I feel very very sad these days, everything I was doing this year after my Dx last November doesn't work anymore. I feel so depressed and hopeless. It seems as I haven't seen the proper D yet. I think I've stopped honeymooning just now a year later (was lowcarbing pretty much since DX, plus was breastfeeding almost 10 months after DX as well, so I had good results like 5,6 and 5,5 in a1c). Now I've switched from NPH to Levemir, and was indeed experiencing good results for a while, but then I had to increase basals and still get high numbers in the morning. Usually it is due to my low carb overeating moments in the evenings. I just can not stop eating! (LC food, but still)
I feel miserable because everywhere I read people get satisfied with LC, they eat less they lose weight. Me on the contrary feel always hungry, despite of large portions of protein (which give me high postmeal BG :( hours later, could be 5-8 due to fat/protein combo).
I am trying to use Regular (Actrapid) for my meals, and had good results for a week or so but now it is out of control again. My family thinks I should increase my carbs intake (they don't know how else to help me) and increase my insulin, but I am so afraid of getting out of control even more. And gain weight.
I guess I don't have a question I just want to talk with you guys, I feel so lonely and hopeless. I understand that it is pointless to look back, what happend happend, But I can't stop going back in my thoughts and try to understand why and how this could happen.
I don't know how to go on. I am stuck in mourning phase. And it is getting worse, now my D control is horrible :( and my family suffers with me. It is pretty selfish but I don't know how to turn this situation around.
Thanks for reading.
To be honest, if I'm making a value judgement, it doesn't seem like the idea of having diabetes has ever gotten easier to think about.
However, as far as treating and managing my diabetes, I feel like I'm a lot better at it now than I was 30 years ago. When I was honeymooning at the beginning, I definitely had "better" numbers on paper, but I had no idea what I was doing. Now, 30 years later, I feel having the honeymoon was like having training wheels. Just like learning to ride a bike, though, the first time the training wheels came of, I ran face first into the side of a car. When I finally came out of my honeymoon, that was whne the real management began. I was completely on my own, but with more control over more aspects of my diabetes than I had ever had before. Sometimes, I ran into cars.
I can only speak for myself, but the idea of having diabetes has never been "comfortable" for me. I'm on edge regarding what I have to do, but it keeps me honest and it keeps me focused. I feel like the Red Queen, but, for now anyway, I feel like I'm at least making a race out of it.
You are looking at a lot of things in a very negative way that, from where I sit, are positives. A year of honeymoon? Lucky! we didn't get one with my son. a1c of 5.5/5.6 during that year? Lucky! I have yet to get my son below 7.2, never mind into the range you're talking about. New baby? Lucky! What a blessing that is, D or no D.
The "bad results" you're talking about are probably just you needing more time to get used to the reality of type 1 diabetes post honeymoon. Cut yourself some slack -- after a year of honeymoon, not to mention the wackiness that accompanies postpartum hormones, it will take some time to get used to the ebb and flow of your insulin requirements. A week is nowhere NEAR enough time to figure that out; you're trying to do in 7 days what it has taken me years to unravel, and I'm still working on it. As for the "why did it happen?" question... would knowing the answer change anything in the way you care for yourself? Would it change the fact that you have diabetes? I know already that the answer to the second question is "No", but you alone can answer the first one. If you answer that question "no" as well, then wondering about it really does not help you any... and I don't want to sound mean, but trying to answer a question when finding that answer is of no benefit to you is a waste of time and energy.
Did you ever consider maybe the reason you're always hungry is because maybe you need more carbs than you're giving yourself? Not everyone thrives on a low carb diet. I'm not saying you should go out and chow on pasta, but if you're hungry, your body is looking for something you're not giving it. Listen to it.
I get the sense that you're working for perfection. Perfection is an unreachable goal... you'll just make yourself miserable trying, and there are better things to do with your energy. So let go of the need to be perfect and just try for doing the best you can. Because what good is it, managing your diabetes perfectly, if you can't enjoy life while you're doing it?
Yes, Tabacblond, it does get better. Personally, I struggled to accept the fact that I have diabetes for many, many years (I already had it when I reached my teen years, so you can imagine the rebellion), and those years were SUPER hard. I acted out, binged on all manor or hi-carb food, had explosive temper tantrums... At this point I have accepted it, and my life is much easier as a result. I think the psychology of having diabetes can be far tougher than the disease itself. So be nice to yourself and recognize that this is a long process you are engaged in, but each time you go back through all those stages of mourning you are getting closer to acceptance.
It gets better; it gets worse; it always changes. But once we learn to ride the waves, D isn't quite as emotionally draining. If you're worried about having post meal blood sugars hit 8 (144); you'll have to get used to it. My last A1c was under 6 and I had plenty of 160s and above including a few 200s.
I want to second what Elizabeth said about low carbing. I do best when I eat 3 meals a day each with between 50 and 70 grams of carb. I'm not suggesting you bump up that much but you may find that low carbing isn't your best strategy. And being hungry all of the time is no way to be happy.
