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Just realised I cannot meet DE expectations

P

plantae

Well-Known Member
Messages
828
Type of diabetes
Type 1
Treatment type
Insulin
Had another DE appointment about 4 days ago and she wants my fasting BSL to be in the 7s or low 8s. Going through my past Libre reports I don’t think this is even psychologically possible for me. The reason I say this is because 2 months ago I was in hospital and on nil by mouth for 48 hours (I was on a drip containing Hartmann’s solution and pain killer only). During that 48 hours I also had no bolus insulin, for obvious reasons, but also no basal insulin. The libre graphs for those two days show my BSL a “flat” 4.5 - 5.5 mmol/L with an occasional dip to 4.1 but never higher than occasional 5.5s… the graph is basically all 5.0. So if I’m understanding things correctly the only way I could get a fasting BSL in the 7s would be to eat some ultra long-acting carb (??). I’m a bit frustrated by all this, I have been 100% in range for over 2 weeks now and don’t really understand the requirement for any insulin / fasting BSL adjustments at all…
 
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My guess us that they are paranoid (with some justification) about hypos...

Do you have any idea of how much insulin and creon you are producing on your own now? Is your pancreas capable of recovering at all? (No idea whether this is a thing that happens to T3c ers so my apologies if this is out of the question.)
 
EllieM said:
That's a fantastic result.
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Thanks :)

Yeah I had quite a rocky road with hypos a few months ago but thought it was all sorted out now…

I don’t know how much, as in a number, insulin and other things I’m producing but not a lot according to endo. I don’t know if 3c in general can expect recovery and improvement (maybe?) but I’m pretty sure that in my case the answer would be no because about 75% of my pancreas is physically gone (I had necrotising pancreatitis). So the insulin, glucagon, etc has to come from 25% of a pancreas and I don’t think they could increase production enough. My endo said I’d be on MDI for the rest of my life. I have had two c-peptide tests and a glucose tolerance test which maybe gives the endo some idea how much I produce but he only told me ‘no where near enough’ (this came up when I asked him if there was a chance I could take a pill which is when he said not enough and needles always)
 
My DE may not know I have 2 days of Libre graphs with nil my mouth and no insulin because they tend to only look at the previous two weeks, so it may have been missed. I’ll mention it next appointment because I think it’s useful data. In the meantime I’ll attempt what I think is impossible and raise fasting BSL. This morning was 5.9. Hey, that’s higher than 5.5 :D
 
plantae said:
My DE may not know I have 2 days of Libre graphs with nil my mouth and no insulin because they tend to only look at the previous two weeks, so it may have been missed. I’ll mention it next appointment because I think it’s useful data. In the meantime I’ll attempt what I think is impossible and raise fasting BSL. This morning was 5.9. Hey, that’s higher than 5.5 :D
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How confident that your reading is accurate? Might be worth checking some of the fasting readings with a glucometer. (I am having horrendous issues with my G6 under-reading for the first 24 hours of insertion at the moment, makes my graphs look weird because I can't calibrate till 24 hours in. I think this must be a change in my body though, because this is a new issue after 3 years with the G6...)
 
EllieM said:
How confident that your reading is accurate? Might be worth checking some of the fasting readings with a glucometer. (I am having horrendous issues with my G6 under-reading for the first 24 hours of insertion at the moment, makes my graphs look weird because I can't calibrate till 24 hours in. I think this must be a change in my body though, because this is a new issue after 3 years with the G6...)
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100% confident. Ok 99.999%. I tested with both my glucometers (abbot and contour)… They all gave different readings of course but within 0.8 mmol (the abbot was 5.1, the contour 6.0, so somewhere between those two readings seems reasoable). I check every morning with glucometer but not normally with both glucometers…. That’s a bit overboard. I used both because this is a new sensor and I calibrated it day before yesterday 1.5 hours post-lunch because it was reading 2 mmol low. I did another calibration in the trough (low point) before dinner. I don’t know if this is the correct procedure hahaha but makes sense to me that if I’m calibrating I do both high and low. If that’s wrong then… oops

edit: i’m happy with the numbers its now giving me
 
I’m “fasting“ now (between lunch and breakfast 2.5 hrs ago) and am 7.3. Maybe this (between meals) is where DE wants me above 7 and not on waking and I misunderstood… will have to clarify that
 
Ok, I didn’t realise that protein could have such an impact. I had a protein shake at 9PM last night (basically no carbs because I used almond milk). BSL stayed at 6.1 until about midnight when it went up to 8.5 then settled to around 7.5 where it remained until 7AM. So it’s possible after all
 
plantae said:
Ok, I didn’t realise that protein could have such an impact. I had a protein shake at 9PM last night (basically no carbs because I used almond milk). BSL stayed at 6.1 until about midnight when it went up to 8.5 then settled to around 7.5 where it remained until 7AM. So it’s possible after all
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Check your almond milk before deciding it’s the protein (which it might well be). Some have quite a lot of carbs
 
HSSS said:
Check your almond milk before deciding it’s the protein (which it might well be). Some have quite a lot of carbs
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Yep good point. My almond milk is unsweetened and 0.8g net carbs per 250ml so it’s unlikely that :)
I did the ‘experiment’ again and was in the 7s again after my protein shake for most of the night. So it seems that the ultra long acting carb I was looking for is, umm, protein
 
HSSS said:
Check your almond milk before deciding it’s the protein (which it might well be). Some have quite a lot of carbs
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I just went to main computer to get full details for the protein shake I make. It’s:

250ml unsweetened almond milk (net carbs 0.8, protein 1.8g)
5g psyllium husk (< 0.5g net carbs, 0.4g protein, 4g fibre) (I mainly add this because I like how it thickens the drink, but it does add some fibre as well)
15g sugar free drinking chocolate (0.3g net carbs, 0.5g protein)
15g faba bean protein powder (0.2g net carbs, 12.5g protein)
totals: 1.4g net carbs, 15.0g protein, 6.1g fat

So, not a huge amount of protein but I had this at 10pm (novorapid was at 5:45pm). Dinner was low carb fairly high protein as well but that should have been covered by the novorapid (although now I don’t know… googling protein and insulin ratios now, but either way novorapid should have been worn off or close to it depending on my body)
 
Hopeful34 said:
If there's artificial sweetener in the drinking chocolate, some people find that raises their blood sugar.
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Yeah, there's Stevia. Would is raise BSL for 8+ hours though? I'll do the experiment again and leave the drinking chocolate out.

I don't think it's my dinner protein because I didn't have the drink last night and the graph stayed flat at midnight to morning (high 5s, low 6s) with the jump to the 7s the nights I had the drink. It's possible it's from dinner protein though... delayed by 6-6.5 hours but I'll have the drink again tonight and see if it happens again before fiddling about with dinner
 
plantae said:
Yeah, there's Stevia. Would is raise BSL for 8+ hours though? I'll do the experiment again and leave the drinking chocolate out.

I don't think it's my dinner protein because I didn't have the drink last night and the graph stayed flat at midnight to morning (high 5s, low 6s) with the jump to the 7s the nights I had the drink. It's possible it's from dinner protein though... delayed by 6-6.5 hours but I'll have the drink again tonight and see if it happens again before fiddling about with dinner
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unlikely. stevia is safe on a physiological blood glucose front. It’s a natural bgl neutral naturally occurring one not an artificial (chemically created) one

There’s a proposition about anything sweet psychologically stimulating insulin regardless of blood glucose and that being an issue for type 2’s but can’t see how that would affect you in this situation
 
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