Finding it hard to cope erratic blood sugars and worsening toe

[AJLang]

Firstly the gastroparesis is making my night time blood sugars the worse they have been since going on the pump and my eating hasn’t changed. They’re either staying stable after A meal but a few hours later threatening to go to low (i prevent hypos when they do) and then shoot up from about 3am when the evening meal starts to digest. That I can just about cope with.
But the last two days it has gone sky high after dinner to 15 on BG machine(based on previous experiences I don’t correct) and then drops like a stone. Last night it was 2.9 around 3am I had two cans of sugary coke, two cookies and some chocolate 15 minutes afterwards and cut my basal by a third until the morning and it took that to get it up to 6. It was similar the night before but the night before that I had the opposite problem.
Then my ongoing toe saga, as well as the existing problems it has developed a blood blister on the bad toe despite only having it bandaged and wearing open toe sandals. I haven’t banged it or caught it at all. High risk podiatry appointment this afternoon.

 

[AJLang]

I can’t inject the insulin up front to prevent the rise because if it’s one of my normal days where it stays stable for several hours after eating (I use an extended bolus) I would have a massive hypo that is extremely difficult to treat because it takes absolutely ages for the glucose to get through the undigested food in my stomach.

 

[grovesy]

Sorry to hear you having problems, good luck for the podiatry appointment this afternoon.

 

[rebrascora]

Blooming Heck! That is a whopper of a cliff edge you dropped off and in the middle of the night too! Would it help to graze rather than have set meals through the day or have your main meal at lunchtime and just a snack in the evening? Apologies if I am talking tosh as I know you are extremely experienced, but just wanting to suggest some practical option rather than just be sympathetic, but that must be horrid to deal with! I think I would be afraid to go to bed the next night after that!

 

[silentsquirrel]

Hope this afternoon's appointment goes well. Sorry to hear about the BG issues, hope you find a way to improve that. Thinking of you.

 

[everydayupsanddowns]

Any news from your appointment @AJLang ?

 

[AJLang]

Thank you everyone. Sorry for delay in replying I’m just generally depressed at the moment. The podiatrist is still doing her best to save my toe nail. She dug out shards of nail that had broken down at the side of my toe nail and put on iodine ointment. She’s hoping this will solve the latest flare up but emphasised that I should phone her ASAP if further problems develop that indicate another infection and who to contact over the Easter weekend if necessary for antibiotics. Although her diary is full she will be seeing me again next Thursday. She really is an NHS hero and spent 45 minutes with me yesterday. So basically it’s a wait and watch approach.

 

[AJLang]

Blooming Heck! That is a whopper of a cliff edge you dropped off and in the middle of the night too! Would it help to graze rather than have set meals through the day or have your main meal at lunchtime and just a snack in the evening? Apologies if I am talking tosh as I know you are extremely experienced, but just wanting to suggest some practical option rather than just be sympathetic, but that must be horrid to deal with! I think I would be afraid to go to bed the next night after that!

Thank you very much for the suggestions which are really good but struggle eat during the day and feel very uncomfortable with it affecting my BG levels if I eat something small more than twice during the day as the food builds up. Six small meals a day is the recommendation for gastroparesis but I just can’t cope with eating that often plus I like sharing an evening meal with my partner who works during the day. Plus I’m more more comfortable if my main meal digests while I sleep and it can take 12 hours to digest. Anyhow last night I cut my basal for the night by a third and reduced the extended bolus amount for the carbs and I ate pizza so that it digested more slowly - I still went up to 16 but at least it was a temporary reprieve from the sudden drops. I’ve now reduced my midnight to 6am basal by five units from tonight and will tweak as necessary. I’m just so glad that swiping with the Libre and it saying LO made me test because I had no hypo symptoms although it was 2.9. I can’t wait to get the Libre 2 with alarms but have to wait until my next hospital diabetic appointment which was due in March but I haven’t got a date for yet.