It’s taking a lot for me to post this and get so personal about my control, but here it goes. This will be long, so sorry in advance:
I have been really struggling with good control lately. I’ve been on Tresiba for about 1 1/2 months now, and I’m at 17u which is more than I was on Lantus (15 to 16u of that). I’ve been averaging at about 170 daily I feel like, although some days (very few) are perfect and my average is better with no lows.
However; I do well on Tresiba (great morning numbers between 78-100) and steady numbers under 180 throughout the day, but ONLY for the first I’d say 4-5 days on a new dose. I thought I had hit my perfect basal at 17u at night. But now I’m right back to higher numbers.
When I start a new dose of Tresiba, like when I bumped it to 17u, my numbers were steady, my carb to insulin ratio with Novolog went down (1:15 to 20g) and I felt great. But as days go on, I’m having to pump in more Novolog to cover meals (1:5-10g) , and I’ll go to bed with a normal blood sugar (117 for example) and end up 226 in the am for no reason!
I don’t know what’s happening!
Is it possible that the more insulin I take, both basal and bolus, is causing resistance? Maybe insulin is circulating in my system causing this? I read someone post something similar in a comment, and I can’t for the life of me find that thread.
I’ve tried a low carb diet, which hasn’t worked at all and seems to send me high, and I stay high. (but maybe I’ll try it again and again with different foods). I’ve tried cutting animal protein and introducing more carbs (sticking to vegetarian eating) which works for a week, then I’m right back to where I am. I don’t have a set exercise routine but I am active. Days that I clean or run errands don’t seem to make any difference in stability of my numbers.
I’m honestly at a loss at what to do. I see my doc in a week, but I’m not even sure what to say there.
I use mysugr app and my A1C is going to be around 7.7 which is a bummer, but I know I haven’t had a handle on this for a few months, although I’m trying. I’ve never had an A1C above 7, ever. Most of them around 6.7.
I haven’t been sick this month, but previously kept catching colds which didn’t help in gaining back good control. I’m just burnt out at this point, but I’m trying my best to figure it out on my own.
Here is an example of 3 days back to back of my numbers which might help give you an idea. I’ve never been a steady line type diabetic. It was like this on Lantus, but with greater ups and then crashes, and I was about to split dose or increase it, because it seemed to just stop doing it’s job. Then I switched to Tresiba.
-210 (corrected & ate)
-113 (after meal, had ONE bite of chocolate which usually never nudges me if I’m at this)
-240 (had to correct again)
Day 2: (the most steady I’ve been; no over 200’s)
-141 (before lunch)
-82 (after lunch)
Day 3 (next day-all over the place and no idea why!):
(I don’t understand this climb???)
-124 (before lunch)
-210 (after lunch), at the SAME thing as yesterday, same amount of insulin)
-79 (didnt correct a number like this and had a bit of a climb)
-169 (corrected with 1 unit)
I check so often. I can’t afford a CGM or Freestyle Libre, although I have definitely looked into them. And I’m on MDI. Can’t afford a pump either; insurance won’t cover one.
So I’m trying my best with the tools I have. I’m just at a loss. More days than not, I look like day # 3 but with way more 200’s in the evening before bed. Sometimes I’m cruising between 150 and 200-something all day. I was truly hoping that switching to Tresiba would give me more steady numbers, but that hasn’t been the case for me. I do pre-bolus and sometimes it works, others it doesn’t.
And let’s not forget that the days leading up to my menstrual cycle, and during, all bets are off and I’m all over the place too. Hormones are NOT helping me either.
I am getting bloodwork done and getting tested for other auto-immune, thyroid, hormones, etc. to rule anything out that might be messing with my control, so we will see.
Maybe this doesn’t look so bad to others, maybe it looks horrible.
The months leading up to switching to Tresiba though, I had so many days filled with so many highs that I just couldn’t deal. No clue what caused even more resistance back then; it’s all starting to jumble together.
Honestly, I’ve been at this by myself for so long without much guidance from doctors. They look at my A1C, and say I’m doing great. Last visit 8 months ago (job changes, etc. put me off from being able to get in sooner) my A1C was 7, and all I got was a letter not even from my doc, but the nurse practitioner saying: “We’re not going to change your medications at this time, just keep checking your sugar”
That isn’t helpful. Diabetes control is so much more than just insulin adjustments first of all! And I explained to the doc that I already test up to 15x a day, sometimes more.
I first saw an endo when I was diagnosed, but he moved away so I’ve only been seeing a PCP since then and that was 6 years ago. I honestly feel like I would get the best advice from those who live with T1D so here I am.
Any positive feedback is greatly appreciated! Maybe there are some tips I can take that will help me out, or at least some insight to know that I’m not alone. Either way, thanks for reading!