I think your DSN needs to work on her “bedside manner”, if she’s making you feel guilty about every tiny thing that isn’t perfect. Eating one sweet that’s only 3g of carbs shouldn’t make you feel guilty. Every time your blood sugars go a bit out of range you shouldn’t feel guilty. With type 1 unfortunately there are so many variables that will affect your blood sugar, that you can’t possibly account for them all, which basically makes it completely impossible to have perfect blood sugars all the time. Sometimes you can see a reason - oops, I bolused too much for that meal, or I forgot to bolus, or I wasn’t feeling very well, or something stressful was happening which might have affected it, etc etc etc, but there are also many many times when it makes no sense at all! Which is much more annoying but there isn’t much you can do about it.
You just do what you can - if you can see a reason then you learn from it and try not to make the same mistake again, or you make adjustments to your insulin doses if you think that will help, and then you just carry on with your life. Yes you have to take your diabetes seriously but you shouldn’t be spending large parts of the day worrying about whether you’ve done every little thing right. If you make a mistake, just correct it and move on, as long as you aren’t repeatedly making the same mistake then there isn’t much else you can do. Some hypos and hypers are inevitable; you do all you can to avoid them, but you can’t stop them all. Our DSN once said that if you never have a hypo, you are probably running your blood sugars too high; but if you’re having them every day then that would suggest that you need an adjustment somewhere. Which you have been doing recently with your Tresiba, you haven’t been ignoring the problem so you have absolutely nothing to feel guilty about. Sometimes it takes a while; my daughter’s blood sugars have been a bit all over the place recently, and because of other problems I’m not quite as on the case with it as I should be. I’ve reduced basal in some places and increased it in others, reestablished a separate basal plan for school days as it has become obvious that one for all days isn’t working; I’ve reduced correction ratios and carb ratios. This has smoothed things out a lot but she STILL has a hypo pretty much every day after school! Yesterday she’d only just got in the car and we got a volley of bongs from the Dexcom announcing that she was low. Again. Sigh. All I can thing of to do is another round of basal reductions - I WILL stop her going low every afternoon if it kills me... and it probably will...
Chin up Gill, you’re doing a good job with a condition that you didn’t ask for and can be bloody difficult sometimes. And is completely relentless. Your DSN would do well to remember that, I presume she doesn’t actually have T1 herself and can just forget about it as soon as she leaves work. She can only advise you, you don’t have to do what she says, but it sounds like she just tells you what to do and isn’t very good at explaining why she thinks you should do that so that you can understand. It’s your diabetes, you are the one who has to manage it every day, not her, and you should be able to work together with your DSN to find a plan that works for you and that you can understand and don’t get confused or feel guilty about. Maybe as you say she’s just trying to help and isn’t getting on your back about it but just comes across that way... don’t be afraid to ask questions though and never feel guilty!
