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Effects of Wide Blood Sugar Swings

S

scottw

Member
Messages
10
Type of diabetes
Type 1
I've been T1D for 37 yrs.
A1C typically a little above non-diabetic 6.25% +/-.
4-6 shots/day, 6-8 bG tests daily. Tight Control
Now continuous glucose monitoring (Dexcom G5). Age 62.

5 years ago I could no longer stand my bG ranging from as low as 35 mg/dl to 350 mg/dl, sometimes, multiple times/day. The harder I worked at my job (Engineer) the wider and steeper the swings. The lower the lows got before I could recognize them. . The higher and steeper the rebounds.
The lows beat me to a pulp mentally and physically, the rebounds were intoxicating and the highs made me depressed, sluggish, lethargic and dull. I quit my job to take better care of myself and do something less debilitating.

2 MD's have said to me that such swings are major cause of long term complications.

Does anyone have any; experience, information, references, citations about long term effects of such swings ?
 
Hi @scottw :)

I don't have any links to hand but I read that spikes after meals can cause neuropathy so I bolus in advance to stop those. I'd also heard that madly swinging blood sugars aren't good for the eyes.
 
scottw said:
I've been T1D for 37 yrs.

2 MD's have said to me that such swings are major cause of long term complications.

Does anyone have any; experience, information, references, citations about long term effects of such swings ?
Click to expand...

My situation is similar and I share your concerns. It seems that it is the magnitude of the variation that is more the cause of the cognitive issues. I found this page (https://www.bd.com/us/diabetes/page.aspx?cat=7001&id=14131) includes a formula that I've worked into my log (a spreadsheet of my own devising), for the purpose of warning me when the variation is a cause for concern. I think that an engineer should find it thought-provoking.

"You can use the standard deviation to look at your overall blood sugar control, or to check on specific times of day such as before breakfast. Just use the rule of thumb developed by Dr. Irl Hirsch, an endocrinologist at the University of Washington in Seattle. His guideline is that the standard deviation multiplied by two should be less than the average blood glucose number."
 
scottw said:
I've been T1D for 37 yrs.
A1C typically a little above non-diabetic 6.25% +/-.
4-6 shots/day, 6-8 bG tests daily. Tight Control
Now continuous glucose monitoring (Dexcom G5). Age 62.

5 years ago I could no longer stand my bG ranging from as low as 35 mg/dl to 350 mg/dl, sometimes, multiple times/day. The harder I worked at my job (Engineer) the wider and steeper the swings. The lower the lows got before I could recognize them. . The higher and steeper the rebounds.
The lows beat me to a pulp mentally and physically, the rebounds were intoxicating and the highs made me depressed, sluggish, lethargic and dull. I quit my job to take better care of myself and do something less debilitating.

2 MD's have said to me that such swings are major cause of long term complications.

Does anyone have any; experience, information, references, citations about long term effects of such swings ?
Click to expand...

Hi, scottw, although i have occasionally heard this, my doctors have not mentioned it. I have had type one a little longer than you and find that getting older and having other, unrelated to diabetes, health issues does lead to more swings, have you always had them? what sort of swings are you talking of? My doctors think that hypos are a more serious issue for older people, and i have read this also. There is research showing that 6.5 % HbA1c is the absolute lowest older people should be - hypos are dangerous, and can lead to all sorts of issues when you are over 60, including afib. Especially if you have none of your own insulin. If you do not have other complications now, it is safer to run around 7.0% to 7.5%. My advice would be to avoid hypos at all costs, the swings may ease up a bit. As you are lucky enough to have a Dexcom, and can monitor a lot, why have what you call tight control? - this may be what what used to be called tight control when we were first diagnosed, but is not now, as you are swinging about. Forget the average. Tight control is smooth. . Maybe your type of control is not at all suitable, especially for an over 60 year old? i am a bit older than you and had to wean myself off what i had called tight control also . It was too much for my body - i had lost the ability to spring back from even a mild hypo, as i could when i was younger . i find that, with type one, changing one's way of dealing with it has to alter over the years. Things for me not too bad now. i feel younger! - i found it was an effort to learn new ways, though. And i was not having hypos such as you describe. It sounds as if you have no pump - do you have the opportunity for one? Best Wishes
 
noblehead said:
Hi @scottw

As a type 1 you may be interested in the following article, it's written by the author of the book Think Like a Pancreas and mentions the damage that postprandial & long-term spikes in bg levels can do, he also offers advice on bolusing techniques to help reduce postprandial spikes that @azure has already alluded to:

https://www.diabetesselfmanagement....blood-glucose-management/strike-the-spike-ii/
Click to expand...
Thank you much. There seems to be a lot of good stuff there. Will get into soon
 
ann34+ said:
Hi, scottw, although i have occasionally heard this, my doctors have not mentioned it. I have had type one a little longer than you and find that getting older and having other, unrelated to diabetes, health issues does lead to more swings, have you always had them? what sort of swings are you talking of? My doctors think that hypos are a more serious issue for older people, and i have read this also. There is research showing that 6.5 % HbA1c is the absolute lowest older people should be - hypos are dangerous, and can lead to all sorts of issues when you are over 60, including afib. Especially if you have none of your own insulin. If you do not have other complications now, it is safer to run around 7.0% to 7.5%. My advice would be to avoid hypos at all costs, the swings may ease up a bit. As you are lucky enough to have a Dexcom, and can monitor a lot, why have what you call tight control? - this may be what what used to be called tight control when we were first diagnosed, but is not now, as you are swinging about. Forget the average. Tight control is smooth. . Maybe your type of control is not at all suitable, especially for an over 60 year old? i am a bit older than you and had to wean myself off what i had called tight control also . It was too much for my body - i had lost the ability to spring back from even a mild hypo, as i could when i was younger . i find that, with type one, changing one's way of dealing with it has to alter over the years. Things for me not too bad now. i feel younger! - i found it was an effort to learn new ways, though. And i was not having hypos such as you describe. It sounds as if you have no pump - do you have the opportunity for one? Best Wishes
Click to expand...
Sounds like you faced exactly what I did. I have other conditions unrelated to diabetes which are aggravated by the hypos and the highs also. I quit work 5 yrs ago after 22 years at my job to get out of those swings. By my late 50's I had lost a lot of the resiliency of my youth. I can't march to the beat of somebody else's drum anymore. I use a Dexcom G5 since then. Combined with the CGM and a lot of compromise of my ambitions and enthusiasm and plans I've reduced those swings to a tolerable level. I applied for disability based on this in 2013 but my lawyers, US Soc. Sec. Admin, judge, the court's vocational expert, and the pfshrinks basically ignore my argument. I've got to document this phenomenon.
PS I used a pump for 2 years in the '90s. I hated it and would rather take 8 shots a day than use one.
 
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