Is the honeymoon over?

[tpaz]

how will I know that my honeymoon period is officially over?

I had just gotten to a place where I could look at a plate of food, estimate the carbs, and my bolus amount would be perfect.

The last week and a half I have been all over the place. My carb ratio has gone from 1:5 to 1:2. My post meal reading will generally be on target 50% of the time now (about 5-7 mmol) but 4-6 hours later, I've shot up to 9 or 10 mmol.

The unquenchable thirst feeling is back, and I'm waking up to go pee at least twice a night. I lost 4-5 pounds in the last week and a half.

Is it time to see the doctor, or am I just worrying for no reason?

 

[GrantGam]

Morning,

Have you any idea whether your fasting BG and basal insulin is correct? 1:2 bolus to carb seems fairly high if you are, like me, a fairly recent diabetic. I'm assuming you haven't been diagnosed for that long as you're referring to the honeymoon period?

It's possible that 1:2 is the ratio you're using to compensate for a lack of basal. If you're readings are going high again 4-6 hours after food and your bolus insulin, injection then that may suggest a lack of basal insulin. Bolus insulin is pretty much out of your system 4-5 hours after injecting.

How are your bloods at bedtime and on waking?

If you are experiencing symptoms of hyperglycemia which you've described then it can never hurt to ring your Dr or DSN.

Grant

 

[Kristin251]

how will I know that my honeymoon period is officially over?

I had just gotten to a place where I could look at a plate of food, estimate the carbs, and my bolus amount would be perfect.

The last week and a half I have been all over the place. My carb ratio has gone from 1:5 to 1:2. My post meal reading will generally be on target 50% of the time now (about 5-7 mmol) but 4-6 hours later, I've shot up to 9 or 10 mmol.

The unquenchable thirst feeling is back, and I'm waking up to go pee at least twice a night. I lost 4-5 pounds in the last week and a half.

Is it time to see the doctor, or am I just worrying for no reason?

Are you on basal? If I remember correctly you're just on bolus, or was that someone else? If you're not on basal it might be time. When was your last c peptide?
I have days/weeks that I am slightly more insulin resistant/ sensative. Have you added new foods? Sometimes things that shouldn't spike us do? Have you lowered fat? If I don't have enough fat ( avocado) I go much higher and faster.
Has the weather changed a lot ? We just got a lot warmer and my insulin is working too well, I'm needing to snack and I really don't want to. I'm kind of fighting to keep bs up these last few days.

Could be many things....lots of variables. This is why I basically eat the same meals everyday. I don't mean the same food per se but the same macros at each meal. I mix up the proteins but veggies and fats stay similar but quantity goes up as the day goes on.

 

[tpaz]

Morning,

Have you any idea whether your fasting BG and basal insulin is correct? 1:2 bolus to carb seems fairly high if you are, like me, a fairly recent diabetic. I'm assuming you haven't been diagnosed for that long as you're referring to the honeymoon period?

It's possible that 1:2 is the ratio you're using to compensate for a lack of basal. If you're readings are going high again 4-6 hours after food and your bolus insulin, injection then that may suggest a lack of basal insulin. Bolus insulin is pretty much out of your system 4-5 hours after injecting.

How are your bloods at bedtime and on waking?

If you are experiencing symptoms of hyperglycemia which you've described then it can never hurt to ring your Dr or DSN.

Grant

Thank you. I started on insulin back in March and am on bolus only. So from what you're saying it seems I may need to be on basal. I thought 1:2 was extremely high. I was at 1:5 just about 2 weeks ago.

My bloods at bedtime and upon waking are ok - in the 5.5 to 6.5 mmol range. I was easily under that before, about 4-5.5.

I've emailed my diabetes nurses and their response was to go see the doctor

 

[tpaz]

Are you on basal? If I remember correctly you're just on bolus, or was that someone else? If you're not on basal it might be time. When was your last c peptide?
I have days/weeks that I am slightly more insulin resistant/ sensative. Have you added new foods? Sometimes things that shouldn't spike us do? Have you lowered fat? If I don't have enough fat ( avocado) I go much higher and faster.
Has the weather changed a lot ? We just got a lot warmer and my insulin is working too well, I'm needing to snack and I really don't want to. I'm kind of fighting to keep bs up these last few days.

Could be many things....lots of variables. This is why I basically eat the same meals everyday. I don't mean the same food per se but the same macros at each meal. I mix up the proteins but veggies and fats stay similar but quantity goes up as the day goes on.

