Is this Burnout or Fact

[lins100]

So I've had type 1 diabetes since aged 9 when I got diagnosed with cataracts in both eyes. I'm now 37 and on novo rapid and levemir pen insulin. I am finding it increasingly difficult to keep good control. I am regularly getting hypos and am constantly having to adjust and readjust my insulin to no avail. I liaise regularly with my diabetes clinic but all they seem to do is tell me what to increase and decrease. I seem to notice that my sugars vary from day to day even if I stick to the same food and insulin to carb ratios. This makes me think it's all hormone related. That no matter what carb/ ratio is right the next day this will change. I honestly can't keep up.

I am aware that exercise can reduce insulin, stress can increase it so can a viral infection.

I feel increasingly frustrated as I cannot keep up with the changes and feel adjusting my insulin is only a reactive response. I long for something to stabilise my sugars but my healthcare team seem unable to provide or offer any response to this.

I feel to stop going to my diabetes clinic as this only frustrates me more and seems a wasteful exercise.

Has anyone else gone through a similar thing or is currently experiencing a similar situation or is it just me?

 

[Sad Birdie]

It sounds like burnout!
I have had enough of doing everything by the book and still never in a good range of hba1c!
Being type1 is very frustrating and I suffer from depression as well.
They tell me to exercise more, but I find it hard just getting to work and yes, am on medication for it!
I am so sick of hypos and hypers that am requesting a pump!
I will meet with the team in June...

 

[lins100]

But is this how the management of diabetes should be? I'm sure we both are strict as could be yet still got the hypos and hypers. There must be a medication that works at a more stable level. I never had such issues as a child. It's only since going on the pen have I really struggled with fluctuations of blood sugars. I have requested to go back on the first insulin but they look at me like this should be a last option?

I worry about the pump as you can't easily change your insulin using this. So say you were to get lots of hypos could you suddenly reduce your insulin or would you need to wait 4 or more days before your next at the clinic?

I am really struggling at work and in life with my regular hypos and the draining lethargic feeling I get afterwards and when my sugar is high. I can't seem to live a normal life and it does affect me wanting to exercise as either I have to eat something beforehand which I dont necessarily want to do.

 

[Charles Robin]

Hi Lins, sorry to hear about the problems you have been having. Sadly, it's a much repeated cycle for so many of us. Now, the last thing you are going to want to hear about is restricting certain foods. It sounds like it will make life even more difficult. So if I was to suggest cutting out the majority of carbohydrates in your diet, I am guessing that you would be fairly horrified. So was I when I came across the idea back in January 2014, after more than 20 years of struggling with my control.

What I can say is that I tried it, and I have been eating low carbohydrate meals ever since. It has made a huge difference to my life, and I actually enjoy food a lot more now. I could go into the many benefits, but in all likelihood you would switch off after about two lines. At least if you're anything like me then you would. Instead, could I suggest you go to YouTube and search for Dr Troy Stapleton? He is a type 1 diabetic, and explains how he manages his diabetes. His videos are around half an hour long, but they really are extremely worth watching.

If you want to know more, there is also www.lowcarbdiabetic.co.uk. There are recipes there, as well as lots of information on how eating less carbohydrate can improve your health, and give you much better control over your diabetes.

If you look into it and decide that you would like to know more, there is a low carbohydrate section of this forum. It set me in the right direction when I found it, and has loads of really knowledgable members. Best of luck, and keep posting about your progress.

 

[lins100]

I'm willing to try it...so I will but right now I can see I might still have the same fluctuations depending on my hormones each day. Also I don't eat much food each day but brown bread is in my diet. I'm going to give this a go though and will indeed keep you all posted. Thank you for contributing and offering such advice

 

[Charles Robin]

No problem at all. If you want the absolute authority on it, check out Dr Richard Bernstein's complete diabetes solution. He is a healthy type 1 diabetic who is now in his 80s. Be warned though, his book is VERY hardcore. Before he was a doctor, he was an engineer, so he writes in a very scientific and matter of fact way. However, I have never come across a more in depth resource. Also, he is American, and they use a different system to measure blood sugars. It's good to keep a conversion chart handy if you read it. It may also be worth checking out my blog on this forum. I have given a multiple post account of my entire journey with diabetes so far, including my experience of switching to low carb.

 

[lins100]

Do you know of any diet recipe book on this I could carry around with me?

 

[lins100]

I found the book on amazon by Dr Bernstein. Will read this and also do research on Dr TrioyStapleton. Thank you! You have given me some hope which I am really thankful for

 

[Charles Robin]

Very happy to help. I don't know of any specific recipe books but I'm sure they are out there. The best thing to do is to find a small number of meals that are easy to prepare, and then gradually expand. Omelettes are fairly great, I usually have one for breakfast. As a rule of thumb, most meat will be good as its high in protein and low in carbohydrate (always check nutrition labels, sausages can be a bit of a minefield sometimes). Smoked salmon is one of the most amazing things ever. Bell peppers, cauliflower, broccoli and other vegetables are good to eat too. I also bake a lot using ground almonds. Not the cheapest ingredient in the world, but super tasty! Www.lowcarbdiabetic.co.uk has some good recipe ideas too.

 

[lins100]

Ok but do you ensure you eat some carbs for breakfast, lunch and dinner? The last time I ate a salad for lunch and missed a bolus my sugar shot up. I didn't get a hypo just a rise in sugars. Yet someone on the daphne course I attended supported this could be done and was a great thing about the pen regime.

