Advice on dosing please

[Ughdiabetes]

Hi all. My first post here. Brief history. Was diagnosed 18 months ago as type 1 aged 43. All a bit mad to start but after 6 months or so I managed to get fairly good control thanks to my dexcom and watching how different foods affected my blood sugars like a hawk and my latest hba1c was 34.
In the last 2 weeks or so I've noticed that my blood sugar kept rising between meals. Not to crazy levels, but nonetheless concerning. I try to eat low carb, but sometimes have some potato or bread. To make matters worse my insulin to carb ratio seems to have totally changed. I need at least double if not triple the amount. I spoke to my diabetes team, they just suggested I change my pen, which I had already done. At this point, in the last 2 weeks I've doubled my basal from7 units to 14, am only keeping steady if I walk like a demon, and am now almost afraid to eat carbs as I have no clue how much insulin to take. I cannot deal with the roller coaster of highs and lows and how bad that makes me feel. An y idea what could cause this? Maybe hot weather...maybe cos i gained maybe 4 pounds? Its driving me cracked. Any advice welcome. Thanks for reading.

 

[EllieM]

Any advice welcome. Thanks for reading.

Could it just be that you are now producing less of your own insulin? I know that LADA folk can get very long honeymoons. I would expect insulin needs to keep going up until your pancreas finally stops producing insulin altogether???

(Disclaimer: this is not a diagnosis, we're not allowed to diagnose on the forums ).

Weather and weight gain can also have an effect, as can exercise, and probably a whole lot of other stuff I haven't thought of, including illness.

Personally, I find I need to quite regularly adjust both basal and my bolus ratios.

ps Welcome to the forums !

 

[Ughdiabetes]

Could it just be that you are now producing less of your own insulin? I know that LADA folk can get very long honeymoons. I would expect insulin needs to keep going up until your pancreas finally stops producing insulin altogether???

(Disclaimer: this is not a diagnosis, we're not allowed to diagnose on the forums ).

Weather and weight gain can also have an effect, as can exercise, and probably a whole lot of other stuff I haven't thought of, including illness.

Personally, I find I need to quite regularly adjust both basal and my bolus ratios.

ps Welcome to the forums !

Thanks a million for replying so quickly.
It probably is what you suggest but I'm just surprised it happened so quickly...everything was good 2 weeks ago and since then its just gone mad! I've also discovered I'm a bit of a control freak when it comes to this, and get stressed once I go over 7 or 8, especially if I didn't eat any carbs and walked. Maybe I need to chill a bit!

 

[MrsA2]

Stress can raise levels too, so maybe add some meditation/mindfulness/ counselling in to the mix?
Find a way of living with it that makes it liveable with, and I'm not t1 but that level sounds set impossibly high to maintain?

 

[EllieM]

Find a way of living with it that makes it liveable with, and I'm not t1 but that level sounds set impossibly high to maintain?

I certainly couldn't dream of achieving an hba1c of 34 but (a very few) others do achieve it. But honestly, I think it depends a lot on your personal metabolism, injected insulin doesn't have the same time profile as the endogenous stuff. Pumpers often seem to do a bit better? 48mmol/mol seems to be the level below which you are unlikely to develop eye issues, which is probably why they use it as the diabetes diagnostic level.

I'm glad @Ughdiabetes has a dexcom because whenever I tried for very low hba1cs in the past I has too many hypos and lost hypo awareness, and the dexcom should keep the number of hypos down.