I’m struggling with my diabetes right now. Maybe it’s Dex with his bigger picture view, but I’m really not liking things right now.
I have been spiking high (230s) 2 hours after I eat. Highs are stubborn and take for ever to come down (even with rage blousing). My fasting has gone up into the 120s. This is after having about a month of really great numbers (70-130, with a few lows, but easily caught and corrected)
All of a sudden, it doesn’t seem to matter what I do. I can eat strictly low carb (15-30 carb meals; steak and salad, protein shakes, Oh yeah/Quest Bars) and spike high. I can eat high carb meals and spike high. I can eat very little walk all over campus (4 miles by the end of the day) and still go high! I feel almost as bad as I did prior to having the correct diagnosis made in January.
My sites are fine, my pump seems to be working fine, and Dex, while occasionally getting an attitude, is fine. My meter has been tested and is in range.
I started out at a basal of .8 between 5am and midnight, .75 from midnight and 5am. After adjusting each day, I’m at .9 and .8. Correction factor of 1 to 40, carb ratio of 1:7 (Previously 1:7.5). Nothing I’m trying is working. The more I adjust, the more stubborn it seems to be.
I’m super stressed, between writing a second thesis (my first draft was trashed after the co-PI came in from NY, but he was right to do so) taking a class that’s super frustrating, my grad assistant position and house-hunting. Maybe that’s it? Or could this be the end of the suuuuppppeeerrr long honeymoon period I can’t explain and neither can my endo (antibodies from day one, but a super slow destruction of my pancreas, very similar course (we guess) to what my Grandfather dealt with in the 40s and 50s, until he died from Type 1 in 1963).
I’m frustrated, but most of all I’m scared. My husband is a little nervous about going from lows to highs, and he watches me like a hawk, which adds to the fear. Not to mention the heat and humidity makes me a mess on top of it.
Ideas, encouragement, a swift kick in the a$$, questions, all are welcomed. I’m looking for an adultier adult than myself right now. 
We all have bad days, even after 25 years. It’s about the only thing that’s consistent about Type 1.
Stress can have a major impact on blood sugar levels. So can hormones, and so can the honeymoon ending. Yours may even be a combination of all three happening simultaneously.
I often have to make huge changes in my pump settings to deal with hormones (probably what’s up now). We’re talking a change in ratios from 1:12 to 1:6 and a change in all basal rates of 0.3 U/h. And still having blood sugar that’s harder to keep down than the “easy” times when my hormones are calm.
If you’re sure it’s not your site or insulin, I’d continue to change your pump settings. Once you’ve been at it for a while, you start knowing when things are hormones and when to crank things up really high as soon as you start to run high (like I’ve done today).
You win the internet today, in my humble opinion.
Anyway, I’ve had a Dexcom since the end of February. For the past few months, Dexcom Clarity has been predicting my A1C to be around 6.3%. I went today to see my endo, and I looked at my labs when I got up. 6.8%. On top of that, for the whole time I’ve been using the %&^&%^ Dexcom software, it has never seen a pattern in my glucose numbers.
Until the last seven days. Suddenly it says I have a pattern of high BG between Midnight and 12:20am. And they weren’t caused by rebound highs. Great. Suckered for three months and then a pattern out of the blue that I won’t be able to correct before my appointment!
Diabetes just sucks. I’m sure I’ll figure out something funny about it once I can ditch this test. C’mon BG, drop like a stone!
Sounds like you need a day off! You didn’t need an “adultier adult” to tell you that, but it’s true. If it were me, I would concentrate on getting a good night’s sleep and skipping a meal or two. Fasting has always been my friend in situations like you report. Drink lots of water and continue to walk.
Monitor your blood glucose and do what you need to do to correct when needed. Combine corrections with a well-timed 30 minute walk. Do your best to stop the BG roller-coaster. Try consuming most of your carbs with some fiber in them such as berries, avocados, and veggies like broccoli. Avoid bread, crackers, rice, noodles and any fast carbs.
Perhaps a day off is the only thing you really need. Keep on keeping on. It’s the long game that counts. Be gentle with yourself. You will figure the path out of this thicket.
After taking a break from it all (as much as one can “take a break” from Type 1), I’d suggest performing a major overhaul of your pump settings. There’s no one “right way” to approach this endeavor, but here’s a down-and-dirty summary of how I go about making major adjustments in my daughter’s insulin regimen when she ends up in the 200’s for 50% or more of the time for several weeks on end.
I get a better idea of her current TDD by adding up her TDDs for the past 2 weeks and dividing the total by 14. I use this number to calculate a (hopefully) more accurate ISF by using the 1700 rule (divide 1700 by average TDD) and I set a lower ISF during sleep hours. I then try to step back and look at her Dexcom graphs to spot patterns which show me where I need to either increase or decrease her 8 or so different basal rates and/or adjust the time periods. I then do some additional tweaking of her basal rates in an attempt to reach the “magic 50/50 basal/bolus split”. I call it magic because, almost without fail, the closer I get to dividing her TDD evenly between basal and bolus doses, the lower her TDD trends. This 50/50 goal is not for everyone, however, and is definitely a YDMV sort of thing. I again review Dexcom graphs and make sure her DIA is set accurately. I’ve found that if your DIA is incorrect, everything can quickly go to D-hell in a handbasket and no amount of tweaking will make things better. Then I look at what post-prandial levels are doing, try to the best of my ability to determine whether my daughter has been too cavalier with her SWAG-ing and needs to get back down with some more serious carb-counting, and/or whether I need to adjust her I:Cs. (She has three different I:Cs depending on the time of day, per the advice of Gary Scheiner). I try never to look back and avoid thinking things like “But she didn’t used to need this much insulin” or “Her TDD just keeps increasing; will it ever stop?” or, the absolute worst “She must need more insulin because I’m doing something wrong.” You need to work on accepting the fact that you need as much insulin as you need, plain and simple, and that Type 1 is a constantly moving target and you need to move with it if you want optimal control. Good luck!
