I was diagnosed type 1 in August, probably heard this type of story over and over. I guess everybody starts looking at complications right away. Are my feet going to fall off? Am I going to die much earlier than most? I guess I have been so worried about having my blood sugar high all the time that I end up walking around with low blood sugar, feel bad eat candy to reach normal level again, repeat.
I usually keep my blood sugar highest 6-7 but typically 5 down to the 4 range. How high is too high and how long before it does damage? I mean if we go like 1 hour at 10 mmol./l is it doing damage? When people say they have high blood sugar is that like weeks at a time and how does that happen if we are taking insulin? Just eating the wrong food? Now I feel scared of food and try to avoid carbs all together especially if I'm going over to a friends house to eat and all they are serving is white bread sandwiches chips and soda. Do you just say screw it, take a shot and go for it? Am I being overly paranoid? Thanks for any feed back.
Some websites you read might try to convince you that a single reading of 6.1 mmol (140) means that damage has been done and all hope is lost.
But the more long-lasting studies, over decades, like the DCCT and UKPDS, show that's it not single bg readings that are correlated to diabetes complications, but it's the long term (decades) running average as measured by A1C's:
Of course the long term average is made up of millions of individual bg readings so it doesn't help any to have it high for extended periods. My point is, it's not the end of the world to have a couple numbers out of whack, don't let it get you down, you'll have millions of more swings in the batting cage :-)
Your last question... insulin is no magic bullet. It's a tool, one of many. Taking insulin by no means results in all your bg's being OK. And yeah, if your choice is between saying "screw it" or getting depressed because some website told you that a single bg number means the end of the world... "screw it" will be the better choice. Of course there are other choices too, like using the bg number to adjust your insulin doses or any of the other difficult controls we have.
I know there are people who also say that large surges in blood sugar can harm you. But I am also big in balance in your life. It is easy to become fearful and obsessed over all this blood sugar stuff. It is sometimes good to remind yourself that if you keep your blood sugar at 5 mmol/L all day except it goes to 10 mmol/L for an hour after all three meals, your average blood sugar is still 5.6 mmol/L. Only about a 10% rise in your average blood sugar.
I think many of us have to go through a period of coming to terms with our mortality and the risk of complications. Over time, you should feel less anxious about this. We all have risks in our lives. But you have to balance things, if you spend every waking minute worried about your blood sugar, never doing anything in life that you enjoy, then what is the point? So have some birthday cake on your birthday. And over time, you will just learn to make prudent choices, at times enjoying a treat, but mostly just taking care of yourself.
Unfortunately everything you have mentioned is true for some of us and false for others. There are many individuals that live with BG in the 250+ (14.0+) range all of their lives without a single complication but for others just talking about high BG will cause complications. Most of us probably fall somewhere between these two examples. I do the best I can and have learned not to sweat the little things...like a few high blood sugars every month, or a piece of my Moms pie on Christmas day.
The Bete's has not killed me yet, My Doctor says anything can happen there are plenty of landmines out there you can step on besides diabetes....I have always looked for something more exciting like skydiving, my motorcycle, or even a jealous husband would do in a pinch...;-)
I guess my point is, don't stick your head in the sand. If there is something you would like to do, "do it!"...and remember for somethings you will probably need a helmet.
thanks for the response, you think that a person should worry less in the beginning ? I mean some people have been living with this since they were like 6 years old. I'm 35 and was just diagnosed in August. How many years after being diagnosed should a person really start being super careful?
I think you should do the best you can from day one...I also think there needs to be a summer camp for LADA's...;-)
I was diagnosed at 34 was a single parent with two small children, There where many, many, days my "life" was out of control, was I worried about my BG...HaHa
When I was diagnosed there was no information highway...no one had even herd of Al Gore...;-) They just looked at me like a horse with a broken leg and gave me a sack full of syringes a bottle of insulin and said pay on your way out. The nurse had tears in her eyes and I though to myself...this is probably not good .
I think folks here have already given you some good advice. It's ok to relax a bit. As long as you're testing and correcting highs, being high for a short period of time isn't going to kill you. Keep in mind that there are many of us who have been living with this disease for decades, since we were small children and long before there were fast-acting analogue insulins, multiple-times-per-day testing, and pumps. Heck, there are folks on here who have had T1 long enough to remember a time before disposable syringes, human insulin, and meters!
Definitely make wise choices. It's ok to treat yourself now and again, but you don't want to make a habit out of it.
