Things that Improve My blood sugar Control

I don't limit my carbs (I eat over 300 per day and often many more). I've got hypoglycemia unawareness, and have for over a year. My c-peptide is negative. I'm not pumping. I don't have a CGMS. I've averaged different numbers of blood sugar tests per day in different months, from about 5 to 11, but mostly around 7. I'm active, but not really an athlete. I don't have a fixed schedule (which my endo is always saying I should). So sometimes I wonder howcome I've had A1cs below 6.5 for over a year.

Here are a few factors I think matter and get overlooked:

1. Speed of digestion. I digest my food pretty slowly and I rarely get dramatic after meal spikes. That's not to say that my numbers four hours after eating are in range more than half to two third of the time; they're just not any lower than the one hour or two hour mark would be. My blood sugar does not spike if I inject before eating unless I eat a really big meal. Often the Novolog kicks in before the carbs do and I have to inject after or into my meal if I start out with a lowish blood sugar.

2. Computation skills and memory. I remember what my blood sugar was doing in the recent past, and I make judgments based on that. I carb count and compute doses.

3. Riding the trends. I'm open to changing my doses daily depending on the previous day or two days' numbers. Not changing your Lantus for three days to see the full effect is ■■■■■■■■.

4. Patience. I don't retest a hypo for a half hour after the first reading (and sometimes I don't bother retesting at all), and I don't stack insulin.

5. Willingness to risk hypoglycemia.

Thats awesome for you, and made me think about the fact that my digestive system is FAST, I mean I get the 2nd burn of Mexican going out the other end a few hours after I eat. They recommend symlin for this, which made me vomit. I had not really looked at how strongly this affects my sugars. I can spike in 20-40 minutes if the insulin is behind. I am uber jealous. However, 1) do you not cut your Lantus for three days previous to an all day activity ( I do for big bike rides) 2) have you never put yourself to serious harm during a hypoglycemic episode? 3) how is your weight for your height? I am not trying to be nosy I am just curious about different ways of managing.

  1. No. I sometimes cut it the day before and the day of. I expect Lantus to stop affecting my blood sugar about 30 hours after I inject it, so I’m lowering both of the doses that really affect that day, but that’s it. I would lower the previous day’s dose a little bit, and that day’s dose dramatically.
  2. Last year I had major memory problems that I think were from hypoglycemia, but I was also under other major stress. The memory problems went away. I currently test in the 30s about twice per month, but I have yet to lose consciousness.
  3. I’m still growing and athletic, so I’m not much worried about the possibility of being overweight, but my BMI is 22.