This does not feel good. That’s from not taking enough insulin to cover high carb meal and correction doses being too small. That’s from being wrong about insulin dosage. It made for a low energy evening. It helps to see others have similar experiences. And this is with doing my best but getting hungry and not checking that sensor often enough.
I hear you AARON10: my daughter is so effing sick and tired of checking her Dex and making corrections that she’s become pretty “mouthy” with me whenever my Share alarm goes off and I remind her to correct and/or set a temporary increased basal rate for a few hours. Jeeze Louise, I’m just trying to be a good mom and do my best to decrease her risk of developing complications down the road! Last week she got pretty nasty with me (oh, the looks of hers that kill and that tone of voice that just drips with utter contempt!) and I hate to admit that I snapped back and said “I’m so totally tempted to stop reminding you to correct, calibrate, count carbs, and pre-bolus; then you can watch your beautiful high 5/low 6 A1c’s go down the drain. And when that happens, don’t come crying to me…” Regretted (pretty much) saying all that, but even grownups have their limits…
Thanks Everyone! I appreciate the feedback so much. I’ll write in a little more detail in the morning, but we are about to get walloped by a big 'ol storm and my laptop is about dead.
I love this little haven of people. The only other person I know with type 1 is a cute little toddler, and while adorable and her mom is super sweet, it’s a whole different ball game. 
Thank you again!
I think one of the harder parts about diabetes is that those times you have to work harder to get things back on track are the same times that you feel crappier from high or low blood sugar. I’m still trying to get into single digits, even after corrections, a site, a cartridge change, a walk, and increased basal rates. Grrrrr…!!!
Diabetes is often like walking the ridge line on the mountain. If you stay walking on the ridge line you can often have an easy hike, but stray off one side and you drop down and it is a nightmare. When things go right, you can get in a groove. And it sounds like you are not in the groove. And when that happens, things work against you. None of your settings work, your blood sugar does crazy, you chase your tail and diabetes gets hard.
I would encourage you to pick your self up after your tumble and just get back on your feet and do what you have to do. Learn some new techniques to get yourself back in the groove. And remind yourself that you are not a number. And the display from your Dexcom is just that, a number. Don’t take that number personally, just use it as an input to what you have to do.
ps. And as my first tip, remember to bolus for protein, particularly for high protein and low carb meals and use an extended bolus so you don’t go high hours after a meal.
pps. And another tip. Consider some fasting or going a couple of days with low carb or mediating as a way of limiting some of the things that are messing with your groove.
perhaps an appointment with a CDE would help. I did just that some years ago when I couldn’t make heads or tails about what was going on. I took extensive logs for a couple weeks and she examined them with great care and we made several tweaks which made all the difference. [quote=“Jenn_Audrey, post:8, topic:54700”]
I love this little haven of people.
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I do too, so very very much.
You are a good mom. I am guilty of getting snappy with my boyfriend when he brings up my diabetes management to improve the outcome for me. Usually this happens when I am out of range and not in my best mental state… But he just tolerates it and afterwards I feel sorry and really appreciate his input. Want to wear this T-shirt some days and really mean it. 
[URL=http://s1126.photobucket.com/user/ninikay6/media/image_zps6yuxwqy0.jpeg.html]
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Can we get this t-shirt somewhere??? 
It shows up as an ad on my FB feed all of the time!
Hi again! I’ve been crazy busy, but I wanted to update you all.
Things have calmed back down the past couple of days. Fasting is still elevated, but I think I just need a bit of a basal increase between 12am and 5am and it’ll settle back down.
No more crazy spikes! The adjustments I made, plus the protein bolus that @Brian_BSC suggested has helped. I tried the extended bolus on the t-slim, but I’m not super sure of how it works, so that will take some work.
@rgcainmd I am going to try what you do for your daughter over my 10 day break this summer. I will be up with my Dad in NY, and since he doesn’t get around very well (stupid ALS) I’ll have some time to fuss with it. I’m up to my eyeballs with stats homework right now, so I get tired of the math by the time I’m settled at home.
@Timbeak48 Haha! I’m a non-traditional student at a large R1 institution, and am closer in age to my professors than my cohort. I get asked to be the ‘adultier adult’ a lot. 
My very best college friend is almost young enough to be my daughter, and she calls me ‘Mama Jenn’. I’m glad you got a laugh, because I get a giggle out of it.
@Jen Is it just your monthly that does this? Or ovulation too? I only ask because it shouldn’t be a hormone issue yet, but I guess it could be. I think my honeymoon is coming to an end slowly, and with a lot of T2 in my family and only a couple T1, I think I may struggle some with insulin resistance anyway, and I know right before that time plays he!! with my sugars.
I’m counting the days until I have a few days to relax! I think that will help a lot.
Thanks again for the advice, encouragement and I hope everyone has a fantastic night/day!
I had saved the image from my facebook feed but I don’t even know where to get it. I am sorry.Shouldn’t be hard to find, though. I have seen them lots like Jenn_Audrey said.
Zazzle.com has it. They have others, too. I’d direct link to the diabetes-themed shirts in general them but a few have swear words. Heh. The “and high” looks like it was added on with photoshop though, alas.