I need help

I've been a type 1 diabetic since 19 and I am almost 21 now.
I was at 279 at 9:25pm.
Also, I took my slow acting insulin, at 10pm.
I have a blood sugar of 239 since 10:56pm
I just checked right now,at 11:26pm and I am at 189...
Am I doing the correct thing?

I am having trouble understanding diabetes and how insulin should be working.

It's been almost two years since I check my blood sugar, record it, inject insulin, then eat. The check again, only to find it high. Then low about three hours later, then high, then low. ALL day it is like that, no meter what I do?

To try to fix my high sugar, at 279,I injected 4 units of fast acting insulin.
I waited about an hour and a half.
It went down. Usually it goes as low as 42 within half an hour just because injected insulin.I used to be extremely sensitive to insulin , and constantly fought with hypoglycemia. So I decreased everything: my long acting insulin, my short acting insulin, and now I deal with highs... I'm upset because I fear diabetes now.
I used to think it will be okay, but now I just want to give up trying. I still get highs, lows, SOMETIMES regular blood sugars between 80-120. I think my diabetes is bipolar....
If I saw an endocrinologist, would they help? What do they want to find out? How would they help and how are their action plan and interest in details different than a regular internal medicine doctor and nurse?
I just want to know because I always see my doctor but all he does is check my tracking journal where I write my blood sugars does throughout the day, and he just increases or decrease my insulin, then he moves on. However he is not a diabetes specialist, and I am interested in seeing one, but was wondering if they help or not. Do they? If they do, will this stop my blood sugars from being unpredictable, will I gain control of my blood sugars, and will I benefit from seeing one?
Is this normal, or do diabetics deal with these same issues?
If you don't, how can I be like you?
What do you do, that I should do, that may perhaps help me stop having highs and lows?

Good for you for trying to improve this now. I lived with numbers like that for thirty years - I would go from 40's to 300's routinely. I really didn't think it was possible for me to do anything else. I'de been seeing an endo for 20 years and never got any useful advice from him. But I know there ARE good endo's out that that can make a big difference - I just never found one.

What a good endo will do is to help you figure out your treatment ratio's, and help you figure out your basal and diet planning. You don't need an endo to do this - but it is more work to do it by yourself. I would encourage you to try to find a good endo - and keep trying.

If you want to do it yourself, you need some of the books that are available these days that explain the management process. And you need to be willing to do some math, and you need to be willing to treat yourself as a test subject guinea pig, and you need to be willing to test your BG a LOT.

The best of the books to explain management in my opinion are the "Pumping Insulin" or "Using Insulin" books by Walsh, and the "Think Like a Pancreas" book by Scheiner.

These books (or a good endo) explain the process to use your Total Daily Dose and fasting tests to adjust your basal insulin (Lantus or Levemir) to cover you when you are not eating food. This makes a HUGE difference - if your basal is set incorrectly, then your BG will always be unpredictable.

Once your basal insulin is reasonably well adjusted, you can measure how different foods affect you at different times of the day and figure out your carb/insulin ratios for boluses at different times of the day. Once you know this key number, you are much better able to judge how much insulin to take to prevent yourself from going way high or way low. It then becomes a matter of knowing how much carb is in the food you are eating; and doing things like eating similar foods (for example the same type and amount of bread for lunch) can make this more predictable, as can trying to moderate the amount of carb you eat so that it will be more predictable.

There is a lot more to explain, but the main message is that it IS possible to even out the extreme BG's you are seeing. Be patient, keep trying, buy some books and ask questions, and you'll get there. Good luck.

I actually think that it might be useful for you to see a diabetes educator. My local diabetes center runs a standard class on intensive insulin management that is (at least in my case) covered by insurance. Jag is right, you need to get your basal right, count the carbs in what you eat and then dose properly for those carbs. Once you do that properly, you should get much better results and feel more like you are controlling your diabetes rather than it controlling you.

