This past 2 weeks my sugars have been everywhere- and that is with making changes every three days. On top of that this whole week every time I exercise my blood sugars are up, not down…what gives?
I know you have only recently started on a basal/bolus regimen, so my question to you is did you get your doses adjusted and have your numbers pretty much stable and thenit started going haywire, or are you still in the process of tweaking numbers?
No I had my numbers great zoe! For a whole month and a half and now for 2 weeks it has been nuts!!! I am frustrated, and I just started. I can’t imagine all of you who have done this for years I commend you all!
Sputtering pancreas. When you are a LADA or a new Type 1 in honeymoon, sometimes it makes insulin and sometimes it doesn’t. And you can’t predict when it will or won’t. Also, Type 1’s with little to no pancreatic function are all over the place anyway, because it’s really impossible to calculate the EXACT amount of insulin needed for meals, exercise, etc. The goal is to reduce the excursions, but it’s impossible to eliminate them entirely.
Do your BGs after exercise go down after a while, or do you have to correct for them? High BGs after exercise CAN mean insufficient insulin on board, but for some people, first they go high, and then they go low later. Can be MUCH later, like 48 hours. This is where careful testing will show you where you are.
hmm well I know 3 hours after the exercise I have been testing and I have to correct every time this morning blood sugar was 176 upon awaking(yeah I know not good) and after I walked a mile and a half it was 196, then 3 hours later it was 209. I have upped my bolus to 30u of lantus, and my carb ratio is 1:7 morning, 1:8 during lunch and dinner. my correction factor is 1:30 and I have been having to do a lot more correction than before. My total carbs for a day are 125. Natalie I never thought about that aspect at all. I am scared to death of gaining weight from using so much insulin. I say a lot but it like 42-50units.
I suspect you may be a “double diabetic”. That means that although you clearly have auto-immune diabetes, therefore Type 1, you may also have insulin-resistance, which is characteristic of Type 2. I also think that’s probably why your doc was so stubborn about classifying you as a Type 2. The main issue is that you will always need insulin, but for Type 1’s with insulin resistance, Metformin can be very useful in bringing the BGs down while using less insulin. It also helps with weight loss, or at least weight maintenance, depending on the person. You might consider asking Richard157 about his experiences – he’s a double diabetic – Type 1 since childhood, but with insulin resistance in later years. He takes Metformin, and has had success with it. Then you can talk with your doc about whether it would be a good choice for you!
Also, try to be patient. Good control takes a lot of work, and testing, and analysis, and TIME. You’re just starting on your diabetes journey, and your pancreas has not yet settled down to where it’s going to be. Just take it one day at a time, and do your best, and then let yesterday go. Your numbers are not to be judged, but only acted on. There is no such thing as a “good” number or a “bad” number – they are just information. You’re at the start of a steep learning curve, but I have no doubt that you can achieve the kind of control you want – you just have to keep at it!
Thanks Natalie! I needed that more than you can possible imagine! I’m just so annoyed I guess this happens sometimes. Alright I will keep moving on and working hard.
It is not unusual when you first start on this for stuff to whack out. You are honeymooning. So know that this will not be forever. I agree with Natalie though that it sounds like you may have some insulin resistance going on (Type 2). You may need Metformin or another Type 2 drug to help. That being said, however, I can spike after moderate exercise. If I do intense cardio, I’ll drop bg. But if I’m exercising but not spending the majority of the time in my target heart rate I will spike sometimes. This is all part of the learning. The best thing you can do for yourself is log everything – eating, exercise, bg, and insulin amts. That written record will help you immeasurably in sorting out what you need. As for the fear of weight gain - -I so understand that. But I’ll tell you what my endo said to me about that, which proved to be the right thing. She said – right now it’s about getting healthy and not what the scale says. She said, you main gain back some of the weight you loss (which I loss unhealthy way due to undiagnosed T1) but you won’t necessarily gain it all back. She said, get healthy and then let her help me with the weight management. It was fantastic advice. I did gain back some of the weight. But once healthy, I could start thinking about reducing carb intake, increasing exercise, and lots of other things to manage my weight. And the more you manage your weight, the less insulin you’ll need. but give yourself a break – be kind to yourself. Get healthy and get BG management down. THEN you can address any weight issues. One of my favorite phrases: you can’t boil an ocean. So do the BG then move onto whatever next it is you want to address.
Yeah, what the others said, Stardust, it’s hard. I also feel like I have periods of great stability and then periods of unexplained deviations. For me, I don’t think a supttering pancreas is something I can blame anymore as my c-peptide was .38 and .70 over two years ago, but who knows, I might still produce some but I doubt it. But for you that is still a factor. And as Natalie said you apparently are a type 1 with a degree of insulin resistance and that is a rough combination. If your wake-up numbers are consistently that high it does sound like you need to up your Lantus a tad, or split your dose (or switch to Levemir). I too encourage you to see numbers as just that, numbers. My I:C ratios have been stable for awhile and I have really hesitated when I’ve been seeing some signs of my breakfast and maybe lunch needing to go down (from 1:7 and 1:8 to 1:6 and 1:7). It’s just a number and what counts is that I do the dose that will work, but in the back of my mind I just realized I’ve been attributing all sorts of negative meaning to that change. How silly that I would tolerate high post prandials for days instead of just changing the I:C!! It’s hard to do but the more you can do as others suggest, and just see numbers as information, the better. Don’t hesitate to up your basal if you need to because you are “scared to death of gaining weight from using so much insulin”. It takes what it takes. I can say that to you, but weight gain is my greatest irrational fear as well, but I know I need to take care of my diabetes while doing what I can to prevent weight gain in addition. I think upping your basal is a lot more effective way of managing high numbers than trying to exercise them away. If you add a unit of insulin to your basal, sit with it for 3 days to see the results before you decide to add one more.
