Long Time Type 1 Suddenly no control

[Stefp]

Hi, I am new to this forum - though I have read lots of threads over the years. I am 46 years old and have had type 1 diabetes for 30 years now. Until a few years ago I always have great control, but now I just can’t seem to get things right. I switched my diet a few years ago and mostly eat low carb when my blood sugars starting going haywire. I no longer go anywhere near pasta, rice, cereal, potatoes, most types of fruit, or any of the good things!
Over the last few weeks things have gone crazy again. My blood sugars can change from 17 to 1 in less than half an hour and they are all over the place whatever I eat. It is is exhausting and frustrating. I check levels up to 20 times a day and have been keep a diary but there are just no patterns at all. Last night my blood sugar fell to 1 and I couldn’t get it back up for several hours, I waited for the inevitable high but that didn’t come.
Today I have eaten 1 piece of low carb bread, cucumber sticks and cheese, a piece of fish with salad and 3 strawberries - my blood sugars have been 6.7, 14.7, 14.9, 3.3, 12.9 and 14! No sense at all.
Any suggestions?

 

[Jaylee]

Hi @Stefp ,

Welcome to the forum.

What insulins are you using?

Get the ball rolling from there.

 

[Rokaab]

My blood sugars can change from 17 to 1 in less than half an hour and they are all over the place whatever I eat

Just a thought but have you tried the checking with the control solutions for the meter, from 17 down to 1 in 30 mins sounds like a very drastic drop, could your meter be having issues? Or the test strips.

 

[Stefp]

I am on Humulog and Lantus. I have two meters and the numbers are the same - yes I know - a scary drop makes me nervous now, I have changed insulin cartridges too - just in case.

 

[Stefp]

Oops - sorry, thank you for the welcome!

 

[Jaylee]

I am on Humulog and Lantus. I have two meters and the numbers are the same - yes I know - a scary drop makes me nervous now, I have changed insulin cartridges too - just in case.

OK? I use Lantus. There have been accounts from others regarding it being a bit unstable.
I have a CGM set up & have sometimes found this to be the case myself. Armed with the proof, my endo still wouldn't prescribe an alternative basal...

Without this getting awkward. Would you say you had minimal body fat? Possibly the basal had gone into muscle tissue?
Or maybe even the bolus did..

 

[Stefp]

I would say I have a decent amount of body fat! I am of a normal body weight. I had recently taken Lantus when I had the drop but my levels seem all over the place all the time. I didn’t realise Lantus could be unstable.

 

[Jaylee]

I would say I have a decent amount of body fat! I am of a normal body weight. I had recently taken Lantus when I had the drop but my levels seem all over the place all the time. I didn’t realise Lantus could be unstable.

There have been a few reports. I myself find it can loose potency about halfway down the cartridge? (It is stored correctly.)
Then with a new cartridge business as usual..
It's odd, the basal can work for me unintentionally fasting having a (last meal midday'ish.) night out being active.
It can keep me in a holding pattern twix 4.8 & 5.2 even when it's meant to have tailed off or even an hour overdue for the shot.?
(Don't ask I'm in a couple of bands. & can't do that stuff on a full stomach.)

 

[Rokaab]

I would say I have a decent amount of body fat! I am of a normal body weight. I had recently taken Lantus when I had the drop but my levels seem all over the place all the time. I didn’t realise Lantus could be unstable.

Lantus also has the issue of if you hit a blood vessel then some of it can in essence act like a fast acting insulin, may that's what happened last night (note: this is from what I remember reading somewhere)

 

[Jaylee]

Funny you mention that @Rokaab . I just dug up this old topic which may help.

https://www.diabetes.co.uk/forum/threads/lantus-users.67760/

 

[Stefp]

Ok thanks for the insight - I will have a read of the link. This wouldn’t be causing all of the instability though would it?

 

[Jaylee]

Ok thanks for the insight - I will have a read of the link. This wouldn’t be causing all of the instability though would it?

There could be other variable factors? Not all my days are bad with Lantus. (Or if so, atributed to the basal.)

