Even with very multiple daily injections (MMMDI,) I am finding, at this point, that I must eat very low carb to keep my numbers respectable. Coffee raises my BS, all breads, sweets, potatoes, my beloved margaritas, most fruit, etc, etc, etc, etc, etc…Remind me. What can we have?
What CAN we have?
Hi Elaine, have you thought about pumping?
I had a much more difficult time controlling the rise of my BG with MDI than I do with my pump.
The pump doesn’t fix everything but I’ve found that my control is a lot better with it than it was without it.
As for what we CAN have…I have pretty much whatever I want just not whenever I want, if that makes sense.
For coffee: If I’m having Starbucks I check online for the carbs and bolus before drinking; if I’m having a cup made from home (I have tassimo that brews one cup at a time) I know that the carbs are 10 per cup. The box says 3 but Ive experimented a bit and found that 10carbs worth of insulin covers my morning cup very well.
As for everything else…I eat what I want but keep pizza, cereal, Chinese food as special foods that I only allow myself every once in a while.
Also, I find that taking my bolus about 30 mins before eating really helps the post meal spike.
Doesn’t always work…as I type its 2 hours post lunch and I’m 160…but it does seem to help me more often than not.
I KNEW it! Pumping is going to be the answer, isn’t it? I am slowly working my way there, I suppose! Thanks, Stacy, for your reply. I am getting sick of meat, nuts, cheese, nuts, eggs, nuts, veggies, and a little dark chocolate when I am being wild!
Elaine,
Boy do I remember the “nuts, eggs, cheese, veggies” routine with MDI! I’ve actually been able to keep a respectable A1C with both MDI and pumping but it’s much easier to do with more of those “normal people” foods if you’re pumping. For one thing, if you’re prone to snacking, it’s TONS easier to snack the way you want and do a bolus as you’re going rather than taking the time to pull out pen or syringe and insulin AND calculating how much you need to take (or convincing yourself that it’s just a few carbs, it won’t hurt). Another thing that has become easier is breakfast. I used to spike pretty badly with a half-whole-wheat-bagel-and-cereal breakfast and now that I bolus right as I’m eating rather than waiting until I’m done, my numbers in the morning are much better. IME, you can do equally well with either MDI or pumping, but pumping takes the headaches out of preplanning everything and makes fine-tuning easier by an order of magnitude.
Good luck!
-Sarah S.
Hi Sarah…thanks for your advice. I am most likely headed for the pump. I have continually said that, as I don’t mind the injections with the pen, although it isn’t always convenient as I feel the need for privacy when I am out in the world, I do mind the constant BS checking. I have been waiting fo the CGM and pump to be one unit…supposedly in the test market phase as we speak. Unfortunately, I just don’t seem to be getting it right, despite trying, so I may be on the pump sooner rather than later…I may need the fine tuning you speak of.
I’ve thought about the CGM and decided I can’t justify the expense right now. I’m in grad. school and working on writing my dissertation proposal. Maybe one day when I have a real job… The other thing about using the CGM (aside from accuracy) is that I feel like I would be in information overload as well as belt overload 
All that stuff attached would be even more inconvenient than the pump by itself.
I’m starting to get so I don’t mind testing as much as I used to. It really goes in cycles for me - if my numbers are consistently high, I avoid testing. For me it’s all about positive reinforcement. When my numbers frustrate me, I stop checking them. When they’re good, I almost get excited for my next fingerstick. Weird, huh? Lately I’ve been doing pretty well so I don’t mind it. I just got back from a run and clocked in at 96 (after being about 257 when I left…).
All the best with the pump/CGM. Let us know how it goes!
-Sarah
Elaine,
I had a hard time keeping my BG in control when I was on MDI. I thought my Lantus would cover the basal and the Humalog/Novolog (I switched about a year before starting the pump) would cover the food. In theory, that works great, but since basal requirements change throughout the day (I have 5 different basal rates through the day, an an entirely different set on weekends), you’ll find that sometimes (mornings most likely) your Humalog/Novalog is actually covering part of an increased basal rate, and at other times, your Lantus (or equivalent long-acting insulin) is covering some of your meal. This is why the carb-to-insulin ratio never seems to work on MDI. Plus, I would always try to size my meals in 15-carb increments so I can take an even number of insulin units. (I never wanted to inject a whole unit for a cup of coffee, so I would either eat more, or not take an injection and let my BG rise a bit).
But that wasn’t your question, and I know how tired I got of “try the pump!!” responses before I actually caved in and did it.
So to answer your question, there’s not a whole lot you can’t eat. Sweets and margaritas I would try to stay away from, but if you’re having them, I’d suggest having some protein or fat at the same time. That will lengthen the time it takes for the sugar to reach your bloodstream, so the sudden spike might be muted a bit.
Don’t think that a CGM will help you figure everything out though. I used to test my BG about once an hour, and in my effort to keep on target, I would constantly take small doses of insulin or eat small snacks to the point that nobody could figure out what was going on. (I’m probably one of the few people whose doctor told them they test TOO frequently!) I’m a bit scared of a CGM because I don’t want to resort to that behavior again. Sarah is absolutely right about information overload.
If you’re using Humalog, talk to your doc about Novolog (or vice-versa). They are supposed to be equivalent, but Humalog peaks a bit sooner and tails off a bit later in some people. I (reluctantly) changed, and doubt I’ll change back.
Good luck Elaine!
Thanks Sarah and Scott. You never know who is going to say something to you that inspires or influences you. Your explaining your experiences with the pump might be what I’ve needed to jump on in. I am still not excited about having a half a kiwi sticking out from my cute outfits, (my endo pushes the Omnipod,) but I am a big girl and need to make adult decisions about my health. I thought I could master this as I am interested in nutrition and health, blah, blah, blah, but I am not where I want to be after 4 + years.
About the CGM, it sounds as though neither of you suffers from hypo unawareness…me neither. I would think it almost a necessity, then. I do feel fortunate thinking that we will probably see more helpful technology through the years…
Thanks again.