 

[dancer]

I worry about the pump as you can't easily change your insulin using this. So say you were to get lots of hypos could you suddenly reduce your insulin or would you need to wait 4 or more days before your next at the clinic?

I don't know where you got this idea from. Of course pump users can change insulin doses or carb ratios. My clinic appointments are 6 months apart.

 

[Charles Robin]

Ok but do you ensure you eat some carbs for breakfast, lunch and dinner? The last time I ate a salad for lunch and missed a bolus my sugar shot up. I didn't get a hypo just a rise in sugars. Yet someone on the daphne course I attended supported this could be done and was a great thing about the pen regime.

I only have around 30g of carbohydrate in a day. Eating in this way reduces insulin requirements, but it does not eliminate it completely. Your body can convert protein to glucose through a process called gluconeogenesis. So I bolus for protein as well as the small amount of carbohydrate I eat.

 

[LucySW]

I found the book on amazon by Dr Bernstein. Will read this and also do research on Dr TrioyStapleton. Thank you! You have given me some hope which I am really thankful for

Dear Lins, Charles is right. The reason it helps so much is that it makes your blood sugar levels consistent. Spikes if there are any are much smaller, lows less extreme. In my infinite wisdom (ha ha) I don't think there's any medicine that can do that. That's what you crave, is it not? And it would make hypos less frequent.

I think it's the most powerful way you can achieve stability.

Certainly worked for me. Of course my story is different as I'm a late-onset Type 1 trying to extend my honeymoon. But I've managed it (touch wood). Average blood sugar 5.2 recently and very consistent - and that's LCHF.

Do check it out and try it. But watch your BGs as you'll have to scale down your insulin doses as you go.

Good luck. Lucy

 

[Charles Robin]

I'm going to post a link to a video by Dr Troy Stapleton. At about 6 minutes 20 he covers why carbohydrate consumption logic is flawed.

 

[misswhiplash]

I worry about the pump as you can't easily change your insulin using this. So say you were to get lots of hypos could you suddenly reduce your insulin or would you need to wait 4 or more days before your next at the clinic?

The whole joy of the pump (I'm a recent convert) is that it is incredibly flexible - you can change much much more easily than with MDI and you can tweak basals and things to suit whatever you are doing in a particular day (or even hour).
It is particularly good for activity as you can reduce insulin instead of eating and very good for dealing with those weird days when your blood glucose is persistently high or low.
However, it *is* very "hands on" and demands a certain amount of commitment to careful monitoring and tweaking of blood glucose and dosage, so isn't necessarily for people who want a simple life!

I love mine, though - quite life changing...

 

[Juicyj]

Hi Lin,

I also recommend following the low carb rule, it stabilises your control and blood glucose levels, I was in the same boat but when I got better control through cutting out pastas, bread, rice, sugar etc I found my mood and my levels stabilised.

There's 2 mindsets on this forum to this approach as some believe they can manage good control through eating normally, however for some this doesn't work. It's finding the balance that suits you best.

I avoid carbs for breakfast as i'm more insulin resistant then, so it's a courgette/ham/cheese omelette or bacon and eggs at the weekend, then a salad for lunch with tinned fish and protein and veg for supper, I still take some quick acting as your body still converts this to glucose but try to keep daily carbs down to 50g or less. I also still have the odd treat so made a tiramisu on Saturday and had some of that but still managed to stay below 10, to start with it will be a bit of trial and error but after a week you will notice better control and the tiredness should disappear too.

 

[Heathenlass]

Ok but do you ensure you eat some carbs for breakfast, lunch and dinner? The last time I ate a salad for lunch and missed a bolus my sugar shot up. I didn't get a hypo just a rise in sugars. Yet someone on the daphne course I attended supported this could be done and was a great thing about the pen regime.

The issue with that advice given on DAFNE , is that there really isn't a no carb food . The example given on the course is an omelette and salad as a no carb meal. That is incorrect . A bolus, albeit tiny, is necessary . All food contains carbs or the potential to convert to glucose in the digestive process, even vegetables, protein and to a lesser extent, fat .

So in answer to your question, do you ensure you eat some carbs for breakfast, lunch and dinner , yes I do, as we all do, but not necessarily what most people perceive as " carbs " . Once this is understood, carb counting becomes more accurate and better , more stable control is achieved.

I've seen many people have problems gaining good control despite trying very hard , but turn their lives around once they learn that the advice they have been given is not the whole picture, and trying to follow that incomplete advice is a hiding to nothing . You will learn far more from people who actually live with the condition 24/7/365 than you ever will on a week long course , devised and run by non diabetics . Think of DAFNE as being training wheels, not the Diabetes Bible , and it is indeed an excellent starting point though not the big picture .

Signy

 

[noblehead]

@lins100, have you been tested for Gastroperesis, this can often lead to Brittle Diabetes due to the food being absorbed at an unpredictable rate which in turn can lead to lots of hypo's & hyper's.

 

[Ali H]

Google for recipes and food ideas, just put "low carb....." in front of whatever food type you fancy. Believe it not there are low carb muffins, cheesecakes, breads, rolls, flat breads, rice etc etc etc. Join pinterest and look at a site called typeonegrit who have tons of recipes categorised into brekkie etc. Pinterest is free.

Lidl do a high protein roll, 8.5g per 100g. I had half a one with lunch today and a salad and protein, no issues at all. I can't eat normal bread at all, spikes too high or requires too much insulin!!

Ali