I had a period where my BG got out of whack, I got a pump and it made an enormous difference. A lot of what I've learned from pumping and later CGMing (I dunno how readily available these are in Sweden?), is that little adjustments can make big differences. I am very lucky to be a fidgety tinkerer so, if things are off, I fiddle around with it. I also am not "gun shy" about turning things up when my BG is off. The only time I've had a conversation with a doctor about my rate, by the time she contemplated my numbers and had her nurse call me back with "orders", I'd already done what they'd ordered (I should have asked for a refund...).
The other thing that I've always done is throw myself into other activities, even when they were uh, horrible (partying, rock bands...), I had to test my BG so I could make sure that I was passing out b/c I was wasted, not b/c I was hypo. Fortunately, many of my friends were in the same boat so I wasn't stigmatized for accidents. More recently, I went through a stage of reading a lot, in late 20s/ early 30s (although I did one more rock band...which was a blast but super frustrating...) and then started exercising to help burn off weight. Diabetes is always a huge pain in the ■■■ but I am not going to let it get in my way. I will keep fighting it until I'm dead or, perhaps a horrible thought, I get put into a home and someone else will control it, a thought which makes me more nervous now as I'm not getting any younger and well, I have a horrible disease. I don't know what to say but I am totally selfish but I lug my meter and Smartie Beans around and do what I need to do. Some times I $*&% up and have to fix stuff and that's what I do.
I couldn't agree more Maurie! It's a constant roller coaster. You will have ups and downs as long as you have diabetes. And it is constantly changing. Once I finally think I have it right, something else throws me in the other direction! It can be really tough to think positively all the time. And as far as I'm concerned, that's OK!
I found I was tired and cranky all the time on low-carb. I prefer to have some carbs in my diet. Not a lot, but enough to keep me feeling good! And yes, I'm going to recommend a pump. It's a life-changer :)
God, grant me the serenity to accept the things I cannot change, The courage to change the things I can,
And wisdom to know the difference.
We have to do what we can do in life to manage our diabetes. If you set your expectations to something that just cannot be achieved, you are setting yourself up to be unhappy. Instead of focusing on some number, focus on the real thing that matters, that you are taking care of yourself. I still cannot get my morning numbers down, I routinely am rising 50-100 mg/dl overnight. I do what I should to deal with it, but things are the way they are, so when I awake I just take a correction and move on.
Think about setting goals that are achievable and really matter and don't get all focused on a number.
First, thanks for sharing how you are feeling! We are all here to learn and to support each other!
And it sounds really hard and painful to face the end of the honeymoon. We know that the change is most likely that, but there are still other possibilities.
It sounds like you've made changes in both your insulins. Was that recent? Is there any chance that either of those are out of whack for some reason?
Do you have any other illness or infection that might be affecting your blood sugar? Stress can do it too, as I'm sure you know.
Are you getting enough fat in your meals? Sometimes that helps with the satisfied feeling. Or maybe thinking about what food you long for when you're hungry--is it something with fat? Dairy? Protein? Carb? It might help clarify what you (or your body) feels is missing. I also really want to eat when I'm stressed, even if I've just eaten a lot.
And then there's hormones.
And thyroid balance.
Plus it's cold, dark winter!
Please be kind to yourself. And please let us know how it's going for you.
As some others have suggested, I think you need to loosen up on the carb restriction. This is my opinion, undoubtedly not shared by others, so take it for what it's worth:
Low carbing as a management strategy is for experienced diabetics. It is a second or third-tier strategy -- not something to be implemented as a first-order control mechanism for people just getting started.
When you're having control problems, carbs can be your friend rather than an enemy. The most direct, most immediately relationship to BG come from carbs eaten. Fat and protein are quite a bit dicier, given the slow digestion, and variability of liver gluconeogenesis from protein. A lot of things impact the metabolism of protein, so it's harder to account for it in insulin administration. So....
When you're having trouble managing BG and your on a low carb regimen, shift calories from protein to carbs, 5g of carbs at a time (thereabouts). This will give you more control -- you can manage what you eat, insulin you administer to cover it, and the relationship between the two is much more predictable.
HOWEVER!! Be careful. If you have a tendency to binge, or have difficulty with self-control in what you eat, do not do this free-form. Sit down and make a list of stuff you're going to have on your menu, then stick to it. Adjust the menu as you go, adding/removing higher/lower carb things as needed. Most of all, watch portions.
Low carb is not the panacea many of us here make it sound like. I generally try to keep my carb intake low to moderate, 60-120g a day. However, I'll modify that greatly depending on how my demon diabetes is feeling like acting during the day, and if I'm having control problems, I shift more to carbs and it helps me get under better control.
Having had diabetes 44 years, one thing I can tell you is that you have to take it one day at a time.
Don't expect perfect numbers, but look for something obvious you can do to improve control. Talk to your healthcare provider about this.
