Help I don’t know what’s going on

I’m trying to stay positive and do this stuff but it just throws me for a curve ball when my numbers are decent and then all of a sudden It seems like nothing makes sense. Getting low blood sugar after eating and stuff. Spikes 5 hours later or spikes in the morning after drinking water.

You will have this figured out in a couple months. Keep at it. It’s just all gotten away from you. You gotta play catch up, now. Its super frustrating, but keep at it. Little by little things will improve.

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All of the statements by Mastering Diabetes are evidence based. One of the two founders, Cyrus Khambatta, has a PhD in nutritional biochemistry. The other founder, Robby Barbaro, spells all this out quite succinctly in this interview by Rip Esselstyn (I hope you can see past the rather distracting arm-waving in the video!):

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Thank you for the additional links!!

I have been following the Mastering Diabetes way of eating for almost 4 yrs. I eat close to 300 carbs a day on about 20 total units of insulin. When low carbing I was eating 30 carbs a day while using about 20 units of insulin. I am a type 1 who makes no insulin. I also lost 15 lbs following this way of eating.

Well I got the gastric emptying test and it’s Gastroparesis. Significant delayed emptying almost 40% at 4 hours.

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@Rleb I’m sorry to hear of your test results! I don’t know much about gastroparesis but I surely hope those who do, will be able to help and guide you effectively.

@Rieb My diabetic dog has a huge delay in digestion, it’s pretty difficult to deal with. One time when she threw up she still had exact pieces of stuff she had eaten 4 hours before.

I can tell you to make sure your basal is at the minimum needed when your digestion is at it’s best. Otherwise you will find yourself dropping continually for days in a row. And then you have to learn that sometimes you will need correction doses maybe days in a row. She can have such even keel days and then she will have mountains and valleys, same food, same activity.

A CGM to let you know all the time what your BG’s are doing preferably with alerts, and a pump so you can do those adjustments easier as needed would be useful.

Crap, @Rleb. That is gonna make this tricky. Let me try and recruit some experts.
Upfront, I’m gonna say that this complicates matters. I recommend MORE data collection before making changes to insulin regimen just to get a good idea of how gasteo is contributing to variability in the numbers.

Give us a weeks worth of data. Good job getting that CGM running.

Your overnight Lantus looks too high. I would worry less about an 30 point increase after eating, and more about that 150 point drop. That’s enough to kill you. I recommend decreases there right away. Keep a log of your dose in the spreadsheet.

I know that you are under stress. The best thing to resolve this ASAP is to collect ALL data everyday. Fill in this spreadsheet with everything you eat, every time you take insulin, ALL manual finger sticks and some sensor data.

Information is everything in making good decisions.

Make sure the time/date on your CGM is set correctly and I will fill in the CGM data for you if you upload the records.

Here is an excel file. You can open it in excel and fill out the data in the spreadsheet.

CLEANBG.xlsx (11.8 KB)

Or, you can print it out and fill in data using a pencil. Here is a word document:

CleanBGData.docx (52.3 KB)

It looks like this:

Let find out what the heck is going on.

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If you are female, there often changes in insulin due to hormones every month, Some need higher dose/carb on days before start, then maybe lower dose first few days as levels of hormones change again.

@MM1, do you recognize that data output? What CGM is he/she using?
Sorry, for some reason, I assumed he was male. Should check that.

@Rleb - I know several T1D’s who’ve solved their gastroparesis issues (uncontrollable BG’s) by transitioning to a low carb diet and avoid foods with fibre.

Thinking of you -
Jim

I didn’t assume either. But this is something most doctors never share or acknowledge. There have been a few topics on this over the years, particularly as the cgms gives more evidence it really happens.

I am male lol but thank you for that input as well

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I am using the Medtronic cgm right now Guardian connect

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I am not sure how to upload it tho

Yea, that might be an issue. Let me ask around.

Hey @Rleb, not trying to nag you, lol, but how is stuff looking these days? Also not trying to forget about you - you doing ok?

I’m struggling pretty bad I don’t know what todo I don’t know how to test my Basel or bolus. With the delayed emptying. My endo isn’t helping and she seems to think this all isn’t much of a big deal. She brushes me off after 20 minutes and tells me it’s stress related. I’m not sure and I could be wrong but I have not read anywhere that stress could cause someone to have a delayed emptying of solids result on a gastric emptying test. I feel like everyday and every meal is just a stab in the dark when it comes to bolusing for it. I started using your spread sheet for excel today and have been keeping track of everything. I have a new endo set up and see this one this Thursday. My old endo felt like I shouldn’t of went to the gi doctor before because I already Knew I had delayed emptying. I only knew because I kept seeing the long rise in blood sugar and sometimes a peek 4 hours after eating. Also she keeps saying it’s STRESS. This gi doctor now wants todo an upper gi and a colonoscopy. My old endo keeps telling me not todo it because it’s a scam for them to make money. I kept believing her but with the actually delayed emptying I’m scared there is something else not just diabetes causing it. I have an appointment in October for a gi that specializes in Gastroparesis but I think I should just get the test previously mentioned while I’m waiting. I just don’t know what todo and I’m eating low carb to try and not have blood sugars over 200. But I’m losing so much weight I’m scared so I’m upping the carbs a little and taking more insulin but I’m lost on a how much insulin to take. There is just so many variables and I feel like until I can get the food to digest in some reasonable amount of time I just can’t figured out what amount of insulin to take and until then I’m taking close to what I though I should be taking and taking corrections later. I will post the spread sheet later tonight or tomorrow. I don’t know if any of this even makes sense. I’m in a constant panic because I feel like I’m just getting worse and losing weight while none of my doctors help me.

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