Sometimes I just don't get it

[Doddy]

Argh!
I don't think i will ever get the hang of this diabetes lark.
Woke up at my usual 8.0
Lunch I was 7.9

I had 2 white cheese topped rolls with ham and grated cheese. I knew this would more than likely send me higher than I should be. From experience, just one roll would send me to above 10, so never mind 2!
I took my usual lunchtime dose of novorapid, expecting for me to be at least 10.0 if not higher.

Go to the drs to pick up my prescription, start to feel a little shaky. Drive to my in-laws (literally 3 mins away), feel even more shaky. hey presto...3.4

I really don't understand how one day a lunch can have one effect, and another day, has another.
I haven't been any more active than usual today, I definatley took the correct amount of insulin, today hasn't been any different.

So why does this happen?

 

[Northerner]

I'm afraid that's diabetes for you It's possible that for some reason the insulin got absorbed more quickly from the injection site. How long after injecting/eating did you start to feel the symptoms?

 

[heasandford]

story of my life, keep trying it all!

Read everyone's ideas, one day it might work, but I agree it can be a bit dispiriting! Sorry I can't help or offer solutions

 

[Doddy]

Is this to be expected then? Im not some sort of strange person!?

It was approx 2 hrs after I guess, maybe closer to 3? It really took me by surprise.

 

[Northerner]

Is this to be expected then? Im not some sort of strange person!?

It was approx 2 hrs after I guess, maybe closer to 3? It really took me by surprise.

As with many things, it does vary from person to person as we all have little complicating factors that may make unusual reactions more or less common. I find that, most of the time, I can find a decent explanation for any lows (or highs!) I have, but there are still occasions when I get something totally out of the blue. Hopefully, you will learn to recognise all (or most) of the possible underlying causes of such 'excursions' so they will become few and far between.

Naughty having white rolls! As you say, you might expect them to push your levels high, but alternatively it could be that the cheese slowed your digestion sufficiently to mean that the insulin peaked before your food raised your levels sufficiently to cope.

This is why I think that people without diabetes get it wrong about what is difficult about the disease - it's not the injections but trying to get everything right so you can stay within that very narrow 'Goldilocks' range of not-too-high and not-too-low! 😱

 

[pgcity]

You're not weird. Sometimes there is no obvious explanation.

 

[Doddy]

You're not weird. Sometimes there is no obvious explanation.

LOL...thankyou!

I could understand the cheese slowing everything down, but it seriously was a negliable (sp!) amount of grated I put in there...the dregs of the bag haha!

I know, I was very naughty having white rolls, and I normally wouldn't be so naughty, but I had no burgen left, and the cheese topped smell soooo good when they are fresh! I guess this is my punishment!!! This will teach me for being so wicked!

Do the amount of hypos you suffer cause you to lose awareness? I know this is only my second one, but is it a case of the more you have, the less aware you become??

It is very hard to walk the fine line between good figures, and tipping over the edge and hypoing. It has taken me a while to bring my figures down and I didn't have to worry about hypos, but now they are lower, they have become a possiblility and a reality.

 

[robofski]

LOL...thankyou!

Do the amount of hypos you suffer cause you to lose awareness? I know this is only my second one, but is it a case of the more you have, the less aware you become??

It is very hard to walk the fine line between good figures, and tipping over the edge and hypoing. It has taken me a while to bring my figures down and I didn't have to worry about hypos, but now they are lower, they have become a possiblility and a reality.

From what I've read too many hypos and you can loose your awareness, how many is too many I have no idea!

I know what you mean about the hypos being a real possibility once you get your numbers in the right area, it's still one of my concerns and I think that's why I'm happier at 7 than I am at 5!

I just wish you had to take x units x times a day and all would be good, as has been said, the injections aren't the issue it's working out what to inject and when that's the issue!

 

[Northerner]

...Do the amount of hypos you suffer cause you to lose awareness? I know this is only my second one, but is it a case of the more you have, the less aware you become??

It is very hard to walk the fine line between good figures, and tipping over the edge and hypoing. It has taken me a while to bring my figures down and I didn't have to worry about hypos, but now they are lower, they have become a possiblility and a reality.

