When I was diagnosed

Does anyone have records of their blood sugars from their first months of diabetes? About five years ago I found my first logbook. I had no idea that my parents had kept it, and I was fascinated looking through it! I was shocked that it took a month to get my blood sugars to reasonable levels, and the logbook even captured my honeymoon period which lasted two to three months (the last month is kind of fizzling out, though). Several years ago I was going through a phase where I wanted to digitize everything in case the physical copy got destroyed, so I entered my entire logbook into an Excel file.

Tonight I was backing up files and happened to find the Excel file and opened it. I was fiddling around with charts and statistics and thought it was interesting enough to keep. I broke up the seven months worth of readings I had into the month after diagnosis which was all about getting my blood sugars under control, then the three months after that which were the honeymoon period (and ending of), and the three months after that which is when the real rollercoaster began.

The First Month

Here is the first month after my diagnosis (at nine years old). Horrendously high blood sugars that take forever to get under control. When I first saw this I was kind of surprised they were so high—this is after they released me from my four-day hospital stay. I have no idea how high I was at diagnosis, but if I was this high after starting insulin I’m not sure I want to know!


Average BG: 15.2 mmol/L (273 mg/dl)

Standard Deviation: 7.9 mmol/L (142 mg/dl)

Lowest BG: 3.4 mmol/L (61 mg/dl)

Highest BG: 32.0 mmol/L (576 mg/dl)

Enter The Honeymoon

Here is where the honeymoon period is in full swing. Keep in mind this is on only two shots per day, no carbohydrate counting. During this period my insulin is decreased quickly (due to lows) until I’m taking about half of what I started with when I was diagnosed. Towards the end of the graph my dose starts getting raised. The great thing is that with the pump, this graph looks pretty similar to my control now when I am totally on top of my game. The advances in the past 20 years have been amazing! The last month or so of this graph the honeymoon looks like it’s fizzling out.


Average BG: 7.6 mmol/L (137 mg/dl)

Standard Deviation: 4.0 mmol/L (72 mg/dl)

Lowest BG: 1.2 mmol/L (22 mg/dl)

Highest BG: 21.5 mmol/L (387 mg/dl)

The Rollercoaster Begins

Here is where the rollercoaster of highs and lows really begins! It looks like it took a month or so of “fizzling out” for my honeymoon period to truly end, as the start of this graph looks a lot better than the end. During this graph my insulin dose continues to be raised over a period of a few weeks until I’m back to the amount I originally started with. So overall my honeyoon period lasted four months, I’d say, with two of those months going strong and another two fizzling out. The end of that graph shows pretty much what control was like for me until I got onto MDI in 2005, and this graph is only showing testing before meals as I didn’t begin testing after meals until 2005, either. My A1c was decent most of the time, but probably just because of a balancing out of highs and lows!


Average BG: 9.0 mmol/L (162 mg/dl)

Standard Deviation: 4.9 mmol/L (88 mg/dl)

Lowest BG: 1.5 mmol/L (27 mg/dl)

Highest BG: 24.3 mmol/L (437 mg/dl)

And thus ends my trip down memory lane. All I can say is thank GOD for the pump and carbohydrate counting, I do not miss the days of four tests a day and two shots a day at all!

I don’t have a chart of the first month bg’s, mostly because we didn’t test bg’s back then, just urine.

I can tell you that turning in a “4+” on the urine scale was far from rare and I’m guessing probably coincided with bg’s in the 300+ range. That’d be like 18 on your scale (mmol/L).

Even after starting bg testing it was decades until the concept of “test after a meal” came up. The first decades it was all about getting the before meal bg’s reasonably in whack (thus the magic 4 tests a day… before breakfast, lunch, dinner, and bedtime).

And yes, MDI is so much better than 2x a day of R+N. I really turned a big corner when about 20 years ago I started doing MDI. Felt so much more in control.

Tim, how did you do MDI 20 years ago? Multiple injections of R and NPH? I was diagnosed 20 years ago and did not start MDI until five years ago, mostly because that’s when Lantus came to Canada. I know some people were using it before then, though, like people in the intensive group of the DCCT. There was a kid in my high school in the last half of the 1990s on a pump, before the rapid insulin analogues came out, and he must have used carbohydrate counting. I wish I’d found out about it sooner than I did, although I’m not sure I would have been all that interested prior to 2005, anyway, as those were my high school and college years when I did what was necessary for diabetes but was not into the whole tight control thing.

I switched myself to MDI when I was, probably, 20 years old or so. Circa 1986-1987-88. This was several years after starting home bg testing. I’m stretching my memory to remember back that far… but I think I remember the morning when I resolved to try MDI :-).

I had been talking to my doctors about such a move because I had read about it starting with DCCT prospectus literature in the early 80’s, and was in college so I could go visit the medical library and read about it both MDI and pumping. But… they never particularly wanted me to make a change. Pumps were a little more awkward circa 1988 than today, but not hopelessly awkward.

So one day I just decided to try MDI. I did MDI with 4 shots a day of R+N, spaced roughly 6 hours apart. The N was the same in every shot but the R was tweaked for the meal. My bedtime shot was often just N. It was pretty flat. The other approach at the time probably involved UltraLente.

I felt so much more in control with MDI than I ever had with just two shots a day of R+N.

Looking back, I probably wasn’t looking so much for “better control” but “more flexibility” in what and when I ate. I was getting tired of the strict R+N and mealtime regimen and wanted to be more flexible if for nothing else social reasons.

