Whoops… just lost everything I wrote.
Hi Gary,
How are you feeling today? I hope you are a bit better.
I checked your profile and saw that you were diagnosed in 1975. Back then, when there weren’t so many of us, hospital stays were the norm and treatment plans were individualized.
While most people on Tudiabetes, including myself, seem to get paranoid about high blood sugar, they never seem to complain about how it makes them feel. It sounds like you first feel physically ill and then the fear and panic set in.
I hope you can find a doctor who will treat your physical illness so you can get close to be superglued at 90. Must suck to feel so sick all the time.
Peetie, I honestly don’t understand why your endo is keeping you on oral meds if you have an HbA1C of +10. Maybe when you have your appointment in August you can ask to go on insulin alone (basal and bolus).
If you live near Toronto, you’re too close to civilization to get a Joel. Now, if you lived in Yellowknife, Resolute, or some remote area like that, then you probably would get a Joel. 
Thanks Natalie for correcting my mistake. No, no, no - not that low! Fortunately, none of the pens come in that super-duper size.
I can relate to that… actually, it’s the same with me most of the time.
It’s difficult to explain to someone that you don’t eel well despite a (to the rest of the world) “near perfect” control. I am right at this point. I thought a lower A1c would solve the problem but even at 5.5 I’m not feeling much better.
I also can relate to the 120. If my bg is higher than 130, I feel like other people feel at 230. I still notice lows very well so it’s not because I’ve been on the lower side too often.
I do know that it is not realistic but why can’t I still wish my bg was 75-110 all the time? I’d feel great if that was the case. In other words, I’d feel normal.
What I’m trying to do is to find an I:C ratio that actually fits. An I:C ratio that prevents spikes but doesn’t cause lows either.
Right now, that’s the only thing I can think of that might help… I’m on the hunt for answers/help/tips myself.
It’s hard to admit to oneself but maybe we should eventually seek psychological help since even a perfectly matching insulin dose does not help with all the other things. As difficulty to interact with people who don’t have diabetes, as constantly worrying where the bg is (maybe even if it’s fine).
Thanks Jean, I would recommend AVOIDING a lot of the places I’ve been!
Well yesterday was a rather pleasant day for the most part but its very rare I get a good diabetes all day long. Its strange how from one day to the next this condition is like Jeckyll and Hyde. Everything becomes overwhelming for me to deal with when the levels are off so I live a very simple life and I live that way mainly due to the diabetes. No kids no girlfriend, no traveling. I cringe when I hear people take a vacation as the stress of managing this disease under those circumstances dictates that I don’t get away. If I had a penny for every time my diabetes dictated how I lived my life over the last decade I’d be pretty rich.
So good to hear you had a better day. Hope today is another. 
Bruce…I just have to say that my initial - albeit - very MINOR experience with transitioning to some use of insulin has been so gloriously EASY! And SO WONDERFUL! I am JUMPING for JOY this morning!
When first Dx’d my issue was HIGH post prandial sugars. My fasting sugars were actually pretty normal. Under 110. Go figure. So my doc put me on Onglyza (like Januvia). And it did the trick. My post prandials behaved, staying under 120 most of the time, though I do restrict carbs mostly to 20 and under per meal except for an occasional splurge (mostly when eating out).
However, recently things have been deteriorating (I suspect because my thyroid has been going whacko…but cannot prove this. Thyroid now back in line…but last time this happened the diabetes damage was done and it never went back to “normal.”).
Night time sugars were rising beyond 150 regularly and one night when I had a low carb snack of less than 9 carbs (mostly protein and 2 squares of dark chocolate) I woke up at 3 am at 200! Thirsty, with a headache. I was miserable. And my morning sugars had not been behaving. Well over 110 and really 118 and above to 128 for close to 6 weeks now. At my Internist my fasting last sugar a week ago was 121.
So my Endo added a dose of Levemir long-acting insulin at night. Based on my body weight and a c-peptide test done early one, she determined my insulin resistance to be very low. So she calculated all I’d need would be around 5 units.
I started the Levemir 2 nights ago with only 1 unit. It was SO easy with the pen and you cannot even feel the needle. WHAT needle? Truly, finger sticks for a glucose reading are SIGNIFICANTLY more painful. You feel those. This…nothing.
1 unit brought BG from the 118-128 range to 108 the first night and I slept like a log and managed to LOSE a pound (I think this was water weight).
