Hi, gang. I’ve had T1D since 1975, and currently use the Omnipod pump and Dexcom G6. I’m focused and diligent about diet, exercise, and diabetes management.
I returned a week ago from a trip to Hawaii (I know, life is tough!) and since then I’m really struggling to get my BGs down. I’m hanging in the 150-225 range and in spite of correction boluses, long walks, carb restriction, pump changes, and breaking out a new bottle of insulin, nothing works. Gah!
Complicating matters is that I am between endos (my wonderful guy left last fall and I don’t see a new one until next month) and sadly my primary care doc just died. Adding to what the experts call “barriers to care” is that I live on an island and every specialist is on the mainland, a two hour round trip boat ride away.
Sorry, this has now turned into a poor poor pitiful me rant! Does anybody have any helpful ideas to tide me over until next month? This community is a great brain trust, so thanks in advance for your help.
My guess would be that you’re fighting travel germs. Even if not really symptomatic, your body could still be fighting. Think standard sick day rules… Especially hydration, plus the usual check ketones, whatever crazy amount of insulin required, etc…
Not sure if this is applicable to you, but I had this problem a couple of weeks ago…days of bg’s in the 200-300’s. Changed the site, changed the bottle of insulin…nothing worked. Finally gave myself a shot, and it worked.
Discovered I’ve apparently developed some scar tissue, and those two sites weren’t working. Moved the site yet again, and all is well.
I don’t produce keytones, but running that high for days totally wore me out. Good luck getting this under control.
Did you gain any weight on your holiday? I know I’m always tempted to relax my eating habits when on vacation and I do make some exceptions due to my interest in enjoying the culinary delights of my destination.
Like @DonR says, yeah. Best way to eliminate all those pump variables from the troubleshooting, not to mention get your BG back where it belongs while you’re figuring it out. And having been in the situation you describe all too many times, it’s amazing to me how often I forget this option.
I had some unexplained high BGs a few weeks ago, and I think it was because I was super active the week before and then went back to my usual level of activity. Maybe the extra walking gave you a boost and your body needs to re-acclimate?
Totally. I end up doing an injection way too late in the process. I guess I am still figuring out the pump. It’s been four years now, so I am not all that experienced.
The ironic thing about all this technology is that my A1c was way better when I didn’t have it. I had WAY more hypos back then, which skewed the A1c lower. It’s not bad now - usually hanging just under 7 - and after 45 years the only complication I’ve had is trigger fingers. Heart, kidneys, circulation, and eyes are all good. It’s a blessing. But those Dexcom ads that say the device puts YOU in charge of your diabetes make me laugh like a hyena! As if.
I disagree vehemently with you blowing off the usefulness of CGM tech. I’ve been saved from COUNTLESS lows since I’ve been wearing a CGM during the past 2.5 years. Using a meter-only doesn’t do much for safety when one is asleep. I used to check 17x a day on average and it wasn’t nearly as safe for me as wearing a CGM.
Dave44, you misunderstand me. I acknowledge in my post that the Dexcom technology has helped me avoid lows. I think my situation shows that even with great tech, there are times when I am not really in control of my diabetes because weird stuff happens.
I am glad you are happy with the Dexcom. I am not unhappy with mine. But being in control - for me - would be normal blood sugars all the time, without tweaks and corrections and constantly changing basal rates. Being in control would mean not having to worry about lows OR highs. Being in control would mean not over-treating a low because the Dexcom doesn’t catch up with my rapidly rising blood sugar. Being in control would be trusting that the Dexcom numbers are accurate. Here’s an interesting update: after a correction bolus yesterday afternoon - as recommended by my friends here - I had a crushing low of 37 but my Dexcom blithely informed me I was 85.
Being in control would be great. We make the best use of what tools we have. The tools are getting better, but they aren’t where they should be. That’s my beef about what Dexcom claims.
Yeah, back in my MDI days, both on Lantus/Novolog and R/NPH before that, I used to get yelled at if my A1C got too far below 7. “You can only do that if you’re having too many hypos!” was the rule, and it wasn’t wrong exactly. Like you, I also had higher BGs when I first transitioned to a pump, though once I got the hang of dialing in my own basal settings I ended up doing better. Took several months. That was pre-CGM for me, though, and at least in my case CGM would have helped a lot. My DBEs had that institutionally-ingrained hypo-aversion that made them far more cautious and incremental than they or I would have been if we’d had a CGM for real time data instead of just finger sticks.
Indeed! Once, about 20 years ago, I had an A1c of 5.4 and my endocrinologist told me to relax and eat a cookie! And after having two successful if difficult pregnancies my obstetric endocrinologist told me to just stay below 200 and I’d be fine. (My boys are 28 and 30 and both got married this year!) I tend not to obsess about the A1c too much, if I’m under 7 I think I’m doing pretty well.
I don’t think I misunderstood you. You continue to mention that being below 200 is fine. I got it. I simply don’t agree with that being a laudable goal. It’s your body–I’m just pointing out that tighter control (assuming one doesn’t kill themselves with insulin) is commensurate with long-term success. Success being the absence of debilitating complications. Take care!
Thanks for sharing your experience, Ruth. It’s really helpful to know others have been through the same thing! I hope you are doing better now. T1D is not for the faint of heart!
Um, I mentioned once that I had an endo who told me to stay under 200. I didn’t say that was fine, and I don’t say that that’s my goal; it’s not. An A1c of <7 is recommended by the ADA to avoid long term complications. I try to keep my AIc under 7. After 45 years with T1D, I have no long-term complications. No neuropathy, no retinopathy, no circulation issues, no kidney disease. This is not due to my extraordinary diabetic virtue. While I work hard at it, and am as diligent as I can possibly be, I believe I also am blessed with a certain degree of genetic luck. And even so, sometimes things get temporarily…strange.
That’s why I came here for help. This community understands my struggles and can give good advice and wise perspective. Everyone’s story is different, everyone’s diabetes is different, but we all share so much.
Thank you all for being kind, truthful, and helpful.
UPDATE: After whacking my high blood sugars hard with the insulin stick yesterday, my body seems to have rebooted and I am now back in the normal range. What a relief!
You continue to mention that being below 200 is fine. I got it. I simply don’t agree with that being a laudable goal. It’s your body–I’m just pointing out that tighter control (assuming one doesn’t kill themselves with insulin) is commensurate with long-term success. Success being the absence of debilitating complications. Take care!