I.Just.Can't.Do.It

[petsnponies]

Hi there,

Im not sure if anyone can help or can sympathise.

I'm type 1, have been for 8 years now. I've always been quite a 'good diabtetic', and able to achieve a1c's of between 6.6 and 7 without trying too hard.

I had a baby in 2012. The pregnancy was very difficult but I managed (with extremely intensive management) to get an a1c of 5.9. My little boy is 2 now.

Since the pregnancy something's changed with me. My blood sugars are unpredictable and frustrating, I just can't seem to get on top of them and I can honestly say that I have been trying really hard for at least a year. (The first year of my sons life I was suffering very badly from ptsd due to the whole experience and traumatic birth so it took me a good year to feel sane again). My a1c is about 7.5 at the moment (that is not a good reflection, I am very up and down and all over the place) but I would really like it to be in the mid 6's. I have done a basal test and my levels are steady without bolus insulin or food. Unfortunately it is the addition of food/insulin/activity/hormones/stress that seem to through me off. I can do the EXACT same things on two different days and get wildly different results. Sometimes I can have days where it is easy, all readings in target, and then the next day can do the same things and it will be completely different!

I don't know what has caused me to lose a hold on it so much.

I know I am fatter than I was pre-pregnancy (by 2 stones). Although I am making huge efforts with my diet it will not shift. The only way it will come off is if I reduce my calories down to below 900 per day and even then it comes off so slowly (like half a pound a week at most, and I never lose anything during the last week of my menstrual cycle). The doctor told me to stop as it wasnt enough calories, and so all the weight I lost (around 10lb over 6 months) just came right back on. At the moment I am low carbing, keeping my carbs to 50g per day or lower. My calories are still only around 1200. Have lost nothing. I know being overweight affects how your insulin works and would really like to remedy this, but how?!

I have pcos. I become very insulin resistant during the 2nd half of my cycle. To the point where I increase my levimir from 30 units (pre ovulation), to 40 units (for the week after ovulation) and then again increase to 50 units (week before period). I often think that my hormones account for much of my troubles. I take 2000mg metformin per day.

I don't exercise much any more. I used to have a very active job dog walking and caring for horses, I was literally moving all day. I was no slimmer, still overweight, but must have been fitter and had more muscle. Now I have a little boy I find it difficult to exercise, as there is no one to care for him so wherever I go, he goes. That means going for a walk means going for a slow walk (there is nowhere to take the pram around here, it's all muddy tracks or roads with no pavements), going swimming means just bobbing about. I am trying to remedy this, arranging nursery care for 3 mornings a week so that I can swim properly, and on the other days I exercise in the house, sit ups, squats etc.

I am feeling so demotivated and defeated by it. I don't want to be experiencing 11's and 12's every day (with the odd hypo thrown in to confuse me). I don't want all of the complications that could come with this sort of control. I NEED to do this better.

Unfortunately there are no points for effort with this disease. It doesn't matter how hard I try, If i don't sort this out I'm going to damage my body, and the thought of blindness of kidney failure terrifies me, even if the prospect is years away. I don't want that to happen to me.

So far my plan is:

Contact the diabetic nurse again (although they are never much help anyway but I will try)

Exercise more, build up my muscles again.

Lose weight (HOW I don't know though, perhaps the exercise will help)


Should I continue with the low carb?

Should I ask about a pump? How would it help cope with the unpredictability?

Should I treat myself as 'brittle' and manage more intensively? ie testing after each meal and correcting highs, and setting an alarm for 3am each morning to test and correct? I'm sure this would bring it down, as this is how I managed pregnancy, but it's pretty hard to have a life doing it this way and it just seems that no body else does it this way. Everyone else seems to be able to suss things out.

Any advice or other ideas would be much appreciated. I need some hope that I can change this, I can feel a burnout waiting for me around the corner.

Sorry for the super long post!

 

[Riri]

Although you are feeling demotivated, which I can understand, you have a plan which is a great place to start. I think a pump would help as you can regulate your insulin to normally smaller doses as and when it's needed through the day (smaller amounts of insulin may help with weight loss too). I have 12 different basal rates set throughout 24 hours for instance. The unpredictability might start getting better once your basal rates are sorted - this is what I found worked for me. On the weight loss front, as soon as I cut my carbs to under 100g per day I lost weight and have kept it off for over 2 years. You say you are on 50g so there may be an underlying reason why you are not able to lose weight? You could ask your GP for some tests to see if there are any abnormalities which could cause this. I test frequently, you need to with a pump. I also test every night at 3am which is a personal choice of mine as it gives me piece of mind that my pump is working ok - this may be OTT but it works for me and I'm now used to it so I wake, test and I'm back to sleep in 5 mins. All the best and I believe from reading your post you will get there.

 

[Scandichic]

I think your plan is sound and you have had some good advice from riri. You've had a tough time. I am t2 and on tablets but have you tried low carb high fat? There are plenty of t1 who do - I think Ely Dave does? You say you lose half a pound a week. That's 26lbs or 1 stone 12 lbs in a year. Nearly what you are trying to lose. The problem with advice is that it can be subjective so no 2 docs will advise the same. Obviously you must make your own decisions but why not try LCHF and see what happens? I have now lost 1 stone 5lbs since the 28th of Jan. I did have 3 very frustrating weeks where I rigidly stuck to the diet, gained and lost a lb in the same week then maintained for 2 weeks. Then I lost a lb and this week I'm back to losing 2lbs. My husband was at home while I worked due to redundancy but wondered, are you on your own? If so huge respect! Have you got family or friends who can help? The nursery is a great idea! You need some time just for you and it enables your son to socialise and learn social skills as he gets older. Big hug!