Running low all the time is really not good for you. If you keep doing this, you will slowly begin to be unable to recognize the low BG symptoms. Those low symptoms are a good thing because they alert you that you need to do something. If you run low all the time, you will eventually develop hypoglycemia unawareness.
that's what's got me worried some people say just having high blood sugar for 15 minutes will do damage. That's probably why I'm always low, as if gambling with hypoglycemia unawareness is better than having high blood sugar. probably stupid of me though.
Zip, relax :) As others have said, a few highs now and then won't make your feet fall off. It takes time to learn a new way of life, new way of eating, and how your body reacts to various factors. Use those highs as a learning experience - What caused it? How can I avoid it happening again?
There's a LOT to learn, and as much as we'd like to learn it all instantly it's just not possible. Some of it only comes from experience.
When you say you're always low, how low do you mean?
usually between 5-4 mmol. I'm paranoid about the highs, but on the other hand don't want to crash my car into a tree which I've heard a few people doing on this site. I guess it's better to be a little high than on the low side.
THe left hand axis is relative risk...1 means no more risk than nondiabetics, 2 means 2 x the risk.
TO give you another data point, my endocrinologist says an A1C of 7% corresponds to a complication rate of 1 in 100 patient-years.
As has been mentioned above, these are averages over large populations and individual responses will vary. Many people who are Joslin medal winners (have had diabetes for 50 years) have no complications.
Hypoglycemia is not risk free either. Severe hypoglycemia can cause brain damage as the brain is starved of fuel....so the people that are so paranoid about complications they pass out frequently are damaging themselves in other ways.
The advice you have gotten above is good...the objective is good control while avoiding severe hypoglycemia and living an enjoyable life. Control diabetes, don't let it control you.
I just plagiarized that graph off the web. I think the left is probably risk relative to an A1C of 6.0 over a baseline of a decade or so. (A decade is the timescale over which DCCT and UKPDS have good data; extension studies to the DCCT go longer.)
Risk continues to decline as A1C goes below 6.0 but very few diabetics have A1C's under 6.0 so there's not a lot of data to sample there and the curves you can see are flattening out already there. Not perfectly flat though.
I don't know about "worry" but every year spent with high bg's is measurably increasing someones risks with complications. So getting thing under control early on is certainly the right way to go.
Otherwise it becomes like balancing a big government's budget... one year you overspend a little, next year overspend more, you start raiding trust funds and taking loans from other countries... and in a couple years you have Greece.
In that analogy it's OK to have a couple bg's that are high but you should have the majority of them not being high, and you have to start as early as possible.
I don't think 5 is low enough to smash into a tree, but I wouldn't want to drive around at 4. 4.5 is probably the lowest I'd get into a car after eating a few carbs to make sure it didn't drop.
[replying directly to zip -- man I hate how this forum works sometimes...]
Yep, that is true right there. I tend to ride high specifically because it IS so much more dangerous to hit the hypo lows (my doc is in firm agreement here, and is happy to see me well above 100 mg/dL -- and my last A1c was 6.7 a few weeks ago). That's the real danger zone down there in hypo-land where you have been holding yourself hostage. No reason to do that (you're gonna have highs anyway -- get used to it). Believe me I have spent a fair amount of time down at the bottom there (a lot can happen in 30+ years... and I am far from being the person here who's had this the longest).
So shrug it off for now and get used to the daily drudgery of dealing with this. It is what it is and we all do it. If you can afford them, get yourself a CGM (continuous glucose monitor) and maybe even an insulin pump when the time is right. But for now, settle in and take things a bit easier so that you don't stress out. Stress can certainly cause erratic blood sugar numbers...
so is 6.7 good? my last A1c was 5.6 that might be too low. My whole point of this thread was kinda to find out where the damage starts to happen. 1 hour at 10? nobody really seems to know the answer. Diabetes is super lame. 30 years you have any issues ? how old were you when diagnosed?
I have had good BG control for most of my Diabetical career, my eyes and kidneys are in good working order but I do have some nerve damage in my feet and stomach.
You are not asking a simple yes/no question. The A1c is just a different way to track progress or compliance. Having a low A1c does not give everyone a bullet proof vest. Good control and low A1c's is very important because you have no idea if your wearing one or not...If you do not control your BG then the odds are "not" in your favor...but you could walk through a mine field without stepping on one...;-)
Again enjoy life, do the very best you can, controlling your BG is important. Don't leave this world until you have everything on your bucket list completed.
