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Losing control.

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wendyj

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Hi,
I'm Wendy, 45 and new to this site. I have had type 1 for 27 years and have always had pretty good control and lived my life without major problems. However, since October I've experienced problems which seem to be spiralling out of control and although I attend the diabetes clinic, every 3/4 weeks at the mo, I'm just looking to see if anyone can offer any advice and also, just to chat to people who have experienced similar things...(a problem shared...and all that!!)
In a nutshell, I'm having loads of low blood sugars, often ending up in hypos requiring intervention and although I'm adjusting my insulin, nothing seems to be making much difference. In addition, I'm very rarely getting any warning signs until it is too late which is frightening and just makes the whole condition so much harder to control...
If I'm honest, there are other things going on in my life which are complicated and which cause stress and even grief and I'm also waiting to have a hysterectomy in november which is impacting on my general health but more than anything, I feel more confused now than when I was first diagnosed and would love to hear from anyone with either similar problems or just diabetics who like to chat and share experiences....Thanks for taking the time to read this.
Wendy :?
 
Hi Wendy and welcome to the forum :) I'm sure some t1s will be along soon to share experiences with you and help with your problems.

In the meantime, since you ask for advice, here is some general information (even though I know you are not newly diagnosed) which the former monitors wrote for new members and I hope you will find something useful and interesting in here. Ask as many questions as you like as there is always someone who will know the answer.

Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.
Click to expand...
 
Wendy,

Sounds like you are having an awful time! Basically as you are well aware the hypo's are caused by your insulin being set to high and the more you have the less likely you are to feel them coming on, what insulin regime are you on?

Nigel
 
Hi wendyj,
No wonder you're struggling , you have more than just the diabetes to contend with...!
Stress with other factors and issues in your life, worry of the hysterectomy ahead, and the daily battle with your low sugars and hypo's too.
All this certainly cant be pleasant nor easy for you.
What support is in place for you with the repeated hypo unawareness?
If there isnt any, you really could do to ask for this to be assesssed and addressed.
We do have a type1 thread where there are experienced type1's who have suffered with hypo's and can give you some help,tips starting points to read up on. It would be worth a trip into there!
November is thankfully a while off yet for you, so hopefully by then you will feel more prepared to face this then.
Best to take things a step at a time, makes it more manageable and bearable for you. [if you see what I mean] Too much all together! Break it alll down to smaller chunks easier to cope with?
Stress can affect us all too well, try and reduce this bit by bit by bit.... helps gradually over time.
What insulin are you using?
I have seen an hysterectomy thread on here somewhere, will wander around and try find it.
Hope this helps you a bit?
Ask any questions you feel/need to. As we are here to help and support you along.
Anna.x :D
 
Hi wendy

Two things that come to mind with what you are saying..

First have you changed your any of your insulins recently? Sometimes unpredicaable hypo's or unstable control can be linked to the insulin more so when you've recently had a change of insulin.

The other thought

Has your clinic checked out the possibility of Addisons disease?

As what you are experiencing can also linked to Addisons,

May be worth asking for a ACTH (cosyntropin) stimulation test which can rule addisons in or out
 
Hi, jopar what is addisions disease? This is a new one to me. