Thank you guys! I felt much better after reading all your answers.
I will answer to all of you but it will take some time :)
Tabacblond! first of all, i just want to say thanks for being honest. i've had type 1 for 21 years and while your control can definitely get better, i think it's always a challenge and underlying source of anxiety. it's nice to be able to just say that!
one thing that can make a *huge* difference in your diabetes experience is your endocrinologist. i have had both ends of the spectrum... those who always made me feel like i was doing terribly and those who have encouraged me. i would say make sure you're with a doctor that is a good partner for you. different personalities work for different people.
let me also say that you're never going to get your numbers perfect, so there's no use beating yourself up over it. that doesn't mean that you should stop trying, but just give yourself a little grace.
i don't know anything about the insulin you're taking... are you on a pump or injections? not saying that the pump will magically fix everything, but you are able to make tons of tiny adjustments that might make a difference, such as different basals for different times of day. the dawn phenomenon is a pretty common experience... you're not the only one!
in terms of your low-carb eating, i'll just say i've never done low carb (i love my carbs!!) and my a1C stays around 6. don't be afraid of taking more insulin! if you didn't have diabetes, your body would just be pumping the stuff out!! i'm a vegetarian, so i do have to make sure i'm getting sufficient protein at my meals so i don't feel hungry after.
i hope this discussion has been helpful for you! here's to blue skies and sunshine and a few delicious carbs!! : )
hey...i totally understand what you're going through, i've posted on here many, many times, asking for help as I phased out of my honeymoon, trying to deal with this reality of REAL type 1 diabetes without any honeymoon left, it is like another loss or feels like a whole new diagnosis. Honestly, I haven't figured this out. I too have been so confused about the increases of my insulins, I didn't and don't want to take more either...but we just have to. I understand your fear (do you have a CGM, it's really helped me as I've had to adjust to more insulin, etc..) Also, if you can get blood sugars better controlled and a good, strong basal dose, you won't be so hungry. That's what I have found anyway. I have hardly any appetite when my BG's are within normal range. High blood sugars and lows can cause hunger. Remember when diagnosed, weren't we all starving, literally. :( Also, if you're low carbing, you may have to bolus for protein, do you know how to do that? I hear you too about patience, instant gratification doesn't work here especially when adjusting basal insulins (i've learned this the hard way), we (you) have to stay with something for at least 3 days, unless terribly out of whack from highs - lows, to see the effects on your body. maybe post some numbers, etc...and maybe we can try to help? I'm feel like this often, to the point where I don't frickin care..i went for a few years after diagnosis (over 3 years in now) where I never went about like 130's and now I'm all over the place, higher highs and lower lows, but that's what this disease is, that's what my endo keeps telling me. it sucks but..nothing else to do but do our very best, ya know.
Brian, Do you have a CGM, can you do a trial one if don't have one? Could it be you're taking too much and having a rebound effect. I'm having the same problem, it's the d@mn overnight I can't get under control on MDI, last night..again, was 108, within an hour i'm at 190..and it's too early in the night to be DP..ugh! Makes no sense and so frustrating.
actually, low carbing when i was honeymooning worked great! i was able to eat protein, veggies, etc..with NO insulin or very little. but now, i have to bolus for it and for everything else and a meal high in protein is a big challenge. I agree, carbs can be our friend and that's how the analog insulins were designed, to work with carbs.
You aren't alone. I think we are all struggling with D in one way or another. The thing is we can all give each other advice but imo we are all so different and no one can really say what is going to work best for you, only you can do that by experimentation and changing things as your D changes. I'm still honeymooning I think, but my management is anything but easy. I work very hard at it and I still fluctuate all over the place. A lot of the time there is no reason for it! I just have to get better at accepting that. I feel pretty much hungry a lot of the time on insulin period, it doesn't matter what I eat, lo carb or not, and I feel tired too- there are days I just want to sleep all day. I also am mourning what I lost more now,( at first I was just in such a shock from all the health issues I was dealing with etc.)- my good health and my life as it was without constant worries and controls on what I eat as well as all the other stuff we have to deal with. But what choice do we have? Without insulin and managing all of this we will be dead pretty soon. I think as an adult if you were pretty healthy your whole life you have to give yourself time to work through all of those feelings. I just try to find something that is happy everyday and to enjoy the food I eat and be thankful if I didn't fluctuate around too much.