I would suggest basal testing to find out where you are with it. Before moving on with what could have happened with the fast acting for meals..

 

[gto19660]

Funny you mention that @Rokaab . I just dug up this old topic which may help.

https://www.diabetes.co.uk/forum/threads/lantus-users.67760/

Have you ever considered going on a pump

 

[Stefp]

I looked into going on a pump a few years ago but in Australia they are not funded for type 1 diabetics over 18 - the same with CGMs. At the time my endo I thought my control was too good to warrant the high cost. Might be worth a rethink but I really don’t know if I can afford one.
I have recently transitioned from Lantus to the replacement - could this have had an impact? Just checked my blood sugar and it is 14.9 - after a meal of fish (normal serve) and salad. At my wits end.

 

[Stefp]

Just read through the old Lantus thread - might be worth me looking into- though it is never easy to get anyone to change medications. My endo and GP often look at me like I have no idea what I am talking about even though I am the one who has to live and breathe this stuff 24 hours a day. A few years ago when I was having problems and told them there were no patterns they didn’t believe me until they loaned me a CGM - the data told them what I already had - things were all over the place!
Thanks for all of your suggestions.

 

[Jaylee]

Have you ever considered going on a pump

Hi,

It has been mentioned in the same way I'd "make a good dad." More than once or twice..
I've been refused a change of basal & prescription of the Libre earlier this year by the endo. (I self fund a CGM set up.)
I've estimated if I sold my van the cash could purchase a pump, & the yearly savings on running costs could push for the periferals..
I remain child & pump free by choice. Not for me.. Though I am seriously contemplating "scoring" some Tresiba from a reliable source..

I appear to be flying solo regarding the NHS support I get these days..


@Stefp , I empathise with what you're dealing with. Endos are a little like mechanics when presented with an intermittent fault.
Assume it must be "driver error."

 

[becca59]

Menopause??

 

[Robinredbreast]

Hi, I am new to this forum - though I have read lots of threads over the years. I am 46 years old and have had type 1 diabetes for 30 years now. Until a few years ago I always have great control, but now I just can’t seem to get things right. I switched my diet a few years ago and mostly eat low carb when my blood sugars starting going haywire. I no longer go anywhere near pasta, rice, cereal, potatoes, most types of fruit, or any of the good things!
Over the last few weeks things have gone crazy again. My blood sugars can change from 17 to 1 in less than half an hour and they are all over the place whatever I eat. It is is exhausting and frustrating. I check levels up to 20 times a day and have been keep a diary but there are just no patterns at all. Last night my blood sugar fell to 1 and I couldn’t get it back up for several hours, I waited for the inevitable high but that didn’t come.
Today I have eaten 1 piece of low carb bread, cucumber sticks and cheese, a piece of fish with salad and 3 strawberries - my blood sugars have been 6.7, 14.7, 14.9, 3.3, 12.9 and 14! No sense at all.
Any suggestions?

Hi @Stefp and a big welcome to the forum. You have had some helpful advice already and I thought of menopause too
( same as @becca59 ) or another thought of Double diabetes, here is a link from this forum.
https://www.diabetes.co.uk/double-diabetes.html
I'm only a year more than you, 31 yrs diagnosed and my Bg can sometimes be frustrating, as Type 1 can be predictably, unpredictable
Take care

 

[Dillinger]

Just read through the old Lantus thread - might be worth me looking into- though it is never easy to get anyone to change medications.

I was on Lantus for a long time and found moving to Levemir really helpful; for one thing you can split it so the action is flatter. Whatever the drug companies say no long acting insulin lasts as long as it is claimed.

See if you can persuade your GP to prescribe you some.

 

[Stefp]

Yes, the GP has confirmed I am menopausal - I have (sigh) suggested this might be a reason for my unpredictable blood sugar swings but been told there is not ‘evidence’ that menopause has any impact on this, and that effectively I must be doing something wrong - like stuffing my face secretly with donuts! I did request a referral to a new endo who might be experienced with diabetes and menopause issues but she wasn’t sure they exist.
Double diabetes sounds horrifying - I will check out this thread too - lots to think about -