Advice please

[rebrascora]

Mind you a BG result between 5 and 6 makes me feel good. As if I have passed yet another exam or won the lottery for the day.

Yes, I totally get that, but it is almost certainly unsustainable long term (since a normally functioning pancreas can't manage it) and the concern is that you get so involved in trying to keep it there that it becomes obsessive and you lose sight of the fact that diabetes has to fit in with your life not the other way around.
I got into a similar sort of mentality over the summer and was "over the moon" when I got a really great HbA1c result in October having put a lot of effort in to get it. Now I am putting the same amount of effort or even more perhaps but things have gone totally haywire and my stats are rubbish and I am having hypos through the night or I have to take my levels up to 12 before bed to prevent a hypo in the night and I am experimenting with all sorts of different strategies to try to fix it and I've discussed it with a DSN but we are both baffled. The thing that is keeping me afloat mentally is that I have had good control before and therefore I will do again but at the moment all I can do is my best and accept whatever results I get. There is a spanner in the works and it is taking some figuring out where it is and how to get it out. I am only in my second year with this so there is every likelihood that these spells of good control and poor control will ebb and flow with life and whatever it throws at me and I have to learn to accept that control will not be perfect all the time.
I think many diabetics go through this thought process and it can easily lead to anxiety and depression or feelings of failure.... In reality the only time we fail is when we don't try.

Did you click on the link posted by @helli and see the graph of the 24hr readings of a fit healthy non diabetic person. That really demonstrates that you are shooting for the moon trying to maintain readings between 5 and 6 and any medical professional who suggested as much deserves to get diabetes so that they see just how impossible that is. Putting unrealistic expectations on us has to be one of the major causes of burn out.

 

[trophywench]

Gwynn - the Abbott Libre system - a Flash glucose monitor gizmo a fair number of us use, has a central range between 3.9 and 10.0, and they like us to stay within that range for 70+% of the time!

Mike (@everydayupsanddowns) manually set his tighter than that and got a bit of a telling off from his Diabetes clinic, for setting himself unrealistic targets!

 

[Gwynn]

5.6 this morning. Elated for the day.

All the house electricity died first thing this morning, not so elated.

Life!!!

 

[Gwynn]

I did go to the link. What scared me was the fact that diabetes is an unstable condition. Oh dear that did not fill me with hope.

However it was mentioned on here that the only failure is to stop trying and I AM a tryer. So I have hope in that.

I use an app that details exactly what I am eating and eat 7 small balanced meals a day. Whether it is working to help me or not as much as I think it is is moot but I do feel overall really well. I have never felt really well, all my life!

Just waiting for the hidden trap door to spring open....

 

[trophywench]

Oh Lor Gwynn - the fridge!!!!!!

 

[Gwynn]

I have just been reading the support and advice you all give to many on this forum and I must say that this is one of the most helpful and positive forums I have ever encountered.

My own BG reading yesterday evening was a tad higher than I had aimed for. I discovered after looking at the days data, that I had mis-weighed things.

So this is a chance to see if lowering the evening carbs will have produced a reduction in line with my calculated guess, this morning, or will I find that my body has a mind of its own. Ummm

Electricity sorted. The muppet who installed new wiring when I had the kitchen rewired and installed a new consumer unit too, had done a bad/dangerous/careless job. There could have been a fire anytime. Several circuit breakers replaced. One with burn marks on it. Wiring sorted to make the whole thing secure and safe. The stress of the whole thing (which was significant) has now gone. Perhaps that also had a bearing on my BG levels.

Up at 2am this morning. Bright as a button. Does anyone else find that they sleep less but feel good? Mind you I have always been an early riser. This is a bit earlier than usual (5am) though.

 

[Gwynn]

My fridge is full of fruit and skimmed milk. It used to be full of jelly and full fat milk. Ho hum.

I am finding that fruit tastes really good - and sweet too. I used to put sugar on everything! Now sugar is banned. A bit extreme but I have to get a firm grip on myself and never allow any bad (for me) eating habits to creep back in.

 

[Gwynn]

I had a very long assessment with the extensive care unit this afternoon. They advised that my aim of BG being between 5 and 6 is too low. Completely opposite to the hospital. However his reasoning was sound. Too low at night where i could unwittingly get into trouble whilst asleep if the BG varied for some reason. I have decided to try to get my BG to between 6 and 7. This evening redult was 6 (coincidental).

They also said that the reason they don't firmly understand what is wrong is because they are still waiting for confirmatory blood test results.

Their feeling is that the most probable diagnosis is latent adult autoimmune diabetes (i think that is what he said). LADA.

I am pesently on zero insulin but carefully adjusting my meals. They were happy with that for now as long as I keep testing (as if I would dare to stop).

I may be jumping the gun but does anyone here have LADA and did it have more or less complications than type 1 or 2.

 

[Inka]

Yes, there are a number of people here with LADA. It’s like a slow-onset Type 1. It has just the same complications if your blood sugar isn’t well-controlled. That’s the main thing, not so much what ‘type’ you have.

