It's all too much

[susieg]

I'm in my 2nd year of being dx type 1, I tried within this time to keep my bg's within reach, and I suceeded. my Hba1c went from 11.0 on dx down to 7. I am now struggling to keep those levels down, Just recently I have had to up my doses from 1:10 to 1.5 :10 to try to get the levels down, it seems to be working,but then if I walk/exercise, it does into hypo,But how do you know if you're going to go into hypo just because you walk the dog or go to the shops? It's a bit of a chore to plan everything.
I also increased my lantus by 1u. This morning my waking level was 10.0! I can't understand how and why they are rising this much in the mornings, I've tried eating before bed, not eating before bed, getting my levels down to 6-7 before bed or letting it go up to 10.0 but nothing seems to work.
I'm getting really fed up with reading up about it all, I feel like just giving up. I'm fed up weighing everything, checking, and double checking labels, not eating this or that, and I suppose I'm just generally getting sick of the whole thing. If my levels were ok I might feel better, I've had a cold for the past 3-4weeks and I suppose that doesn't help, but I just can't get my head around how much insulin I should have at each meal. My DSN said I should be on 1:10 and 14u lantus, but if I stayed on that my levels would be up in the 12's.
Is this just a general feeling of 'it's all too much' or does everyone go through some sort of aftermath of dx?

 

[robert72]

Hi susieg

You're not alone - we all go through this stage. You're doing well and it's absolutely worth persevering.

Exercise will bring your levels down so it's worth taking some extra carbs to cover it. I can't really say why your BGs are high in the morning. It would be worth trying to do some tests during the night to see what's happening. If you had dropped too low during the night, for example, then your body would release stored glucose to raise your BGs, but maybe a bit higher than you want.

If you haven't done a carb counting course ask your nurse if you can go on one or try an online version here:
http://www.bdec-e-learning.com

Any questions, just ask - there are plenty of folks here who have been throughout the same frustrations and are willing to help.

 

[susieg]

Thanks Robert72, I felt like a real moaner after writing that, but funnily enough it helped me vent my frustration. I am booked in for a DAFNE course in August. I hope it helps.

I wondered about the BG's dropping during the night, but I don't know how to stop it, I've tried eating toast before bed, as I said, or not eating, it doesn't seem to make any difference. I'm sure there's something I'm doing wrong, but I'm so fed up with reading all this stuff about what to do and what not to do, I get so confused.
I'm glad I'm not the only one though. Of course I'll persevere, I have to don't I? or the consequences are not acceptable.

 

[pickle76]

Hi Susie,

I completely agree with Robert, and am glad you're booked on a DAFNE course. I'm sure it will really help. And yes, if you find yourself doing some unplanned exercise and it's therefore too late to adjust your insulin, have some carbs to help keep your blood sugar up. And I have to say it's been overnight which I'd always struggled with. If I went to bed with a decent reading I would go hypo overnight, if I went to bed higher, I would still wake up high. Have you heard of the dawn phenomenon? Many people find their blood sugar rises quite significantly from about 5am so even if you had perfect blood sugar all night, you may well wake up high. Like Robert said, it's worth setting aside a night every now and again and setting your alarm for every couple of hours, testing your blood sugar and seeing what's happening.

Keep on trying - every month that your blood sugars are more under control than if you weren't trying, is well worth it and keeping you as healthy as poss for as long as poss. Glad you feel better for venting. Do it again when you need to! :wink:

 

[mazthegardener]

I am having the same problem as you. I have a job that can vary greatly in activity day by day and sometimes my bg level is 5 or 6 before tea and then in the evening it is around 6 or 7. I the have a top up of Levemir before bed and sometimes I have hypo around 5 pm and other times I wake up at 7 am with a bg of 10 . There doesn't seem to be any rhyme or reason to it sometimes. I have only been type 1 for two years.

 

[jopar]

There is a difference between a Dawn P and sleeping through a night-time hypo..

