Wow! I am sooo appreciative of all the responses I received to my question about blood glucose targets. I am very, very encouraged by your experience and insight. As a result of all the great input I decided to split my Lantus dose (the diabetes nurse congratulated me yesterday for figuring that out… I gave you guys the credit!) and have started testing more often so I have a better idea of what is affecting what. It seems that one gram of carb will shoot me up five whatevermakalits on the meter. So, I’m eating almost no carbs. And, I don’t think I’m getting enough calories. I had a small salad for lunch, some romaine with a half can of tuna and a handful of pumpkin seeds, and started to get hungry a couple of hours later, now it’s three hours later and I feel ditzy and low, but I measured 139, and was 120 an hour before that. So, I’m choosing to not eat, and I’m not hungry anymore, but I’m still out of it. So… this is illogical to me. And there’s nothing like confusion to drive me crazy so I guess I’d better get used to being a little nuts. I’m going through too many test strips, but I really want to understand… !! I hope this isn’t an inappropriate qquestion for a discussion.? Carolyne
I’m a little confused, Carolyne by your focus on how many points a gram of carb brings you up. It’s normal for carbs to raise our blood sugar and as long as it’s in target range, and it comes back down in a reasonable time, that’s a normal process. I think most of us look instead at I:C ratio. How many units of insulin we take for how many grams of carbs in order to stay in target range two hours later. You might be right that you are not getting enough fuel. Are you going overboard with the low carbs? I would be low if I ate that lnch because it is nearly carbless.
Oh yeah and I wondered about you referring to “unexplained highs”. My target for post prandials is under 140, so for me, 139 would be considered fine. I know some people do aim for 120. But still I don’t think too many Type 1’s consider 130 a “high”.
Sounds like you might just be hungry…and it will take a while to fine tune your insulin:CHO ratio (I:C) as your Lantus dose gets ironed out. Bottom line is - the more you take in basal…the less you may need in coverage for meals…so until the Lantus dose is correct you may need more short acting insulin for meals than required once you get the dose right. Get the Lantus right and then fine tuning the I:C will be easier. You need to eat…so team should be helping you figure this out. There are rules-of-thumb (The 450-rule) on amount of fast acting insulin you should need per gram CHO…but, only guidelines…I would take what you were using and increase or decrease from there and test, test, test…to determine next move. Also good idea to let Lantus settle out over a few days and then reasses how your I:C is working…I would chat w/ diabetes educator about this:) Take care and hope you see even better BGs in the next week or so.
The blood sugar was going up instead of down even though I was feeling very much like I was going low. So, it’s not “high” but it’s going up instead of down in order for me to feel comfortable having a snack.
I can understand you not wanting to eat, Carolyne when you were at 139, but hunger is your body telling you something. I’m still very much in the learning process myself and I would just take that experience as a learning. A salad may not meet your needs and next time you might need to add some carbs, like a couple crackers or some fruit. Once you figure out your I:C ratio you will be able to eat enough to satisfy your hunger AND not go too high…at least most of the time…lol
If you was used to your sugars being high for some time and then all the sudden you are having normals sometimes you still get a little low feeling here and there. But when I get hungry and my sugar is at that rate I have a snack. Or maybe even a protein snack if you don’t want to chance raising it back up any.
You may be hungry because you’re eating too little protein & fat. Since protein is slower to digest (& fat even more slowly), these keep away the hunger pangs longer than carbs. If you’re eating very low carb, you’ve got to up the protein & fat (good fats). It helps to try to keep your daily protein intake pretty consistent.
Carolyne, it sounds to me like you are STARVING yourself. The other posters have given excellent advice.As they have mentioned, 139 is not high for most people; and everyone, diabetic or non-diabetic, is expected to go up some after eating. It is just the body’s normal response. You should not be AFRAID to eat. I applaud your efforts to maintain control, but I believe you may feel so bad because you are under “fueled”, as Zoe mentioned. Please talk to a CDE ( certified diabetes educator) or a nutritionist/dietitician, if you can). They should be able to help you fine-tune an eating plan that keeps your diabetes in control AND gives you enough energy to live life with zest!!
Everyone has given GREAT ideas. I’ll add one. Sometimes when you’re starting to lower carbs your body has to have time to get used to it. Sometimes the liver kicks in, saying hey, you were low, now I’m going to take you higher, and I’m going to kick in everytime until I get used to your new average. A liver needs to reset, too!
And another. Feeling low may be a transient feeling since your body may have been EXTREMELY low and you then measure when your brain catches up and you think about it - and the liver has already kicked in. Feelings are late and last longer than the actual measurement. Are you on humalog, too?
At 139 I can understand your not wanting to eat. But IF I’VE eaten as YOU have, I’LL NEED something! I’ll take 5 grams of a cereal bar (takes me up 7 per gram - up 35). Now I know I can take a unit to cover that since one unit will pull me down 35-50, and I will not go too low: 139+35=174-50=124. I can even take 1.5 units but that’s because my body has gotten USED to being at 100. I wouldn’t do this unless my body were used to it.
And if you’re not on a bolus insulin, too, show your daily figures and your food diary with grams of both carbs and protein to the CDE.
And by the way, I agree with everyone on here: you CAN eat more carbs for lunch. Your body has been used to probably much higher carbs. Ease it down over a few days. Even Bernstein suggests 12 as a starter for lunch, not zero. You could add some toast made up of 8 gm carb bread, some 3 gm carb strawberry yogurt (Dannon Diabetic Friendly), and you’d still be on a low carb diet! You’re doing GREAT!
You’re doing WELL!
Wow - good for you for being so diligent. It sounds like we have similar approaches although I think I’m checking Caleb a lot when I’m up to 14 times a day. I wish I could use the term “seldom” regarding over 270. It is not often, but more than I would like even with all the BG checks. I’ve contemplated CGM considering sometimes I feel like we are just about doing that, but, I just haven’t been able to make that plunge, particularly since it means asking Caleb to endure another device. It would be easier if it were just for me.
Anyhoo, thanks for sharing. Oh and PS - we’ve been using chocolate milk lately for lows from your recommendation on another thread - it really does work like a charm, particularly if Caleb is really not in the mood to eat something.