Diabetes, Colitis, Gall Stones, Unstable BG and Weight Loss

I had an unexpected low in the 40s today, and realized - I need advice. Thing is, even following my doctors' orders, I've been unable to consistently keep my blood glucose up. Or my weight. I'm not too thin yet, but at the rate it's going, I will be by the end of the year. Meanwhile, it's contributing to sometimes overwhelming fatigue.

So. I've recently been dx'd with lymphocytic colitis and gall stones in addition to the T1D and rheumatoid arthritis. The gall bladder comes out next week. I'm on a new med for the colitis, Lialda.

My endo's orders have been to reduce my insulin, up my carbohydrates, and allow my BG to rise. My gastroenterologist's orders have been for a bland diet with plenty of refined carbs. Most of the time it works, but then sometimes - like today - it doesn't. There's a correlation between especially bad bouts with the colitis and lows.

For those who will bring it up - I know you're out there! - yes, I've been tested for celiac, and I don't have it. I am mildly lactose intolerant, and yes, I've eliminated most dairy from my diet; all I've kept is cream in my morning and evening tea, which hasn't caused any issues. (Weirdly, cream in moderation never has.)

I don't know what to do next. Or if there's anything I can do, for that matter. I'm hoping some here have dealt with similar issues, and might have some tips.

I'm so sorry you're dealing with all of this, it must be really difficult. I don't have any specific advice unfortunately but hopefully someone else will. Has upping your carbs and lowering insulin helped at all? Maybe try more of both if not?

I'm sorry to hear of your difficulties. Colitis may be causing you to have serious malabsorption issues. And if you aren't getting bile due to the gall stones you may be having trouble digesting fat as well which may complicate (or even trigger) the colitis. I might suggest that if you have a colitis bout it might good to consider ramping back the insulin. If you don't actually digest the carbs that may actually be contributing to your lows.

It sounds like you're dealing with a lot.
My T1 started years after the gallbladder surgery, but I've dealt with both and with the weight loss issues. I had to wait a couple months for the surgery and the only thing that helped my symptoms at all was an almost no-fat diet. Any fat would cause me pain. (Poached eggs became a staple in those months.) So even though you're trying not to lose more weight, think about cutting back on fat for a while. In my case, had to stay low-fat for about a year while my body figured out the lack of gallbladder. Don't know if it will help you or not. But keeping the gallbladder from being inflamed should help your surgery next week. Good luck with that!