Grrr. High then low

[Amberzak]

Okay I'm getting so frustrated. I'm really really trying to control my sugars. Straight after breakfast I go up, then before lunch I go low. Had dinner (pasta salad with no sauce at all) I measured the pasta and was precise in my carb counting to be sure. Was 7 before I ate. 13 an hour later. Decided not to correct this time because when I've corrected I go low, and now I'm low (2 hours later). I even avoided my lumpy parts.

Doesn't seem to matter how often I test (10 times a day) or what I do, I can't control them. And then this is where I got last time, when I then start to think what's the point in all this work?

Can I ask you type ones for some honesty for a second. Because people make out that they have perfect control 24/7. Is that really true? Are 99% of your readings really between 5-7? Because I just can't seem to get it.

 

[Miss_Melissa]

I find it very hard to believe that anyone could ever be 100% perfect - I managed it once... for a day. Then I got bored of not having a life and focusing all my energy on diabetes.

It sounds like your carb:insulin ratios could possibly be off?
Whenever I eat pasta, my blood tends to spike soon after. I think because of the high G.I. of the rubbish white stuff I eat 🙄

Obviously no-one on the forum can give you medical advice, but it sounds to me like you're maybe taking too much insulin in your bolus, or your background insulin is too high. That's the annoying thing - so many variables!

Also, how soon before eating do you take your insulin?
I've found that to make a huge difference in spiking afterwards 😱

 

[Sally71]

I don't think it's possible for T1s to have perfect control all the time, much as we'd like to. Even with a pump! We get fairly good numbers in the day most of the time, although not all 5-7 of course (that would be bliss!). It's being helped by the weather at the moment though which is lowering everything, numbers were starting to drift upwards and I was beginning to think about basal adjustments and then along came the heat wave and it all went back down again!

Night time is harder, I have all sorts of fun and games trying to avoid highs at night. It seems to be that as soon as daughter gets into bed her BGs shoot into the stratosphere and stay there for most of the night, unless we have a massive increase in basal, and I still keep having to nudge it even further upwards! And then if she's had a dance class after school she will go low at night unless I put a temporary basal rate on overnight to lower it by 10%, so of course I have to remember to do that. Going to Brownies can have the same effect but it depends what they are doing; sometimes basal reduction needed and sometimes not, so it's really good fun trying to get that right! So have to do a test sometime in the small hours, if we're lucky it's somewhere near normal, if not then it could be approaching 18 or somewhere in the 3s...

In short, T1 is a right royal pain in the a*** and you can't be expected to get it right all the time, no matter how hard you try, there are just too many things which can influence your blood sugars. So don't beat yourself up, just take a deep breath and keep trying. Pasta can be a bit of a nuisance because it digests slowly, we have to put a multiwave bolus on for that to avoid hypos afterwards. If you are on MDI maybe you could try injecting half up front and then the rest an hour later, so that the insulin will get going more closely to when the carbs hit your bloodstream?

Good luck, and don't give up, we all have rubbish days sometimes🙂

 

[Amberzak]

I am on novorapid. I used to inject after I had eaten because I had problems with not knowing how much I was going to eat, but I've changed to injecting before. If I'm not sure how much I fancy, I inject for smaller amount and give more if I eat more.

 

[jalapino]

I find it very hard to believe that anyone could ever be 100% perfect - I managed it once... for a day. Then I got bored of not having a life and focusing all my energy on diabetes.

Agree! 🙂

 

[Miss_Melissa]

One thing that really used to help me when I was on MDI was injecting at least 20 minutes before. But that doesn't work for everyone! And like you say, you never know how much you're going to eat.

Even now I'm on the pump, I try to take my insulin 20-30 minutes before if possible.

Like Sally says, don't beat yourself up - T1 is a nightmare. You're obviously trying hard 🙂

 

[DeusXM]

Can I ask you type ones for some honesty for a second. Because people make out that they have perfect control 24/7. Is that really true? Are 99% of your readings really between 5-7?

Not if I'm eating pasta.

Carb counting is only part of the deal. It's often painted as a panacea for everything with T1 but it fails to take into account one specific problem.

The problem is that bolus insulins have a specific action profile which often bears little resemblance to how your body actually digests carbs.

I find it largely a lot easier to just go without the carbs as much as possible - smaller variables mean smaller variations.

 

[Hanmillmum]

Also, how soon before eating do you take your insulin?
I've found that to make a huge difference in spiking afterwards 😱

Yes I would agree with this to avoid spikes, and learnt that here some time ago. It's particularly beneficial for us with brekkie 15 -20 min wait after insulin before food and hey presto generally no spike (touches wood)

I don't think anyone could be perfect for very long in this game, you would get burnt out very quick with such high expectations. You need to have a life too 🙂

 

[Amberzak]

I do eat carbs. (One forum I was on kept telling me to go no carb, but not only do most research and health authorities say that's bad for you, I don't really eat much else, and I still want to actually enjoy my life as well.

