carb counting/insulin resistance?

[heasandford]

Unlike many other T1s on here, I seem to be more insulin resistant and use 1unit of insulin to either 6 or 7g carbohydrates (depending on the time of day). Does this mean that small inaccuracies in calculating carbs are exaggerated, and is therefore a reason why I seem to get more fluctuations in my BGs - or am I making excuses for myself??

 

[Kim23]

I am on 1.5iu per 10g carb but I am on a pump so calculating my carb so it can work out my dose itself in the wizard section. Sometimes we all miss calculate it though and that is why bm's flucuate. I was told by my consultant that the longer you have had diabetes and the level of the control does mean you can become insulin resistant more and more over time. Some people don't though if they have been controlling it brilliantly (the lucky ones)! lol. Do you have a pump or a bm kit that you can put your carb intake into so it works out your dose correctly? Some of the kids in my PEDS (ponies educating diabetics and siblings) have the bm kits that do this so injecting is easier and gives them the confidence.

 

[heasandford]

I have an Aviva Expert meter, and Carbs and Cals app plus a degree in Food Science so I have no excuse! I am just trying to find why I get such terrible fluctuations compared to some of the folks on here who get SDs (standard deviations) in the 2s whereas mine are not usually less than 4 ie roller coaster!

It is entirely down to the valuable help given by this forum when I joined that I realised I could get my HbA1c down by taking more care during calculations etc, and they put me onto an Insulin Calculator app before my meter, which was brilliant. My problem is still with wide fluctuations though - clutching at straws?!

My consultant has suggested I may be eligible for a pump and having seen a Cellnovo at an exhibition I feel quite excited. Thanks for your help and support!

 

[everydayupsanddowns]

I'm not sure, but it seems logical.

Part of the problem for me, I think, is that it doesn't necessarily seem to have to do with the precise number of grams of carb.

In my head I sort of see it like a long piece of elastic stretched out. Overall the tendency is toward level, but it is easily bent out of shape. Insulin has a 'pull' toward me with varying intensity over time. Carbs have a push away from me, partly this can be understood by the number of grams, but importantly it matters over what time they will be absorbed. I seems to be able to eat extra carbs while the insulin 'pull' is strongest if those are in and out quite fast. On the other hand if absorption is delayed (by fat or whatever) then there can be extra 'push' when my insulin has run out of 'pull'. The end result becomes a line graph of my BG - I've tried to explain this before and just ended up causing confusion so it probably makes no sense. Basically though I have observed on more than one occasion good BG levels which were not counted accurately (but the pushes and pulls were balanced carefully) and poor levels which were counted scrupulously (but the timing of the push and pull were ignored)

 

[pgcity]

The problem is not all carbs are equal. Different meals with the same carb count can have a dramatically different effect on bs. Have you looked at the glycemic load of what you are eating and tried to see if you can spot any patterns? Also fat content can delay any spike which can make you go low before you go high later. I expect the people who have a low standard deviation are either very lucky or keep very good records for each meal.

 

[Pumper_Sue]

It could just be a simple! thing like your insulin (basal) is not compatable with your own basal pattern.
So there is no way on earth you will get it right unless you have the help of a pump to do so.

Have you ever done any fasting basal tests to see what happens to your blood sugars?

 

[Medusa]

agree with what sue says start by making sure you have basal right then go from there

 

[heasandford]

Thank you, all of you!

I have done some basal testing, but perhaps it was a bit half-hearted after I didn't get any response from the health professionals I was dealing with - for instance I know my lantus doesn't last 24 hours, but they don't want to discuss splitting or transferring me to levemir - because I'm doing well enough?? I must have another go and take the results with me again.

I agree about timing/absorption, but can't seem to find any pattern - I do think this is something we are given no clue about, maybe because as you say, EDUAD, it's just too confusing to try to explain - pretty good attempt though! and makes me feel as though its worth trying to explain again to my new team. I suppose the downside of this is that a pump won't necessarily solve the problem?