I have a question for you all. I was told yesterday that I shouldn’t have as may hypos as I do (usually at least once aday) and that my sugars drop too quickly. My manager can’t believe that my sugars will change so drastically in hte space of 3 hours. He has diabetes in his family, so is probably one of the few people who know what he is taking about.
I heard about a thing caled ‘Brittle’ diabetes, where someone goes high or low a lot, but I can’t findvery much information.
I got really upset yesterday. I felt like I had failed. I have been trying so hard, monitering, eating wisely, carbs counting. And I still can’t control my diabetes. Yet according to these other people, it should be easy to control. Why am I the only one who can’t control it no matter how hard I try. My fingers are sore from all the sugar tests.
And another thing. I go to a daibetes course where we are learning more about our diabetes. I leant one thing there. Apparently stess brings sugars up, except with me. They cause me a hypo.
Sorry about the rant. I am normally a lot more happier than this. I am just having a downer with it all. I have put so much energy into trying to control my diabetes the last few months, and it hasn’t done any good.
Take a deep breath. We all, and I meand ALL, have our ups and downs. I was in a pretty bad rut until I found an old friend who I went to diabetes camp with and found this site. I work in the incredibly stressful world of advertising for Goodyear. My suggestion would be that your basil insulin whether on a pump or using lantus is probably working better than you think and you may be a little too aggressive with the short term insulin either bolus or Humalog. If you are going low about the same time every day try backing off the coverage you used right before you were going low. The foods you eat can also be absorbing at different rates which is a whole different can of worms. Processed or fatty foods can take longer to absorb so if you take your shot pre-meal or quickly post-meal you may go low before your body starts to break the food down.
May it be due to delayed stomach emptying, gastroparesis? If you have it, then the insulin you are using for covering the meals may work earlier than the speed glicose is entering your bloodstream, which results in a hypo.
I had a diabetes course too. One of the first things they taught us, that you can take back to your manager and use anytime anyone puts you on the spot about your diabetes, is that EVERYONE is DIFFERENT. What affects one person and causes a high, or a low can very well have the opposite reaction in another person. Don’t let people like your well meaning manager make you feel less because your diabetes doesn’t fall into line with what he has experience with. We’re all different and we’re all our own experts (and super sleuths too as we figure out what causes various reactions).
Sending you lots of hugs – I too have been very frustrated lately with trying to do all the right things, so I know what you’re going through!
Stress makes me go low, too. So you’re not alone there. Have you checked your basal levels lately? When I am taking too much basal insulin, I have a lot of problems with quick-dropping lows (though three hours doesn’t seem that quick to me).
I wouldn’t worry so much about what your manager is saying. Everyone has an opinion about diabetes, and most of them should be ignored. It doesn’t matter how his relatives treat their diabetes. They could be type 2 or let their blood glucose run a steady 200 for all you know. All that matters is that the number of hypos is bothering YOU.
Brittle diabetes is a mostly outdated term for “we don’t know how to make your blood glucose levels stay in target.” There are a few people who have a very difficult time keeping the numbers in range, but “brittle diabetic” is often used as an excuse for not trying by either doctors or patients.
I’m just here to reinforce everything that has already been said. Mike is right-on when he says that you should think about what you do (eat, give insulin, etc.) three hours before your lows in order to see if that is part of the problem. MollyJade’s idea to do some basal testing is also a good one. Take one period of the day and don’t eat anything or take any insulin, and then test your BS every hour. This will let you know if the problem is with your basal or your meal boluses.
As far as brittle diabetes goes, I am on board with MollyJade’s definition. There are some people who have a harder time controlling their diabetes, but if somebody is experiencing the symptoms of “brittle” diabetes it is probably due to a diabetes management issue than can be fixed over time. Don’t give up! Keep working at it! I went through a period where I had routine lows, and once I got a better handle on my treatment plan I was a much happier person.
Hi, Rebekah,
One of the most useful things I ever read about diabetes is Dr. Bernstein’s “law of small numbers.” If you do very small amounts of carbs and the corresponsing very small amount of insulin, you will have a much better chance of avoiding highs and lows. 3 hours is definitely not a quick drop. When I mistime my insulin or eat more than about 20g per meal, I will go up to about 200 and within half an hour or so drop down to 60. I feel terrible when I am on that rollercoaster so it is easy fro me to stick with a very low carb diet. How low are you going when you are hypo? Some people feel hypo at normal levels because they are so used to high BG.
Like everyone’s been saying, you are not alone in having trouble getting off the low/high roller coaster. It took me a while, but if I had all the great suggestions from the people here, I’m sure I would have gotten in control much quicker.
The only think I can add to the outstanding suggestions people have made already, is about the finger tests. I was originally told to test my finger on the pad (meaning the front, fingerprint part of the finger). After testing more and more, the pain was definitely more noticeable (and since I am at the keyboard all day for my job, that was something I couldn’t deal with). What I do now is test the sides of my fingers. I don’t go below the first knuckle of each finger, and while sometimes I still get some pain, it is very temporary. Using the keyboard now, it doesn’t feel like I have upside down thumbtacks for keys either. By the way, I test myself 15 or more times a day now.
Keep at it Rebekah, and I know that you will be able to get your lows under control… and that will be GREAT!
Thanks everyone. You are all so supportive. I don’t know how I coped before I found this website.