Then last night I did get a bit bold/impatient. I upped the dose to 3 units. I really did not think I’d go hypoglycemic and I did not think I’d have an allergic reaction. This morning my BG was a beautiful 98!!! I was SO excited.
Tonite I will add one more unit to see what happens, but I have dextrose tablets close by - just in case. One unit should not drop me 30 points, but you never know. What if my meter is off? So, I’ll be very very careful. I am documenting all of this in a little notebook.
Of course, I am not driving at night…and I was doing this close to a weekend… If I were transitioning to insulin 24/7, I would choose to do it over a weekend and possibly arrange to work from home a few days. If I were on both basal and bolus, I would also arrange to take some sick leave and vacation, just to make sure I had the carb counting down if I could…but…at the same time, Bruce, you seem to ahve managed it very nicely. Yet, you are really pretty hypo aware.
Last night my BG was fairly low when I injected and about an hour and 15 mins later I did feel just a bit shaky as the insulin kicked in. My meter read 84, but since I felt jittery…I trusted by body not the meter. I ate 1/2 of a jellied orange slice which is 6.5 carbs (all sugar) and within about 10 minutes, I felt great. I checked my sugar a half hour later, it was 106. Again in the middle of the night, 108 and in the morning, the beautiful 98!
And, I lost a bit more weight, according to the scale this morning…after a nice meal out on the town for Father’s Day last night. Not a lot of carbs…but as my dear T1 friend says, they have a bucket of “Carb goo” in restaurant kitchens with a ladle and they just dump a ladle full over everything, it seems when you eat in a restaurant!
So, Bruce, a few questions…
How many of those test strips does insurance cover for you? About how many carbs Do you eat per meal?
The reason I ask is that I just attended an education session with a newly diagnosed friend (T2) who is in her mid 70’s and I was shocked at how many carbs the program was recommending that the patients should eat.
They were recommending that this 74 year old woman (who while active for her age is still 74, so her metabolism has slowed down some, right?) eat AT LEAST 45 carb grams PER MEAL plus snacks. They actually said 45-60!!!
They also forebad her from even having a pat of butter with her whole wheat toast in the morning (while approving of the 2 pieces of toast…I have her on Trader Joes, Low Carb Sprouted Wheat Bread, so it’s only 14 carbs for both pieces).
Now, 45 carbs per meal is probably what I was eating BEFORE I became DIABETIC! That is a full sized serving of spaghetti!
So, are any of the people here eating that many carbs? Maybe I am just really unusual. When I said that I could not really eat much more than 20 and 25 was a stretch before my glucose started to really rise, the CDE asked me if I were SURE I was not a Type 1.
I replied that “I don’t have anti-bodies” and she did not know what to say.
Now, I did not share with her that I AM indeed a very atypical Type 2 and my Endo had just referred me for genetic testing for MODY. And she is going to test me again for GAD antibodies to rule out 1.5 again. Because I was initially negative for antibodies…but it was early days and now my sugars have degenerated in the 6 mos since dx…so maybe I DO have autoimmune diabetes…and the antibodies just had not shown up yet.
And it looks like I am very insulin sensitive…so all of that is to say …maybe I am so atypical that this whole carb convestation is different for me…but I’m just curious about other T2’s because I want to advise my newly diagnosed friend and don’t quite know what to tell her. She is pretty confused.
Also, the CDE told these people that they should not go more than about 4 hours without eating (fine) … and that if need be they should get those peanut butter snack crackers and carry them with them. I said “Junk food?” And she looked daggers at me and said “well if you CAN make real peanut butter crackers at home and carry them around.”
I realized that all of the people in the room did not perhaps have the luxury of doing that and I felt bad. But I was also a bit concerned about that advice. One person asked about an apple and with the peanut butter crackers…and then she said…no apple and peanut butter, skip the crackers. WHY did she not suggest the apple and peanut butter in the first place? Or celery and peanut butter? Is that not healthier? Fruits and veggies vs. flour? I was scratching my head.
If someone can explain, I’d like to know. Cost? Celery is not that expensive, is it? You’d get DAYS of snacks out of one package of celery at the store…cut up…and a jar of peanut butter. And don’t get me started on peanut butter, because, sadly commercial peanut butters have more carbs than natural…but…okay…I’ll stop the rant…
I’m a Type 1 and so have never transitioned to insulin since I was put on it from the start, but if I were moving from oral medication to insulin I would NOT take time off work or stop other normal activities. The reason being that you would then set your dose for what you need when you are lounging around doing nothing, and as soon as you go back to work and other activities you do every day (running errands, exercising, etc.) your entire dose may change.
