First week with good control

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.

my settings:
Basal .80, at 11:00a .85

Carb Ratio 8.1 (still needs tweaking)
Sensitivity 26

BG Target
12am: 80-120
11am: 150-160

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.


Great Job doing something proactive to get yourself on track. I have also not seen much of a "feeling" difference. I do feel better but it is not ground breaking differences. However, I do know that I am healthier and will be around to just enjoy life longer because of my efforts. Your efforts will pay off with a long healthy life so keep up the great work. It is awesome to come on here and see the self dedication of the members working well for them. It is awesome to see diabetics that know they need to change and so they take it on themselves and make those changes. I know way to many diabetics that just don't take it seriously and they will not be around as long as they think. I was DKA in November 2011 and if I can eat right, exercise, dose insulin correctly, and monitor closely and never go DKA again it is well worth the effort. Because that was NOT FUN. So keep up the great work you have figured your diabetes out and it is working for you.

Again GREAT JOB!!!... You deserve a virtual HIGH FIVE!!!

Thanks so much, Mike. High five right back at you!

I feel like I've been getting little pieces of information about D my whole life from Doctors, books; more recently on-line. Sometimes, they are contradictory or flat out wrong. I feel that I am finally putting the pieces of the puzzle together, now. The biggest piece is diet. Quitting carbs is how I imagine an alcoholic feels when they quit drinking.

I only know one other T1 in person. She's my friend's wife. A wonderful person, but with much confusion and misunderstanding about D. She's in her mid 30's, and has already lost most of her vision, due to retinopathy in both eyes. I'm hoping I can offer her some sound advice, and convince her to turn things around.

Thanks again. Good luck, and take care of yourself.

Great job Sam! Congrats and very inspiring! I’m really trying to figure out how to cut my carbs but I just don’t know how. Any good books that you can suggest?

Thanks, Renka. Mostly, I'm following the recommendations from "Dr. Bernstein's Diabetes Diet."

The first half is guidelines and explinations, which I found very useful. The second half was recipes. I just skimmed through them. Some sounded okay, but nothing special. I stocked up on Wasa crackers. Also found some low tortillas made with soy flour at the grocery store. Sometimes I use about 1/2 - 1/4 teaspoon of agave nector for sweetness. Otherwise, I follow the diet pretty closely. My nondiabetic wife read the book and is also on the diet just because I'm doing it. She emptied out the cupboards and gave away what we had on the No List. Our son still eats whatever, though.

When I look at foods I used to crave, like spaghetti, now all I see is a big pile of flour and sugar. It can be done. It just takes some adjustments. Best of luck to you.