The thing is also that stress and female hormones also affect blood sugar, as does illness , not enough sleep, diet and exercise.
So think about one positive change you can do FOR TODAY, to help make things better.
The problem with chronic illness is that you have to live with it each day... good days and bad.
Maybe low carb is not the thing for you. Maybe 5 or 6 small meals per day might help with the hunger. Do what works best for you, not for what works best for everyone else. You are unique.
I think you've gotten excellent advice on the limitations of ultra low-carb eating for T1's. I think you have yourself identified the two major limitation of ultra low-carb for T1's - namely that bolus insulins (which all long-term T1's need to take) act much too fast for a meal consisting almost exclusively of protein and fat, and that eating a lot of fat runs the risk of overeating due to its very high caloric density.
I think you've also gotten excellent advice on trying to lighten up on yourself. You're obviously trying very hard and as long as you keep trying you WILL figure this out. As many of the other long-term T1's have pointed out, you're way ahead of where we were for the amount of time you've been diagnosed.
I'll just add a link to a response I gave to you several months ago about this same issue LINKHERE and apologize that I hadn't seen your question back to me. You asked "When you eat mixed meals - do your bother to make extend boluses after 3 hours, when proteins turn into BG? Or is this like Scheiner theory - if you eat higher carbs you don't have to?" - my answer is that for most mixed meals that have a healthy mix of carb/protein/fat with some vegetable and fruit fiber, that the rapid acting insulins are a very good match, and I don't get a noticeable rise from protein/fat after three hours so there is no need to extend boluses (plus I don't have a pump and couldn't extend boluses even if I wanted to). I do check BG after eating meals to correct if necessary, and think that is a good practice for any T1.
Good luck, there will always be bad days, but it WILL get better.
It appears to me that your emotional challenge with D is making it harder for you to deal with the nuts and bolts of managing your BG. Despair and frustration undermine the energy needed to make a sustained effort. Perhaps something that addresses the emotional side of dealing with a 24/7/365 condition would help you to break the cycle. Or at least reduce the extra stress that it creates. Professional talk therapists might be one tactic.
Does the lack of sunlight this time of year bother you? Perhaps some light therapy to combat seasonal affective disorder (SAD) may help. Vitamin D levels also suffer when sunlight diminishes.
Once you start to feel better emotionally you can address your food/insulin program. Maybe if you reduce your diet for a few days to some simple limited fare that will allow you to learn about your I:C and background insulin needs. If your diet starts out as limited in amount and diversity of food then it could make analysis easier.
The problem that you describe is very much like the question, "Which comes first, the chicken or the egg?" You have an emotional/psychological challenge made worse by out of range blood glucose. If you break the psychological burden then that would allow you personal resources to address the food/insulin issue. Alternately, if you address the food/insulin problem and restore reasonable BG levels then your emotions should brighten. Where should you break into this vicious downward cycle? Only you can make that choice. You could even choose to work on both problems a bit.
Take it easy on yourself. Set limited and achievable goals. I know it's so hard when you're in the bottom of a hole looking up. Unfortunately there are no easy solutions. Sometimes you just need to persevere and let the passage of time move you to a better place. It's not easy. I wish you success and peace!
thank you! It does. I think I thought that with going LowCarb I would prolong my honeymoon for a long time, but this is not the case. I need to start over.
For some reason I am really afraid of the idea needing more insulin. I can not say I had super small dosages before, but now I am terrified every time I take insulin. I know its irrational behaviour, but it seems like I am loosing control instead of getting one.
"Why" question is really bothering me, I don't have closure somehow. And this is 100% stupid and changes nothing. I know. My brain is really stuck in "Undo" state ... Also very stupid.
I am trying to address my hunger issues in many ways, I feel that all my body signals are not what they used to be. And I really regret reading about amylin & satiety. Now it is somehow stuck in my sneaky brain and justifies my hunger feelings :) It is so messed up right now, I can not tell if I am hungry or not, if I am full or not. It is exhausting then food becomes a big elephant in the room.
I don't really try to have a perfect control, I understand that it is impossible. I really just want to live my life without thinking too much about D, lowcarbing seemed like a reasonable way to do so. But I am not sure any longer.
I think so too. It is more difficult to except the new reality than manage it. I understand that it takes time, and feel very angry that D has such control over me right now. I feel like I am loosing so much energy and thoughts on it. And it makes me very unavailable for my family, I desperately try to speed up the healing process and it backfires me all the time.
Thanks Maurie, I'll try to overcome my "carb fear" and try it for some time.
My problem is I am very impatient person, I try something for a short time and then go to the next thing. And diabetes is all about patience. I will probably have very high A1c next time, my stats are very jumpy right now :(.
Thanks Nicole. Unfortunately, here, in Sweden I am not a good candidate for a pump, because I have a good control, too good control according to my doctor. I am in line to borrow CGM after NY, I hope it will clear some stuff up as well.