As for lows, I make sure I have fast-acting carbohydrates with me at all times. If I happen to leave the house without them or I use them all up I will stop and buy something at a store somewhere. Lows can come at unpredictable times (for me, at least), but they are rarely a big deal. If I feel low and can’t test for some reason (though that’s rare) I will treat as if it’s a low.
It’s also my understanding that Type 2s often (though maybe not always) tend to go low less frequently and feel lows more strongly then Type 1s because they have a functioning counter-regulatory system that kicks in properly, still produce at least some insulin of their own which helps prevent extreme highs and extreme lows, and haven’t been having lows regularly for decades, all of which are problems for Type 1s and contribute to them having severe lows out of the blue with no warming.
One thing I’d suggest might be to try 3 1/2 units instead of 4 to see what happens? I realize that not all syringes are marked that way but, when I was injecting, I’d often pull the shot 1/2 way in between two numbers to get an extra “1/2” unit in there? If you can get the smallest incremental syringes, you may be able to get one incremented for 1/2 units.
Anni, so glad to hear that Levemir is working for you. I know what you mean about feeling somewhat liberated by using insulin. I had the same feeling when I started using it. It had made me wish I had started much sooner.
As for adjusting the basal dosage, I was instructed to adjust once every three days until I reached my target of 110. I don’t know the reason for this waiting period. Maybe the body needs time to adjust to the dosage change? Perhaps some with more knowledge can shed some light on this.
When it comes to test strips, I honestly don’t know what my insurance company would set as my limit. My Rx calls for testing 4-5 times per day, but I test 7-10 times per day. I burn through about 250 (six vials) of test strips per month, yet I have never been turned down for refills.
The carb thingy. I try to keep my carbs at around 30g per meal, sometime a little more, sometimes a little less. Fifteen of those carbs are usually in the form of fruit. That’s my dessert. For example, I’m cooking dinner tonight. I plan on starting with a salad of romaine, spinach, mushrooms, tomatoes, green olives, and sliced egg. The only carbs I will count will be in the dressing, and I use very little of that. The main item will be stuffed bell peppers. They will be filled with lean ground turkey (97/3), diced onion, and bread crumbs seasoned with cumin, ground thyme, garlic powder, and creole seasoning (Zatarian’s). The small amount of bread crumbs I will estimate at 15g. I will serve that with a side of cooked down sliced yellow squash, onions, and diced ham, seasoned with creole seasoning. Zero carbs there. For dessert I’ll probably have a sliced kiwi fruit or a half of a Fuji apple. That meal should come to about 30 carbs.
It sounds like the CDE who was teaching at the event you attended didn’t know what she was talking about. It’s sad that all the CDE ended up doing was confusing your friend. I can only image how many other people left the session confused or armed with less-than-great information. It’s good that your friend has a friend like you to help guide her.
Take a break and relax. I don’t get it are you just trolling? If this is a true person with this issue, I suggest getting your A1C higher than 6% and you will feel better. After 52 years I disagree strongly with the below 6% is good ideology, I am happy and feeling good between 6.1 and 6.9, which is my goal. But that’s just me.
Unfortunately…yes, I’d be delighted to work that out…and am comfortable that I could do so! However, I was prescribed a Flexpen, designed to be idiotproof…but not for micromanagement of dosing. So, I will figure out if 3 is too little and 4 is too much for now - if that is correct…I’ll then go ahead and ask for the vial and syringes…
And yes, I feel confident that I could figure out how to dose 3.5 by eyeballing mid-way between 3 and 4 even if there aren’t any hash marks…
Bruce…thanks SO much for the 3 day advice. No one said a WORD to me…SO, I will definitely stay here at 3 units for 3 days and see how I adjust…
Yes, I agree about what the CDE was teaching and my friend said that the people in the class were just buying it hook, line and sinker…
I’m not a type ii but a lowly cheese cracker with peanut butter in it is only 3.5 carbs and no trans fat…
Well, I think you have a good point. If your diabetes control is good, and you still don’t feel well, it’s time to start looking at other things.
The unfortunate side of the coin is that the body is so complex, and docs don’t know everything, and even if they did, some things have no treatments.
I often don’t feel well, but I know it’s not usually diabetes. I have a bunch of other stuff going on, and I also have Major Depressive Disorder, which makes everything worse. So I keep on trudging, and don’t have any other brilliant advice to offer.
