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completely unstable BMs despite a pump...

JessP

JessP

Well-Known Member
Messages
139
Type of diabetes
Type 1
Treatment type
Pump
Hi,
I'm 28 and 2 years ago out of the blue was diagnosed with Type 1 DM. For the first year it was fine, being a doctor I didn't have any problems with injecting or doing my BMs. However last October my sugars started to go mental, hypoing at least 2-3times a day and going really high.
I was started on the pump in March this year and told it would transform my life. Unfortunately this doesnt seem to have been the case. Despite rigorous carb counting and working hard on getting my pump working well my sugars aren't much better. I can at least now go for a run again which I wasn't able to do for a while although it takes a lot of planning!
However; day to day my sugars are still quite mental, going from 28 to 2 in 30minutes and no particular pattern. My consultant seems to be a bit at a loss as to why it's so unpredictable. Currently I have a continuous monitor on which at least helps predict my hypos, especially over night. Unfortunately it's now greatly affecting my career...obviously I can't be on call and doing surgery with my sugars doing this and my poor partner is having to put up with horrific mood swings associated with the changing BM's.

Has anyone got any experience of this sort of thing and advice on what I can do? Am losing the plot a little now!

Thanks,
Jess
 
JessP said:
Hi,
I'm 28 and 2 years ago out of the blue was diagnosed with Type 1 DM. For the first year it was fine, being a doctor I didn't have any problems with injecting or doing my BMs. However last October my sugars started to go mental, hypoing at least 2-3times a day and going really high.
I was started on the pump in March this year and told it would transform my life. Unfortunately this doesnt seem to have been the case. Despite rigorous carb counting and working hard on getting my pump working well my sugars aren't much better. I can at least now go for a run again which I wasn't able to do for a while although it takes a lot of planning!
However; day to day my sugars are still quite mental, going from 28 to 2 in 30minutes and no particular pattern. My consultant seems to be a bit at a loss as to why it's so unpredictable. Currently I have a continuous monitor on which at least helps predict my hypos, especially over night. Unfortunately it's now greatly affecting my career...obviously I can't be on call and doing surgery with my sugars doing this and my poor partner is having to put up with horrific mood swings associated with the changing BM's.

Has anyone got any experience of this sort of thing and advice on what I can do? Am losing the plot a little now!

Thanks,
Jess
Click to expand...

Is it possible you're still in honeymoon phase? That can make things very unpredictable.

Have you tried different insulins? I used to find that some insulin just didn't seem to absorb in a predictable way for me. The most consistent one for me is Apidra but I'm sure it varies.

I went through a couple of years of nightmare hypos about 10 years ago and it wasn't good - so I sympathise. In my case changing insulin and reducing carb intake has stabilised things a lot, but I wasn't in honeymoon phase!

It can take a while to get the ratios and basal rates right on a pump - especially if you're doing a demanding job as you are. Might it be worth taking a week of holiday to get things sorted, when you don't have anything to worry about so can test regularly, get all your basals set up right, experiment with different foods and ways of dealing with exercise, for example?
 
Hi Jess,
do you have the book pumping insulin by Jon Walsh, if not invest in it.
Have you done any proper basal testing? http://diatribe.us/issues/13/learning-curve
As a matter of interest at what level do you have your durration of insulin set, and at what time do you change your basal pattern ie, 1 hour or 2 hours before a change is made?
I have an allergy to all the insulin's except bovine neutral and Isophane and my reaction to the other insulin's were exactly the same as you are having 0 - 60 and down agan all within an hour. (Slight exageration). I now use bovine neutral in my pump and it works very well for me.

So well worth looking at this as a cause of your problem.
 
Thanks for your input....have ordered Jon Walsh's book so will see how it goes.
Will also talk to my consultant about differet insulins. I'm on apidra and previously tried novorapid which was a disaster but will ask about bovine insulins.
My consultant doesn't think I'm honeymooning anymore which is a shame. My CGM from last week looked like the london tube map again!
Anyway, thanks for the advice!
Jess
 
Hi Jess, sorry to hear about your trouble with blood sugar control.
Ive had diabetes for a long time (42 years) and am poly-glandular, and oftenl find that my sugar levels can suddenly go out of control.
I take the attitude that readings between 6 to 11 are OK for me - this has helped me to keep hypos to a minimum, although I still get unexpected ones that pop up from time to time. I have also found that menses hormones play a drastic altering factor with my blood sugars. -also adrenaline can play havoc when stressed to, with highs and then sudden drops in blood sugar.
I dont wish to sound 'airy fairy' but I have found that feeling relaxed and not panicking about blood sugars and diabetes in general can often lead to better results? Easier said than done though!
I don't know whether any of these things might help you but they may give you some ideas for now or for future use.
 
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