Hello my friends
While i usually use this forum to help others or network with friends, this time i just need to vent. And maybe ask for advice a little bit.
So this is the crap i am dealing with at the moment:
and the biggest problem: i have upcoming exams. so while i go high at night for mostly unknown reasons, during the day i go low. while i actually should be studying. exams are on monday and wednesday and i have probably lost 2-3 hours worth of studying today alone, and today was not an exception.
it seems to happen mostly after meals, and i know it has to be the bolus, but i just dont seem to get it right.
i have raised my low alarm so that i can start eating earlier to prevent an upcoming low. i have stopped prebolusing and only bolus when i start rising after meals. i feel like i don’t bolus agressively, but then again maybe i am. the problem, i think, is it seems i have two personalities, one when high (in the 12 range) that feels like that BG needs to come down, and then me at low where i curse myself for bolusing so much before and knowing it was probably too much…
i know it will probably go away after exams, as gastrointestinal problems are part of me being under stress (and i think part of the problem must be my stomach acting up), however i usually had good bg control in the past 2 years during studying phases. but i really just have to make it work for the next 5 days…
a few ideas i’ve come up with on my own:
my goal BG for the next few days will be 10 mmol/l, and i must maintain this by any means, i just don’t know if i will be able to control myself not to correct at a bg of 11.
putting a sticker or something at my pen that will remind me of being conservative with dosing.
any other ideas? i really just need to stay out of the red area for the next days and KEEP MY SANITY, during all of this mess.
times like these make me really angry at diabetes, and i am usually not the person to feel that way at all…
Ugh! I have been exactly where you are. Trying to do something important and blood sugar is just all over the place and will not stabilize. My endocrinologist used to say he could tell when exam period was by the fact that my blood sugars would be constantly out of range (high in my case) for a two-week period.
I think your idea of bolusing less is good. If you are going high overnight and if bolusing less also makes you high, maybe you need to increase your basal and decrease your boluses by a lot? It could be that your basal is too low and you’re boluses are too high to make up for that, but then it drives you low. Just some ideas, but I know how hard it can be to figure out, especially when you know it’s just temporary. Running a bit higher may not be a bad idea (safer than risk of extreme lows showrt-term). It is so hard with injections…one of the big reasons I went for a pump is it makes these types of temporary situations easier to deal with by using temporary basal rates.
I can see you are troubled by the way you are writing your post. I hate to see the sharp drops on your display - we have had a few of these ourselves in the past few days.
How do you calculate corrections? Do you use a correction factor? For instance, my son has a correction factor of 1:50 (for mg/dl): if he is over by 50 mg/dl, he injects 1 unit (FYI he only uses it to correct from a stable BG level).
If you use a correction factor, then you could up your correction factor, from 1:50 to 1:60 or 1:70 for instance, and that would automatically make your corrections more conservative.
If you don’t have a correction factor, you could decide on a rule to use a correction factor for the next few days.
When you go to a second correction, you could decide on a rule where you don’t correct again until at least 2.5 hours (or 2, or 3) have passed. We frequently correct more often that that (but we always calculate IOB in that case), and find out that not having such a rule sometimes leads to a “rage bolus.” It helps if you know fairly well what your DIA (Duration of Insulin Action) is, although if your BG numbers and behavior are unusual right now your DIA is also changed…
You could bring up your BG goal (from which you calculate corrections). For us, it is normally 100 mg/dl to 110, but in the past 2 weeks, my son has been quite sick, so it is now 120, because we are getting too many lows in these chaotic BGs.
Sorry about using mg/dl - I am not quite accustomed to mmol/L yet.
Have you ever considered fasting on test days? Or even just eating very little of food that you know will not upset your BGs. If you can’t think straight while fasting then, of course, this is a bad idea. I’ve often found I think more clearly when I fast.
Good luck. I’ve had similar BG frustrations when I wanted to command a nice level in-range blood glucose when preparing to undergo surgery. It’s like the diabetes devil knows and will do his best to upset your metabolism!
I’ve finally built into my memory these convenient 1:18 conversion landmarks to help me think in mmol/L:
Try a small dose of long-acting insulin late in the day. like 3:00 PM to 6:00 PM? perhaps no more than 5 U and keep your basal at the current level overnight. I have had to do this when I have steroids. It will buy time to work things out after finals.
