Blood sugar all over the place

[amandacockayne]

Hi
I'm asking this for my husband, who was diagnosed as type 1 this time last year - he's 59. He has struggled getting any personalised advice from HCPs. When he started injecting his blood sugar levels came down quickly and all was fine, up until about a month ago. His sugar level started creeping up and we could see no reason for this. He's been told its all about diet - but he's very disciplined and eats healthily. For instance his blood would leap up from something like 6/7 in the morning to close to 20 in the evening, despite a lunch of bread and cheese - nothing really sweet at all. Last night his blood was 17. Late evening he ate a large (one of those huge bars) of chocolate. This morning his blood sugar was 7. What the heck is going on? Clearly something has changed. Do the blood testing machine thingys develop faults? Are the test strips accurate? Because if these results are accurate we are back to square 1 with understanding how this works, with no idea at all how to manage his diet.
Thank-you

 

[dawnmc]

If you can, buy Dr Bernsteins Diabetes Solution. His diet recommendations are very low carb. He is Type 1 and has lived a very long and healthy life.
The bread your husband is eating is pure carb as is pasta, rice, potato etc.

 

[Weens12]

Hi
I'm asking this for my husband, who was diagnosed as type 1 this time last year - he's 59. He has struggled getting any personalised advice from HCPs. When he started injecting his blood sugar levels came down quickly and all was fine, up until about a month ago. His sugar level started creeping up and we could see no reason for this. He's been told its all about diet - but he's very disciplined and eats healthily. For instance his blood would leap up from something like 6/7 in the morning to close to 20 in the evening, despite a lunch of bread and cheese - nothing really sweet at all. Last night his blood was 17. Late evening he ate a large (one of those huge bars) of chocolate. This morning his blood sugar was 7. What the heck is going on? Clearly something has changed. Do the blood testing machine thingys develop faults? Are the test strips accurate? Because if these results are accurate we are back to square 1 with understanding how this works, with no idea at all how to manage his diet.
Thank-you

Hi Amanda,

His HCP should have told him about the role of carbohydrates in his diet. Many diabetic members on this forum of all forms of
diabetes find that reducing the carbohydrates in their diet, not just the obvious sugary things, has a very beneficial effect on their blood sugars. So the bread and cheese might be the culprit, especially if the bread is white. the huge bar of chocolate has got to be a culprit too!!
There is some basic information given out by the "newly diagnosed" forum moderator, Daisy1. In case, she hasn't spotted your post, I've replicated it below...

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 70,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

Reduce your carbohydrate intake
Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

Before meals: 4 to 7 mmol/l
2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

Before meals: 4 to 7 mmol/l
2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

Before meals: 4 to 8 mmol/l
2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education


Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

I hope this helps a bit....
Keep asking questions, and tell us a bit about your husband's diet, so that we might be able to help identify problem foods, and offer some advice on alternatives.

Best wishes,
Elle

 

[amandacockayne]

Thank-you so much for this really detailed reply - lots to think about. No, he hasn't really been told about carbs - he was given a lot of information about diet when it was thought he was type 2 diabetic, but it seemed to be mainly aimed at weight loss - and my husband isn't overweight. The carbs thing resonates - yes, he does eat bread and I guess quite a lot, we make our own bread, wholemeal generally. But his diet hasn't really changed in between blood sugar being stable and the past month where it has been all over the place.
Thanks again.

 

[Weens12]

Hi Amanda,

There are a number of T1 insulin users who hopefully will come along soon and may be able to offer some advice on some things to try... such as adjusting the timing and dosage of insulin. I'm a T2 so don't know much about insulin, other than what I've read here. I've heard a lot of people talking about a "honeymoon period" after diagnosis, which I think means that when it ends, blood sugars may be a less stable than before. Although someone may correct me on that!

I'll leave it to those who know a lot more about it, to explain further.

I'll just say that you've come to the right place. There are some very knowledgeable members who frequent this forum, who give support to other diabetics and share information on how to manage the disease, based on their experience of living with it.

Elle

 

[Weens12]

I know that many T1 diabetics on this forum are enthusiastic low-carbers. Some are even very low-carbers. They find that it may allow them to reduce their insulin, and thus can give them better control over their blood sugars.

