HELP ! it's getting way out of control

so i’ve been t1 diabetic since a year and it was going all fine, i even reached A1c of 6.3, until 5 months later i started gaining weight, like 3-4 kgs, i tried to lose them but it was REALLY hard and when i asked a nurse she said it is gonna be hard because i’m on insulin. the thing is that if i cut foods i get hypoglycemic & if i try lessening my insulin doses i get hyperglycemic. i really dont know wat to do !. plus, i’m getting sick of all of it, the counting the logging the testing the medication the dr visits the blood tests, it’s all so freakin consuming, i’m not getting much of family support and it’s going way out control like i’m now used to get morning readings of 240s ! i eat sugar and chocolate i dont count carbs i dont take my insulin when i’m having meal out wth friends. i alos have anemia and my last A1c 3 moths ago was 9.8. it’s just freakin me out and i dont know wat to do. i’m afraid about my health & body and i want to get back to the way it used to be at the begining. i dont know how to do that.

Well first thing is first…don’t ever skip insulin, why on earth would you do that?

i guess i get busy wth friends and it’s like i dont care i can take it when i’m home!

I would encourage you to have an adult heart to heart conversation with yourself and choose to get this thing under control. There is no excuse for not taking your insulin or attempting to control your diabetes. If you are suffering from depression, you need to get professional help. The sooner you take control of this situation the better your long term outlook will be. You have many on-line and professional resources that can get you up and going.

Take a deep breath and make a committment to yourself. Skipping doses, not matching your carbs to your insulin and deciding that you’re sick of it only makes things worse. Diabetes isn’t going to go away just because you ignore it - but you know that.

It’s time to reset. Just pretend that you’ve been recently diagnosed and ask your doctor for some help bringing the numbers under control. You did it once and you can do it again. If trying to lose 4kg is going to make it difficult for you to commit to taking care of your diabetes, I suggest accept the weight gain.

First, I would guess that, in the beginning, you were having your “honeymoon” phase. That’s when your body is still creating insulin and things are easier on you. I would guess that is probably gone now.

Second, unfortunately, you’re just going to have to accept that you have diabetes and your life will never be the same. Yes, it’s awful. Really awful, but you are one of the unlucky people who got diabetes, and there’s nothing you can do, except accept it and try to make the best of it. You can try to rebel by not giving yourself insulin or not testing, but you will probably experience negative consequences later in life if you do so. I guess you can be grateful that you enjoyed those early years without diabetes and that you didn’t have anything fatal, though that’s not much.

But don’t get worried if you’re a little high or a little low; aim to be in range but accept that you will have mistakes.

Well, you can cut the sugar and chocolate (chocolate is okay if it is dark chocolate with a high cocoa content - and only one bit of it!). You can count carbs - easiest way to do this is to have only as much as will fit in the palm of your hands. And you could take some insulin. Keep low fat and if you get hungry have some crackers with something tasty on them. I like marmite (equavelent to vegemite where you are) or peanut butter … the choice is endless.

I totally sympathise with you on the logging, medicating … I have just bought a Contour USB meter which takes all the readings and you can download it into the computer and printed. I will let people know how I get on with it after I have had it a while, but reports I have read about it, have been very positive.

Your nurse is quite correct in saying that it is going to be hard because of the insulin. If you inject too much of it, the excess gets stored as fat. I used to be hyoglycaemic before I went diabetic. If I did not eat I would go low. I found it difficult to lose weight which is why when I turned diabetic (mine is down to a tumour on my pancreas) I could not understand why I was losing weight so quickly and seemingly without effort.

Unfortunately we do have to accept that vanity is not part of diabetes life. Sometimes I go on a lower dose of insulin for a few days to allow myself to go higher and that way I can lose weight, but I am not recommending this without talking to your nurse, but you must NEVER cut out insulin altogether. Yes, you might lose weight, but the long term consequences of doing this are simply not worth it.

You need to be a bit disciplined about taking it. Ask your friends to remind you to take your insulin or set the alarm on your mobile phone to remind you. Think of the adverse consequences of skipping insulin. If you inject then you can safely eat and enjoy the meal out. And from your further replies that I am seeing, I wonder if you are suffering from depression. Ask your doctor to see if this might be the case. I know it affects me in the way you describe.

The reason for logging is to find out how much or how little insulin you need at any time of day - you learn the amount you need to correct - in my case I need to have a base rate say 8 of fast acting and if I am over the norm I will take one extra unit of insulin for every 3 units over the norm that I am.

  1. count carbs
  2. if you want to lose weight safely, you need to eat less and take less insulin, to avoid hypo and hyperglycemia. The goal isn’t to take a certain amount of insulin, the goal should be to have balanced BG. Counting carbs is pretty essential. I guessed what i was doing for years until I hit 275 lbs @ 5’ 10" tall, not exactly an ideal BMI for someone who’s 37 and has T1 diabetes. It has been a lot of work to get it off. If, in turn, you are counting carbs, you shouldn’t ever not take insulin when you are eating, particularly eating out. I agree it’s annoying and time consuming but if you like your friends, you will be more likely to be able to continue liking them a lot longer if you take even moderate care of yourself.

Make diabetes your number 1 priority. Your friends will understand if you just take 1 or 2 minutes of your time with them to care for your health. After a while it will be completely normal for your friends that you test or inject insulin. It is not a big efford actually. But please do not try to ignore your condition or it will kill or hurt you. It is bigger and stronger than you.

It can be quite frustrating. I think many of us have struggled with similar problems. Often our family and friends don’t understand what we are going through and they are useless to help. And I’ve often found my medical team to be of minimal help. First, I’d like to encourage you to believe that you can deal with this stuff. You can figure this out and get your blood sugar under control. I have every confidence in you.

Second, I’d like to point out that you have probably not been given the tools to deal with this. This is a common problem. As diabetics, we are given a prescription, a couple of syringes and shuffled out the door with a “good luck to ya.” Now in truth, we do get more help, but it is really far short of what is needed. And in the end, the only one who can truly help you is “you.” But you need more tools.

So, here I come to the point of my post. You need to become an expert. You need to figure out how to do all the counting and dosing and it will become second nature. You can lose weight and you can bring your blood sugar under control. And while it may seem overwhelming, in time it will just become routine. I found two books quite helpful, “Using Insulin” by Walsh and “Think Like a Pancreas” by Scheiner. Your blood sugar and weight troubles sound like they are typical of what might occur when your basal insulin levels and bolus ratios are off. If your basal insulin levels are too high, you can have hypos when you don’t eat and you can compensate by snacking causing you to gain weight. Lessening your bolus won’t do much, just leave you high after meals.

So, please, tell youself that you can do this. Get those books. Use those new tools and I bet you come back here and report to us that you have made great progress.

Not taking sufficient insulin to lose weight is a very risky road. Subjecting your body to high BG is damaging & the damage is cumulative. I hope that no healthcare professional would condone this. Better & healthier to eat less carbs to use lowered insulin doses.