Hi Kristin, nope, no basal yet, just bolus. I have no idea what my last c peptide was. My endo doctor doesn't like giving me any numbers, even when I ask specifically. Isn't that strange? She's just said things like 'your cholesterol is a bit high' or 'your A1c is good'. When the LADA results came back she said I had some antibodies and had a little bit of insulin left. That's all I know.

I haven't eaten new foods, I pretty much stick to what I know as it's easier to count carbs that way. I haven't lowered fat at all. It has been super hot here, as well, but the insulin doesn't seem to be working any better for me! I even thought my pen might have gotten too hot and switched it for a new one, but that didn't help.

I had a salad for lunch today, all veggies and some guacomole mixed in, and the dressing was 1 carb per tablespoon. Something told me to bolus 6 units, and I did it and it was just enough. I'm shocked to think I need 6 units just to eat a salad? It seems so high to me.

 

[GrantGam]

Thank you. I started on insulin back in March and am on bolus only. So from what you're saying it seems I may need to be on basal. I thought 1:2 was extremely high. I was at 1:5 just about 2 weeks ago.

My bloods at bedtime and upon waking are ok - in the 5.5 to 6.5 mmol range. I was easily under that before, about 4-5.5.

I've emailed my diabetes nurses and their response was to go see the doctor

I've never heard of someone being on just bolus before. I'm no expert but I assumed that with T1D that bolus/basal were always used together. Maybe you were diagnosed early enough when your pancreas was still doing fairly well, I don't know?

Check your bloods in the middle of the night as naturally this is the time when your body will be empty of bolus insulin. If your BGL is really high at this time then it would seem like you're needing basal insulin to help with overnight and fasting periods.

Good luck!
Grant

 

[TorqPenderloin]

I question if you should ever see that same doctor again. Having an insulin: carb ratio of 1:2g suggests, out of context, that you have pretty significant insulin resistance.

However, in the context of this conversation it seems obvious (though I'm not a doctor) that it's an issue that your body is in dire need of basal insulin and the only way you can address that is to inject large amounts of your bolus.

At diagnosis, I had the opposite problem (though I was on a basal/bolus approach within 2 weeks). I was injecting as much as 30 units of basal a day because I hadn't been prescribed a bolus insulin yet. Almost a year later and I now take 12-14 units of basal a day and my insulin:carb ratio is 1:20g.

 

[Kristin251]

Hi Kristin, nope, no basal yet, just bolus. I have no idea what my last c peptide was. My endo doctor doesn't like giving me any numbers, even when I ask specifically. Isn't that strange? She's just said things like 'your cholesterol is a bit high' or 'your A1c is good'. When the LADA results came back she said I had some antibodies and had a little bit of insulin left. That's all I know.

I haven't eaten new foods, I pretty much stick to what I know as it's easier to count carbs that way. I haven't lowered fat at all. It has been super hot here, as well, but the insulin doesn't seem to be working any better for me! I even thought my pen might have gotten too hot and switched it for a new one, but that didn't help.

I had a salad for lunch today, all veggies and some guacomole mixed in, and the dressing was 1 carb per tablespoon. Something told me to bolus 6 units, and I did it and it was just enough. I'm shocked to think I need 6 units just to eat a salad? It seems so high to me.

I too have never heard of just bolus. I was on basal only for a week or so before starting bolus. I would talk to your Dr ASAP and request basal and if denied I would change Drs.
I would need to inject 1.5 - 2 units for a large restaurant salad with protein but I could never finish it. Of course we are all different but if it was a fatty dressing and with the avocado that sure seems like a lot of insulin.
Sounds like you did and are doing all the right things. Must be very frustrating.
Have you asked your dr directly for the numbers, explain you are in top of your diabetes and you need those numbers? Odd she doesn't want to tell you.

 

[tpaz]

I too have never heard of just bolus. I was on basal only for a week or so before starting bolus. I would talk to your Dr ASAP and request basal and if denied I would change Drs.
I would need to inject 1.5 - 2 units for a large restaurant salad with protein but I could never finish it. Of course we are all different but if it was a fatty dressing and with the avocado that sure seems like a lot of insulin.
Sounds like you did and are doing all the right things. Must be very frustrating.
Have you asked your dr directly for the numbers, explain you are in top of your diabetes and you need those numbers? Odd she doesn't want to tell you.

Yes, I have explained everything to her, and she thinks I care too much'. To her, as long as your not above 12mmol, she thinks that's not bad, and you don't have too much to worry about.

 

[GrantGam]

Yes, I have explained everything to her, and she thinks I care too much'. To her, as long as your not above 12mmol, she thinks that's not bad, and you don't have too much to worry about.