Low-carbing is not necessarily about losing weight, although it can help. But as you say, it's not an issue in the case of your husband. By low-carbing and/or switching to foods that are low GI (lower on the glycaemic index - which provokes less of an increase in blood sugar), it is possible to keep bloods sugars lower and more stable.

Certainly something that your husband might want to consider. There are many delicious alternatives to eating carb-laden foods.

Elle

 

[amandacockayne]

Thanks - I will suggest he thinks about his carb intake. Blimey this is complicated!!!
Amanda

 

[Weens12]

****Bump*****

Any T1's got any advice??

 

[amandacockayne]

Well...... blood sugar down to a respectable 6 tonight. Following almost exactly the same pattern of eating today as yesterday, when blood was 17. Honestly we are beginning to think this is just random......

 

[noblehead]

Amanda, could be your husband is coming to the end of his Honeymoon Period (google for more info) and he needs to make adjustments to his insulin doses to compensate.

There's an on-line carb counting course that is similar to DAFNE (again google for more info) which should be of some use when it comes to making adjustments to his basal and bolus doses, you do have to register first but do take a look:

http://www.bdec-e-learning.com/

Eating a huge bar of chocolate is far from healthy and not something he wants to be doing too often, chocolate isn't off limits and a square or two won't do any harm as an occasional treat as long as he can bolus for it, you can buy dark chocolate that has a high cocoa content (80% or above) that has very few carbs compared to milk chocolate.

To learn more about food and the impact it has on blood glucose look for books on The Glycemic Index, there's some really good books out there and most can be found on Amazon, there's a book I would highly recommend that your husband gets and that is Think Like a Pancreas by Gary Scheiner, it's a must read for type 1's and will tell you everything there is to know about controlling diabetes.

Good luck!

 

[jeves]

No not random lots of hidden carbs in food that's why I love my slow cooker I know exactly what's in it but even today I've been out for Sunday lunch and very nice it was tested bg and it was 8.1 2 hours later!

Sent from my KFTT using DCUK Forum mobile app

 

[amandacockayne]

Thanks - no, my husband doesn't actually like chocolate :shock: . He only ate a massive bar as a test. The honeymoon theory sounds plausible - how else would virtually the same eating pattern on 2 days result in such a massive difference in blood sugar? Unless his testing kit is not reliable?

 

[mentat]

I've been told and have read that honeymoon periods TEND to last a lot longer if you are diagnosed as an adult. So my money is on honeymoon fluctuations.

That said, it's quite normal for blood sugars to do rather different things over a couple of days of eating the same thing and doing the same activities. There are lots of reasons for this, some are fairly well understood, like getting a virus, hormonal changes (typically greater in women more than men), differences in temperature, or "hidden differences" in food, while some are inexplicable.

Personally my insulin needs do wild things routinely. My daily Lantus needs have crept down from 10 units to 4 units over the past 3 weeks! I've posted about it here. I've seen two endos about it recently and neither of them have a clue. Diabetes is a very poorly understood disease and the simple mathematical models of blood sugar are just a rule of thumb for living with it.

Early in my diagnosis my sugars were quite predictable and stable, and as I got older they got wilder. I tried harder to control them, and blamed myself for the poor control, and ended up having a breakdown. Don't assume diabetes will play by any rules, just do your best to live with it.

That said I've always held out hope that my body could heal itself under the right conditions, and I've been on the paleo autoimmune protocol for a while now, and my sugars have never been better and my dosages have slowly been getting lower and lower. Can't hurt to try...

 

[amandacockayne]

Thank-you Mentat that is really useful. (Apologies for the lack of reply, every time I checked the site the forums were down).

 

[hale710]

Hi there! I would agree with noblehead, sounds like he coming out of the honeymoon period.

I would suggest he asks to go on a DAFNE course. Having just completed it myself I can clearly see that he would benefit from it. It teaches you about the action of carbs and how to adjust your insulin dose based on how much carb is in your meal.

Is he on fixed doses currently? If so I would be wary of vastly reducing carb intake as it might result in hypos if the insulin is not correctly reduced.

Does he speak to a diabetes specialist nurse at all?