inconsistent reactions

gbswales

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I am type 2 diabetes originally controlled with metformin but after a serious attack of pancreatitis (two months in hospital) I was told I would need insulin control.

At first I was on novamix for about two years but despite increasing dosage my levels were generally too high. My hospital moved me onto nightly Lantus and novarapid during the day because Novamix wasnt working well. The reason for this is probably that I find it difficult to sustain a regular pattern of meals and sleep. The idea was that I woud be able to match my insulin doses more closely to when I ate meals. I am achieving some level of control but my HBa1c at 10 is still too high.

One thing I cannot understand is that the sugar levels do not always seem to relate to what I have eaten. For example one morning last week I woke up with a pre-breakfast reading of 4.4 - took 24 units of nova rapid ate 2 weetabix with milk (no sugar) and a small class of orange juice - 3 hours later when I tested having had nothing other than a cup of coffeee (dash of milk no sugar) My level was 10.2! Another evening I ate late, had the wrong foods including ice cream and a bottle of cider (very rare that I even drink) and woke up the next morning expecting a level of about 12 and it was 5.3? Another night with a pre-dinner level of 6.9 I will have a much better meal (with no ice cream) then before bed (about three hours after) find that my sugar level has hit 15.

What happens with all this is that I get frustrated and think whats the point in all this testing if things dont work they way they should - and so I end up giving up testing and guessing for a few months.
 

kegstore

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It's frustrating but worth the effort compared against the alternative...

The trick lies in understanding exactly what (specifically carbohydrate) is in your food, and how much of it is in there (weighed in grams). Carbs are the one thing guaranteed to raise your blood sugar level, and by a measurable amount although possibly at different rates, again depending on what you're eating and in combination with other food types. Once you learn to match your insulin dose to the carb you're eating (in the context of the whole meal), you should see much better control with greatly improved blood numbers.

Would you consider going on a carb counting course? And buying a small reference book? I reckon it would all become a lot clearer if you did, so maybe have a chat with your diabetic healthcare team about it? The one caveat I would add is that I've been counting carbs since diagnosis (27 years ago), but still occasionally get the odd surprise even when I think I know what I'm doing! Just my body keeping me on my toes...

Some people would suggest reducing your carb intake, but I'm not one of them and in any event I don't think that's your first step. It MAY be something you want to consider once you've learned more about the food you eat and the effect it has on your blood sugar.

Whatever you choose to do, better control IS possible, but "giving up testing and guessing for a few months" leads to only one destination... :wink:
 
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gbswales

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counting carbs sounds a lot like counting calories and I have never been any good at that when attempting to diet :roll:

It is the thought of doing things like this that takes me into a depressed state - I am a spontaneous, whatever takes my fancy, type of person and am absoulutely hopeless at planning meals - about half an hour before dinner I look at whats in the cupboard, fridge or freezer and throw it in the wok. oven or microwave. I hate cooking, though my thai partner does some of the cooking he cannot conceive of cooking a stir fry or the like without adding sugar - the good thing is that he gets me to eat lots of rice which I believe is good.

Tonight as an example - I am throwing 1lb of good beef mince in with vegatables into a hot pot covered with sliced potatos (that is major league cooking for me) then I take it in the dining room and we spoon it out from the big dish into bowls - do I need to have the kitchen scales in there for my portion and how much of a meal like that should I eat? Planned to follow that with yet another attempt to make a low calorie ice cream (in ice cream maker) that will have whipping cream, eggs and sweetner plus vanilla extract - goodness knows how much that will be per portion in carbs.

I have to find a way to make diabetes fit my lifestyle because it simply wont work out any other way
 

kegstore

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The difference with counting carbs is knowing what food contains it (e.g. potato), and what doesn't (e.g. meat). If you're on insulin I don't know any way around carb counting if you want even reasonable control - sorry!

Whenever I'm cooking I normally find it easier to work out the total carb content before it's prepared, combined and cooked. In your example for tonight's meal, if you knew the weight of the potatoes, with a quick look in a carb reference book you could calculate the total carb they contain, and therefore for the whole dish - the mince has a negligible carb content. Don't forget any other ingredients (mushroom? tomato? other veg?), although herbs and spices typically have zero carb.

Another factor is how you buy your food, you might even find that quite a lot has the carb content on the nutrition label, mostly expressed as "per 100g", then it's just maths. From the ingredients for your ice cream, the only one with any carb will probably be the cream, but it won't be much and depends on the quantity you are using - the label should tell you more.