I think that a doctor would help. A lot of times, diabetes is characterized as a fight vs. high BG but it's really about balancing food and insulin, along with activity, stress, astrological phenomena (ha ha?), etc. Most people who are doing pretty well have two things, a basal insulin rate (long term insulin, Levemir or Lantus) and a bolus ratio. The books that Jag1 recommended are both excellent owner's manual type of books and you can probably get them on Amazon for like $10, maybe less than the co-pay at an endo but seeing an endo would be useful too. I suspect that reading the books may actually be better than the doc, simply because it would only take a couple of days and the timeframe for doctors seems to be very frustrating to many people.

Hanging around here may also be useful as there are a lot of smart people who can help you here!

are u drinking lots of water?

Hi ambee,
I'm 18 years old and I've had diabetes for 9 years.
My blood sugar was like a roller coaster too. Four month ago I read the book "diabetes solution" of Dr. Richard Bernstein and it helped me a lot. I don't have these extreme blood sugars anymore. He recommends a very low carb diet and I think it's really worth to give it a try!
Seeing a diabetes educator could be useful to understand how different insulin works and how to use them.
All the best! ;)

Hello Ambee:

. Lets start at the beginning... ok?

We've all wanted to walk away from this, forget it for a while, pretend they do not.... I'm over twice your age give or take, been a Type 1 longer than you have been alive . You want to try kicking its butt again... good! Welcome back to the fight: D

Start from the beginning... You clearly have a meter, you've got numbers! What you will need is more strips, or another meter with generic strips... how old are the ones you are using now? Are they expired????

Is your insulin, are they both new? Or have you been using the same vials for the last two years 8 O??? (Hey some people REALLY pretend).

Depends on which short acting you use, when it peaks, how long it lasts. SOME insulins are totally done by hour 4. The standard to see if you got a dose right is TWO (2) hours after injecting.... if you hit your target number two hours post injection, consistently... you are using the right calculations and formulas.

Testing, 4+ times a day (eg every meal + before bed) will get you patterns to examine, just like a science experiment. Get enough data, enough readings and you can figure out pretty easily whether you need MORE (or less) long acting. Get enough post injection readings and you can tell if you need to tweak those doses... or not!

Even though we use the stuff every day, takes a while to find MOST patterns. Long as we are careful, and SLOW with most corrections, most tweaks. Its not impossible.

Based on your initial numbers, looks like you did/are using the right formulas to calculate your doses... to me. I might tweak it a little tiny bit, before doing so, Id have to get 3 days of readings before changing impulsively?!

Long acting does absolutely nothing to drop high numbers. Its designed to be a glass ceiling. Insulin running in the background so that any break through HIGHS do not become NASA projects. Its not meant to lower much so much as prevent it from getting TOO high...

Don't forget those @*#(*&@#)&@ GREMLINS (sic. insulin gremlins)... we fight with them too. Well ok, they mess with us but you can never tell when they are working, they dont tell... they just show up...LOL

Just checking in, anything new...?

Yes, I am working really hard on improving those blood sugars. I am working on testing just as I was when I wrote about this, but I have no insurance, nor do I qualify for any only one, but I am waiting for my appointment date and I'll see how it goes. In the mean time, I am purchasing my test strips and "experimenting" by eating, then checking. I do this very routinely. For example: I eat, count the carbohydrates of my meal, I rule out any sugary items such as ice cream (unless I have low blood sugar), I wait 30min, test. Wait another 30min, test. Wait yet another half an hour, test, and test once more thirty minutes after that. All this for a total of two hours! And so by doing this, I am able to track my blood sugars. A LOT better, and how my "foods" affect my blood glucose. :) That is good news right. I found it's so much better if I do this. I also make the time to write this activity in my daily food journal. I am currently awaiting to attend some diabetes classes to learn more about taking care of my condition. Thank you so much for your response!

Im going through the same thing,just had a mmol of 20 injected 4u of fast actingan hour ago now im 12.2 iv been suffering too many lows spoke to my dsn and they suggested lowering my insulin and now im battling highs all day! I think you should speak to a diabetic specialist,i didnt see mine for nearly a year and i must admit i feel alot better now i have im still having problems with highs but feel better as i have someone to talk to x