Nailed it!
Dear Lots,
Thank you so much for this wonderful post! I'm going to print it out so I can use it when I get discouraged to remind myself of the perspective on life that I want and the steps to take to get there!
Thank you!
marty1492
Thank you, Sarah!
I will probably get CGM after NY, hopefully it will help to clear some stuff out.
As to my appetite, it seems if I don't eat - I am OK, I can do long fasting with great numbers, but as long as I start to eat, it is hard to stop. May be it is not only amylin/diabetes, may be it is psychological. I've been addressing all that stuff both with therapist and through my own research. I've read many books on that topic. But I do still struggle. I understand that all those techniques they describe do not work if you try to loose weight. But I really do need to loose it. I am impatient. I feel a bit childish, but I want to proof to myself that I can control my weight despite all that insulin I inject.
I was never able to go without bolus insulin since DX, as you describe below you could. I've always had to bolus both for protein and even 10% fat I was experimenting with (moderate protein and high fat). High fat made me really sick and did not help me with my hunger at all.
The only time they checked my C-peptides it was at the time of DX and I had like 0.3 (where normal is 0,5-2,5 ng/mmol). I want to know what is happening now, am I really out of honeymoon. So I've spoke to my endo and she ordered new C-peptide tests and thyroid hormones. Hopefully it will clear some stuff out. My previous thyroid hormones (checked 2 times since DX) were just fine.
Hi Acidrock, thank you!
CGM are available but are for people with out of control diabetes management,according to my endo, as well as pumps. I spoke to my endo and hopefully I will get to try CGM for a month after NY. Really want to understand what is happening.
I try to check my BG during nights as well, but being a toddler mom it is not always possible, LOL. usually I am too exhausted to get up. I understand that I probably miss the window to inject some insulin to prevent DF. And when I get up with high BG in the morning the whole day feels ruined. Blaah.
At some point I am thankful to get D so late in life, I was 33 (actually I got it 1 day before turning 33, Happy Birthday to me! Now I will always have something else to celebrate), so no heavy partying and rebell stuff for me, too old for that :-) but it still feels bad.
But I still wish it would happened later in my life, not the same year we've finally got our baby (after years of IVF challenges).
Thank you Brian! I've learnt so much by reading your posts! And thank you for taking time explaining Regular math to me!
I will try to set reachable goals!
sounds like me :)
Hi Marty!
I did a number of changes.
First, I've changed NPH HUmulin (I had split doses, morning and evening) to Levemir. They put me on NPH due to breastfeeding. I had great numbers for 2 weeks on Levemir. Then my morning BG started to crawl up. I had 5 units in the evening and 6 units in the morning according to my endo prescription. But then I did basal tests - fasting until the evening, and had to increase both dosages to 8 and 8 units morning/evening.
As to my bolus. I was practicing "extended bolus" with Novorapid almost from my DX. I usually took 1 - 1,5 units before meal and injected more after 1,5 -2 hours to address my proteins and fat. But lately I've started to experiment with Actrapid and had marvelous results, but now it changed as well! I can get great numbers after 2-3-4 hours but then I get high, and I mean high. Like 10,9 mmol. I never had those numbers before. I can not inject more before my meals, I will go low.
I tried opting fat to the LCHF levels - with moderate protein, but I couldn't handle it. I was and still am Fat-o-fobic, despite of all the research and everything I've read about fat. I felt disgusted eating all those sauces and butter and so on...
