Burned Out

Mental and Emotional Wellness
21

Lots of good advice on these replies! (Sorry for this massive post, but I edited out half of it!) You are a mess! (I’m saying that because I have SO been there—and, actually, I’m there a LOT!) First of all: you need to talk to more people with diabetes. Totally. I think many, if not most, if not ALL! have spent massive amounts of time feeling EXACTLY!!! like you. How old are you and when were you diagnosed? Any family members with it? Did you, and do you, have a support system? Where do you live (if you don’t wanna say, is it small town, etc.)? Are you having any major complications like vision, kidneys, etc.?

My “diagnosis” (giant LOL!)—you’re spot on. You have a great great great ability to identify the causes and effects of T1 emotions.

I have a Tandem pump too. I was excited to hear about the Control IQ thing until I learned it just adjusts your basal. When I’m high I do a correction bolus. I use the Tandem log-thing to detect trends and will change basal, ratios, everything. I see my endo (Dallas) every 3 mos, he recommends precise changes—I just go like up or down 5% basal, and 70% temp rates for heavy activity). I need to see a CDE for emotional support (only tiny lol here) because we all really need it. Partners can’t get their heads around T1 no matter how familiar they are.

Runaway pump. It’s not gonna happen. It’s not. Yes, it did a few times way back then in the 1970 when pumps were invented.

Do you have a Continuous Glucose Monitor System (CGMS)? If not, you NEED one bigtime. Right now. It will gigantically simplify your life.

Last, my “qualifications.” My T1 street cred, lol. T1 55 yrs., yes, I said 55 years. Age 11, 1967. Parents deeply ashamed. I ignored it, but took my shots. Many, many years no control, no insurance, same attitude. DKA a lot. 1983: insurance, I tried to be better. Finally regular endo visits. Pump 2003. Developed Hypo Unawareness and a little Gastroparesis. Lows with seizures maybe 15 times until CGMs came along mid-2000s. I try for control, day by day. I get low a lot, and high sometimes. My A1Cs run in the 7 range (because of the Hypo Unawareness). I have NO other complications.

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22

Thanks for your response. I had not considered taking a break from the pump to reassess what’s been going on.
I have had a particularly stressful past two weeks. I had a rabies scare and had to get vaccinated for it. I’m sure both the stress and the vaccine itself had an impact on my numbers. I’m calling my endo tomorrow to see if I can get some advice on my pump settings.

I think most of the issues that I described above have been a long time coming. I’m feeling overwhelmed by what feels like constant fluctuations. Ironically, I thought the more control I’d have with getting on the pump was what I wanted, but it feels like I’m making more decisions, and I guess I’m fatigued by it all. Then when my blood sugar swings too high, it’s like I shut down from even trying to make improvements. Like I can’t think. I start to veer off into territory that is unproductive, like wishing I had a different body or a different life.

23

Thank you for your reply. I do sometimes use exercise to correct a high. Do you find that it’s difficult to even move or exercise once it’s reached a certain point? Sometimes I feel so sluggish even over 215 that moving around is too much to deal with.

When you make your corrections at 20 minute intervals, would you consider that “stacking” insulin? Sometimes I am afraid to do this because I had been instructed that stacking was not encouraged. Maybe it’s different with the pump?

24

I have not! I’ve never heard of Afrezza. I will have to talk with my endo. Thank you!

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25

Thanks for your reply. I checked my weight and the time and date settings. Both were correct. My endo had set up my basal profiles, and to be completely honest with you, I have no idea how to set them up myself. So would you create a different profile each time or set up a temporary basal rate and record somewhere what worked and what didn’t?

26

Thank you for your advice. I think my basal rate is mostly steady when I’m fasting at night and in the morning. It seems to all go downhill when I’m eating. I’ll discuss with my endo to see if my carb ratio is off. I’ve been eating a lot later on in the day these past few months then what I’d normally done when I first set up my pump settings. I think I need to become more comfortable setting them up on my own.

27

Thanks for your reply. I’m so glad you got it adjusted to your liking. I think I need to learn to accept that it is natural that there will be fluctuations. I don’t think I quite realize or understand my blood sugar’s relationship to stress quite yet. I am usually game for learning new things and am pretty flexible, but lately I feel like it’s all so overwhelming.

