Hi,
I’m Ashley. I’m new here. I was diagnosed with T1D just 2.5 years ago when I was 23 years old.
I’ve maintained fairly good control ever since then…until recently.
My post meal blood sugars have been outrageous. My eating habits have remained the same. I’ve been using the same amount and type of insulins (Lantus in the morning, apidra with meals) and for some reason my post meal BG has been running an average of 235-285. That is 2 hours after I eat.
I’ve tried switching my Lantus to the evening instead of morning. I’ve tries changing my carb to inulin ration from 1:15 to 1:12. I even tried 1:10 this afternoon and still ended up with a 240 after 2 hours.
I’m so frustrated. Is it normal for your insulin sensitivity to change after having diabetes for a while? Any idea on why this may have started all of a sudden or what I can do to correct it?
I called my endo today for an appointment, but can’t get in for a month. I really don’t want to let the high BG go in for that long.
Any advice is appreciated.
Thanks!
Ashley
Hi Ashley,
Sorry you're having this problem. Are you eating the same thing you normally do? Maybe there is a new reaction to some foods that could cause these spikes like being gluten sensitive. I would probably try higher bolus doses as long as you don't go hypo.
You could try some exercise before eating too if possible.
I'm sure others will have some good advice for you.
I actually did change my diet a little. I was recently diagnosed with a few food intolerances. Things like gluten, corn, chocolate, and bananas... just to name a few. Do you think having these items occasionally could be contributing to the unusually high blood sugar?
We have had diabetes for about the same length of time— for me it has been a constant game of readjusting and reevaluating. It is not unusual for my doses to change substantially. Just keep fine tuning— more bolus and or less (and slower) carbs until you find balance again… Take notes as you go… That’s what has worked for me
Did a real doctor diagnose you with those intolerances, or a “naturopathic doctor”. Just curious?
My chiropractor recommended the test for food intolerances. The actual test was done by ALCAT. I believe it's a national company that does these sorts of things. Would there be a difference in results if done by a "real" doctor?
I can’t say for sure but in my experience “real” doctors tend to just roll their eyes when chiropractors, naturopathic docs, etc make these kinds of claims. Who knows they may be valid but I’d run it by a real medical doctor before changing your life based on it.
Learned that the hard way… Took my young son to a naturopathic doc once who ran all sorts of tests and several thousand dollars later (since insurance wouldn’t cover) declares he was allergic to gluten, soy, casein, and had excess yeast in his intestines. I immediately went to see a pediatric GI specialist who immediately threw all those test results in th garbage and told me not a single one of those “labs” was medically valid— several other docs since told me the exact same thing
Very interesting. Thanks for the info. I will definitely look into that. I'm sorry you had to go through all that hassle and expense.
Regardless of the reason you need to learn how to test and adjust your basal and rapid insulin with out having to wait for endo.
Have you read either Think like a Pancreas by Gary Sheiner or Using Insulin by John Walsh?
Both books are outstanding resources for diabetics using insulin. You can get both in hard copy, but they are both available for instant download for e-readers via Amazon.
First thing you need to do is a basal test to see if your Lantus dose is keeping you steady when you are not eating. This gets broken down into 3-4 time segments over the 24 hour day. Once you know that the basal is good then you need to look at your rapid insulin and how it works for you personally.
You will need to test your duration of insulin activity (DIA), and then look at your CF - correction factor and then your IC - insulin to carb ratios. This will require pre and post meal testing as well as good records of your insulin dosing, carbs consumed, time from dose to start of meal, and BG peak post meal.
Both books will lead you through the process. Don't be surprised if your IC ratio, and CF vary through the day. Some of us can eat more or less carbs in the am vs pm. Sometimes it's the type of carbs vs time of day. Be sure when you track your meal time info that your keep each meal desperate. It will let your see if this is true cor you at this point.