 

[mo1905]

Great advice from both Riri and Scandichic. Your lifestyle has changed, you used to have an active job walking dogs etc so it makes sense your BG levels are a bit wacky. Exercise makes you more insulin sensitive, ie, you need less. Now you are more sedentary, you need to adjust your dose/ratio's accordingly. I would go back to basics and keep a diary of all BG readings, carbs, exercise and insulin taken. I read you've done a basal test but I also read your BG levels are unpredictable and frustrating ? You sound very upset and I can understand why but this will also affect your BG levels. You can't fix everything at once and need to break these problems down. I would begin with trying to stabilise your levels by adjusting basal/bolus as required. The weight loss is long term and as Scandichic says, half a lb a week is fine. If you set your targets too high you'be be disappointed. Try to do regular exercise, even if it's walking up and down the stairs a few times or a 10 min walk but you can build on it. This may not have any affect on the weight loss but it will improve your cardio-vascular system and it releases endorphins so you actually feel better. Good luck and I hope you begin to see improvements soon.
Mo

 

[Scandichic]

And keep coming on the forum! It has been a life line for me as you get to talk to other people with the same issues and even when I feel **** somebody always manages to make me feel better! Sometimes I have a rant because I have just had some healthcare expert give me advice which is rubbish or had some unsolicited advice from some well meaning colleague, sometimes I want to celebrate success ( my own and others) and sometimes I just want a laugh or a recipe! Keep posting!

 

[zand]

Yes continue with low carb and add high fat like scandichic says. Don't worry about calories, your doc is right you need more to keep your metabolism going. As far as my body is concerned not all calories are equal. Those from carbs are the worst. I lived on a similar amount of calories to you for a while and eventually got so many colds/flu bugs I had to give up. I didn't lose any weight. Diet drinks were bad for me too as they just made me fatter. Some advice which someone else on the forum gave me a few days ago was to get your vitamin D level checked as low levels can make you retain fat. also have you had your thyroid checked?
I have been type 2 for 3 years. So far I have managed fairly well by eating low carb, recently though I have lost the plot and am finding it very hard to find the right path again.

 

[Scandichic]

Yes continue with low carb and add high fat like scandichic says. Don't worry about calories, your doc is right you need more to keep your metabolism going. As far as my body is concerned not all calories are equal. Those from carbs are the worst. I lived on a similar amount of calories to you for a while and eventually got so many colds/flu bugs I had to give up. I didn't lose any weight. Diet drinks were bad for me too as they just made me fatter. Some advice which someone else on the forum gave me a few days ago was to get your vitamin D level checked as low levels can make you retain fat. also have you had your thyroid checked?
I have been type 2 for 3 years. So far I have managed fairly well by eating low carb, recently though I have lost the plot and am finding it very hard to find the right path again.

You need some new recipes! It's easy to get stuck in a rut! How are you with lentils and beans?

 

[petsnponies]

Thank you so much for all the replies it means a lot to me. I certainly will keep posting and have saved you in my favourites bar!

Also forgot to add that I'm going to keep more detailed records. Just spent the afternoon designing a new record sheet which will be able to fit more information on it. Maybe it will help me pinpoint more where I'm going wrong.

Mo - yes I did a basal and my levels kept steady on it. However all I can conclude is that they were level at that point in time - it doesnt mean that the same would happen the next day I suppose. The night time basal test showed my levels steady through the night. Yet when I went to bed last night at 7, I woke up at 13!! What?! My morning and lunch time basals were fine, just dropped a bit on my tea time one. Only 1.5 of a drop though. I need to do a few more basal tests to be certain of it I suppose, just not too keen on missing meals especially when I dont eat much anyway, maybe I'll do another in a few days time.

Schandichic - I lose about half a pound a week on a low cal diet, but only for 2 weeks of the month! The two weeks after ovulation I have to diet just to not put any on. I suppose that's still a pound a month and 12lb a year but the doctor told me 900 cals was just to little. Unfortunatley 1200 cals only maintains my weight. I still need to give the low carb diet a chance I think, maybe it will start working

Riri - I think Im going to try waking at 2.45am and testing/correcting if needed. I got into the habit whilst pregnant and think I would benefit from doing it again, at least for a few weeks to find out whats happening in the night.

Zand - yes have had thyroid checked. Will ask about vitamin D though! You're right about low carb being difficult, and expensive too!

Thanks again, feeling a little more positive now.

 

[Daibell]

Hi. Others who have posted on the forum have sometimes found control difficult post pregnancy for the range of reasons you suggest. Hopefully time will resolve some of that. Yes, if overweight you do need to persevere with getting it down. Low-carbing is essential but 50gm/day is already very low so I wouldn't go lower. I'm afraid I don't agree with going high-fat as I don't see what the benefits are supposed to be, but you do need to have enough fat to provide the calories you need bearing in mind the low carbs. Most dieticians recommend a daily intake of calories that is too high (so that's why we're all obese?), so choose a sensible level. If you can gradually get the weight down you should remove any insulin resistance, reduce your insulin and reduce sugar swings; well that's the theory anyway! Good luck.