If your BG's rise consistently everyday, easier to clock if you miss breakfast.. Then highly like you'll dealing with Dawn P, the best way of dealing with the impact of DP is splitting the basal injection to 2 a day, So your PM jab deals with your morning levels and the AM injection deals with the rest of the day...

But if you've got a very pronounced a pump may be more suitable, this is the reason that I have a pump couldn't get a workable basal profile on injections..

But if the raise isn't consistent then it's unlikely to be DP, but may be you've slept through a hypo..

Indicators of sleeping through a hypo, is a large increase in BG's compared to bed time level, you feel groggy, hung over it can even effect your vision (visual effect on me, was as though I was looking through very thick and dirty net curtains)

If these indicators aren't there, the other possibility is your previous meal (likely tea) is still impacting on your blood glucose, if you've had a high carb meal, that is high in fat content or slow to process foods such as pasta or rice, you'll be pretty shocked how long it can continue to impact on your blood glucose level!

Can I ask one thing, when you inject your background insulin at the same time every day, as background insulin is a timed injection, if you constantly change the time of injections then it faff's up...

I'm also glad to hear you going on DAFNE as you will find this a great help, but I would also advise investing in a book called 'Using Insulin' by John Walsh, as this explain basal/bolus (multi injections) regime as shows you how to work out, carb-insulin ratio's, check your basal is correct with fast testing, how to work out your corrections factors etc...

 

[susieg]

I am having the same problem as you. I have a job that can vary greatly in activity day by day and sometimes my bg level is 5 or 6 before tea and then in the evening it is around 6 or 7. I the have a top up of Levemir before bed and sometimes I have hypo around 5 pm and other times I wake up at 7 am with a bg of 10 . There doesn't seem to be any rhyme or reason to it sometimes. I have only been type 1 for two years.

You're the same as me then, I've been Type 1 for almost 2yrs, I have my Lantus every night at 10pm on the dot, I'm wondering if it isn't lasting a full 24hrs, as I was 4.1 before tea at 5pm I had quiche/salad, mousse and sf jelly, so only bolus'd for the quiche and mousse. I was a good 5.2 2hrs after, now at 10pm I was 10.1!! now I know I'll still be high in the morning.

I wonder if I can split lantus?

I don't know if I could go a whole day without food to test my basal, but I will read the book mentioned. I've read the one called 'Think like a pancreas' But although it was very informative, it was in american and a little confusing for me. A lot of it just went over my head. Perhaps in time I'll know what everyone's talking about ! :?

 

[robert72]

I did split my Lantus for a while, but because it's a 24 hour insulin it doesn't really let you have a day/night dose adjustment - just made it very smooth. The John Walsh book is really good, although American it usually has mmol/l as well.

Another tool that will help you figure out unexpected things is to keep full records of BGs, insulin, foods, exercise. You can use it for forensics, to look back and see what might have caused the unexpected event - and of course it's useful for spotting patterns too. It can be a chore but if you've got a smartphone then most of the diabetes apps are pretty good.

 

[susieg]

I did split my Lantus for a while, but because it's a 24 hour insulin it doesn't really let you have a day/night dose adjustment - just made it very smooth. The John Walsh book is really good, although American it usually has mmol/l as well.

Another tool that will help you figure out unexpected things is to keep full records of BGs, insulin, foods, exercise. You can use it for forensics, to look back and see what might have caused the unexpected event - and of course it's useful for spotting patterns too. It can be a chore but if you've got a smartphone then most of the diabetes apps are pretty good.

Cheers Robert!, I do actually write it all in a diary. and I have a Aviva expert I've just started using. It does help, but there's no explanation about what happens overnight roblem: Ah, but I don't always write down what foods I eat, might start doing that.
I can see by my records that I do jump up considerably about 8 or 9pm, or if I've been out and about it'll be about 6, but whether I eat or not, I still seem to be high in the mornings. Perhaps a word with the DSN, but I always feel like my problems are too trivial to bother her, she's always mega busy.

 

[robert72]

Susie - certainly talk to your DSN about the morning highs.

Other things for the diary might be illness, stress, anything you think that might have an impact.