I was just havinga downer, but it is because I am so sick of everyone getting on at me all the time. They seem to act like I don’t try to watch my sugars.
I do have a very supportive boyfriend, so that helps.
I don’t get any symptoms of going low until I am low. Usually it is between 2 and 1, but has gone as low as 0.4 (in the US terms it is 36-18 and as low as 7.2)
First of all, telling you that you are having too many hypos without proving ANY assistance with how to avoid them or at least reduce the incidence is like telling someone who is deaf that they just aren’t listening!!!
I cannot stand this argument, and in my experience, CDEs and doctors tend to blame the patient for making “stupid” errors like not counting carbs correctly, rather than blaming the faulty counterregulatory response that people with type 1 suffer from. Shame on them for doing nothing to help you!!! You should also know that many people incorrectly believe that “brittle” (now known as “labile” in the medical profession) is fictitious, when the facts clearly indicate otherwise.
Having said that, I recommend reading some FACTS on the subject, followed by some info. which may help with hypoglycemia unawareness:
Hypoglycemia in Diabetes
Iatrogenic hypoglycemia causes recurrent morbidity in most people with type 1 diabetes and many with type 2 diabetes, and it is sometimes fatal. The barrier of hypoglycemia generally precludes maintenance of euglycemia over a lifetime of diabetes and thus precludes full realization of euglycemia’s long-term benefits. While the clinical presentation is often characteristic, particularly for the experienced individual with diabetes, the neurogenic and neuroglycopenic symptoms of hypoglycemia are nonspecific and relatively insensitive; therefore, many episodes are not recognized. http://care.diabetesjournals.org/cgi/content/full/26/6/1902
Negotiating the Barrier of Hypoglycemia in Diabetes
Hypoglycemia is the limiting factor in the glycemic management of diabetes. It is a barrier to quality of life and even survival in the short term and to true glycemic control, with its established microvascular and potential macrovascular benefits, in the long term. Although it is possible to both improve glycemic control and minimize the risk of hypoglycemia in many patients with currently available regimens—by applying the principles of aggressive therapy and practicing hypoglycemia risk reduction—people with diabetes need treatment methods that provide glucose-regulated insulin secretion or replacement if euglycemia is to be maintained safely over a lifetime of diabetes. http://spectrum.diabetesjournals.org/cgi/content/full/15/1/20
Blood Glucose Awareness Training (BGAT-2)
An overview of blood glucose awareness training (BGAT) has been shown to help improve awareness of blood glucose (BG) fluctuations among adults with type 1 diabetes. This study investigates the long-term (12-month) benefits of BGAT-2. http://care.diabetesjournals.org/cgi/content/full/24/4/637
People say all sorts of things - and anyone who says they know someone with diabetes doesn’t know anywhere near as much as you know, you’re going through it!
It’s quite likely they once knew a type 2 who was diet controlled, or knew someone who didn’t get lows because they were always HIGH… or or or… y’know, they don’t know YOUR situation.
Now that I have that off my chest… Yes, one a day is a little heavy if it’s impacting on your life. Personally I’d experience around 4 - 5 a week, nothing serious though. Some weeks I wont get low at all. It’s the typical diabetes roller coaster that we all experience. I aim for tight control. I am not perfect. Lows happen. End of story!
Then of course there’s the fact that you get different absorption rates from every injection. Different levels of activity in every day. Your body could at any point be fighting a bug you don’t know about. Your hormones could be going mad. Our meter readings aren’t as accurate as we need to them to be. All those things and lots more will affect your numbers - we really shouldn’t blame ourselves so much when we get lows & highs!
If you want to find out what’s happening I’d suggest looking at your basal rates, and making sure you’re testing lots. As far as I’m concerned testing is our biggest and best tool against diabetes. If we know where we are, we know what to do. Seeing as you’re not noticing lows until you’re quite low I’d hope you could test at least 8 (10? 12?) times a day. The more you avoid lows the better you’ll get at feeling them because they’re more of a shock to your body.
Don’t let anyone make you feel bad - you are you, your diabetes is yours alone. Of course we need to try to stay on top of it but it’s just not easy (Who said it should be easy to control? If they say that again please slap them! I’d like to see them try it!)
That sounds like a problem to me. Do some research on hypoglycemia unawareness. I am lucky enough to not have developed it yet, but there are some people on the board who understand what you’re going through. Have you considered switching to a pump with a CGM? I know of at least one TuDiabetes member who got her insurance to pay for a CGM because she had documented cases of hypo unawareness.
How long did it take you to get used to different foods? My diet has recently changed drastically because I have found I have an intolorence to yeast. I also have only been diagnosed since I was 21, I am now nearly 25.
I go low usually just before lunch. At first I thought it was due to having breakfast as early as 6.30 and not having lunch until 1, but I should be able to go without lunch on my insulin.
Here in the U.S. it is a fight to get the pump also. It all depends on your insurance. It is not required for the insurance companies to cover the pumps or the supplies. I am in the process of fighting for one now.
My diabetic nurse said to me that because I live such an irratic life, the type of insulin she put me on - Lantis and Novo Rapid - will suit me being able to have meals late or miss them, as long as I have breakfast. As an example,on Saturday I will have a 12 til 10 shift. I wont get my first break until about 2.30 and that is only a 15 minute break. So I wont be having a proper meal until about 6.
