Type 1 & low carb

[Aybrice (Blueduck)]

It’s really hard being diabetic, but you learn as you go. Forums are so helpful lots of experience, but we are all different and go on a different journey. Acceptance is a big part of that, best to be glad it’s now and not 50 years ago, technology is such a blessing. It’s so good to have libre 2 and not finger prick, such an advantage. You will have ups and downs, and as a control freek myself it’s has been hard. You sound quite lucky being able to see a consultant, I can’t see one unless I do the DAFNE, which is a whole week out of work, we can’t all manage that. I can’t get a pump unless I get to see the consultant, and there is a huge waiting list in my area. I think in general we all plod on, do the best we can, get advice where we can and try not to become too obsessed. We are all normal, what ever that is, we just have diabetes. Early days for you, try not to worry to much and take advantage of all information, but you have to learn about your own body, I take it all as an experiment and record everything, it helps me a lot. Knowledge is power. Good luck on your journey.

 

[Proud to be erratic]

Can I ask why you don't find fast rise fall alarm useful.

I appreciate this question was for @Tdm. For me, because I have a relatively high "low alert" setting I invariably get that before the rapid fall alert is activated. Its as if my insulin resistance is noticeably decreased after I've dropped below 5.5 and by that point I already know change is happening. Its not completely unnecessary but rather more providing braces for my normally OK belt.

I'm not particularly concerned about rapid rises. Usually I get alerted, monitor and find there is an element of sensor overreaction and the apparent rapid rise "fizzles out". Also, I tend to no longer get concerned about brief forays above 10 and will wait and / or exercise before considering a correction.

 

[nonethewiser]

I appreciate this question was for @Tdm. For me, because I have a relatively high "low alert" setting I invariably get that before the rapid fall alert is activated. Its as if my insulin resistance is noticeably decreased after I've dropped below 5.5 and by that point I already know change is happening. Its not completely unnecessary but rather more providing braces for my normally OK belt.

I'm not particularly concerned about rapid rises. Usually I get alerted, monitor and find there is an element of sensor overreaction and the apparent rapid rise "fizzles out". Also, I tend to no longer get concerned about brief forays above 10 and will wait and / or exercise before considering a correction.

Appreciate your comments @Proud to be erratic

I like rapid rise & low alerts, fairly active most days so do find rapid low alert useful to help prevent hypos ever happening when out & about, but guess we all have our own preferences when it comes to tech.

 

[Evergreen]

Hello again everybody, good to hear about the experiences with dexcom and fast rise and fall alarms.

I actually have a fairly urgent question about this now!

I thought I was getting somewhere in the past days with my levels, but today has been difficult and I could do with some advice/support.

I had breakfast late this morning as we were away with friends. I had half a bagel with egg and bacon and read the labels, it was 22 gram of carbs. I did my usual insulin for it and I did have to walk about 10 mins about an hour in. I’m on a train and it starts to drop (fast). I panicked and overtreated as my first treatment didn’t seem to do much and I was in charge of my toddler. It’s gone up to 17 (bad bad I know), but now it’s falling again. Is this normal? I was about to take some insulin for the high blood sugar but I don’t dare now.

My husband is trying to tell me/reassure me that all people with diabetes have days where their blood sugar inexplicably drops and I know he’s right, but I feel like isn’t there mostly a cause you can identify when this happens? I literally can’t think of why this is happening to me and it’s feeding into this anxiety.

Thank you all again

 

[Evergreen]

Sorry i noticed I’m rambling a bit in that last post, I think it’s because I’m feeling quite unsettled.

Basically I’ve got two things I’m trying to understand (and maybe won’t be able to): is it normal for blood sugar to drop after you’ve treated a hypo (without using insulin), and do other diabetics have days where they take their usual ratio insulin and have a completely different response where their blood sugars just drop fast (not related to miscalculating carbs, exercise etc)

Thank you!

 

[Inka]

@Evergreen Did you fingerprick to check the low and the drop? Sometimes the Libre or Dexcom can lag slightly behind your actual blood sugar so it shows you still dropping when your blood sugar is actually rising. That exact thing happened to me today! And yes, I overcompensated because I didn’t have my meter with me to check.

Yes, blood sugar can drop fast sometimes. This could be because the carb count was wrong; you injected in a super-absorbent area; you nicked a muscle or capillary; you got hot/had a hot shower or bath; you exercised just as the insulin was at the peak of its action - amongst other things.

