus (Lantus releases more insulin during the first 12 hours than during the last 12 hours).Once this explained, it may be that you lack basal during the day because you really lack insulin or because you do something for your body to be very resistant during those hours.Or because your body simply has very different basal needs depending on the time of the day.The very intense exercise, by releasing counter -regulatory hormones, of stress (catecholamines, cortisol, GH ...) can cause hyperglycemia because the insulin that you have guided for a normal day, cannot counteract those stress hormones.And as they say in some comments, it can cause an increase in insulin sensitivity many hours later (for example at night), and therefore the insulin that you have guided can be excessive for that situation.

And the toujeo deduce that too, since I usually wake up normal, and at night I low
With this, it can be said that "there" basal insulin during the night (perhaps because of the late effect of intense exercise, or perhaps because you need less basal insulin during the night than during the day)

It is as if the toujeo does not work during the day, or here there is an X factor that escapes me and "it is destroying the control.
Just, the conclusion is correct.

It is crazy because in the end there is no way to have a single good day, and I am constantly exercising like a donkey so that it does not rise so much, and then I find that the rapid of each meal I have to descend that value, so that later between hours I get up again.
What I commented before, the very intense exercise can cause hyperglycemia shortly after, and late hypoglycemia.

(forgiveness for billet, but I had to explain it clearly).I'm desperate and I'm going crazy, really.
You have explained it very well, of book, and it is no billet.

What happens to you happens many times in type 1 diabetics.

What would I do?
Try to see how your profile goes in a more "basal" situation, that is, with less physical activity.If you exercise light, or without exercise, the profile is still reproduced that lowers you a lot between the postcena and the predesayuno (touching the hypo, as you seem to comment), and yet it still goes up to you a lot between the post -desayuno and the predominate, andBetween the post -composition and the predem, we have a problem with the toujeo insulin.Could it be that before, if you carried Lantus, this would not happen to you, or were it less accentuated?I say it because it would make sense, since the lantus,Put in the morning, it makes more effect during the day than during the night, which would better cover the interprandial periods (especially the afternoon) and would make less effect during the night-mudda, avoiding the tendency to the predesayuno hypoglycemia.If before the change to Toujeo you were better, it would be worth trying with Lantus again (in the morning).If you improve at all, great.And if it continues to look at basal at night and miss during the day, another option would be to change to two doses of Levemir (in which you can already put more in the morning and less at night, to adapt to your profile).

If making a more leisurely life, the profile is resolved, we already know the cause (the intense exercise).In that case, you could play with fast insulins.Or even, if you always exercise in the afternoon, change the rapid of noon for regular insulin (the actrapid of a lifetime), which would give you an "extra basal" during the afternoon, although this is not the most optimal, becauseThe postprandial peak of food would escape us a little.In any case, the influence of being half an hour at 250 after eating is probably less than being 200.

There are thousands, one of which, of course, could be the bomb.

How many options, really thanks.Yes, let's see, I use Toujeo, right now 16 units before bed.And if I have not increased it is because I get up well (sometimes having to bed high so as not to go down to the hypo).And not under the dose because it seems that later, during the day, I am missing.He came to use Lantus, but the problem already had it then.I have the feeling that I am quite the same with one that with another, and I do not think they are bad basal for me, but during the day I go to trumpets for some reason.

I can be wrong, but the effect is that with exercise then always under levels and I am more controlled (when I do not move is crazy).Although everything is trying a little more.

I came to think that I went down a lot at night for having exercised in the afternoon, but if I do it in the morning, the truth is that I keep going down a lot when I sleep (and there I no longer think that I am affecting an exercise that I didso many hours).

I take note of everything, being a problem that I already had with Lantus, I would not return to it either.But I could assess what you say about the dose in the morning (lower during the day and not so much down at night).

If exercise really is what carries me problems, it would seem quite incredible to have to reduce it to be better, although I don't know what to think, hehehe.

