I have been doing pretty good with my control overall until this week. I am kind of freaking out as it almost seems like my insulin isn't even working and I have changed my Humalog pens. I have a lot going on as we got two new puppies and they are up at night and I have been taking naps to keep up with this screwed up sleep schedule, I have been running high around 140-150 and not eating really my carbs at all, but still spiking when I eat anything. I gave myself 3 units at lunch just now and had a cup of clam chowder eating only 1/2 the potatoes and a salad with baby shrimp on it and some italian dressing. I was 120 before lunch and am now 255 when finishing and I waited 15 minutes before eating. Yesterday I was running high 150-160 around 11am after eating nothing but having some coffee with cream for breakfast. I took a unit to bring it down and then I went to go do my hike /run and my BG went up instead of going down and so I went longer to try to bring it down some and then I went higher up to 225. It was really hot when I finished 6 miles and I was hungry when I got home but couldn't eat because I was so high. I gave myself two units and waited 15 min, no change, gave myself two more units and waited then said screw it and ate some tuna and some salad. It hovered around 200 so I gave myself another unit and of course had a crashing low of 54. so then I ate a cookie. Probably not the best choice but I said wtf as I am fed up. I only ate half then tested 15 min later and I was ok at 125. I usually have an insulin to carb ratio of 1;8 in the am 1;10 or 1:15 at dinner and lunch depending on how hard I worked out during the day. I try to stay around 60-100 carbs a day. I am expecting my period (sorry guys, but you are lucky to not have this wrench thrown in to everything) but it has never had an impact like this before. Also, just to mix things up more I started to think that it was my Lantus wearing off too early (as more of my spikes were with dinner, but now it is happening with all meals) so I split my Lantus dose for the first time today. I usually give myself 13 units before bed. Last night I did 7 at 11 pm and this am I did 7 at 11:30 am. I think the thing that makes me nervous about upping my Lantus is that I occasionally go low from a tough workout in the middle of the night. I mostly have been around 100 when I check at night. Is it that waking up at 3 and then 5 and then sleeping on the couch while the puppies play then fall back asleep, Is that what is screwing with me, like I have all day dawn phenomenon? This is my first summer with D as I was diagnosed in Dec. Is it the heat? I am so sick of the up arrows this week!!!!!! Any advice would really be appreciated.
Thanks!
Molly
You know Molly, it might be the head. But it may also be this crazy thing we all have called diabetes. It don't matter whether you are a 1 or 2 or 1.5. Sometimes things just go nuts and there is no real explanation for it.
Some of us here on Tu have called this "riding the wave".
I swear sometimes this little disease puts you on a roller coaster and all you can do is hang on and enjoy the ride.
I actually hoep someone can help you figure out what is happening. But if you do a search in Tu you will find hundreds of posts that read much like yours does. I think I have done one or two myself.
Ahhh the mystery that is diabetes.
Just remember that YOU CAN DO IT!!!
Molly - I've been through periods like you describe. I know how frustrating it can be. You're going along and and your BG seems to act predictably with logical cause and effect. Then it's as if the your diabetes world gets turned upside down and inside out. Nothing makes any sense and it makes you wonder if it's even worth trying.
I always come back to one tool that always works: logging everything. Keeping a daily diary for a awhile that tracks BGs, insulin, food, exercise and anything else that you think influences your BG levels including stress or your monthly cycles. Once you put it down on paper it takes the 101 things flying around in your head and starts to bring some kind of order to the chaos.
It would probably help if you could get someone like a diabetes educator to review your logs and offer some suggestions. Sometimes a more distant perspective allows them to observe some relationships that you can't see because you're at ground zero.
Keeping a daily diary has restored order to diabetes chaos more than once for me.
Don't give up; I know for certain that that path produces nothing good. Good luck and please post an update when you learn something useful.
BP is right. Sometimes it just doesn't make any sense. But, it is always good to try and figure it out. You may uncover some valuable information about your body's reaction to whatever it may be. Then again you may have to chalk it up to sun spots.My two cents on what you describe would be the sleep / schedule issue and type of carbs. I find for myself that any change in my routine (which by the way, I despise) gives me problems. For instance, If I sleep in til 8:00 or so I will spend half the day stabalizing my BG and I will probably have a low. All because I was 2 hours late with food and Lantus. I eat about the same amount of carbs as you. But not all carbs are created equal. Something like clam chowder is an unmeasurable time bomb. Even if you eat none of the potato chunks, the broth is basically a starchy paste. BTW I LOVE clam chowder, but I avoid all starchy carbs except in limited and very controlled situations. I would especially avoid them when trying to bring things under control. Since there is probably not a lot you can do about the schedule I would limit my diet to things that I know are safe and require the least amount of insulin possible. Like I said, this is my two cents and all about what I would do. I hope it is helpful, but you are obviously not me. And that is your silver lining. lol
Oh yeah, what kind of puppies?