It is possible to start to lose your hypo awareness if you have too many, or symptoms may begin appearing at much lower levels. The usual advice is to 'run your levels a little higher' so you regain the symptoms, but I think this is also very difficult to do when you have got into the mindset that higher levels are 'bad'! I find that my symptoms are good if my levels are dropping quickly, but sometimes if they are dropping slowly then I can be in the mid-2s before thinking I ought to do a test 😱

 

[Doddy]

From what I've read too many hypos and you can loose your awareness, how many is too many I have no idea!

I know what you mean about the hypos being a real possibility once you get your numbers in the right area, it's still one of my concerns and I think that's why I'm happier at 7 than I am at 5!

I just wish you had to take x units x times a day and all would be good, as has been said, the injections aren't the issue it's working out what to inject and when that's the issue!

I want to get my figures down to 5's, but if it means I am at risk, then I don't know...
I think if I was properly carb counting, then it might help, but as it is I have stuck to my usual amount of units. I might talk to my GP about this when I see her next.

It is possible to start to lose your hypo awareness if you have too many, or symptoms may begin appearing at much lower levels. The usual advice is to 'run your levels a little higher' so you regain the symptoms, but I think this is also very difficult to do when you have got into the mindset that higher levels are 'bad'! I find that my symptoms are good if my levels are dropping quickly, but sometimes if they are dropping slowly then I can be in the mid-2s before thinking I ought to do a test 😱

Blimey, mid 2's! How do you function if you are that low! I was struggling to hold my tea steady when I was at 3.4!
Hopefully I won't have to worry about running high for a while as I don't plan on having any more hypos...although I today learnt to expect the unexpected, and although i do all i can, sometimes, these things are going to happen.

 

[Otenba]

Have you tried a carb free meal to check your background insulin is correct (if you were okay before the meal, where it holds you should be within a good range still if it is okay) if you don't think it's the meal dose?

Are you definitely carb counting correctly, and if so, what units do you take per 10g? Is it 1 unit? If you find it happens inconsistently, it may be your background insulin being the culprit.

It does seem you've not done that DAFNE course so I'm asking questions you may consider if you had done. Try not to let it get you down, okay?
Take care.

Edit: Did you not test before driving..?

 

[Northerner]

Doddy's still on fixed doses Otenba, so not carb counting, although it is logical that eating two rolls would send you higher rather than lower than it did when only eating one the previous day on the same dose. I blame the Diabetes Fairy! 😱

 

[Doddy]

Have you tried a carb free meal to check your background insulin is correct (if you were okay before the meal, where it holds you should be within a good range still if it is okay) if you don't think it's the meal dose?

Are you definitely carb counting correctly, and if so, what units do you take per 10g? Is it 1 unit? If you find it happens inconsistently, it may be your background insulin being the culprit.

It does seem you've not done that DAFNE course so I'm asking questions you may consider if you had done. Try not to let it get you down, okay?
Take care.

Edit: Did you not test before driving..?

This is the first time this has happened Otenba, so not tested my basal. I have been titrating slowly, and so really don't think it is down to my basal. As Northerner says, I think it must be the Diabetic Fairy!

As for dd I not test before driving...yes, I know I should have done, but having had 2 white rolls just before I left home, i seriously didn't think I would be approaching hypo territory. I learned a lesson today..no matter how short the journey...I am going to test before i get into the driving seat. This has been a huge wake up call as to have how easily this can happen, and how unpredictable this can be.

Interestingly, just before my tea tonight, I was 10.9! I am presuming this is rebound...i only had 3 jelly babies and a cuppa tea...with 2 sugars. I am thinking it might a take a couple of days to be stable again??

 

[Otenba]

You're clearly guessing everything you do when it's more complex than that I'm afraid. Carb counting and getting a good idea on your carb to insulin needs will help you a lot. It does take a lot of work to find out your needs, but it's very worthwhile finding out because you be one more step closer to having confidence that your BG will remain stable.

...but I guess "the fairy" a easier thing to blame it on I suppose. Doesn't fix the problem though. Sorry I couldn't help you.

 

[Mark T]

The thing is, for a Type 1 generally the pancreas has been destroyed.

But in a Type 1.5 there is still some ability left to create insulin and some of the cases I have read about show that the pancreas occasionally decides to flex it's muscles and show you what it still can do.

I remember seeing in one report that rather then a straight line of decreasing insulin production over time, in the Type 1.5 cases they showed a wavy line 😱

 

[Doddy]

You're clearly guessing everything you do when it's more complex than that I'm afraid. Carb counting and getting a good idea on your carb to insulin needs will help you a lot. It does take a lot of work to find out your needs, but it's very worthwhile finding out because you be one more step closer to having confidence that your BG will remain stable.

