Okay i have had type 1 diabetes since i was 18 months old. I know a lot about this disease and I feel pretty confident when it comes to carb counting, exercise, insulin usage, pump and sensor using and injections for treatment.
However, I have had crazy levels lately and do not know why. I have been to my doctor and the RN’s at his office for feedback on what i can do to get my A1C down. I feel like a crazy person b/c nothing i am doing is working. I tried the sensor for the first time this month with my pump which i have been on since 2006. Then i made adjustments with the help of my doc, and had extreme highs and lows. I finally got so frustrated I began doing injections instead of the pump. I am still having extreme highs and lows.
The type of insulin you are using is not working for you. I have had this happen to me. Have your “doctor” (they aren’t of any use past the large amount of money they charge to tell you no information) switch you over to a different insulin. Humalog and Novalog work best. Any other brand is a hit or a miss.
Maybe after all these years, you have gotten used to being in a groove and the small adjustments that always brought you back under good control just don’t work when you have run off the road. Perhaps you need to just start from scratch, do basal testing, figure things out again. If your ICR and correction factors are just markedly off that makes things even worse. And it is times like these that detailed records in a log book make all the difference. What seems like random acts of vengence can sometimes be revealed as patterns when you have recorded them in vivid detail in your log book.
I’m 43 and wasn’t dx’ed until I was 16 or so but two things I’ve noticed since I got the pump are 1) insulin needs can change for no other reason than that they change. . Or maybe it’s b/c of Jupiter and Mars or something like that but I have noticed changes without any significant change in my life and just have to change, nudge the pump up or down a couple of clicks? I’ve also noticed that being off w/ basal rates, even .05U/ hour can mean the difference between 90s and 140s in some of my numbers so, if you were off by .10 or .15U/ hour basally speaking or maybe a couple of units carb-ratiowise, it could blast your numbers up? When I was doing self-taught MDI ('til 2008…), I didn’t hesitate to use insulin like something I’d buy in the parking lot of a Grateful Dead concert and just take more until my BG got where it needed to be. This is not without hazards (275 lbs of them!) but if the numbers aren’t there, maybe make a significant adjustment, under controlled conditions (like a day off, when you have plenty of supplies with which to beat up any accidents?) and see if it will get things in line?
How did the CGM work for you? Did you get one of the ones that you could see the data with or was it the doctor model that the doctor gets the report so it is useless while you are wearing it? I did ok prior to getting the CGM but I find it a lot easier to keep an eye on things w/ the steady state data.
Hi, if you are new to the sensor/CGMS, and can see the continuous curves of your bg,
are you sure you are not just caught off guard as to how much your bg usually swings?
I started using a sensor this fall and it sure was a shock to me!
If you’ve been used to testing at regular times pre- and post meals, you don’t really have a clue of what’s going on inbetween those times (one would like to think those are steady curves, but that isn’t neccesarily true). I had spikes after my 2 hour mark, I had low bg’s that I didn’t notice at all… The sensor was a real eye opener!
I agree with the others, start from scratch with basal testing- it’s a real pain, I know, but you might have to do it every once in a while. I have to change my basal rates drastically (about 30%) twice a year now, and tweak them every two months or so (don’t know why!) The sensor is a great tool though, even if I get out of range, I can now nip it in the but and lower it straight away (while before it might have stayed that way, or risen, for 2-3 hours before the next time I checked!)
Oh, and I find it takes a couple of days before the body can properly settle to changes in basal rates etc,
so be patient and work at it a little at a time.
PS! if things are different emotionally lately, due to stress, heartache, grief etc, there’s not much to do with insulin (highs and lows will not be predictable and have to be dealt with on the occasion). So if this is the case you’ll need to work on those emotions, as your mind and body needs to be somewhat balanced for the bg to be so too