One thing that is a constant with T1 is that it will always change. Things will drift up and down depending on amount of insulin you can make,type of carbs you eat and when, hormone cycles, activity/inactivity levels, phases of the moon etc etc.
Understanding how to test and adjust is a very important part of good control. We all have been there. Knowledge is power. You can do this!
Life is always throwing us curves. Sometimes you have a period of time where your insulin production just slowly draws down. The "Honeymoon." It is much more common in adults. And a honeymoon may last literally for years. It is also true that as you get older you may get less active. For all these reasons it may not be all that surprising that your insulin needs change.
First, if your premeal blod sugars are elevated you may need to adjust your basal. If you are constantly high before your meal (and generally during the day), then that alone can make you insulin resistant and require more insulin to handle meals. And we need as much insulin as we need. So if you need 1:10 or even 1:8, then do it. But first I would recommend that you spend some time "normalizing" your blood sugars. Eat lower carb, correct any high blood sugars promptly and then try to figure out what you proper basal and ratios should be.
ps. And the ALCAT test is not generally considered a reliable test by mainstream medicine. You should see an allergist who will do percutaneous tests, test your IgE and suggest you do food challenges. There are accepted tests for allergies that are covered by insurance.
Thanks for the advice and book suggestions. I haven't read either but will be downloading them tonight.
I had heard of the "honeymoon" phase but never really knew what it was.
And thanks for letting me know about the ALCAT test. That is upsetting. I paid quite a bit to have it done. :(
I have had problems with wheat/gluten and dairy my whole life with symptoms and after D diagnosis I noticed wheat products nearly always spike my bg. I think it can cause lows too. BTW I did have testing done at a GI and an upper endoscopy for other problems at that time but the celiac test, I think that is what was done, was negative so I assumed it was something else. I recently had another done but I'm not sure of the results yet- however I had eliminated gluten so I'm not sure if the test will be accurate and I may have to retest. Even with a negative test you can still have sensitivity to foods, or the test could be false negative, or as with lactose intolerance, you may need a more sensitive test sometimes to find if you are intolerant or not. I have spoken with at least two doctors who acknowledge this and that the tests aren't always accurate. I would determine what is good for you personally by your symptoms and reactions to various foods.
Hi,
this may be a wild shot in the dark, and do forgive me if I am off-base, but is there any possibility you could be pregnant. in women, that can cause a dramatic change in blood sugar control.
Nope. Definitely not pregnant. I have heard that this can happen during pregnancy though.
2hobbit, many of your replies have been spot on. However, your frequent comments on “Using Insulin” by John Walsh as being available in eBook format are not accurate. I purchased the hard copy edition of the book but have not been successful in locating an eReader/eBook edition. If you have information to the contrary, I would definitely appreciate details and a link.
I am not 2hobbit, but here you can find a download (you are correct in that it is not available as an eReader/eBook): http://www.dlwares.com/
You will need to type using insulin in the search ribbon.UGH! Still high again today. I increased my Lantus dosage by 2 units yesterday and woke up with a fasting BG of 131. Much better than it has been.
I had a bowl of rice krispies for breakfast, I realize it is a high carb food, but I am allergic to most other breakfast foods... oats, eggs, wheat, corn. Anyway, I increased my apidra and took 1 unit for 10 carbs and two hours later my BG was 251!!! I don't undertand. It rose 120 point past my fasting blood sugar. Its almost as though the insulin did not work at all.
I took a correction dose 45 minutes later, because it hadn't come down much. And ended up hypo with a 49.
I dont know what else to do. I'm so frustrated today. :(
Sorry to rant.
Well it sounds like your lantus dose is getting closer so that's progress... Give it a couple more days at that dose and see what you think. I don't think most of us could eat rice crispies first thing in the morning without similar results. I gave up on all cereals almost immediately when I realized how hard to manage they are. Try huigh protein, high fat breakfasts (just edited this post because I reread that you're allegic to eggs, maybe egg-beaters)