Hi Luis, thanks for you story! I find it very interesting. I’m about to take off for a romantic Valentine’s day dinner with hubby and son… so I will write more when I get home. 
Hello, I’m back. Had a nice lunch at Pizza Ranch. Managed to do ok and 2 hrs. later bg was at 123. I could do a lot worse!
Louis, I sometimes do a lot of injections per day… depending. Some days I get buy with just one for breakfast. Every day is so different for me. I’ve been used to eating 30g carbs/day most days since 2005 so it’s easy for me to go through a day with so few carbs that I can easily walk off the rise many times. But that’s getting harder so even with a low carb meal my pp bg sometimes spikes surprisingly high. My dr. also told me that my diabetes would naturally progress but I always felt if I stayed low carb it would not. Apparently it has anyway, maybe due to my failure to stay perfect with it. I don’t beat myself up about it anymore though, because I’ve come to the point where I need to find my comfort zone that I am able to live with practically. for the most part I’m happy with my low carb woe, but I’m wanting to be able to be more flexible now and then. I am thankful I have more flexibility with using the Humalog.
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Good for you, Gin, stay healthy. I am a little less carb shy since I started MDI.
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Hi. I’m not on here much. I’ve had T1 going on 52 years this September. I have good control. I don’t have any medical advice, but I guess the thing is is that you are always going to be diabetic, so the numbers you shared are actually pretty good for a diabetic. I find with myself that I eat mostly paleo though have some yogurt. I find that exercise naturally brings the sugar down. I walk 2 miles a day. today for instance, I took 4 units at lunch. Had yogurt almonds and fruit. Sugar was 200 after lunch, walked 2 miles, and now it’s 95 and going down. It’s basically if your body isn’t sick, getting used to insulin. I wish you well. I have the Dr. bernstein cookbooks and diabetes books. I find his stuff too intense. I have done no-carb before, and I end up getting 20 million insulin reactions. Instead, low-carb works for me. Remember it’s a disease, so you can do your part, but sometimes the disease has a life of its own. anytime i get sick the sugars go totally out of whack. Anyway, blabbing on here, but welcome to the forum.
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Thanks ame_e for sharing your experience! I find everyone’s is different and there is no size that fits all.
Just be aware it’s not recommended by ADA or the Endocrinologist association to move straight to insulin. I would get the non-fasting C-peptide to confirm low insulin production. They also said again, that a basal insulin is first prescribed, before a bolus.
Endo
ADA
Hi, Gin. It’s good to read your story. My doctor reminds me that diabetes is a chronic, progressive condition which is why it can be unpredictable at times or over- or under- responsive. She says it’s more important to notice what’s going on than to ignore things, but she’s also nicely pragmatic about the times when we all fall off the wagon, so to speak!
My endo is a truly wonderful doctor whom I respect very highly. He says I’m probably a LADA, though my C-peptide test and other bloodwork results are borderline. He says that there are more than 50 types of diabetes and that no one eats their way into becoming diabetic. Having an idea about what type of diabetes one has is useful for knowing how to manage it, and he’s very straightforward about all of that. Since I’m the kind of person who can be a bit obsessive about numbers and things, I pay attention to my insulin sensitivity factor, which changes throughout the day, and I calculate the total available glucose (TAG) in whatever I eat and bolus Humalog for that. This means that I will cover a meal of bacon and eggs, which has no obvious carbohydrates, because the body does convert some of the protein and fat into glucose. Working with TAG is more complicated, but I get better results and am happier with it, overall.
I also take Metformin. It does give me gastric trouble, but if I take Metamucil with it, things are much, much better. I also take a heck of a lot of Imodium but my endo and GP both assure me that Imodium is not addictive or damaging. Using it to control/prevent gastric distress is just sensible. So, I usually take 2-3 tablets half an hour before breakfast and another 3 before dinner. Sometimes, I’ll need to deal with, er, “urgency” about half an hour after dinner and may need to take up to 6 more Imodium tablets to stop serious diarrhea and settle my gut overall. I’ve been doing this for a few years, now, and it works for me. At one point, I took the time-release Metformin and had a much easier experience with it, but, unfortunately, it’s not covered by my provincial health insurance (I’m in Canada) and is very expensive, so I work with the regular Metformin.
I’ve also been using the Freestyle Libre flash glucose monitor for about a month and am really loving it!
Ann
Amazing how the idea of TAG has survived. I first learned about it 10 years ago on this forum. It’s based on information published in the 1989 book entitled, TAG: A Diabetic Food System, by Mary Joan Oexmann, a registered dietitian.
To this day, I still dose meal insulin based on 50% of the protein grams and 10% of the fat grams that I combine and count as carb equivalents. I also count the carb grams, too.
Welcome to TuD, @Ann2! Where did you hear about TAG? Was it here?
Hi, Terry! Yes, I heard about TAG here, about ten years ago. I tried it and was able to get my A1c down to 5.2 in four months by being careful and keeping my carb count at <30g/day.
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I also calculate meal insulin based on 58% of protein and 10% fat, plus carb grams.
Yeah, I rounded down the protein percentage for calculation simplicity. Do you use a pump?
Before I started on Loop, I would deliver two separate meal boluses on my pump. The first covered the carbs and then the second one covered the protein and fat, but I usually extended that over 2-6 hours to better match the longer metabolic absorption of those macronutrients.
I know Dr. Bernstein often recommends R and NPH insulin to cover meals with longer absorption times. These days I just let Loop figure out when I need extra insulin in the hours after eating.
Thsts weird cause protein and fat don’t effect my sugar at all.
I mean hardly any food is purely one thing except maybe butter.
But I only dose for carb and generally spot on.
When I eat packaged food especially.
If it says 35 grams of carb and I dose for 35 I come out even
The effects of using TAG dosing are most prominent in the context of low carb. At least it was for me. It’s my understanding that the body preferentially metabolizes carbs for energy before it goes to more effort to access fat and protein.
Wow… 50 types? Interesting. I would love to have a dr. like yours! I fired my last doctor because she didn’t want to treat me at all until my a1c was above 7. I wanted to prevent it from getting there. So I found a PA who is more familiar with treating diabetes and her husband has diabetes so she has personal experience besides. She agreed to let me have insulin. She would not do all the necessary tests for LADA however, but at least is treating the high blood sugars and helping me with that.
I really don’t know how to do that at this point. Am still trying to figure out the best way for me. The sliding scale she gave me doesn’t seem to work. I’m just guessing based on experience right now with how much humalog has worked and how much was too much. I normally eat mostly the same for most meals or at least the same amount of carbs but if it varies I have a problem. I’m feeling pretty stupid with it all actually. One time I had about a tbsp of almonds and a cheese stick and my bg went up about 60 mg/dl which was crazy. The almonds I found out later had some sugar in the ingredients but even so… wow.
I could not live with metformin. Rather than adjust to it I got worse and worse the longer I took it so that I was disfunctional. I already have IBS problems so didn’t need that.
I’m thinking about trying that. My PA said she would prescribe it if I decide to but I’m not sure if my insurance will cover it anyway.