yoyo shall be my new name

[grainger]

Soo frustrated at the moment...my levels are yoyoing and i know it's my fault because i'm not taking the time I normally do to monitor but I'm finding it so tough... my new work colleagues are lovely but make me feel really self conscious about injecting (even though I know they don't mean to)... we get an allowance for Pret everyday so I'm not eating as healthily as normal.

But.. and I know this isn't a positive "it's Christmas" post -sorry, but the worst thing is in the evening I'm hypo'ing before I finish digesting my dinner, so I have to treat which I do to the minimum and then I'm finding myself sky high a few hours later.

ARGHHHHHHHH - I know I need to discipline myself again and really get on top of it but (and this is a lame excuse) I'm just so manically busy.

As always advice is welcomed and greatly received.

Despite being negative I hope everyone is having a great build up to Christmas 🙂

 

[bennyg70]

But.. and I know this isn't a positive "it's Christmas" post -sorry, but the worst thing is in the evening I'm hypo'ing before I finish digesting my dinner, so I have to treat which I do to the minimum and then I'm finding myself sky high a few hours later.

QUOTE]

This is the bit I struggle with most and if I dont get it right I find my self high the next morning too... With me its all about the fat content delaying the digestion of the carbs, So ill inject as normal after counting the carbs end up low about 2 hours later, then correct, then the undigested carbs kick in a few hours later and ive got those plus the corrective hypo treatment all spilling into my glucose reading. Im playing around with split does etc at the mo.

Sometimes I get this if I have a too low gi meal aswell, as they take longer to digest. Ill inject all upfront and then the insulin works quicker than the food it seems.

You not alone!

 

[AJLang]

Hi Benny I'm not trying to say that you have something else wrong with you but what you've described is exactly the problem I have with my BGs due to gastroparesis. Have you discussed this with your consultant?

 

[bennyg70]

I have read your posts regarding this, but i think id need to do a bit more reading up, its very much with me related to when I have naughty meals. If I eat healthy ones I can almost guarentee my bloods will be OK the next morning... For example my results the last 10 days.. (morning readings)

6.3 ,4.3 ,5.8, 7.8, 5.4 (went up to 10 in the night and had to correct, this night we ate out), 7.5, 5.3, 4.2, 8.4 (Went up to 14+ in the night , we ate out this night)

So theres a def pattern as to the kinds of food i eat, ie high fat mixed with carbs.. And it does seem to affect me more than most. Fortunatley for me i think there is quite a repetetive pattern of a 5 - 6 hour spike so in theory I should be able to adjust my insulin accordingly when I eat out, or have takeawy... How ever theres always that niggling little doubt in your mind, of how much fat should call for thsi sort of action required, and am i going to over do the insulin and go low in the night.


Ill def look into what you have suggested though..!!

 

[trophywench]

Re fats, that latest bit of research from Joslin suggests we need about a third more insulin for a high fat meal - but God knows what they fed em as the fat content was 60g as opposed to 10g in the 'normal' meal they fed the 'control' group.

This was done with a small group of people since they were all hooked up to a closed loop system. So the pumps automatically issued the insulin when the CGMs detected the higher than required BG, rather than an up-front bolus, I believe.

That's a LOT of fat - 6 oz of Cheddar for example.

If this ONLY happens after high fat and not at other times it's not gastroparesis though I confess I went off on that false trail myself and properly scared meself, once when it was happening randomly, but of course at that time I didn't realise that the completely debilitating panic attacks I was also having were what were really doing it. And of course the added stress of thinking I had G didn't exactly help much ! LOL Once I got rid of them, normal service was resumed.

But anyway the hypothesis has always been that you need 10% extra for fat. However typically my high carb/high fat spike comes anything up to 6 hrs after I start eating* which is a PITA if you aren't pumping but what you could try in your case is have about 2/3rds of your bolus up front and test test test. Then take the rest once your BG rises again, plus that 10% ish (of the whole carb bolus for the meal) and see what happens?

Or say hang it, I only do it once a month, or pack in eating HC/HF meals. Since I've NEVER actually cracked it, I do a mixture of both.

* usually at some time after I'm in bed and asleep, first I know is I'm up for the loo (nothing unusual there) and as I'm contemplating my navel sitting there, I realise I'm very thirsty an' all .....

 

[bennyg70]

Ive pretty much given up on trying to crack it perfectly.. If I go for a meal now normally, ill aim for the healthier options, Or eat a fatty lump of meat with salad and veg and minimise the carbs. Althoguh, a blowout once in a while I think is OK. But thats just me.

It took me back to my childhood last night waking up gasping for a drink and testign and seeing I had risen to 14.5mmol . I was annoyed at my self as I knew it was going to happen & probably could have dosed to accomodate, however I feel a little reluctant to inject incase it results in me going low..

Useful advice though - ThankyoU!

 

[trophywench]

I think the main prob Benny with us poor mortals sans CGMs is, we can't tell what's the meal and what's the liver dump after the hypo, or whether there was even one of them.

Trouble with liver dumps if you correct em as you do for carbs - you subsequently get a reactive hypo and here we go, see-saw see-saw. Again.

Now something that worked for me during the panic-attack time was my DSN suggested (she's a very good DSN not least, IMHO, because of her 30 years with her husband - a T1 !!) that when I thought it was panic related to only have HALF the correction dose I would have if I'd miscalculated the carbs. OK so your BG ain't gonna be perfect, but neither is going from HI to LO on the meter thrice daily ..... it most certaily stopped the see-saw and in fact whilst all this carp was happening my A1c actually got down to 7.1 and that was the first time in my entire D life (35+ years) it had ever been under 7.5. We both knew the A1c masked the peaks and troughs but it was quite ironic really.

So that is summat else you could perhaps have a go at in the middle of the night? I need 6u, so I'll have 3. Or whatever. I'm not saying it will defo work!

 

[bennyg70]

Ill have a good think!

Im taking it all step by step at the moment... Ive given myself 6 months to try and crack my diabetes..


Im fairly happy with my basal dose now.

Next step which Im working on (Expect some postings) Is fine tuning my mealtime ratios.

Correction doses at different times of day

Then looking at the effect of differnt foods on my bloods.

Then looking at battling the high fat meals.

Then alcohol! (To celebrate, and to test)

I wanted to do it all in one go, but theres so much. So i decided to take it step by step!