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gastroparesis and diabetic control

macstubble

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Hello everyone,
Type 1 diabetic for 34 years, have never managed steady BG control, and now unfortunately with a variety of long term diabetic complications as a result. One of which is a lot of nerve damamge, peripheral, and autonomic.

Been told probably have gatroparesis, which is causing erratic blood sugar fluctuations. Was prescribed Erythromycin to try and speed up digestive process, as it was felt I had gastroparesis /dumping syndrome.

Thing is I have had severe fluctations all my diabetic life, so I'm not convinced I have gastroparesis, but feel the large swings in blood sugars over a lifetime is the cause of all the diabetic complications.

But for example last week, had a blood sugar of 13 at 8.00 p.m evening meal , took Humalog 10 units with 30g of carbs. 2 hours later blood sugar of 5.9, 5 minutes later it was at 3.5 took some lucozade and 18 minutes later not feeling any better checked it again and it was at 2.8.So had some more lucozade and blood sugar when rechecked was was then at 9.00. Took my 12 units of Levemir at midnight , woke at 2.00 with a raging thirst , checked my blood sugar and it was at 27.6.

Tonight again BS of 7.4 , normal insulin dose and meal at 8p.m , 3 hours later bloods sugar of 2.7, some lucozade to sort and blood sugar 1 hour later at 8.9 so far so good . But 35 minutes later its at 18.5. Altho the 12 units of Levemir I took at midnight each night will probably have this down to between 6 or to 7 by the morning.

Does anyone else have such variations normally in such a short space of time? And if anyone is dealing with gastropresis do they have any suggesions, as trying to keep reasonable levels in amongst all the other helath problems I have (not all are diabetic) is doing my head in.
 
I don't suffer from gastroparesis but do understand the problems that it cause to diabetic control..

Which your discription shows quite well, insulin hitting the system way before the food started to digest, and then raging highs when the stomach starts to sort it self and adsorb the food into the system... It's far from easy to resolve indeed..

Some things to look at and discuss with your health care team, is the type of insulin you use, Humolog kicks in pretty quick so perhaps a change to one of the older anulogs or animal insulin, might prove to give a better profile to suit your gastroparesis better as these don't start to kick in until 1/2 hour after injection..

Another thought would be insulin pump thearpy, won't cure it but can be very good at helping to tackle it, with several different bolus that can be set to deliver over a period of time in a slightly different manner, give better flexibility to bolus to suit asorbtion, then the ability to increase or decrease the basal on a tempoeray bases can help avoid pending hypo's or high.. As I said not a cure but has a lot of flexibility to enable you to maintain a lot better control..

Hope this helps
 
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