5 1/4 years in, I think I am at the end of my honeymoon. Every time I test nowadays I am higher than target.
Every time I eat I now go high.
Time to reevaluate basal and bolus. Time to get extra strict on diet - am finding myself unable to cover carbs without going high first and low later..... What I could eat before without problems I can no longer eat. I hate being consistent and eating on a schedule / set meals, but looks that that is my future.....
Time to get my exercise schedule back on a daily track!
Time to work really hard on getting my weight to target (I could stand to lose 15 kg at least), so that any insulin resistance will be minimized.
Time to study Bernstein again. :( Time to take the lessons I preach to others on board and apply them to myself. I know the theory, but I sure as hell don't like the practical.
And this is pretty much a matter of life and death, or at least quality in the short term, and quality and duration of life in the medium to long-term.
This is not fun anymore!
I am pretty upset at this development.
I have had a pretty easy run so far, but looks like it is payback time now.
I'm sorry to hear your honeymoon is ending, Sally. Sounds like you've had a really good ride and even though we talk about honeymoons all the time, I think it's human nature to hope it is just how it will be forever. As a LADA/Type 1 who was misdiagnosed as a Type 2, I did my own honeymoon on oral meds, not changing my food at all and testing just a few times a day. When I figured out my reality it became a whole different ballgame. But for me, I guess, I just looked at is as a challenge, first to correctly diagnose myself and then to figure out how to handle it.
I think we all find our ways to mentally and emotionally handle our D and whatever your strategy was originally it might still serve you well or you might have to change it. I know that for me, feeling like "it is payback time now" wouldn't work in the long run, though being pissed off for awhile would be just fine.
Personally Sally I've always admired how committed and motivated and knowledgeable you are. A big difference between that and my own honeymoon where I just popped a pill and didn't think much about it. But my feeling is, and tell me I'm wrong if I am, but that you are someone who always gives it 150% and sometimes that is a set-up for burn out. I could see thinking, "If I did all that before what on earth will be "enough" now?" I know that you have everything you need to handle your "new normal" but you are the one who needs to know that and find a comfortable place to settle, perhaps ironically, a more relaxed, rather than more intense attitude/management?
Meanwhile enjoy the holidays and use them as a time to take a deep breath, come to a place of emotional acceptance and then move on into the new year.
I'm sorry your honeymoon is over. I hope that you can figure out a way to manage it all that will still allow you some flexibility and some choices still remaining for what you can eat. I think the exercise and the weight loss is a great idea. You may find with the weight loss that you will be able to eat more things with less insulin.
Why do you feel you need to eat "on a schedule/set meals", Sally? I tend to eat on a fairly similar schedule, but not rigidly. I definitely don't eat set meals. My breakfasts and lunches have a limited number of variations, but dinner is very varied as I love to cook and try new recipes!
Sally, I'm just going to come out and say this: How reasonable do you think it is, now that you're out of your honeymoon, to stay between 80 and 100 much of the time or even 70-120 for the "vast majority of the rest". I honestly think you might have to revise your expectations. Not saying you should suddenly accept 180 or 200 on a regular basis, but just have a more flexible expectation, or, at the minimum known that if you set tight targets, that meeting them 75% of the time is success. I have students who come to me paper in hand to ask what they did wrong when they got a 90. The work involved to get 100 might be a quality of life thing that just isn't worth it. 90 is a great grade!
As for food. With 19 years recovery from an eating disorder I still tread lightly over my issues, because, yes, D can bring them out. But for me, part of my recovery is to enjoy my food, not just tolerate it, or else I will feel deprived. that's just me.
I definitely understand how hard that must be to have to eat out frequently, in places you may have trouble evaluating the carbs. I find it much easier to be in charge of my food. Are there ways you can find reliable places you know are predictable and return to them to eat the same meals? Or times you can bring your own foods?
have you ever gotten the cpeptide to know for sure if/when your honeymoon ended? i am 2 yrs in and things havent been changing too much other than my basal creeping up a bit. i just got the cpeptide a month ago and found out my honeymoon is in fact over. bernstein believes honeymoons can last forever so i was surprised, i generally am able to keep very tight bernstein-like control. This just tells me that diet is the #1 factor in control, whether honeymooning or not. Even during my honeymoon(however long it lasted), i couldnt just eat whatever i wanted.
Like you, i have times when my insulin needs go up and my bgs go higher than normal for no apparent reason. I definitely worry less about those times now than earlier in my dx, i just increase my insulin as needed and usually after a week or two things even out again. That easy run may not be over for you, things just need to get back on track again!
