Hi everyone, I’m new here. I’m 43 and was diagnosed with type 1 about 3 years ago.
I am on levemir and novo-rapid (pens) and somehow am still not able to get a handle on my
blood sugar. Sometimes its my fault and other times its not. I’m really happy to find this site
because, even before I joined here, I had already found some very helpful info on here and
started feeling a lot less alone just by reading some of your comments 
I know how to count carbs and match it with the insulin but my body seems to keep changing
its mind as to how much I need. Is this common? I use up at least 20 strips a day because I’m constantly checking to see where I’m at and I know how to count carbs but am somehow not managing
well. I used to take my dose of levemir only in the mornings but now have split my dose----about 16 units in the morning and 5 or 6 units at bedtime. Is anyone else on levemir and rapid, and how often do
you have to check your blood sugar?
hi maria. i was diagnosed at 36 about 4 years ago. my insulin needs have changed little by little as the years have passed. i try to avoid white foods like breads and rice and pasta, as they make things go a bit wacky. i also take levemir, splitting the doses and apidra as a fast acting because where i live it comes in half unit pens.
i check my blood sugar about 8 times a day, whenever i eat and before and after exercise, sometimes more, sometimes less.
when things get really wacky, i log all exercise, food and insulin and that helps me a bit to get a handle on what is causing problems.
Thank you for your response. Wow 8 times a day, that’s not bad! My pharmacist’s tell me
that I shouldn’t need to check more than 8 or 10 times a day…I’m really hoping to get to that point.
The thought of a low (especially in public) gives me so much anxiety that I tend to over-treat my possible lows before they even happen, causing a bg rollercoaster affect for myself that can last all day. There are countless other things that make my bg a little unpredictable for me that I can’t recall right now. I think I need to spend a lot of time on here. lol
Welcome to TuD!
In the event you haven’t already read Gary Scheiner’s Think Like a Pancreas or John Walsh’s Using Insulin, I highly recommend these books for the invaluable information they provided (and continue to provide) me whenever I make dosing adjustments for my Type 1 13-year-old daughter whose current favorite pastime is “pubertizing.” There is so much more that goes into attempting to keep those pesky BGs in range besides accurate carb counting: determining whether your basal insulin is correctly timed and dosed, knowing your DIA (duration of insulin action), knowing how certain foods specifically affect your BG (not all carbs “behave” the same for many PWDs), etc., are also monumentally important. Have you considered pumping? Although, speaking for myself, pumping is significantly more complicated than using MDIs, it has allowed me to fine-tune a handful of different basal rates throughout the day and night which, along with the ability to set temporarily increased or decreased basal rates and different I:C ratios and ISFs depending on the time of day, have resulted in a vastly improved ability to better manage my daughter’s Type 1. Additionally, the Dexcom CGM system has dramatically decreased the number of times per day my daughter needs to perform fingersticks to determine her BG. Also, unless you test your capillary BG level every five minutes 24/7 via fingerstick, you won’t come close to the number of perpetually updated BGs values (technically glucose levels in interstitial fluid) the Dexcom CGM provides, not to mention the trend arrows which have dramatically reduced the incidence and severity of low BG episodes my daughter experiences …
Thank you! I have just written down the names and authors of those books and am going to look for them right after I log out here. I’m at the library so good timing
I found out that my medical doesn’t cover me for a pump. I’m going to read those books though. I figure I must be missing something because I know there are a lot of type 1’s who live normal lives. Thanks again!
One of the most frustrating things about Type 1 is that no matter how well you try to manage it, sometimes your blood sugar seems to have a mind of its own and will not behave no matter how you try to beat it into submission. Among the 100 or so things that can adversely affect BG are exercise, food, the fat in food, the fiber in food, alcohol, sleep, emotional stress, weird dreams, PMS, steroid meds, bacterial infections, and the list goes on. So pretty much life affects your BG. However, all we can do is the best we can. It’s great that you’re willing to check your BG frequently, but keep in mind that due to post-meal fluctuations and the amount of time insulin hangs around before it fully does its job, it’s counterproductive to check it too often. 6-8 times a day is usually plenty unless you’re trying to troubleshoot and identify patterns. Specifically before meals and bedtime, around exercise or driving, and any time you feel off. You may be a good candidate for a pump now that you’ve been on multiple daily injections (MDI) for a while, ask your doc about it. Then you can fine-tune your basal (baseline) rate and bolus (mealtime) ratios for different times of day and different situations like exercise and PMS. Pumping was a lifesaver for me because I was all over the place and the long-actings never worked well for me.
most would say to start with a Basal test to get that right first, or nothing makes sense.
small carb, small mistakes
your insulin sensitivity can change during the day,sometimes less of a morning and more of an afternoon.
