My morning BG reading have been steadily raising. Two hours after breakfast this morning I was 239! Prior to breakfast I was 191. It's been going on like this all this week. I'm currently on a 1:2 I:C ratio for breakfast, 1:3 at lunch and 1:2.5 at dinner. Any little bit of carbs will send me skyward, but I still get cravings for some carbs in my life. Before it starts to rain, I think I'll go out for a walk and try to work some of this off before lunch.
It hasn't been 4 months of T1d yet and I'm getting tired of the battle. I know it will get better, but not without more work. I've got a wonderful CDE & endo to work with, however when we get things close to being worked out, I go off again. In reading others experiences I know I'm not alone but I just needed to vent this morning.
Sorry you're struggling, NorCal (I'm a NorCal'er as well). You have very low I:C ratios, especially for someone so recently diagnosed. Does your endo think you have some insulin resistance? One suggestion is that if you have any extra weight to work on losing some because that will reduce the need for so much insulin. I know it gets harder when you get into our age range.
Question: I see you are on MDI. Do you know that your basal is set right? You would see this by having decent waking numbers, as well as before bed and in between meals (like say before the next meal). If you are not getting enough basal (which I suspect might be the case), you will struggle greatly with your bolus.
Next question. When you had that 191 before breakfast did you add a correction? If you haven't done so already, you might want to figure out your ISF which is the how much one unit of insulin lowers your blood sugar so you can correct either with your mealtime bolus if you are already high or afterwards.
Finally, breakfast is hard for many of us, even if we can eat more carbs later in the day. You didn't mention what you eat, but I encourage you to try out various combinations of eggs, vegies and meat if you eat it.
But I really think the basal might be an issue for you. How much do you take and when do you take it?
Thanks for writing Zoe. I've lost over 40 lbs since all this began in Nov., so that's improving greatly. My endo has been playing with my basel rate and it could be that we've gone a little too low and need to bump it back up. I didn't include that I did adjust for a correction prior to breakfast this morning and still got the 48 point increase! My breakfast is pretty routine; 2 eggs over toast (whole wheat), diet grapefruit juice and black coffee. This morning I added sausages for 2 additional carbs. Your last question is my basel is currently 13 units of Lantus and is taken in the evening before dinner.
Glad to hear you are correcting, NorCal, sometimes endos don't encourage their new patients to do that. Does sausage have carbs?? I'm a vegetarian so I don't know but I thought no meat has carbs!
Yes, it does sound like the basal might be too low, especially if you're consistently over target at those in between times.There is a general formula that basal and bolus should be 50/50 and though we all vary a bit from that, yours sounds like it is way off. Your I:C ratios are very tight and you could probably give yourself a bit of a break if you shifted more to the basal. Also, you might consider taking it later or even splitting the dose. If you take it say at 6PM, it is peaking around 11, which is not when you need it to.
In time, you'll find it's a lot easier to keep good records and tweak your own numbers without having to wait for the doctor.I highly recommend the book Using Insulin by John Walsh.
Congratulations on your weight loss! That's the same amount I lost at diagnosis (though I gained 10 back). Mine was effortless, just part of being a Type 1!
Not sure how many carbs DIET grapefruit juice has, but that might be causing your BG to spike even more after eating. I know for me juices are off limits unless I'm low. If you want graprefuit, you might be better off eating the real thing.
Hi, NorCal. Sorry for your diagnosis and frustration. We all feel it as T1s.
Different kinds of carbs have a different reaction. (taking any cholestroal meds, please avoid the grapefruit juice. Very forbidden on in the C meds. Please check the labels.)
Juices work VERY quickly and have a lot of sugar. Even if it SAYS it is 10 carbs, I find that labels lie a lot for me. Discouraging, but very true. Only basic non-processed food may have an accurate count. Tried a restaurant? Had a fabulous French meal--salad, fish, a little bread and have fought the high BGs for 24 hours. (And yes, I thought I correctly, but as many of you know, I think restaurants sprinkle carb powder on everything!)
Stay here NorCal T1. Even after a lot of years as a T1, I learn a lot and these people have really helped me. Keep the faith.
The grapefruit juice is sweetened with Splenda and does not have any interactions with my oral meds. Before dinner this evening, my BG was down to 86. Yeah!! Maybe the rollercoaster ride will end soon, but I'm not counting on it. Thanks to all that took the time to write.
There is another way to look at the situation, a 48 point increase 2 hours post meal with insulin still on board is not bad for matching insulin to carbs. Since you didn't say, how long after dosing did you wait to eat? Toast is one thing I can't eat, bread is fine but toast raises my blood sugars 2x as fast.
I personally would have done a correction bolus and waited 45-60 minutes, then dosed again for the meal carbs if sugars were that high leading into a meal.
Basal is more complex, there are many factors that could lead to a high morning reading and need to consider if that reading is common or only an occasional occurrence? High fat or protein dinner can raise sugars 4+ hours after the meal and there's also the possibility of mild lows overnight with natural rebound, etc.
I vote that your basal is too low. I second Zoe's notion that bolus/basal is usually around 50/50. When I was on MDI, I had a 1:20-1:22 I:C ratio and my total basal per day was 12-14 units. I would suggest calling your doc or CDE and discussing the option of increasing your basal. You may also want to look at the possibility of taking your basal in 2 injections - that allows you to better account for changes in your basal needs throughout the day.
You may also look at doing a basal test (I forget what the official term is). You basically fast for several hours during a portion of the day while checking your blood sugar every 15-30 minutes. If your basal is spot on, those numbers should remain level. If you start to rise or fall, you know you need to adjust. Next day, you adjust and start the test again. There are plenty of entries here on site that discuss this testing.
I agree with the others that a 48 point increase after breakfast is not bad at all. It's the starting point of 191 that was the problem and probably the general insulin resistance that many of us have in the morning. Also, many of us find that when our BG levels are high that we become increasingly resistant to insulin and may have to use a higher correction factor. With such a high pre-breakfast reading, I would have definitely gone low-carb for breakfast.
I've been doing this for 35 years and although I'm doing very well, I still learn new things every day and have never completely gotten off the roller coaster. You can never achieve perfection with Type 1, but don't get discouraged with the battle. It will become second nature to you and every day, you can get up and try to do it better than yesterday.
My CDE & I have talked and she's going to talk with the endo to recommend that I start pumping. I've done some checking and agreed. Waiting now for a return call so see if and when the process starts. I've got a whole new world ahead of me, don't I?