You have done such a fabulous job of extending your honeymoon with your careful and conscientious approach! Please honor yourself for that achievement!
You have also done a very impressive job of educating yourself about your diabetes and the best approaches for good control! Please honor yourself for that, also!
We both know that good early control has been shown to greatly reduce later complications, so please honor yourself for that, also!
It's not fair to have a whole 'nother mountain in front of you to scale! In addition to your work and your family.
Thank you for sharing your update and your discouragement. And I'm not saying anything you don't know, but sometimes the holidays can make us feel a little extra vulnerable, emotionally.
Thank you for being the great model that you are! Wishing you good holidays and a smooth-as-possible next part of your journey!
Yes, I too had a game changing experience when I came on here because it was right when I was in the process of recognizing I was actually type 1 and it was so powerful to connect with and learn from other Type 1's, and even other LADA/Type 1's who had also been misdiagnosed.
I'm sure people are sick of hearing how grateful I am that I was diagnosed with D when I already had 13 years of recovery from my eating disorder. Because even with that I've had some rough patches. When I did I went to online OA meetings and that really helped, though I really wished there were OA meetings that were for PWD's. Maybe there are in large cities but I sure don't live in one! You might check it out. Some of the jargon can be a tad off-putting at first, but there are lots of supportive people. Also feel free to contact me 1:1. As for self-hate: Been there, wrote the book. (Actually I have, literally written a book about my self-destructive life). And came out the other side. Is therapy an option with your busy life? It's amazing what cognitive therapy can do to uncover that negative self talk and blast it wide open. Though it does take time.
I don't think there's a huge difference between 65-140 and 70-120. I find it very hard to hit 120 a lot although I just blame it on eating more carbs. I don't necessarily agree that less carbs guarantees hitting targets as I think that it might do weird things to your metabolism if you aren't pounding protein to get enough calories. I can hit 50% protein on a day and will generally drop a couple of pounds but I end up eating cans of tuna or grilling chicken for nighttime snacks to make the carbs.
I don't think that I'd attribute anything 5 years in to the end of a honeymoon though. I've never heard anything about a honeymoon lasting that long. I think that there's seasonal patterns as my BG tends to run up when the seasons change and then things stabilize as I get used to it. Or maybe they stabilize b/c I switch my pump around to cover them. Maybe what you're seeing now has something to do with that? I dunno what season it is where you're at or even if they have seasons but there's always some type of environmental "sensation" that we experience. I sometimes will see that I think a whole bunch of people all saying "my numbers are going crazy..." when seasons change but me staring at my computer is very unscientific so I'm not 100% sure if it might just be me attributing something to something inaccurately.
Are you using NPH? I can't recall if maybe you'd mentioned that at some point in time. I agree the timeframe graph for NPH is very useful until I learned that the peak had only a 53% chance of peaking when it's supposed to which, with the benefit of hindsight. explains many of the "WTH?" numbers I saw when I was using it. I used it the first time my pump blew up and it worked ok but it was a wild party weekend and I just bolused and ate a lot over the course of a 3-day bender, which may not be the best way to reexperience basal insulin...
15KG is quite a bit of weight to drop but it's good to conceive of things like that to have a target. I had blown up a bit earlier this year and buckled down and have dropped what I put on and a couple more pounds and even had a good AM weight *before* I ran today *after* blue cheese covered potato chips and martinis last evening. It doesn't always work out that way. I have found it pretty useful to use "Lose It!" to track food and help "cook" my protein number to a higher %age. It seems like I'll drop some pounds at 40-50% calories from protein and using an app makes it easier for me to make smart decisions. It's oriented as a weight loss thing but I sort of disregard that part of it and mostly use it to count calories. It is also very useful for counting carbs. when I added up my breakfast and discovered it was more like 20G instead of the 13 I was counting, it helped control the post-breakfast highs a lot.
I was diagnosed LADA 26 months ago with an a1c of 5.7...Stated low carb within a week or so of dx and have stuck to it. Last a1c in October was 5.4. I hope Bernstien is right in that a honeymoon can be extended forever, if not at least I know low carbing should make D easier to manage.
A side note that doctors never mention. Thyroid supplementation can effect BG by making oral meds & insulin less effective. "Thyroid hormone may increase symptoms of diabetes mellitus, diabetes insipidus, or cortical insufficiency." Yea, we can't win on that front other than to adjust basal/bolus doses with corresponding increases/decreases in thyroid meds.
I never ate on a schedule before DM. I've found it far easier to control BG sticking to a pretty consistent schedule. There are just too many variables with diabetes that we can't control, so I feel I have to control the ones I can.
