About a week ago, I suffered a bout of DKA, probably due to an infusion site failure. It led me (back) to this site, which got me thinking more about my D. I have been told that I have "brittle" diabetic. I have to struggle to keep my A1c between 7 and 8. In a normal week, my BG range was about 30-300. I could easily jump up or down 100-200 points, every time I ate or exercised.
I found that most of the members here, that have tighter control, were taking less insulin and eating much less carbohydrates than I was. Basically, I set out to copy them.
I have been testing my BG every hour. 12-16 every day, which blows through a lot of strips. I don't have insurance, so I've been buying the cheap TrueResult strips from the pharmacy. I had a couple readings that I knew were inaccurate, and changed when I retested. I got a HI, which turned out to be about 100 on retest. As with any monitor, I'm sure the readings aren't perfectly accurate, but I'm convinced they're close enough.
I've been roughly following Dr. Bernstein's Diabetic Diet, although instead of 6 - 12 - 12, I've been doing more like 10 - 20 - 20. A couple times, I ate about 1/4 cup of 50% rice 50% barley. I bolused for 20g carb. Also, I decidied I can't completely eliminate pizza, but if I eat it, I'm limiting myself to 1 slice, no crust. I had it once and bolused for 30g. Neither had much effect.
The next hardest part was resetting my Basal to keep my fasting BG level. It was easier, though, because I was eating smaller amounts of relatively reliable carbohydrates. I ended up cutting my basal way back. My BG was still falling at night, so I further cut back my night time basal. I have no dawn phenomenon, perhaps because my hours are pretty irregular.
Basal .80, at 11:00a .85
Carb Ratio 8.1 (still needs tweaking)
The results have been dramatic. My BG stays at about 100 all day. Gradually, it will drift up or down 20 points. I almost never need post-meal boluses or corrections. Exercise will cause me to drop 30-50 points, which is not bad compared to the 100-200 points before. The first couple days I was constantly hungry and thirsty and craving carbs. This has gradually subsided. I was afraid I'd lose too much weight and starve. I only lost a couple lbs, but my weight has stabilized. Like my BG, when I ate more carbs, my wieght used to fluctuate. Often over 5lbs. a week. Now, it's settled on the low side. My clothes are loose, and everyone tells me I look thinner, though. Not so bad.
Having good control and a stable BG doesn't feel great. There is no big payoff or gratification. It just feels okay. Not eating carbs would seem like a big sacrifice, but it's not so bad. It's nice to know that it is possible, as a T1. I just needed a proper strategy. And I think I can keep this up, more or less.