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28

Thank you so much for your kind and encouraging words and welcome into the community. I have been a long time lurker on forums and discussion groups like this. It feels good to talk with others about what I’m going through and know that they get it.
I do seek counseling weekly, not specifically for diabetes though. My counselor is great, but I could probably benefit from someone who more specifically understands what I’m going through or at least treats patients with this disease. Any idea where I could find such a monster? :blush:

29

Thank your for your advice! I think I get so overwhelmed and frustrated when I think of all the ways my disease is impacting me and how it isn’t impacting other people. I know that it’s unhelpful to think this way, but lately my thoughts have been taking this turn, and it’s harder to get them to swing back towards the control I do have. I think without realizing it, my last week’s goal was to finally make a post on here and just let go of all that I was feeling. I’ll have to think on what I want to take on next. I plan on taking your advice and taking it one step at a time. It becomes too much when I try to think of everything all at once (which I have a tendency to do!)

30

Thanks Maurie. I unfortunately don’t live in the Boston area, but perhaps I can find something similar in my area.
I hadn’t even considered this an option to turn off my CIQ or play around with it to see how that could work for me. I like the mindset that each of these functions can be considered a tool to use as opposed to my only option. I guess I don’t always feel confident making these changes and decisions on my own.

31

My A1C was around 6.7 the last I had blood work done. A few weeks ago I was having between 70-80% in range on average. These past two weeks they seem to be closer to 50-60%. I appreciate your response. I am going to try to communicate more with my endo.

32

Thanks so much for your response!

I have heard of changing the pump setting to sleep mode during the day. May I ask, how does this work to improve numbers? I’m not sure I understand.

I read an article that was discussing a man in the U.K. that had been delivered a mass dose via his Omnipod. I think I clearly freaked myself out a little bit (haha). Maybe I need to cut out some of my doom scrolling on the internet too.

I do need to stop comparing myself to others. I think I’d struggle with this issue whether I had diabetes or not, so it is something I’m working on.

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33

Thank you- I will have to look into this and discuss with my endo!

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I appreciate your wisdom in dealing with this, and I commend you for your determination. It really is hard to keep trying some days.

I do think I need to be more honest with what I’m eating or pay closer attention. I do find that it helps if I decrease my serving of carbs. How do you cope with the human side of things like wanting to eat sweets or junk? I don’t think I ever realized before being diagnosed how much of my life revolves around eating less-than-healthy foods. If I’m being honest, I miss being able to eat those foods without thinking or fretting so much about it. Do you still feel you are able to enjoy food while eating a low carb diet?

35

Thanks Jim. I really enjoy nature too. That helps keep stress levels down or to at least focus on something else for awhile.

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36

Thanks for your reply. I was diagnosed when I was 23, and I am 28 now, so it has been almost 5 years. Prior to this I had maintained an A1C between 6.6-7.2. I have been on the Tandem Tslim x2 pump for about 9 months. Prior to this I used injections exclusively.

37

Thank you! I will check these out. :relaxed:

38

Thanks for your reply! I will have to look into this.

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39

When I first switched to a pump about 4 months after I was diagnosed with type 1, I worked closely with a diabetic educator to get the settings right. I was in contact with her 2 times per week. She made small changes each time I sent my data. Gradually we got it right and I have not had many changes during the last 2 years. My HbA1c is 5.4-5.6. I suspect your settings need a major adjustment. Do you have someone in the endocrinology office who will commit the time needed to get it right?

Good luck,
Jane

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40

It sounds like you need to review how the different modes operate - that may help you understand why you’re having so much trouble!

Sleep mode gradually adjusts the basal rate and does not give any boluses, as regular mode does. The target blood sugar is also lower. I want lower numbers and less unpredictability with automatic doses, so I prefer sleep mode and will give myself correction boluses as needed. I use exercise mode prior to working out but not during. If you know what the algorithm will do, you can use it more efficiently.

Whatever you do, you need to remember that the pump is a TOOL - not a independent device that you can leave to work on its own. IMHO we are not there yet, technology-wise. It will take some time but it’s worth the effort.

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