Rice is slightly different, but it DOES contain quite a lot of carb, so will definitely raise your blood sugar. The label on the packet should tell you how much. Depending on the type your partner uses, how it's cooked and what it's eaten with, the rise in blood sugar may take slightly longer. Only by experimenting will you determine what it does for your blood levels. Although I can't advocate including sugar in a stir-fry, if it's just half a teaspoon and you KNOW that, you can work out the carb content.

Diabetics who can make the condition suit their lifestyle - and still achieve "good" blood numbers - are rare. But the changes the rest of us have to make may be less extreme than you think. Possibly the only way forward if you want to avoid long-term complications.
 

meela83

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I am type 1 and on Lantus and humalog since december, I had hideous blood sugars previous to this with my worst being and HbA1c of 14.6 in December. I was taught to carb count and work out my insulin requirements for the carbs I eat, also went on DAFNE last month which was fantastic. My HbA1c was 8.9 on Thursday so is headed in the right direction. The carb counting allows you to eat what you like (at least in theory) and know how to control it.
How much Lantus are you on?
 

janabelle

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Hi Gbswales,
I am a long-term type-1 and experienced a similar problem on Lantus. It doesn't work for some people, me included. Test have shown that a significant percentage of Lantus can remain at the injection site for up to 36 hours after injection. This explains why it seems to work some days, and not on other days. I suffered over 4 years of these ups and downs, with no help from my diabetes clinic, despite reporting it many times.

It constantly surprises me that when people are having problems with Lantus, doctors are so reluctant to change it for an alternative, especially when there are many other long-acting insulins available.

Lantus has not been tested safe on pregnant women, and children under 6, yet it is prescribed freely to both. Lantus clinical trials were only carried out over a period of 28 weeks for type-1s, however patients report problems with control and other side effects even as long as 18-24 months after starting taking Lantus. The results of these trials were only based on HBA1c results,which were measured, against another synthetic insulin. When I complained to my diabetes consultant that my BGs were fluctuating between approx 2- 15 every day(sometimes higher), the problem was ignored because my HBA1c was within the normal range, which really made me doubt the value of this test.

I tried many things to keep consistent control while on Lantus, but nothing, diet, excercise or adjusting my doses worked, it was constantly unpredictable. I changed to Hyprurin Porcine Isophane in May 2008, and I have had daily consistent, predictable control since,so there is no doubt in my mind that Lantus doesn't work. I also feel so much better.
You should contact the IDDT (insulin dependent diabetes trust) for advice, they have a helpline numer on their website.
Best of luck
Jus
 

JohnJ

Well-Known Member
Messages
78
Type of diabetes
Type 1
Treatment type
Insulin
I am type 2 diabetes originally controlled with metformin but after a serious attack of pancreatitis (two months in hospital) I was told I would need insulin control.

At first I was on novamix for about two years but despite increasing dosage my levels were generally too high. My hospital moved me onto nightly Lantus and novarapid during the day because Novamix wasnt working well. The reason for this is probably that I find it difficult to sustain a regular pattern of meals and sleep. The idea was that I woud be able to match my insulin doses more closely to when I ate meals. I am achieving some level of control but my HBa1c at 10 is still too high.

One thing I cannot understand is that the sugar levels do not always seem to relate to what I have eaten. For example one morning last week I woke up with a pre-breakfast reading of 4.4 - took 24 units of nova rapid ate 2 weetabix with milk (no sugar) and a small class of orange juice - 3 hours later when I tested having had nothing other than a cup of coffeee (dash of milk no sugar) My level was 10.2! Another evening I ate late, had the wrong foods including ice cream and a bottle of cider (very rare that I even drink) and woke up the next morning expecting a level of about 12 and it was 5.3? Another night with a pre-dinner level of 6.9 I will have a much better meal (with no ice cream) then before bed (about three hours after) find that my sugar level has hit 15.

What happens with all this is that I get frustrated and think whats the point in all this testing if things dont work they way they should - and so I end up giving up testing and guessing for a few months.

I have a similar problem, I was moved from tablets to insulin (Humalog mix25) in February as tablets not working and it was considered I was a LADA 1.5. Apart from gaining 2 stone in weight with insulin my levels are not consistent. I do carb count and Monday to Friday I have the same breakfast at same time (6 to 7am) of 18 carbs. Pre-breakfast test tends to be around 14 (taken 26 units with evening meal). Take 10 units with breakfast and have hypo at around 10am or 9.30 if exercise.

But this Friday I awoke going towards a hypo at 4.1 and last night I was unable to inject until 90 mins after eating (9.30pm) and had a morning reading (10am) of 7.5. And had a further 2 hypos during the day.

Just can't see the logic, presume so many factors. Do I try eating and exercising the same things at same times to see a pattern?

I have my annual revue this week, shall raise this problem with the diabetic specialist!
 
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