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Help - levels all over the place

B

benunited

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Hi everyone.

My first post. I'm type 1 and have been for around 10 years now. I'm 32 next month and I'm getting worried about what lies ahead.

I think I was lucky, naive and probably blasé through my twenties. Before finding out I was diabetic I was a total sugar junky, drinking litres of coke a day, not to mention sweets, cakes etc. Guess I stayed thin because I was playing football/doing karate 5/6 times a week and because my metabolism would have been higher when I was younger.

My approach to dealing with diabetes probably wouldn't be recommended by many: I cut out the sugary drinks and the sweets but kept my meals as they had been before. I don't like many fruits and can't stand health foods, particularly healthy cereals.

A basic diet for me in my 20s was:

Breakfast: cereal such as Weetabix or Cornflakes with a small glass of pure orange juice
Lunch: white or brown bread sandwhich with a packet of crips and water
Tea: Usually meat, potatoes and veg. Pasta at least once a week and a takeaway on a friday.

This has stayed pretty steady over the years and the docs seem to have always been happy enough with my blood scores of around 7. I don't drink much, don't smoke and stay fit. Even ran a marathon a couple of years ago.

But things have changed a fair bit over the last few years. My last blood score was 9.5, which is terrible, I know.

I can't seem to find the time to exercise so much any more having started a family. A few other family troubles have also lead to some comfort eating and I'm probably a stone and a half heavier than I should be. In all, I'm flat out exhausted.

My diet hasn't changed too much but at the moment I'm struggling badly with my levels, particularly in the mornings.

This morning for example I had weetabix, with water to drink. I know I shouldn't be having a 'sugary cereal' but to be honest I can't bring myself to eat things like all bran.

My level before I went to bed was 5.6. So I took my normal level of glargine (22). When I woke up my level was 10. Why? Docs have tried explaining 'morning rebound' to me, but I don't quite get that.

Normally I'd take 8 units of novorapid to deal with the cereal, which would settle my levels within a couple of hours. I know I probably shouldn't compensate because my starting level was 10 but I did, taking 10 units of novorapid.

So why at 10am this morning were my levels 19.8? I always change my needle and click a couple of units through before injecting to make sure it's working.

This kind of thing is happening quite regularly now and I've no idea why. I definitely don't need to take 12-14 units regularly at breakfast as that would give me a hypo on most days.

I'm feeling very down as through my 20s I felt I had reasonable control of my diabetes. But these days my body doesn't seem to be reacting the way it used to, particularly in the mornings.

Any advice would be much appreciated.

Thanks

Ben
 
Hi Ben

Welcom to the forum

Your diet sounds very similar to mine and I don't have any problems with it.. I eat normal foods

The morning rebound, could be two causes what happening there..

1st one..

Over night you've blood sugar's have dip under the hypo threshold, so after a while the liver will dump it's store of glucose to raise your bg and bail you out, personally I would expect to see an higher rebound if this is happening, but there is tale tale sign that help to indicate this might be happening..

That is you feel ****, like having an hang-over when you wake up..

The other reason which I reckon is probably more likely in your case, is dawn phanomnonon (sp) or called DP for short, this is where you hormones start to increase in the morning to wake you up, hormones can effect your bg and raise this as well. With this you tend to see an increase in BG at a lower impact than from an hypo rebound.

To sort out whats happening, is do over-night testing.. Where you test hourly to find out what your BG is up to over night, You don't have to do them every hour over one night, but can do it over several nights to lessen the impact of lack of sleep.. To get best results, ensure that the strating BG is similar on all nights, and you've roughly followed the same routine during the day..

First night go for the 3am BG, as this will be around the point your blood glucose is likely to be at it's lowest level, this is due hormonal activity over the 24 hour cycle at it is at it's lowest ebb, then work your way at your choosing through the rest of the hours of the night to get an picture of what actually happening..

Shall post the next lot of information in another post, as this will end up as a easy
 
Are you on 4 injections a day? And do you carb count?

Your backgorund insulin should maintain your fasting BG over a period of time within +/- 2mmoml/l of starting BG, some people find that this isn't possible on one background injection a day, so find they need to split there two ino PM&AM so that can adjust to suit each period.. Helps with DP...

Quick acting is then injected to cover carb foods eaten, you may find that you need a different carb-insulin ratio for different times of the day, generally breakfast, dinner and perhaps tea times.. You also need to calculate in factors such an planned exercise either before and/or after injecting so that you can adjust your dose accordanly to prevent hypo's

It sound complicated, but once you start sorting it, it does get a lot easier with time, you do however need to have a very good monitoring regime of taking BG's noting carbs amount (types of carbs is also useful info to note) dose of insulin, exercise done etc, once you've got sorted then you can relaxe a with supporting info, and just note down anything different to normal..

I would asked your team about a carb counting cause, DAFNE (dose adjustment for normal eating) is the best, but a lot of hospital's do there own version... Ask to go one it ASAP..

Good supporting books for MDI (multiply daily injections) are Using Insulin by John Walsh or Think like A Pancreas by Gary Schiendler both available via Amazon and of course further questions/support form here as well..
 
Thanks folks!

Yep, I am on 4 injections per day. I've never really carb counted as such. I guess I follow the 10g = 1 unit rule but in general because my diet is pretty regular I tend to take the same amounts each meal time.

Generally it's the mornings which cause me issues and make me feel exhausted so I'll try the advice suggested.

Thanks again!

Ben
 
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