If I put the toujeo at the same time as the quick of dinner, would it also be an option?That is, the same would avoid the beak after dinner (as the effect of two insulins), and then the night would perhaps would have already surpassed with dinner a possible peak of the basal action.Of course, during the day I would walk the same.

The problem of putting it in the morning also comes because there are days that I exercise during the morning (I know I am complicated ...)

Tyler's profile photo
Tyler
02/15/2018 6:09 p.m.

DM1 desde 2015 | Accu - Chek Aviva Expert | Fiasp + Toujeo

  

So I understand that:
-When you got Lantus, you were more or less the same.
-When you got Lantus, you put it at night
-If you do not exercise in the afternoon, that rise between meals is still accentuated.

You say that when you exercise in the morning, you also get down a lot at night.Does this go down at night also happen to you if one day you do not exercise in the morning or in the afternoon?

So you explain (you even look for high postcena control to avoid hypoglycemia during the night), it seems clear that you have very different basal needs during the night vs during the day.And this is difficult to control by changing the dose or time of administration of Toujeo.As options, separating the exercise factor, it is from putting a basal that lasts less hours, to be ableinvention)).Or leave the toujeo as it is and in the food, instead of fast insulin, put an actrapid or even put novomix70, which has 70% aspart (novorapid) and 30% of aspart protamina, "intermediate" of profile similar to profileThe NPH, which would cover your food peak and give you an extra basal mattress of 8-12 hours.I already tell you, no solution is magical, because with the Actrapid you do not cover the peak well, and with the Novomix70 (I do not know if you adjust quick according to the rations and the pre-) control when the dose of noon varies, you are also varying the doseof "intermediate" in the afternoon.

To put the toujeo at the same time that the fast of dinner would probably not mean any change.Precisely when it was so flat, in the trials it was shown that it could be put with a variability of +/- 3 hours without significant changes in the control, so it should not matter if you put it at 9:00 p.m.I invented), or at 23 h, before sleeping.That is, the rapid of dinner would make the same peak.

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EndocrinaAntiNewAge
02/15/2018 6:34 p.m.
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With Lantus it was more or less the same (perhaps something worse before), I also put it at night.And yes, not exercising the climb has no brake (I exercise to compensate for it as I can).

I exercise daily, so I don't know how to tell you how much I would go down in case of not doing (I panic not to move).

The same is what you comment on the difference in the need for basal during the day, although it could also be that the toujeo made me peak during the first hours and then lost effect (like me and many other people has happened to Lantus).

The novorapid adjustment according to what I am going to eat, what I have moved and what I am going to move.I have not used the other insulins, but I understand the idea of ​​distributing better ... all this could aim and take it to my endocrine (I am not funny to have to put the basal twice, but everything is for good control. If it works...).

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Tyler
02/16/2018 12:59 a.m.

DM1 desde 2015 | Accu - Chek Aviva Expert | Fiasp + Toujeo

  

Have you tried to put the toujeo in the morning?Maybe so the day covers you better and you do not need so much exercise, so you will not go down so much at night.
Sometimes, too much exercise you go down at night. If you went high for the day, you could upload the dose, without going down at night.

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Regina
02/16/2018 1:11 a.m.

Hija de 35 años , diabética desde los 5. Glico: normalmente de 6 , pero 6,7 la última ( 6,2 marcaba el Free)
Fiasp: 4- 4- 3 Toujeo: 20

  

regina said:
have you tried to put the toujeo in the morning?Maybe so the day covers you better and you do not need so much exercise, so you will not go down so much at night.
Sometimes, too much exercise you go down at night. If you went high for the day, you could upload the dose, without going down at night.

It is the option that calls me the most and you are convincing me, hehehe.
Regina, how would you change?That is, the night that touches Lantus, don't I wear it that time and wait the next morning very early?

What if the holidays do I exercise in the morning will not get off too much?That is why I saw the night something "comfortable", not moving.There are my doubts.I am a question.

:-@

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Tyler
02/16/2018 1:29 a.m.

DM1 desde 2015 | Accu - Chek Aviva Expert | Fiasp + Toujeo

  

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