I suggest combining Terry and Randy's suggestions. Log everything and pick a basic breakfast, basic lunch and perhaps even a basic dinner and just work on them until you get some more consistent results. An advantage of using a steady diet for a while is that you'll be able to rule out food issues if your post meal results fail to show a consistent pattern.
One thing I wouldn't do is make a radical change either up or down in the number of carbs you eat until you get back to more regular patterns. You might be using some of your Lantus to cover carbs or some of your humalog might be correcting basal shortfalls. It doesn't matter too much if you keep very steady habits but once you start changing things the imbalance between your Lantus and Humalog might lead to some problems with highs and/or lows.
Good luck and keep trying - that really is all you can do.
Maurie
In that scenario, I'd look at the clam chowder as suspect? Even w/o some of the potatoes, there's often quite a few carbs in it. If it was homemade, at least you'd get nutrition info but, if it's out, a lot of times they'll thicken it by tossing in some cornstarch, which is really concentrated and can add quite a few carbs I think?
If dx in December, it may be time to just turn up the basal rates and ratios, perhaps the "homegrown" is wearing off? I usually change by a couple of "clicks" on the pump and w/ adjusting Lantus, I wouldn't do much more than 5-10%, depending on how much that is? Usually, to make switches (although I have a pump...) I look at "before meal" numbers as "basal rate" and after meals as "bolus ratio". When I make a change, I try to let it ride for a couple of days before I make more and see what happens. Last time, day one, zippo, none of the changes I anticipated occurred? I was gonna give up said "no, try a couple more days..." and it worked fine after that? No real logic but it fell into place?
All great ideas. I guess I'm really just tired and was being too loose with my carb counting. One cup of clam chowder is around 18 grams. I ball parked two units which should have covered it, but I guess I really didn't wait long enough. I also think I got overheated yesterday and that is why I went up instead of my usual down. I need to drink more water overall. The logging is a great idea. I haven't done it in awhile now. Just reading back my post helped me to analyze more. I was getting sort of cocky with my cgm thinking that if I saw a spike coming I could just add another unit instead of counting carefully. The clam chowder was a weak moment, out to lunch with my daughter. She had hers in a sourdough bread bowl, (those were the days!) so I thought I was being good. Not good enough though. I really wanted to try to keep my insulin usage down so I've been erring on the side of minimal carbs= less insulin, but now I am finding that I really need to count the carbs in my protein, etc. too and I am not really doing that very well. I wonder if the "homegrown" was helping, although I really never felt like I had much of a honeymoon phase as far as I could tell. I will try not to let bum me out.
My Doggies are golden retrievers. Here's a pic of the little crazies while they are sleeping and looking like angels. I give moms with D a lot of credit. Raising babies while trying to deal with D is beyond my imagination. At least I can put these guys in a crate.
Hi Molly. We have three grown up Goldens. I guarantee your little ones will give you plenty of exercise for years to come!
I can't wait 'til they get all their shots so I can walk them ALOT!!!
I'd say 18G is really conservative for Clam Chowder. It's been years since I had the Campbell's "hungry man" variety which I recall being a ton of carbs and several servings/ (large) can. I usually assume 25G at least but the stuff can produce spikes. I highly suspect that it was too runny, they dumped in some cornstarch and blewie, 35G/ serving?
You are probably right, it was pretty thick and I should've known. Got that number from an iPhone app, very nonspecific to the type. Gonna log it all for awhile and see if my basal is off too. It feels like it is.
Hi Molly,
I've had type 1 for over 26 years - I've had my good days, my bad days, my good weeks, bad weeks etc. and have just learned to do my best. Sometimes there is just no reason that I can find for high blood sugars, and I had to learn to stop blaming myself all the time and just treat and move on. It took me years to not get upset every time my blood sugars weren't where I wanted them to be. One thing - you said it's been hot. I'm on a pump, and I've noticed that when I've been out in the heat that sometimes my insulin doesn't work as well as it should. Hang in there!!!!
I am EXTREMELY insulin resistant right before my period. Stress and lack of sleep will do it too. Maybe those factors are contributing because the low shows your insulin is working.
Your puppies are adorable, and yes always nice to be able to put them in a crate - I think DYS would frown on that for babies though.
Thanks for the reply! I think I'm having trouble with the blame part. If I see a spike over 200 I feel upset with myself. I know it's part of the deal, but I still do. I have never done well in the heat so it makes sense that it would give me trouble too. Oh well tomorrow is a new day, hopefully better...
I think that I am too, I need to keep track to make sure I know ahead of time next month. Thx for writing!