Congratulations on starting insulin, Anni!! I am totally confident that you will get it all figured out – and will make the transition to MDI and maybe eventually a pump with no problem.
My heart truly goes out to the Type 2’s who know nothing to begin with (as we all knew nothing in the beginning), and are subject to one-size-fits-all, carbs are good for you and fat is bad industrial training. There ARE some super CDEs out there, but even they are subject to oversight, and must be cautious about what they say.
And I, in my totally non-medical squirrel wheel, am sure you are not a Type 2, so you need to let all the Type 2 advice go in one ear and out the other. You need to do what works for YOU, and there is certainly some good ideas floating around here. I was particularly struck by Jen’s post about NOT limiting activities during insulin initiation – if you are ratcheting up your doses slowly, you are not likely to have a bad low – most lows feel rotten, but you can easily treat them. Just be sure to have glucose tabs, or juice boxes with you at all times.
Onward and upward!
It is possible that your A1C could be low because you are having too many lows. If you are experiencing wide and unpredictible swings it will make you feel terrible.
I also get loopy when my sugar is high, I will say something or do something or hear my self laughing and I’ll feel like “who is saying that”? It is scary and embarrassing.
Couple ideas - you may need to redetermine you insulin sensitivity and / or like others suggested change insulin types. If you work with your doctor or educator they may be able to help stablize you. Not sure you mentioned it but if you are not currently using a pump, that may also help.
It is possible that you need medication for depression and anxiety. That is also a common issue for diabetics.
Thanks so much Natalie…I’ve been meaning to message you to fill you in!
And I did feel myself going low…no worries for now. My experiences earlier in life with the hypoglycemia prepped me really well for lows.
I can feel them coming before the meter tells me they are here. I feel myself going low at the point my meter is reading about 82-84.
Now, to be clear…I will get readings at 82 and feel fine…I’m just reading 82 and not DROPPING at the same time. But last night after I injected (at 1 hour and 15 minutes post injection…and I’d injection when I was only at about 88 or 90 I think)…I felt a little low…just that shaky feeling internally…nothing outward…I checked and was at about 84 and thought I might be in the midst of dropping…so just had half of an orange jellied candy slice (7.5 carbs). In about 6 maybe 7…8 minutes the feeling was gone. When I checked about 20 minutes after I felt low I was right at 100 or so.
Then in the middle of the night or at bedtime, 108…morning 98. Beautiful.
Then before lunch today…I felt the same thing…just felt myself dropping…and it was the same thing. At the point I checked I was about 86…but had that feeling sugar was going south so I quickly ate my raspberries and got food into me. And I was fine…
It was reassuring just to know that I’d be able to feel it and to know that the feeling was the old familiar feeling from all those years of having hypos when I just put off eating to long!
And yes…we’ve all been nodding and agreeing that I sure have not been behaving like a Type 2!! So, yes…in one ear and out the other…
Oh, and after hearing the family history I dug up…right back to Great Grandma Evelyn in Moscow who died at age 24 or so…down to me and my cousins from her line (vs the classic T2 cousins from the descendants of Great Grandpa’s kids by first wife)…my doc has referred me to the genetic counseling session for MODY testing! Interesting…huh??? She’s also going to repeat GADs…
So, my dad always used candy and my BFF uses the jellied candy orange slices…which are SO much cheaper than glucose tabs… and very effective. They are 13 carbs per candy vs. the 15 per glucose tab… And 1.99 for a HUGE bag… I put them in baggies and have baggies of 4 of them EVERYWHERE…in the car, in every purse, in the bathroom, by my bed etc…
But are juice boxes better??? Does it get into your system any faster? Just wondering. All advice very welcome!
Anni
Hi, Laura…I completely believe that one cheese and peanut butter cracker has 3.5 carbs…but I’m just wondering how manyy are in a pack. She was recommending an entire pack…as I understood it. She did not say …count out 2 of the six crackers that come in the pack…or count out crackers that make up X number of carbs and Y amount of calories and/or fat.
I looked up them up on line on Sparkpeople and the Keebler versions (there were several…) tended to be between 200 and 260 calories per “serving” and the fat grams were 10 and the carbs per serving that I saw were 30.
There were no vitamins listed and no fiber.
My only point was that it concerned me that this was a recommendation for a healthy snack at a diabetes education session. It did not seem like a good choice to be offering diabetics…but others are certainly free to disagree.
I cannot eat make a habit of eating 30 carbs at every meal, let alone a snack…but others are different I know.