Your glib tossing around of endocrine system terms indicates you don’t understand the processes. But nevermind, I should know better than to hit the tar baby.
Have you done the math on 5000 mg/dl? Your liver cannot produce 5 grams / dl, or approximately 300 grams, of glucose. What you’re calling “liver gone wild” is better explained by an abrupt insulin resistance, which is not so fantastic, miraculous or uncommon. Imagining that you have a blood sugar that is more than 8 times the level that can be measured, more than 7 times the level at which an osmolar coma would be induced, or 5 times the level at which your blood would become so viscous you would die of ischemia… is a little, shall we say, flamboyant.
Jumping from an observation that you’ve injected 200 units of insulin, to the conclusion that you must have had the sugar in your blood to match that insulin, is a bit hasty. I’m understating.
Thank you! I am jumping from from the 200 units needed to “hold down” the non-food, non-rebound “jump” into the presumption that it must be liver-stoking.
So, insulin resistance can come on abruptly and then “go away” on the same day? If so, your statements makes perfect sense-- because I’m not reaching an ultra-high bG, and my Ketone levels aren’t matching my guess. (Well-flushed with many glasses of water, they’re staying below 2.0.)
Do you think that a different “rapid” formula (switching brands) might help? With your idea in hand, I see a very old paper from Clinical Chemistry, Vol 7, #28 (1981). But that person seems to have been insulin resistant at all times, with only the degree of resistance changing radically. (My insulin level has been measured as “typical” for nonresistant T1s, and my average daily dose isn’t terribly high either.)
But thanks! I’ll certainly ask my Endo about your idea at my next appt, and probably WILL switch brands to see if the trouble goes away.
I haven’t had an R-R test, but my endo diagnosed gastroparesis from my fluctuating readings of. lows 2 hours after meals & soaring 4-7 hours later. He said this was a classic symptom because it happened after dinner when gastroparesis typically rears its ugly head. I had to switch to Regular insulin because rapid doesn’t work for me. Also have to inject after eating & then keep testing. Makes things unpredictable.
diabetes is ever changing, i’ve figured out that there is no good or bad just the balance you find in yourself to try and try again. The reality of it is that nobody is perfect, and as a diabetic we can only strive to be perfect but at the same time you can’t beat yourself up about it. Sometimes the control is purposely out of control, and sometimes the control is intentional but still out of control. And certain methods of control can only work for so long before the equation changes on us again, sometimes due to the factors of life. In other words… diabetes sucks, just start each day brand new (why don’t i ever listen to my advice. geez)
i don’t like the word brittle, it makes me feel like i’m broken when really i’m lazy or uncooperative. I think that if you find yourself doing everything you can and your sugar is still wacky, then you need to start a clean slate, go back to the beginning, and figure out what changes can be done. It might be something you didn’t think of before.
I’ve moved around a bunch since I was first told about the gastroparesis. Each time I get a new Endo/PCP and show them my logbook, they always start with “you really need to get better at controlling your blood glucose.” I then tell them about the stomach issues and it is almost like Roseanne Rosannadann saying “oh, well, that’s different now. Never mind.”
Actually, they have been quite helpful, as well as several dieticians I’ve seen about this. The problem is that they need to work together. The endo doesn’t get how various food characteristics influence digestion rate and subsequent carbohydrate abosrbtion, while the dieticians don’t quite get insulin rate of action, infusion variables, etc.
If you are a perfectionist with Type I and gastroparesis, you had better learn agner management.
Tom, I believe your greatest control will be through dietary changes. For this reason I’ve been somewhat skeptical of your claim to having tried everything, though I’m certainly interested in seeing evidence that contradicts my beliefs.
I was described as a ‘brittle’ diabetic and experienced wild blood sugar swings for 15-16 years. As I said, during that time I experimented with everything (or so I thought).
I switched to a Paleo diet, completely, strictly excising all sugars and starches. I eat meat in abundance, a lot of fat (my cholesterol has dropped to 145), some vegetables, nuts and seeds, a tiny bit of fruit.
It is difficult and I still crave carbs regularly. I also miss milk and legumes.
I have cheated on my diet, by drinking beer, wine and whiskey, and by drinking diet sodas (which I’m now going to quit).
I am down to consuming 29 units of insulin per day. My average blood sugar is 103. My standard deviation since switching to a strict Paleo diet is 29, which is fantastic.
And these three numbers are your most important performance metrics:
total daily insulin
average BG
BG standard deviation
You could try to prove me wrong by doing a 30-day switch to a Paleo diet. That’s how I started.
I’ve given up on dieticians because none have been supportive of low carb. I do my best to control gastroparesis with small dinners that aren’t high in protein or fat. Big evening meals do me in. Sometimes that works, sometimes it doesn’t. I stay up way too late at night waiting for the spikes to hit when my stomach empties. I tried liquid dinners (protein shakes or soup), but that got old quickly.
Pardon me for causing your skepticism when I said “I’ve tried everything.” What I meant is that I’ve tried everything recommended by my medical team. They comprise a board certified PCP, my endocrinologist (MD, PhD.), cardiologist (had my first heart attack @ 43), gastroenterologist (board certified), neurologist (MD, PhD. helping with autonomic and peripheral neuropathy), dietician (PhD.), nephrologist (dual board certified MD & PhD.) and CDE (MSN). Given their vast training and experience, I feel it is an intelligent thing to keep them fully informed of my condition and to implement their best professional advice. I am unwilling to risk my health on some treatment de jour that I read on the internet given that I have neither the training or experience with which to critically evaluate the efficacy of various claims.
That said, I appreciate the spirit in which you offered your experiences. It is gratefully appreciated.
I’ll confess that I am unfamiliar with the “Paleo Diet.” I’m on a personalized regiment that generally follows USDA recommendations that are tailored for various conditions I have. In fact, my most familiar encounter with the term “Paleo” is that my father struggled over whether to major in Paleontology or Geology. He chose the latter, for what it is worth.
I am a type one brittle diabetic as well. I have been on the pump for 2 years and i still have lots of ups and downs but it has made my life easier and dose help.
Sometimes I wonder if we are always cognizent of the stress level we are experiencing at any given time. Subsequent to starting on the CGM, I have noticed incredible increases, and decreases, in my BG due to stress or relaxation/happiness. I have started to make a conscious effort to relax myself when stressing, calling up biofeedback techniques I learned years ago but haven’t regularly practiced. Has anyone else worked on relaxing themselves to turn an “up arrow” into a “down arrow”?