I am hoping to find a way to live my life (I am a tutor and run my own company) with it's irregular hours, and fit the diabetes in as best I can. I am happy to test lots and all the rest of it, but I know that if I start trying to change my lifestyle too much (ie the job I do, because I love my job so very much, even with all the stress and irregular hours) I won't keep it up, and then my diabetes will become a back thought.

I need to learn how to control my sugars as best I can around me.

 

[Miss_Melissa]

A pump would be so fantastic for you, if I remember rightly you're trying to get one?

Documenting everything (BGs, insulin, carbs, exercise, day of the week, weather 🙄 ...) was something that really helped me when I was on MDI. And it also helped to prove to my consultant that I was serious about looking after myself. It helped me to get put on the list for a pump.

 

[trophywench]

Well, here's todays BG readings

06.14 - woke up as I wanted the loo and felt 'off' so I tested - 11.0. No wonder I felt off. No reason to be that high. Had a correction went back to bed.

09.14 5.6 - had brekkie and bolused.

13.36 4.6 - well I'd trawled round town this morning in and out of shops and the Post Office. Had lunch and bolused.

19.15 10.1 - absolutely no reason for it to be that high. Bolused and had dinner.

I should imagine it's higher than it should be right now - oh no it isn't it's 4.6. I've only just finished eating half an apple though which I didn't bolus for, so I won't worry about that. Good.

The other day my highest was 8.8 and my lowest 7.8.

There was a 13 amongst the last few days.

I'm not losing sleep .....

I once was really really good for a whole week with my eating , testing and jabbing, recording every mortal thing - at the time I was also wearing a CGM to see what my BGs really did.

At the end of that week, my DSN proclaimed that it appeared my BG pleases itself what it does - which I'd been telling her for ages.

It still does !

 

[Amberzak]

A pump would be so fantastic for you, if I remember rightly you're trying to get one?

Documenting everything (BGs, insulin, carbs, exercise, day of the week, weather 🙄 ...) was something that really helped me when I was on MDI. And it also helped to prove to my consultant that I was serious about looking after myself. It helped me to get put on the list for a pump.

Yes I am trying to get on the pump. Seeing diabetic nurse in August so here is hoping.

Thanks everyone for being honest. It's made me feel better. I thought I was being a 'bad diabetic' 🙂

 

[everydayupsanddowns]

Don't give up Amberzak!

It is very frustrating and you are right - each of us have to find the balance that suits us between life and all the 'working around diabetes' stuff.

Quite often I think of speedboats and oil tankers. Carbs tend to hit my system very fast while insulin is slow to start and then doesn't stop once it has finally got going. Injecting the right dose and leaving it a while before eating helps me like Hanmillmum said.

 

[Sally71]

We really are all different - I don't think bolusing early would help us much, daughter once had a 2.9 at tea time just because she was faffing about and not eating quickly enough 😱

And I find we're having to use multiwave boluses more and more just to prevent hypos an hour later, and it doesn't seem to make much difference what the food is!

 

[Miss_Melissa]

Very true Sally, for some people having a bolus too long before leads to really quick hypos. I think it's a lot of trial and error and just getting to know your own (or your child's) diabetes.

You're not a 'bad' diabetic Amberzak - you're trying your best with a difficult and often unpredictable illness.

 

[trophywench]

Thanks Melissa - that's what I was trying to convey!

 

[KookyCat]

I don't have perfect readings all the time Amberzak, in fact my body has a right Collywobble at 6pm every day, like clockwork. I have no intention of going low carb, I respect everyone's choice, but for me it would not work, but I do avoid some carbs because they have a bizarre affect on me. I consider myself a moderate carb person, with a lean towards the low GI. I can eat pasta at lunch time no problem, no spike, if I eat it in the evening I'll have a hypo because I can't get the bolus right. I can eat a scone and not get a spike but if I eat a white roll from a particular bakery I get a massive spike, and it's just white flour in both, the scone has sugar so logically you'd expect that to be worse but no 🙄 my current working theory is the novorapid really is quite rapid for me, because I tried bolusing 15 minutes before I ate anything and was hypo before my first forkful. I am to be polite, very goal oriented, so have a tendency to want perfect control, but I'm under no illusions either, I know a game I can't win when I see it. I consider I'm winning if I can keep the little monster under enough control for it not to impact too much on my life. If I'm wrong, well I did the best I could with what I had 🙂.

 

[Amberzak]

Honestly it is so reassuring to hear this. So many people in my life are just so judgemental and I think that has may have lead to my negative feelings.

 

[Northerner]

Honestly it is so reassuring to hear this. So many people in my life are just so judgemental and I think that has may have lead to my negative feelings.

No-one will judge you here Amberzak, this is a tough thing to live with. By seeking the help, experiences and support of others you are showing how hard you are working to walk this wobbly tightrope 🙂

 

[pav]

I am type 2 and going through the same, seams impossible to get near decent numbers throughout the day let alone a week. Not had a hypo for a good while close but no hypo, then to throw spanners in the works had a couple this week and sailing very close to hypo at other times.