Thanks so much for your replies already!
i have restricted my food a lot today, and so far so good. No breakfast, granola bar at 10am (which i bolused for) and i stay stable at 11-12. What i have found helps is i set my high alarm up to 14, and that number not being yellow helps a lot with accepting it. the power of colours!
@Terry4 fasting is a good idea, but not really possible as i will have exams in the afternoon. leaving out breakfast is doable for me, but lunch really not. the other concern i have there is the idea of kinda punishing my body for “bad” BG with food deprivation. don’t think this is really a good thought in the long run, but i see how some people might benefit from it. @Rick i see your point but the high bg at night is not really my #1 concern, plus i don’t feel comfortable changing something so drastic one day before the exam. the changes in tresiba really do take a while. @Jen thanks so much for your reply! it means so much talking to people who get it!! as mentioned above, playing around with tresiba so late is probably not the most productive thing, and yeah, times like these are the ones i miss having a pump. i am considering going back in the long run, however i did not expect i would run into such problems so suddenly. maybe earlier is better? @WestOfPecos i calculate corrections with a factor of 1 unit brings me down 2 mmol/L (36mg/dl). Since i have stopped correcting more or less that falls away, however i really think the problem is more the bolus factor. either i use a factor that is just too high atm or i really have some sort of gastric emptying delay, may it be short or long term. (really not hoping for the latter )
i think i really just need to stick to low or easy carbs until exams are over and move on from there. defo gonna talk this over with my endo… the really hard thing is just not correcting, i am flatlining completely at around 12, and it is so easy to just give in and expect those flat numbers at a lower level, but i really just dont want to risk that agian!!
hoping the odds stay in my slight favor for the next few days
oh definitely stress! i don’t wanna know the amounts of adrenalin in my blood, probably not healthy…
plus my period is coming soon, that usually complicates things as well, so it’s just all the fun you can have
When I’ve been under this type of stress I’ve found that prioritizing physical exercise has helped tame the roller coaster a little bit… just making a point of running as fast as I can manage for 30 minutes a day seems to help me both counter some of the stress and seems to help tame the bg swings as well… you gotta exert yourself hard for it to work though
oh yeah, apparently learning this the hard way again.
whole day was stable basically low carb, so i thought dinner might work with pasta. apparently NOT.
crashed from a stable 12 down to 4 post dinner with bolusing just for the food (or so i thought). this still does not make sense to me at all, but when does diabetes make sense really?
If you have hormones playing a part, I’d say that plus stress could easily create chaos. Yikes. I had a similar problem last week: low while teaching, low while taking a class, low while trying to commute, then this weekend high for the most part (had to up all my pump settings). Ugh. I hope you are able to keep things stable for exams so you are able to do well!
thanks Jen for the love.
Today was as mentioned not bad, i could keep stable low carb and my brain was working at the library, so i hope i can replicate this tomorrow. the only glitch was my mistake with a carb loaded dinner. i’ll let you know how it went crossing my fingers…
I find eating low-carb (when you have to cook everything) hard when super busy. So good with eating low-carb and keeping stable! (I’m currently working full-time and taking nine credits of undergraduate and graduate coursework, so I know a bit of how you are feeling!)
first exam went ok. Well kinda.
Of course for lunch i was a perfect 10 on my dex, but when i checked with fingerstick i was 7.5 so that freaked me out, so i ate 10g CHO of chocolate. When exam started i was at 15 and stayed there all exam long. Not the ideal outcome, but i was just glad not to be low and the high BG didn’t affect me except that i had to drink a lot. But we had more than enough time so that was alright.
If thursday goes exactly as yesterday i will be happy, even though there is room for improvement.
After that i will have to figure things out…
Hang in there, swisschocolate! I remember those extremely stressful med school exams all too well. I’d always be in the restroom minutes before these exams, throwing up from stress. Without fail, there would be other students in adjacent stalls doing the same. Not fun!
Not throwing up here, tg. but i do become weird during this phase. 2 hours ago i had the feeling i should lie on the floor and pretend to be a bug. Franz Kafka says hello, haha.
I feel like the second one should be a bit easier, more logic and less learning by heart.
hoping my feeling proves to be correct.