A workbook (the certificate ran out but the site is safe) it has the I:C and correction rules
It sounds unlikely if your insurance doesn’t cover a pump, but it sounds like a CGM would help you more?
Yes I think much more. I don’t mind using the pens and to be honest, the thought of using a pump
is intimidating to me (at least for now)…
Thank you!
This is helpful, thank you. I’m glad you said that about bg having a mind of its own sometimes despite what we do. At least its not just me
Another excellent book (@jack16 made passing reference to it above) is this one:
Richard K. Bernstein, Dr. Bernstein’s Diabetes Solution, 4th. ed. (New York: Little, Brown and Company, 2011)
Be warned, Bernstein is something of a polarizing figure in the diabetes community. Some people swear by him, others oppose his excessively strict regime. But that’s not the point. It’s not necessary—or even advisable—to follow any “expert” advice by rote. The way to approach any expert is to take what’s useful and leave the rest. How much of his specific advice works for you, or fits your circumstances, is entirely for you to decide. What matters is that there is a great wealth of highly valuable information there, all of it empirically based.
When I was diagnosed as a 40-something, my early years looked a lot like yours. As near as I can surmise, my pancreas didn’t go from 100% insulin to 0% insulin overnight; it gradually slipped from full to nil over a period of years. And that decline in insulin production wasn’t a straight, even curve; some days my pancreas blurted itself back to full production, and some days it didn’t seem to make any insulin at all. So the exact same meal would give me quite varying results. Now that my pancreas has decided it’s done, I find dosing easier. There are still variables, but surprise insulin from my pancreas isn’t one of them. My pancreas took a little more than 3 years to idle down. As @David_dns notes, we can relate our own experience which might help guide you, but that’s not the same as hard rules like ‘always drive on the left’.
I also believe a CGM would give you major insight to help you figure out the variables (there are so many).
Over treating the lows can set whole day off, take some time to see how many carbs bring you up to “Good” not way above good. Takes some self control as when your low your appetite kicks in and says “eat more”. I found once I controlled that urge and ate close to “just enough” to bring the low up to target, the roller coaster is like a kiddie ride instead of the big old wood roller coaster that batters and bruises you, lol. The old formula eat 15g of carbs and test 15-20 minute later will get you some practice and you’ll get better at it as time goes on. Glad you found the site and unfortunately have to say “Welcome to the club”
Hi Maria,
I was diagnosed at 33 (about 20 years ago). I’ve been on a pump the last few years (Omnipod) but before that I did Lantus. Have you thought about a CGM? I could give you more information (and less testing).
I would so much love to have one of those! My life would be so much better. But I am on disability (because of other things) and so I can’t afford it. I’m wondering if there’s a way though.
Hi and welcome. I’m sure you have already had tons of experience with this but I’ll just let you know anyway, diabetes is always changing in you, what works one day may not work the next. Every little thing in life has an impact on diabetes and this is why it can be so frustrating and difficult to control. Always try your best to keep your blood sugar under control, but don’t beat yourself up if it goes high or low. Many diabetics suffer with depression because we constantly feel like failures because our diabetes is sooooooo hard to control.
It’s 99% NOT your fault. All we can do is keep trying.
I might add that a CGM (continuous glucose monitor) may help you to be able to prick your finger a little less often, and keep much better track of how your lifestyle and medications are impacting your numbers. You might do some research on a CGM and see if it interests you. Mine has helped me a ton.
Good luck and happy thoughts to you!
Thank you!
Hey Maria for what it’s worth I’ve had a very similar experience - diagnosed at 38, lots of trouble getting dialed in based on carbs and units of insulin at first. Took me awhile to learn about all the other variables at play in addition to carbs: exercise/activity level, stress, sleep, for me even altitude and temperature play a major role. My advice would be to think about those other variables. I agree a CGM would be great idea - so much better trend data. Good luck and don’t get discouraged; you’ll figure it out. I finally did.