Easy for a non-diabetic to say. 12mmol/L is more than twice the ideal BGL as you'll know. Imagine what's happening to your eyes and kidneys with that sort of reading...

Sounds like your doctor is a bit clueless; I'd definitely be seeking out a replacement. Is she a GP or a diabetes specialist?

Grant

 

[Glink]

Is this a Canadian thing? I get the same kind of "if it's under 11 we don't care" from my doctors. I care! I would try to get in what a doctor (even if your GP to consult and perhaps get a referral to another endo if you are not confident with your current one). But what I was really responding to say was that here in BC if I get my blood drawn at a LifeLabs lab I can access my results online directly, which is super valuable to me as a numbers person. I know they are in ON also--not sure if there are any near you, but if you have the option you might try getting your blood draws there so you have your own record and are not completely reliant on your doctor to share your results with you.

 

[Keesha]

Which province in Canada are you referring to?


Sent from my iPad using DCUK Forum

 

[Kristin251]

Yes, I have explained everything to her, and she thinks I care too much'. To her, as long as your not above 12mmol, she thinks that's not bad, and you don't have too much to worry about.

Absolutely ridiculous. It's your blood, you have a right to know.
I would find a new Dr. IF possible.

 

[GrantGam]

Absolutely ridiculous. It's your blood, you have a right to know.
I would find a new Dr. IF possible.

In Scotland, we're lucky enough to have the web based "My Diabetes My Way" where we can see the majority of test results 24/7.

Grant

 

[tpaz]

Is this a Canadian thing? I get the same kind of "if it's under 11 we don't care" from my doctors. I care! I would try to get in what a doctor (even if your GP to consult and perhaps get a referral to another endo if you are not confident with your current one). But what I was really responding to say was that here in BC if I get my blood drawn at a LifeLabs lab I can access my results online directly, which is super valuable to me as a numbers person. I know they are in ON also--not sure if there are any near you, but if you have the option you might try getting your blood draws there so you have your own record and are not completely reliant on your doctor to share your results with you.

It must be a Canadian thing. Unfortunately, I only live near a CML, and they don't service online. The only way I can get my results is if my family doc is cc'd on the results... And even then I have to pay a dollar for each page printed. Most of the times, the endo doesn't cc my family doc.

 

[tpaz]

Which province in Canada are you referring to?


Sent from my iPad using DCUK Forum

I live in Ontario

 

[tpaz]

Absolutely ridiculous. It's your blood, you have a right to know.
I would find a new Dr. IF possible.

Yes you're right. I'm not sure that it is. She's the only endo at the diabetes clinic and the hospital here

 

[Glink]

Unfortunately, I only live near a CML, and they don't service online.

Actually, this is sort of good news, as LifeLabs bought up CML so eventually your CML will become a LifeLabs and use their online eHealth portal. My local lab used to be another company that was also bought by LifeLabs, and while I am nervous about the economics of all this consolidation, the online portal is excellent--both for actually seeing my results and for keeping track of them over time. The online appointment booking is also excellent for standing orders of fasting blood draws--hardly any waiting!

Details on the CML->LifeLabs transition in ON: http://www.lifelabs.com/sites/content_authoring/corporate/Shared Documents/CML Patient FAQs_v5.pdf

 

[tpaz]

Actually, this is sort of good news, as LifeLabs bought up CML so eventually your CML will become a LifeLabs and use their online eHealth portal. My local lab used to be another company that was also bought by LifeLabs, and while I am nervous about the economics of all this consolidation, the online portal is excellent--both for actually seeing my results and for keeping track of them over time. The online appointment booking is also excellent for standing orders of fasting blood draws--hardly any waiting!

Details on the CML->LifeLabs transition in ON: http://www.lifelabs.com/sites/content_authoring/corporate/Shared Documents/CML Patient FAQs_v5.pdf

That's great news!

I've been to life labs before and I find them so much more efficient. Right now I have to wait for about an hour just to get my name called for a blood test.

 

[tpaz]

Easy for a non-diabetic to say. 12mmol/L is more than twice the ideal BGL as you'll know. Imagine what's happening to your eyes and kidneys with that sort of reading...

Sounds like your doctor is a bit clueless; I'd definitely be seeking out a replacement. Is she a GP or a diabetes specialist?

Grant

I feel like it is easy for her to say. Someone who doesn't have it, couldn't possibly understand how high blood sugar really makes you feel.

She's a specialist. An endocrinologist, in fact. Mostly deals with diabetic patients, is head of endocrinology at the diabetes clinic here and the local hospital. She's not concerned unless blood sugar numbers are regularly in the 'teens', as she says.