My docs were a little miffed I had switched to MDI without their permission or assistance but they got over it.

Even today, on humalog and lantus with MDI, I don’t feel that my control is drastically much better (as measured by A1C) than on MDI R+N. I do have fewer hypo problems with the lantus than with NPH. But sometimes the Humalog kicks in real fast and hits me with hypos just after meals, those throw me for a loop too. Humalog is like a little atomic bomb compared to plain old R.

I just found mine last week. I was shocked at the first tests. I hadn’t remembered them ever being so high, but my doc did say she was amazed that I was walking around and alive with the numbers I had at initial diagnosis.

I don’t know what the highest was, she hasn’t told me. I’d like to know though, just as a matter of personal interest.

Emmy, I wish I could find out what my blood sugar was when I was diagnosed. So many people know theirs and I have no idea what mine was. I was only nine so was never told, and my parents don’t have a good memory for that kind of thing. It would be really interesting to know, though! I do know that I was admitted to the hospital within a few hours of getting the blood work done at the lab (which was right after my doctor’s appointment), so it must have been pretty high.

Since I was just diagnosed a year ago, I have kept all of my records, from the hospital records to the log books that have followed. I have an expanding 7 pocket file where I keep all my medical records as well as fast food nutrition guides and other Diabetes related stuff. When I was admitted into the ER and blood work was done on the 20th of January, 2010, I had my glucose level at 1301. I stayed in ICU until the following Saturday. By the end of March, when my first A1C was done, the results read 7.7. By the beginning of August my A1C level was at 5.9, since then, I have let my guard down a bit because my A1C is at 6.1. But I am trying to get back on track and bring my level back to 5.9. Once I achieve that, my next goal will be to bring it down to 5.5. I have been pretty good at not getting any real highs or lows during the past year.

I was just recently cleaning out some boxes “winter cleaning” and I found a log book that I had taken to the Dr. for an appointment. It was from the mid 90’s. I can tell that I had written in the BS based on what was recorded in my meter. I was shocked! 325, 360, 400, 250…OMG for a number of years in the 90’s I did not do a very good job of managing my diabetes. Also I was not able to do a very good job of managing until MDI came about… Late 90 early 2000 flipped to Lantus and now 37 years with type 1 on the pump. Things are so much better.

In that same box I found a book on food exchanges. Today I sometimes mix usage of food exchange and lables for determining the number of carbs to bolus. It works out great for me. But the best is the lable but difficult sometimes with natural foods.

I have everything written down, including a diary of my first 3 months worth of food. (Thank you Blood Sugar 101, and TuDiabetes!)
When I took my first insurance test it showed me at 52.3 mmol. (941.4 mg/dl) I got another test the next day, and it was thankfully only 36 mmol (648 mg/dl) They then told me they “found something” and I needed to see my family doctor.
I know this because I looked at the test results with my new family doctor that I had to BEG to see. His first question was, WHY didn’t they send you to the hospital?

So, my first month saw me with an average of 19.2 mmol, and a swing of around 10. The highest I had was 24.4 mmol (439 mg/dl) and the lowest was 11 (198.)

Once I switched to rapid insulin therapy, my sugars went right down, and I ended up with levels around 9ish, the lowest being 2.3. (41.4)

I switched to Levemir, and now I am averaging around 6.4 mmol, with a variance of 2 to 3. (115 with a variance of 36 to 54.) I try and keep things around that level, and NEVER go past 10.

The lowest I get to is 3.8 mmol (68.4 mg/dL) and that is how I like it. Now, I might be in a honeymoon period, but that is also where I want to stay. I don’t take much Rapid (in fact I have to throw over 3/4 of my vial away after a month…) and I just want to be “normal” for as long as I can.

I don’t mind the shots. Sometimes it is annoying because you have to be so careful, but OTOH, I am not sure how much I would like having a pump attached to me either.

Oops, wanted to say about my A1C as well. At diagnosis, it was 17.1%, then I had a 6.1% 3 moths later, then 5.0% 3 months after that. I am not sure what it is at right now though…

that is fantastic you have such tight control. If I could manage to stay between 3.8 and 10.0 most of the time I would be a happy camper if it stayed like that for the rest of my life. I range from 3 - 12 on an average day with the pump. I didn’t mind shots, either, at least not physically doing the regimen. But without the pump I was never able to get my A1c down past 8% due to a nasty dawn phenomenon (and nasty monthly hormonal variations) and an extremely variable schedule that made spotting patterns near impossible, so that has made a huge difference to me and enabled me to get my A1c into the high 6% range. My lowest-ever A1c was 6.4%, so I admire those of you who can get lower without having too many lows!

LADA tends to have a much slower onset (longer honeymoon) than childhood-onset Type 1 so it would not surprise me if you are still honeymooning less than a year after diagnosis. I am also surprised they did not send you to the hospital with a blood sugar of 52! I don’t know what mine was but I suspect it was somewhere in the high 30s or low 40s. I only had one blood test at the lab and was in emergency within hours (but then, unfortunately high BG is probably taken more seriously in a child than in an adult, I suppose). I was lucky that I was only in mild DKA when I was diagnosed … mine was not as traumatic as some of the diagnosis stories I’ve heard over the years.

Good luck keeping up the great control, I hope it lasts for a long time for you!