Hang in there, it will never be perfect but it will get better.
Thanks Donna! I must say you are awesome! That is very sound advice and I will heed it. I did not know that being out of target heart range would cause a spike that is good to know!
When you say your numbers are crazy, are they rollercoastering all over the place or is it mostly highs?
Have you read Using Insulin and tested things like your basal rate, I:C ratios and ISF (correction factor)? I find sometimes if I’m having to correct and correct and correct if I up my basal insulin by as little as 0.05 units an hour (about one unit overall) it makes a huge difference. Also, once when I accidentally changed my correction factor setting on my pump (so that it was lower than I needed) I found my blood sugars just rose steadily throughout the day no matter how much I corrected them, and it took me about a week to figure out what was wrong!
My blood sugar will rise over exercise if I’ve cut back too much on my basal or bolus insulin. Usually I do this as I go low otherwise, but sometimes I cut back too much and will actually go up a bit. If I have a bad pump site and am not getting any insulin at all, then my numbers will shoot through the roof after exercising (like last week I went from 266 prior to 373 after 30 minutes due to a bad infusion site). So it may mean that you need more basal insulin (Lantus) than you’re taking.
Don’t be afraid to up your insulin. If you need more then you need more … I know how it feels because I hate upping my insulin, but it’s usually amazing how much upping it even a small amount helps (at least for me). From your doses you do sound like you are insulin resistant so you may just need higher doses than an average Type 1 does.
I also agree with Natalie that it’s impossible to get in-range numbers all the time. The best I usually get, when I am keeping carbs below 150g a day and exercising every day and logging everything like I am now, is staying between 60 and 215 or so on a daily basis. One thing I can say is that control is never easy, it’s constant work and constant adjustment. And even with all that work there are STILL daily ups and downs. That’s one of the hardest parts of diabetes, especially because most people don’t understand how hard it is!
I think the fear of insulin and weight gain is a common one, especially for women. We are so indoctrinated that we have to be thin, but the fact is that we come in all different sizes, just like dogs. And women of different sizes are beautiful too, just like dogs (I hope you like dogs! LOL) You are absolutely right that health is the first priority!
In a book I read a long time ago, someone asked “How much insulin do you need?” and the answer was “enough!” Just like you need enough water to put out a fire!
I am the weird one out, because I LOST weight when I went on insulin. It was because my body was still producing insulin, but not enough, and I was eating ravenously – when I went on insulin, the extreme hunger went away and I started eating better. It’s the eating that controls the weight, not the insulin. I’ve been doing reduced carb for the last 6 months, and I have lost 22 lb. And I’m not hungry like I used to be when I was eating a lot of carbs. (Not meaning to be a proselytizer here, just relating my experience!)
Still hoping to lose 10 lb. more – but I’ll never look like a teenager again, LOL!
Not sure that it will cause a spike for everyone – it’s just what happens to me. Everyone is different.
Yes I have read Using insulin and think like a pancreas. that is how I changed my basil and bolus and for a month and half they worked. I was taking 26 units lantus and 1:8 for all meals and having reading in the 75 to 130 range consistently. Then the week my period was due all over as in High. Still on period and still running high. I know that menstrual can cause high’s, right? I had to change Basal to 30units at night, and my breakfast ratio to 1:7 and 1:8 the rest of the day, so perhaps I need to change the ratio? I am on metformin my endo did that as soon as I started insulin. It is so wonderful to have others who are going through all of this I do so love this board!
Yes, menstruation can definitely cause highs! I didn’t realize this until I went on the pump, because my numbers were too crazy on shots to get any patterns, but once I started on the pump I was amazed how much my period affected things. It’s not always a predictable, exact same effect, though … I tend to go high in the two weeks prior to my period. Then I crash low a day or two before my period starts, and then go back to somewhere in the middle until it starts over again.
It’s a VERY sudden rise at the mid-point of my cycle, too; I didn’t realize how sudden until I caught it on a trial CGM I was doing a few years ago, where my time in range (70-180 on the CGM) went from 82% one day, 95% the next, 32% the next, and 23% the next, and nothing had changed except it was the mid-point in my cycle. That proved to me that things really could change very suddenly with no direct influence from me (prior to actually seeing that graphed out I was always looking for something I must have done to cause things to go out of whack). The drop low before my period actually starts is also usually just as sudden.
That describes me to a t! Your pattern is what I did and am. AKKKK!!! So now I had the thin bagel 24 carbs with an egg and slice of cheese with a 1:8 ratio and a correction for a 209 reading 1:30 so total 7 units and 2 hrs after I am 100… go fig.
Somehow I never saw this post. Yes I love dogs and used to have a rottweiler who at the ripe old age of 10 years got throat cancer and I had to put her down. I will forever miss her. I am within my insulin units not even close to 100units a day, but I am determined to loose this weight one way or another.