Type 1 sugar levels all over the place

[nevenaves]

I have been diagnosed with type 1 about a year ago. For 1st 6 months, my pancreas was still pumping insulin, I use to take just basal (8 units) in the morning. Also, I did a bit of stretching and walked to work and back every day and to be honest I took more care of what I eat than in the following 5 months (in the following 5 months I was good on working days but on weekends I would eat what I felt like eating at least for 1 meal). Following 5 months my pancreas was still active, but not as much and the switch was rapid. During vacation I got sick, I couldn't drop my bgl from 12 until I returned home and my gbl/insuline intake never went back to the previous state. We raised my basal to 10 units and I was taking bolus only as a correction (to avoid hypo's as I am very sensitive to novorapid). Still, I did just a bit of stretching and walking. My sugar wasn't as good as the 1st 6 months and my H1ac went from 5.5 to 7.9. Then I noticed that the worse bgl's were in the morning, so we moved basal from the morning for the evening. My levels are usually below 8.0 before going to bed (I was instructed to snack a bit if they are below 8.0 to avoid hypo's during the night), but now if I snack (even if before the snack my bgl is 5-6) I will wake up with bgl 7.2-10. Lately, I have been doing 40 min's power walk 3-5 days a week and I have been swimming 20-40 min's 3 times a week, but my evening/morning values stayed the same. Also, I am as rigorous with my food intake as I was in the 1st 6 months (my main meals are 30gr of carbs and snacks are 15 gr's). We raised my basal to 11 units but, I would have a hypo about 1.5 hours after breakfast (without the power walk because if I go for a walk I eat before the walk and check my bgl as soon as I return home) and my evening/morning values stayed the same. To add more confusion, if I take more than 1 unit of novorapid in the morning or more than 2 units in the evening I will end up with a hypo (at least 2-3 units for lunch are safe)!!! So, we decided to go back to 10 units of basal in the evening (as of yesterday)... I am very frustrated because I can't understand what is happening and I feel like all the good work I invest during the day (both food and workout) is cancelled by high bgl's during the night! Has anyone had a similar experience or can make sense out of my situation? Is this normal for the end of the honeymoon phase? Any tips, please!

Thank you in advance!!!

 

[ert]

Wow. It sounds complicated. 30 grams of carbohydrate in your meal? Are you following a low carbohydrate diet? If so, or even otherwise, I recommend reading Dr Bernstein: Diabetes Solution. I hope you sort out your blood sugar regime soon with your diabetes nurse and consultant.

 

[nevenaves]

Wow. It sounds complicated. 30 grams of carbohydrate in your meal? Are you following a low carbohydrate diet? If so, or even otherwise, I recommend reading Dr Bernstein: Diabetes Solution. I hope you sort out your blood sugar regime soon with your diabetes nurse and consultant.

Thanks! I am not on a low carb plan. I was eating like this since with this regime I didn't need any bolus for my meals and now I got use to this. Also, I am scared my bgl's will be even worse if I increase carbs. I will definitely check out the book!

Thank you!

 

[kitedoc]

HI @nevenaves,
Can I ask, what basal and bolus insulin are you injecting?
It sounds like you are snacking in the evening to avoid hypos at night.
Are you eating snacks to avoid hypos at other times?

 

[ert]

Thanks! I am not on a low carb plan. I was eating like this since with this regime I didn't need any bolus for my meals and now I got use to this. Also, I am scared my bgl's will be even worse if I increase carbs. I will definitely check out the book!

Thank you!

I'm probably still producing my own insulin which makes this game easier. I'm only two weeks into using insulin, but I followed Dr Beinstein's LCHF to stay off insulin for as long as I could. It's easy to follow on insulin how I'm used to his advice and know it backwards. But I've learnt a lot from others on the forum here, like splitting your insulin doses (for example if I need 4.5 units for a LCHF meal, I may start at 2.5 and give the remainder later depending on how quickly my bs rise) and giving maybe half the insulin if I intend to exercise afterwards. I run morning and night but only on long-acting (I wait for 4 hours after short-acting). I walk 20,000 steps a day and go to the gym to do weights and the stepper also. I've just come back from walking the Cornwall Coastal Path (I did wait 4 hours until all of the short-acting was out of my system, and eat squares of dark 90% chocolate and coffee with cream along the way and drink loads of water in the heat.) No hypo's yet, other than one bad injection day 3 where they plummeted within seconds. I usually have bs's of 6 when I go to bed and 5 when I wake up. I don't go to bed until 5 hours after dinner and don't have snacks. I have a CGM and have set my alarm to check they're stable during the night. I'm pretty exhausted from all of this monitoring and need to relax a little, but the hypo I had was terrifying.

