Tim, my fasting numbers are fine. But my numbers in one day can go from 90's to 205 down to 66 and then back up to 190's.............that's my complaint. I eat the same things consistently. And I don't think the grass is greener on any side of diabetes...............it sucks any way you look at it!
Well - I'm five years into my honeymoon and hope it lasts forever :-). I don't need a CGM yet although a pump has been a big help at least for quality of life.
Those of us who were struck late in life are lucky in another way. I was diagnosed at 57. If I can dodge complications for 25 years - not an unreasonable hope - I'll have made it into my 80s in pretty good shape.
Maurie
I don't really think those types of swings are all that dramatic (not to minimize them, just relatively speaking!) nor do I think they are caused by the honeymoon, per se ... I think that's just part of having Type 1 diabetes. I'm long past any honeymoon (and I was never able to stop taking insulin completely ... my "honeymoon" was a three-month period of taking less insulin with relatively better control), but my BG goes from about 55 - 225 on any given "average" day—meaning some days are also much worse than average!
im on a 1:30 bolus so you have me beat :)
Yeah I guess you are right. I am sure every stage of this thing has it's ups and downs. I think I just look at this stupid disease as a destination, but in actuality it's a never ending journey. I need to do a better job of being content where I am at, and I am sure in due time the sugar beast will show up in its fullness. Three months ago I was totally oblivious to this entire realm of people and lifestyle. I can't tell you how much I admire and appreciate all you veterans out there that have helped me along.
I was diagnosed at age 40 and for 6 months I was fine with only 7 U a day of Lantus. Then I started bolusing at meals with a ratio of 1:50. Then I started needing more and more insulin. Now I bolus 1:10 and I have a pump. But overall I still only use 20-30 U/day (with a lowish carb diet). My endo says that's a small amount. I hope your honeymoon lasts a long time!
Maria
A lot of times, I set my (considerably larger...) insulin doses "high" and eat to keep up with it, figuring it's easier to eat food than to "uneat" food if I err on the side of caution the other way? For some time, this led to some weight gain but I've cut out some stuff to avoid control my weight but still kind of steer into the insulin wind rather than going with it? If you are running low, maybe "adjusting" your carb ration with more food would be a solution? Even something relatively healthy like veggies/ protein/ etc. can help maintain BG and, well, I like to eat!
Ok, I did a bit of “experimenting” today. I am trying to figure out of I need just basal, just bolus, or a little of both. I woke up this morning at 89. Ate breakfast, net 70 carbs, and one hour and fifteen minutes afterwards I was peaked at 205. After 2 hours 15 minutes I was down to 145. After 3 hours I am down to 62! With no bolus, is that my basal that is bringing me down that low? Should I experiment with no basal and a small bolus to try and get that peak of 205 down below 180? It is evident that the basal and bolus I am using is too much, so I am at least trying to see what my body is doing, and just help it with what it is lacking… I know these are all questions for my endo, and when my appointment comes up I will show him the numbers, I would just like to have a few different scenarios for him to see.
I had a similar pattern although not as pronounced when I was starting out. Your basal is clearly too high for daytime although waking up at 89 is just about perfect. You might also play with your food choices. If you eat fewer carbs and mix more fat and protein into your breakfast the spike might well be less pronounced.
Maurie
I agree with Maurie that your basal is too much, bringing you down to 62 from 205! (especially if that is a pattern).Since you are on a pump, you can keep your current dose during the night if you are usually waking up around that 89, but lessen it during the day when you are crashing. Most of us have more than one basal rate to meet different needs throughout the day, which is one of the great things about a pump!
Yes, it does sound like you need a small amount of bolus. But you said you want to "get the peak down below 180". That may be an ADA goal, but most of us think that is still way too high. Studies show damage starts with consistent time spent over 140, so that is a more reasonable post prandial goal. (Some people strive for 120). And I also agree that 70 carbs is a lot especially for breakfast when many of us are at our most carb sensitive. You might look more to egg dishes rather than cereal, and get the carbs down for that meal so you can more easily bolus for it.
Yeah, I see what you are saying. I guess this morning I was trying to “test” myself and see how it would react. I had 50 carbs for lunch, no bolus and I peaked out a bit over 100. After this pod is over, I may try to see how I react with no basal, and if I see that my spikes go about 140 with around 50-60 carbs I will try a little bolus. I am an athlete and work out on a regular basis, so I feel I need at least 50 carbs. I agree, 70 is probably too much, even for me. I would like to find the maximum amount I can have without the need for insulin, until this honeymoon period ends.
I eat around 65 net carbs for breakfast so 70 isn't necessarily too many but I eat about 60g of peanut butter and a couple of eggbeaters as well. I actually have to back off on my initial bolus and take a hit a couple hours later. Given that you run low a few hours out, the high fat, highish carb breakfast might work for you as well.
Maurie
Yes, we all vary in the amount of carbs we eat, but my experience with nut butter, Maurie is that it has a limited effect on blood sugar. I adore nut butters and they are probably the only food that I eat more of than I should! I eat it sometimes for lunch and I'd guess if I measured accurately it would be about your 60 grams but I only bolus for 10 and it works fine! I would bet you (or anyone) would have more trouble with 60 grams of cereal or cereal, milk and fruit which I have given up on as I can't bolus successfully for it.
I was giving the actual weight of the peanut butter. I dose for it at 10% of the actual weight. I had to give up cereal but milk and an apple are a regular part of my breakfast. For some reason I'm able to handle a lot of carbs in the morning. Go figure.
Maurie
I think I read a study of typical honeymoon times in pediatric type one, mean was 7 months plus or minus four months, I think. Not sure if holds true for lada... my daughter is in 9th month of honeymoon, still low insulin requirements. best of luck, with omnipod and dex, you will be able to do an outpatient trial of artificial pancreas soon!
Natalie Hodge MD FAAP
www.healthergy.net
I'm a little confused when you say weight, Marie. I've heard people talk about weighing things, but I just measure and then look it up. With things like nut butter I go with what it says for carbs on the jar. when you say 10% do you mean for nut butter or everything (that would mesh with my own experience with nut butter). I don't understand the relationship between weight and volume. I'm used to 1/4 C of this or 1 cup of that. I guess when I look it up I'm doing the translation from volume to weight. Like 1/4 C of flour "weighs" 23 grams of carbs??
Wow, you and Maurie are lucky. Most of us seem most carb sensitive at breakfast (my I:C at breakfast is only 1:5, while my dinner is 1:20!). French toast, pancakes....I've vaguely heard those words...lol. My special weekend breakfasts are a whopping 33 carbs and I still don't always bolus accurately! (My weekday is only 20)
I personally don't think the term "honeymoon" is accurate for LADA, since the very nature of the beast is that our onset is slow and it is anywhere from a couple months to 4 years before we need insulin. I managed on oral meds for 15 months (I was misdiagnosed Type 2).
Zoe,
Almost everything with carbs that goes in my mouth goes on a gram scale and I calculate the total net carbs using a ratio derived either from a database or the package. It's obsessive but it guarantees that I'll never start using total available glucose. I'd never finish counting...
Maurie
Right although I calculate to the nearest 1/10th of a gram and then round the sum to nearest gram. It's amazing how precise a pump can make you.
I actually carry a scale to restaurants and people's homes. I lugged one around Italy this fall for all the good it did...
Maurie