Give yourself some leeway with your blood test results. If you do have LADA/Type 1, then you’ll have to live with it for a long while so you want to ‘keep it in its place’ and not let it take over. I try to be between 4 and 8, but accept sometimes I might go higher after a big meal or a site absorption issue. My consultant says to stay below 10 and above 3.8. The worry about nocturnal hypos is very justified. They’re frightening and best avoided.

 

[Gwynn]

This monings reading at 6am is 5.3. This was after I increased my evening carbs to 140g.

How do you increase your carbs without breaking the bank of calories and gaining weight?

 

[Lucyr]

Given you aren’t taking any insulin, I don’t think you need to be concerned about readings in the 5s, since the main reason to be cautious about waking at 5 seems to be overnight lows. A normal morning reading after a high carb dinner looks like your pancreas did a decent job.

if you want to increase carbs without adding calories you would need to reduce something else, since all carbs have calories.

 

[everydayupsanddowns]

I am pesently on zero insulin but carefully adjusting my meals. They were happy with that for now as long as I keep testing (as if I would dare to stop

Have I understood that right? Are you not taking any insulin now?

If you are on no insulin at all (either background or mealtime) then there is far less need to be worried about an overnight hypo which would be caused by the wrong insulin dose. Did the extensive care team know you weren’t taking insulin?

I would suggest you aren’t going to have much success getting your waking reading to particular levels by eating more in the evening, because your body has hours and hours to try to get BG back into the normal range, which is likely be lower than the 6-7 you are aiming for.

The thing to keep an eye onis of your pancreas starts to flag again (it seems to be feeling pretty perky at the moment, but obviously had a bit of a wobble earlier for you to get your diagnosis.

LADA is a slower onset form of T1, where the autoimmune destruction of beta cells happens over a longer period of time. it may be that after the support of insulin therapy your beta cells have had a bit of a breather, and are able to produce more insulin for a while. Over time though (months or perhaps years) the autoimmune attack is likely to destroy more of them, and eventually a tipping point will be reached where you will need insulin again.

 

[Gwynn]

Yes you understand that correctly. Zero insulin of any kind.

I will keep monitoring things because my pancrease may decide to go south again. Besides, they still don't have a confirmed diagnosis.

 

[Drummer]

It doesn't seem to make sense - if you do not need extra insulin, that you are eating fruit and having 7 meals a day, and the skimmed milk - why hammer in the carbs?
I would have thought that eating twice a day and low carb would be the way to go, a minimum insulin requirement diet so your pancreas gets a rest rather than being constantly stimulated.

 

[Gwynn]

Now that is an interesting thought.

My take is that many small meals would give the pancreas less overall stress rather than fewer larger meals.

I shall think on this some more.

 

[rebrascora]

The pancreas only needs to produce high quantities of insulin if you eat a lot of carbs, so you only put it under stress if those 2 larger meals (or 6 smaller meals) are carb rich. A low carb diet, means that the pancreas needs to produce very little extra insulin for food and can then hopefully continue to tick over producing the bit of insulin needed to meet your basal needs for longer ie the glucose trickled out by the liver to supply your vital organs.

Since you are now no longer injecting insulin, there is no risk in reducing your daily carb intake to see if you can preserve the insulin producing Beta cells you have left.

 

[helli]

I ha

Since you are now no longer injecting insulin, there is no risk in reducing your daily carb intake to see if you can preserve the insulin producing Beta cells you have left.

I have seen people discussing this approach to "save their beta cells".
Is there any research to show that you can, effectively, extend your honeymoon period by eating low carb?

 

[rebrascora]

I ha

I have seen people discussing this approach to "save their beta cells".
Is there any research to show that you can, effectively, extend your honeymoon period by eating low carb?

Don't know but it is surely worth a go.
Logically it ties in with people finding that they need less insulin after their initial diagnosis where the pancreas gets a bit of a break from insulin being injected. But there is sadly so little research on low carb diet, mostly just anecdotal from those of us who find it helpful.

 

[helli]

Don't know but it is surely worth a go.
Logically it ties in with people finding that they need less insulin after their initial diagnosis where the pancreas gets a bit of a break from insulin being injected. But there is sadly so little research on low carb diet, mostly just anecdotal from those of us who find it helpful.

It makes sense to me with type 2 but for an auto-immune disease, such as Type 1 or LADA, I can't fathom the logic that would lead the body to stop killing off cells that it does not like. Type 1 and LADA are not caused by the pancreas being stressed due to a specific diet.
As you suggest there is no harm in trying. My scientific mind is trying to work out why it would work. But there is so much about the way our bodies work that is a mystery so why not?

 

[Drummer]

Now that is an interesting thought.

My take is that many small meals would give the pancreas less overall stress rather than fewer larger meals.

I shall think on this some more.

Your food choices are not the best - by eating foods with higher nutrition AND which do not require insulin, you could be doing yourself some good.
I visualise my pancreas snoozing away the day once breakfast is done with, as I eat at 12 hour intervals.