Actually, my last visit to endo almost resulted in statins, I had super high cholesterol ratio according to her (I've checked it later, it was fine, and she never ordered ApoB/ApoA1), but I've got scared. So I am back to my "mediterranean"fats - olive oil and no bacon :)
I really don't miss or crave anything in particular, I miss the social stuff of going out for coffee and treats. I had bad experience of letting myself indulge in nuts, the only food from my past I could eat without any serious consequences, Until this got out of control as well, plus 1000 easy extra calories a day and high BG after like 8 hours or later. I now do not buy nuts at all :(
I need to overcome carb fear and try that for a while :( It seems like with protein I really never now how soon it will be digested, when do I need to inject additional insulin and dinners are the worst! I can not eat at 5 o'clock in the evening, it is not possible in our family at all, as well as skipping dinners. We need to teach our daughter good relationships to food, and me sitting with an empty plate won't do it :(.
Thank you, Dave, I will try your suggestions.
I tried to keep my carbs under 30 for awhile and it did work, but then my body got very efficient in converting glucose from proteins, that is why I had to increase my basals. At the end I was doing many Novorapid injections and I got tired of it. It was like never ending story. If I took more than 2 units at once, I got low, if i waited I got high. That is why I've started using Actrapid.
I am binge-prone person as the last year has shown :( portion control is very hard for me. My sneaky animal brain always finds it's ways :(
Thank you ame e!
I am a "nextopia" person, it is very hard for me to live day by day. That is why D is so hard on me I suppose. LC was the way to get into control without spending too much time counting carbs, etc. It seemed like a way to go and prolong honeymoon. But I got other problems instead :(
Hi Terry!
Thank you for your insights. I did talk to therapist and it got a bit better, but according to her my issues were not D related. (I don't understand how that turned out :-) thought).
I've stopped seeing therapist right now, because it was too emotionally draining. I never got any help at my hospital with therapist who is trained working with people with diabetes. I went for a week of D-education last year and had a chance to talk to social worker and she was not much of a help.
I take D vitamin, I will try light therapy. It is very dark here this time of the year. It was not bothering me at all previous years, but now I found it difficult.
I've read books and forums on the topic of binge. Unfortunately, many people after years of therapy still don't quit the binge behaviour. There is one particular book Brain over binge that was helpful to me for a while. I will continue to practice it's insights.
I guess DrB with his "diabetics are entitled to the same blood sugars as non-diabetics" made my life more difficult :) 4,8 average is not very easy to get :)
Thank you Jag! Novorapid was a very bad much for hight proteins and low carb, I am trying to make Actrapid work.
But may be I will come back to higher carbs level, I was thinking around 50-60. Right now I am too scared to experiment, need to stabilize my BG and keep them in the normal range.
Hi Kristi!
I had great results with Levemir, especially after NHP. NPH worked as a charm for DP, because it peaks right before the morning hours. And I was breastfeeding so NPH plus that worked good as well. When I weaned her then the problems started, I had to increase NPH to crazy levels and still got bad results. Then I've switched to levemir. I take it at 22 o'clock and at 8 o'clock in the morning. I had to increase basals after couple of weeks, after basal testing.
I really don't have that great connection with my doctor, I will see her only once per year. And my nurse is really old school, No figure out my ratios, corrections or anything else. When I read here about how involved some endos are I get jealous :) And the hospital nutritionist they send me to was scaring me about how bad fats are for you and that carbs are essential for the brain :). They do not support my Low Carbing and my nurse keeps preaching about how low my a1c is (that was without crazy highs or crazy lows like I have right now)
Thank you chandra!
I wish I could find that kind of endo you describing. Mine is OK, but she did not adress my concerns about psychological aspects, she did not adress my weight concerns, no working together on ratios. May be she thinks it is my nurse job, but my nurse is really old school and gives me lectures on how bad LC is.
But at least my endo heard about DrBernstein. That's progress for Swedish doctors :). Sometimes I wish they were reading more forums and real people experiences not just PubMEd papers or authorities instructions :)
Great results onith your a1c! You are counting carb wizard! :)