You say you had a late breakfast. That lateness could be a factor too as your basal insulin might be slightly more active at that time and/or because it’s late your breakfast ratio is not appropriate and you simply needed less insulin.

 

[Evergreen]

Thank you @Inka. I just don’t get it. I didn’t exercise (except for a 10 min stroll), I didn’t have a hot shower or anything and I know the carb count was as correct as can be (I actually ate a little more even than I injected for). How am I supposed to deal with this? The drop was pretty dramatic (I did finger prick and although slightly above the sensor I did see it go down)

I’ve now taken a little bit of insulin and it’s not dropping as fast anymore. But it’s just scared me that my basal is a little too much again…also not sure how to approach dinner now? I’ve decided to just have some toast as I’m usually comfortable with that but how do I bolus for that?

 

[Evergreen]

I also didn’t take my breakfast ratio, I took my lunch ratio. I thought it’s late, so the dawn phenomenon isn’t doing it’s work anymore and I did less insulin based on that, but clearly still too much

 

[everydayupsanddowns]

Sorry i noticed I’m rambling a bit in that last post, I think it’s because I’m feeling quite unsettled.

Sorry to hear about your rapid drop on a train (and in charge of a toddler) - no wonder you were scared by it!

As @Inka says I find the Dex quite laggy to show the response of hypo treatments, so if possible would check with fingerstick to avoid a double-treat rebound. But you did exactly the right thing if fingerstick wasn’t available. Better to bounce up into the teens for a short while, than to risk a debilitating low - especially when you aren’t quite sure what triggered the drop.

Basically I’ve got two things I’m trying to understand (and maybe won’t be able to): is it normal for blood sugar to drop after you’ve treated a hypo (without using insulin),

It certainly can happen. For all sorts of reasons (and none that you may ultimately be able to confidently identify. Sometimes the liver dumps glucose in response to low BG from muscle stores, and then restocks them later drawing glucose into muscle tissue directly. Sometimes whatever it is that caused the drop in BG (dose miscalculation / carb count error / weather / emotional state / change in insulin sensitivity blah blah blah) continues to pull BG downwards.

and do other diabetics have days where they take their usual ratio insulin and have a completely different response where their blood sugars just drop fast (not related to miscalculating carbs, exercise etc)

Thank you!

Annoyingly the answer is yes. While ‘diabetes maths’ can certainly help…

A grams of carbohydrate + B units of insulin + X dose timing adjustment = Y BG level

unfortunately it’s more art than science, and sometimes diabetes just changes the rules, or willfully misbehaves.

Not so much as to make the calculations, carb counting, and careful attention worthless, or a waste of time, but certainly enough that eventually you stop being surprised (or beating yourself up) when your careful plans result in BG chaos in either direction and you have to just firefight the outcome.

Personally I just rely on simmering frustration at my diabetes’ nonsensical annoyingness.

 

[Inka]

Thank you @Inka. I just don’t get it. I didn’t exercise (except for a 10 min stroll), I didn’t have a hot shower or anything and I know the carb count was as correct as can be (I actually ate a little more even than I injected for). How am I supposed to deal with this? The drop was pretty dramatic (I did finger prick and although slightly above the sensor I did see it go down)

I’ve now taken a little bit of insulin and it’s not dropping as fast anymore. But it’s just scared me that my basal is a little too much again…also not sure how to approach dinner now? I’ve decided to just have some toast as I’m usually comfortable with that but how do I bolus for that?

I’d err on the side of caution @Evergreen If it were me, I’d knock a bit off my normal toast bolus. If you’re concerned about going high, then you could just have your normal bolus and watch closely.

If you’ve corrected, don’t pay too much attention to your actual blood sugar as it might still be coming down, and certainly don’t do a correction with your tea if your previous correction is still acting.

Often I find a messed up blood sugar takes a little while to settle, so be patient, monitor carefully and aim to avoid hypos. Even if you’re a little higher than normal, better that then a hypo later.

 

[Evergreen]

Thank you @everydayupsanddowns, not quite what I wanted to hear I suppose but altogether useful in piecing together what’s ‘normal’ and what’s not.

I’m feeling so defeated by this all. I was really quite worried about going away this weekend and it went pretty well, now this has just overshadowed it. I know I shouldn’t let it but it’s hard. For every thing that goes well something really difficult seems to happen and I feel back at square one…

 

[everydayupsanddowns]

I’m feeling so defeated by this all. I was really quite worried about going away this weekend and it went pretty well, now this has just overshadowed it. I know I shouldn’t let it but it’s hard. For every thing that goes well something really difficult seems to happen and I feel back at square one…

I completely understand that feeling. Sorry you are experiencing it. It’s like your body, which used to just brilliantly do something, without you even realising has just let you down and betrayed you. And that you can’t ‘rely’ on it any more. At least that’s how it felt for me.

