Pattern Control
Pattern Control is a method of keeping and analyzing your glucose records (and meals, medications, activity, stress) to look for trends-or patterns. Keeping a logbook of these items and analyzing the patterns will help you learn how to make adjustments in your food, medication, or activity to keep your diabetes well controlled. For more information on Pattern Control, please review the related questions below.
Questions
Q: “I have been a Type I diabetic for 43 years. I have been taking Lantus® at bedtime and Humalog® before meals. Lantus is not supposed to peak but I find it does 8 to 12 hours after I take it. I cannot always catch my hypoglycemic episodes as I lost that ability a few years ago. I also find that approximately 18 to 20 hours after my Lantus shot, before dinner, my blood sugar starts creeping up. I don't always eat 3 times a day, usually eating at 11a.m. and 6p.m. Why does my Lantus peak and dip and do I need to start mixing regular insulin and Humalog with my 11a.m. meal? Even if I don't eat anything but a 6p.m. meal, why would the Lantus not keep my glucose level more even during the day?”
Glucose is Higher in the Morning
Q: "I have been controlling my carb intake and have lost 40 lbs. Why do I have a surge in my blood glucose level between bedtime and my first morning reading, from 126 to 165? How can this happen after 8 hours of sleep and fasting?"
Brittle Diabetes
Q: "Can you please explain the concept of "brittle" diabetes vs. the theory it is just not controlled? Also, does the length of the disease make a difference in one's ability to control it?"
Unused Insulin Rule
Q: "I have read articles referring to the unused insulin rule. Could you elaborate?"
1500 Rule
Q: "I have heard about the 1500 rule and wondered if it really works as a good guide. It is where you take 1500 and divide it by the total amount of insulin you inject into yourself. This gives you a number that tells you the amount of carbohydrates that one unit of Humalog® will counteract. Is this true?"
Feel Better When I’m High
Q: "I have read your answer on glucose goals. I am fairly new to diabetes and am not yet at the target goals, in fact my levels are often still in the 180-250 range. I start to feel terrible whenever my glucose gets even close to what is supposed to be a good level, like 120. In fact, I feel as if I am hypoglycemic at times, but when I check, I can be 130 or even 150—and just so you know, when I think I’m low, I do test on my finger. So I’m wondering if maybe some people are just meant to run a little higher than others? Maybe my body needs a different target range?"
Treat High Post Meal Glucose with Insulin?
Q: "When I have a high post meal glucose, should I take more insulin to bring it down? I have been taking insulin for 2 ½ months, having been diagnosed a year ago, and I am having trouble keeping my blood sugars down."
Dose of Insulin After Hypoglycemia
Q: "I am a diabetic taking one morning dose of Lantus® in the A.M. along with three individual doses of NovoLog® before each meal. I take my blood sugar each morning before giving myself the insulin. My question is: if my blood sugar is low...let's say 60 or below...and I eat some crackers with juice which raises it to above 150, should I go ahead and give myself the morning doses of insulin since my blood sugar is now at an acceptable level, or should I skip them? And why?"
Lowering Morning Glucose
Q: "How can I lower my morning readings? All other times are usually within an acceptable range but the morning fastings are a little high—up to 150. I have type 2 diabetes and I am not on any medication."
Lantus® Regimens
Q: "I have started taking Lantus once every morning. It has been a tremendous help. I take rapid-acting insulin before meals (3 times/day). If I miss a meal my glucose is roughly 4 mmol/L (approx. 72 mg/dL). Would it be possible to adjust to taking Lantus only, with another type of insulin only once a day? My blood tests for everything--protein, cholesterol, kidney etc.-- are fine. I am searching for just a little distance with this disease. I don’t want it to be my best friend."
Important Notice: The responses provided by the team of Diabetes Educators are based on their personal experiences and expertise as practicing diabetes healthcare professionals, and are not to be considered diabetes management advice from Abbott Laboratories. Remember that information provided by the team of Diabetes Educators is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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