Extreme highs and lows no matter what

I am type 1 diabetic. I have had diabetes for more than 40 years. My blood sugar swings no matter what. From 40 mg/dl to 300 in a matter of an hour. I have tried so many things. I am currently on an insulin pump with a cgm and I take 2/3 of my insulin in a shot of Lantus. It seems to be working a little better as long as I am not late on the shot and really watch what I eat. I found this instructions for this on the internet and tried it. I told my doc and he says as long as it works ok. I also have foot problems from neuropathy. I have reumatoid arthritis. Exercise is a problem for me because I have a hard time walking or doing anything that might cause joint pain. I have gained much weight (30 lbs)from taking Lyrica. I have had these wide swings all my life. I can control dka episodes because of the cgm alarms. Every time I have an extreme low it takes a long time to come back up and I over treat because of this. Then it swings really high. I have all but quit trying to have any kind of tight control. Can anyone suggest anything.

My endo made me read it before we even talked about the pump.

Well, first of all, take some solace in the fact that all of us experience those swings. Unless you have additional underlying medical conditions though (like gastroparesis), there are steps you can take to reign it in.

  1. You have to stop overtreating and give the CGMS time to catch up. If that means rationing out snacks into less then 15g ziploc baggies, do it. When I’m 70, 2-3 glucose tabs will actually take me higher than my goal of 100. That’s the equivalent of 8-12g of carb! So imagine what a glass of OJ, a banana, and a bowl of cereal due to you as treatment. It took me literally 18 years to figure this out. I used to think a low meant a chance to order dessert or to eat that second bowlful of whatever. I’ve now learned to treat it as a medical condition requiring MINIMUM treatment. If in 20 minutes, your blood sugar isn’t back where you wanted it, then treat again…conservatively. The CDEs used to tell me this. I wish I hadn’t ignored them for so many years…

  2. Eat smaller amounts of carbs at a time and bolus sooner before meals. I used to take in 90-100 carbs at a meal, no problem, and then deal with the resulting spikes and then the crashes from the too-big boluses. I rode the T1 roller coaster up until 1 year ago - when I discovered this place and learned to use the cgms accurately. I now eat 30-60g at a meal and my insulin is able to compensate for the effects on my blood sugar much more easily. (I also avoid the white-sugar carbs and eat more whole grains and vegetables now.)

My A1c has dropped nearly two whole percentage points from when I first joined here and I now go over 300 maybe once a month, rather than once a day. I still have a lot of lows, but we’re talking 60s now, not 40s. And the best part is that I feel wonderful. I wish you luck, but I think starting from scratch with how you treat both your highs and your lows is a must.

Hi Vicki,

Want to echo Melissa’s caution about not over treating lows. It’s worth experimenting to see how much 1 gram of glucose raises you so you’ll know exactly how to treat a low. We’re all different of course, but 1 gram of glucose raises me 10 pts. If I followed the 15 gram rule, I’d be way high. So, I use 1 gram sugars (jelly beans) to treat because they’re easy to count when I’m ditzy low. It can take almost an hour for me to get back up. Hard to wait it out.

Might be worth speaking with your doctor about gastroparesis because mild cases often go undiagnosed. My endo believes it’s more prevalent than many doctors realize, especially in longer term diabetics. Mine was diagnosed from the wide swings I had from lows after meals to highs hours later. As is typical with gastroparesis, this only happens after dinner. Delayed stomach emptying plays havoc with timing insulin. Took months of trial & error to get even close to knowing when to bolus. I have to take insulin after eating & keep testing for hours after to catch when the spike will occur. The other problem with gastroparesis is that treating lows can take longer. My endo wants me to use glucose gel because liquid form works faster, but I can’t stand the taste.

Have you tried yoga for exercise?

Hi Gerri, I do have gastroparesis and am on Reglan. One of the problems with my lows is that when they happen, I cannot see. I have a bright white light in the middle of my eyes and only can see the outter edges of my vision. Most of the time this is my first symptom. The liquid glucose works the quickest for me but I dont always have it handy. The lows after meals and the highs hours later are typical for me. I will get a book on Yoga and try it. I will also get Dr.John Walsh’s Pumping Insulin and read it. I have read so many books on diabetes it sure gets boring after a while. I sure thank you for your help.


Hi Vicki,

Is Reglan helping? How do you time your bolus? Guess it’s easier for you pumping. I’m on MDIs. I changed from rapid acting to Humulin Regular because rapid is too fast with gastroparesis.

Loss of vision is really scary–sorry. How low are your lows? I get flashing lights.

Try renting some yoga DVDs to find one you like. Books are usually difficult to follow. Seeing the postures on a DVD is easier.

I second, third, and fourth all the folk saying to find out exactly how far up 1 gram glucose raises your blood glucose. For me, 105 lbs, 1.5 grams raises me 10 mg/dl. A 140 lb person can expect 2 grams to raise them 10 mg. And you can figure it from there what’s needed to pull out of a low. I, too, treat a low as a medical condition, I walk away from the refrigerator. When I figured out that 1/2 c juice raised me 100 mg/dl, I stopped doing that and decided that 4 gram glucose tabs could be cut in half and I could take 3 half tablets. My computer comes on in the morning and says: "Put glucose tabs in your pocket. Put your tester in your purse."
I, too, dropped my carbohydrate intake. I keep it so that I don’t go over 140 at one hour post-meals. This means 25 per meal and very very little fruit. After 3 months my knee problem, rheumatoid arthritis, and tendonitis very obviously reduced. I’m back to exercising well. I wrote my rheumatic disease doctor to thank him for his help when I needed him and that lowering carbs was what I needed.
Of course, if you drop your carbs, you have to lower your pump. The cgm will stay very accurate since it won’t have to move fast. Best wishes and let us know how you do! Great control is an everyday process. Bodies change.

Amen. Buy “Pumping Insulin”. You won’t regret it.

You can also order it here and a few cents get donated to Diabetes Hands Foundation (that runs TuDiabetes) without costing you any more!

your body is out of kilta

Im not sure what your diets like but if you can afford it take supplements and food that will regulate your BG

chromium is one of them
google it for a list

I also had swings and resistant to insulin (for instance would have to take 18 units just for eating a medium sized potato)

after regulating my diet, cutting out most carbs and taking a plethora of supplements my latest a1c was 7.2

Good luck

Diabetes is not easy