And it turns out it’s a hard thing to do. And we are trying to do it with the wrong insulin, which acts over the wrong timeframe, delivered into the wrong place.

It’s hardly surprising we get a bit overwhelmed with it really

 

[everydayupsanddowns]

But remember you are still at the early days with this, and you are doing really really well - even if it doesn’t feel like it at times.

Keep learning, keep experimenting, keep adapting… Keep starting over and resetting - your diabetes will be annoying and contrary at times, but keep putting it back in its box.

 

[Inka]

Thank you @everydayupsanddowns, not quite what I wanted to hear I suppose but altogether useful in piecing together what’s ‘normal’ and what’s not.

I’m feeling so defeated by this all. I was really quite worried about going away this weekend and it went pretty well, now this has just overshadowed it. I know I shouldn’t let it but it’s hard. For every thing that goes well something really difficult seems to happen and I feel back at square one…

This is the mentally wearing thing about Type 1 @Evergreen You can do everything right and still get the ‘wrong’ result. It’s not your fault. As I said, it happened to me today and I’ve had diabetes almost 30 years and have a pump and a Dexcom.

Don’t dwell on it or blame yourself. You’re doing great - honestly. All this cr*p is normal. Things do go askew. Swear at in (in your head if you’re in the company of children) and move on mentally.

The anxiety you feel doing normal things is pretty usual. I still feel it, but I think of it as awareness not anxiety. Sadly, we don’t get time off from ‘thinking like a pancreas’. When you’re down about ‘bad’ results, think of something positive related to your blood sugar control. Count every win.

 

[Evergreen]

Thank you both I really appreciate it

 

[rayray119]

I’m feeling so defeated by this all. I was really quite worried about going away this weekend and it went pretty well, now this has just overshadowed it. I know I shouldn’t let it but it’s hard. For every thing that goes well something really difficult seems to happen and I feel back at square one…

When was first diagnosed I got very focused on getting things prefect all the time but that was never going to happen I try not to put too much pursue on myself anymore more to get it right all thr time(I can still slip into that way of thinking sometimes but remind myself). I'm only just over 2 years old in myself so alot less time compared to alot of people here(sorry I wasn't able to see how long you been diagnosed)

So what I'm saying is try not to put pursue on your self to get things right all the time when things happen you can try and think of reason why it might have happened and if you can see one you can learn from it but if you can't find a reason then there just might not be one.

 

[Evergreen]

Thank you, I appreciate that. I definitely had that mindset too, but feel at the moment it’s probably more anxiety and wanting a feeling of control (which really I know isn’t that possible). I’m not wanting perfection anymore (although I definitely relate to what you are saying), but I think the unpredictability of diabetes and me just don’t match at the moment.

I’ve got a long way to go, but I’ll get there I hope! It’s good to remember that these weird incidents don’t always have a reason

 

[rayray119]

Thank you, I appreciate that. I definitely had that mindset too, but feel at the moment it’s probably more anxiety and wanting a feeling of control (which really I know isn’t that possible). I’m not wanting perfection anymore (although I definitely relate to what you are saying), but I think the unpredictability of diabetes and me just don’t match at the moment.

I’ve got a long way to go, but I’ll get there I hope! It’s good to remember that these weird incidents don’t always have a reason

Yeah I know feeling I have anxiety and one of the things can set it off I'd change so I really struggled mentally at first. It's good to have support networks too.

 

[Evergreen]

Thank you for sharing and sorry you’ve struggled with anxiety as well

 

[Evergreen]

good morning everyone, I’m just hijacking my own thread with a different topic in the hope for some wisdom. Didn’t think I’d be back again so soon…

I wasn’t feeling great last night, thought it was just anxiety but then was sick. I measured my ketones and they were 1.9. I managed to get them down to 0.9, rang 111 but that wasn’t too useful.

I’m still not feeling amazing today and I am worried to eat. What do I do if I’m sick after eating and have just taken insulin?

Also I’ve never been sick as much as since diabetes. Could there be a link? HCPs are a little dismissive saying I’ve probably eaten something a bit off or unlucky to catch a virus. I was never very sick and now I’ve been sick twice in two months. Is there anything related to diabetes and issues like this if anyone knows?