...but I guess "the fairy" a easier thing to blame it on I suppose. Doesn't fix the problem though. Sorry I couldn't help you.

Yes, to a point I am guessing, but that is not my fault...my GP has given me no guidance other than to titrate my dosage.
Surely I am better to to this than to guess ratios etc...i tried this before, totally self taught, and it was a disaster.
Compared to how things were, this is a vast improvement, and I am just experiencing a hiccup. I will blame the fairy at this time, because at this present time, I do not have enough knowledge to do anything else.
I haven't been on this regime for a month yet, and so am still getting to grips with it all...I wish I could carb count, but until my GP tells me it's ok to do so, I do not feel comfortable doing it alone, i have tried it, and I wasn't comfortable.

 

[Northerner]

Doddy, I looked back through my first BG record book and I see that it was at least 3 months from diagnosis that I was on fixed doses, varying them only on the instructions of my DSN, so you are doing great 🙂 What I found myself doing was eating similar amounts of carbs at each meal, therefore 'eating to the insulin'. I did learn a lot along the way though, like finding out I needed more carbs if I was gardening than running! When I then got my diabetes education course it all made a lot of sense to me, and I'm sure it will click into place for you too 🙂

 

[Doddy]

Doddy, I looked back through my first BG record book and I see that it was at least 3 months from diagnosis that I was on fixed doses, varying them only on the instructions of my DSN, so you are doing great 🙂 What I found myself doing was eating similar amounts of carbs at each meal, therefore 'eating to the insulin'. I did learn a lot along the way though, like finding out I needed more carbs if I was gardening than running! When I then got my diabetes education course it all made a lot of sense to me, and I'm sure it will click into place for you too 🙂

Thankyou for the reassurance Northerner 🙂 I am now at 3 months since dx, and have never seen a DSN, only ever my GP, whom I do have faith in, but I do wish i could learn to carb count effectively and properly.
I do normally eat the same sort of meal, and when I have my numbers have been steady, even since starting MDI. And I think has added to my shock today of eating what I know would send me hyper rather than hypo, but has had the opposite effect. I find what Mark has said interesting...could it be that my pancreas has had a jolly and decided to kick out some of it's insulin!? Stupid thing! Just makes for a more varied experience I guess LOL!
I might make an appointment to see my GP, and just go over whats been happening, and ask if I can learn to carb count and rather than eat to the meter, inject to the carb amount (is that right!?)

Could this in any way be link to my gallbladder issue? I have had more pain the last couple of days....

 

[Northerner]

I would ask if you could be referred to a clinic so you can speak to a DSN. Not a criticism of your GP, but a DSN has much more specific training in dealing with people on insulin, especially when they have the kind of history you have had. 🙂 Have you asked your GP about attending a carb-counting course?

A spluttering pancreas could be an explanation, or the gall bladder pain, very difficult to say unfortunately. It might even be an idea to repeat the meal and then test at one, two and three hours to see what happens to your BG - it would give you some more information to work with.

 

[Doddy]

I would ask if you could be referred to a clinic so you can speak to a DSN. Not a criticism of your GP, but a DSN has much more specific training in dealing with people on insulin, especially when they have the kind of history you have had. 🙂 Have you asked your GP about attending a carb-counting course?

A spluttering pancreas could be an explanation, or the gall bladder pain, very difficult to say unfortunately. It might even be an idea to repeat the meal and then test at one, two and three hours to see what happens to your BG - it would give you some more information to work with.

I think I will ask to see be referred. As great as my GP has been, like you say, a DSN is "more trained". I haven't asked about a carb counting course as I didn't know if it would be appropriate for T1.5, plus I haven't seen her since coming onto MDI...but to me it's the next logical step if it's suitable for me.

If it is a spluttering pancreas, this is the first time it's happened...fingers crossed it has had it's fun and will either work properly now (which i very much doubt judging on my reading earlier!) or it will go back to sleep! and stay that way if it isn't gonna play ball! I might do some research and see how much the gallbladder might affect the pancreas...I should know about these things really...my next module in my course is all about the endocrine system...maybe I should do that module now! Might help me a little!

I am nervous to eat anything now, let alone eat another 2 rolls! It's funny how a little blip like this can knock your confidence