 

[Marie 2]

I agree with at @Knikki your numbers aren't anything to worry about. It's a problem in the honeymoon phase, everything is irregular .

Read up on DP dawn phenomenon. You can usually test if it's DP by setting your alarm and taking your BG about 4-5 in the morning a few times. Usually DP happens around 5:30 am, right before you get up or before dawn to prepare you for the day. You are not undoing the days better control by the nights high, they really are 2 different things and I don't think if you have DP with your sensitivity to insulin right now that you can do much about it. Down the road an insulin pump is the best way to control it or some people have been known to get up and give a compensating bolus just to deal with it. With your sensitivity that doesn't sound like a good idea.

 

[nevenaves]

HI @nevenaves,
Can I ask, what basal and bolus insulin are you injecting?
It sounds like you are snacking in the evening to avoid hypos at night.
Are you eating snacks to avoid hypos at other times?

I am taking lantus and novorapid. Regarding snacks, I stick to my schedule, but I feel like a hypo might be near I check and if I am close to 4.0 (4.1-3.9) I snack immediately.

 

[nevenaves]

I'm probably still producing my own insulin which makes this game easier. I'm only two weeks into using insulin, but I followed Dr Beinstein's LCHF to stay off insulin for as long as I could. It's easy to follow on insulin how I'm used to his advice and know it backwards. But I've learnt a lot from others on the forum here, like splitting your insulin doses (for example if I need 4.5 units for a LCHF meal, I may start at 2.5 and give the remainder later depending on how quickly my bs rise) and giving maybe half the insulin if I intend to exercise afterwards. I run morning and night but only on long-acting (I wait for 4 hours after short-acting). I walk 20,000 steps a day and go to the gym to do weights and the stepper also. I've just come back from walking the Cornwall Coastal Path (I did wait 4 hours until all of the short-acting was out of my system, and eat squares of dark 90% chocolate and coffee with cream along the way and drink loads of water in the heat.) No hypo's yet, other than one bad injection day 3 where they plummeted within seconds. I usually have bs's of 6 when I go to bed and 5 when I wake up. I don't go to bed until 5 hours after dinner and don't have snacks. I have a CGM and have set my alarm to check they're stable during the night. I'm pretty exhausted from all of this monitoring and need to relax a little, but the hypo I had was terrifying.

Thank you very much. Dr Bernie became my best friends during this weekend.

 

[nevenaves]

Hello @nevenaves.

First off stop beating yourself up about things, looking at the above your numbers look OK, T1 is long journey and you never stop learning. Look around the forum, there are many an old hand around who learns new things

Usually the ideal T1 range is between 4 and 10mmol so by the looks of things your still within those numbers which is good. As for the rise in the morning that could be down to Dawn Phenomenon where the liver dumps glucose into your system to get you up and going for the day. It's a natural things happens to non diabetics as well.

It almost sounds like your still in a honeymoon period what the pancreas cough and splutters some insulin into your system which maybe why so little insulin is causing hypo.

Might be worth chatting with your med team and getting the Basel sorted once that's one it will hopefully make life a little easier for you.

As for sugars all over the place, alas that happens to us all at some points in time and can be rather annoying/frustrating trying to work out why.

Take care

Thaaaankss a looot!!! I arranged a 'date' with my diabetic nurse this week. [/QUOTE]

 

[ert]

Thank you very much. Dr Bernie became my best friends during this weekend.

I couldn't have coped without him. Bernstein's my bestie.

 

[kitedoc]

I am taking lantus and novorapid. Regarding snacks, I stick to my schedule, but I feel like a hypo might be near I check and if I am close to 4.0 (4.1-3.9) I snack immediately.

Good to heaqr you have hypo awareness!!
Re Lantus: just something to read: diabettech.com Lantus: lethal or Lifesaver?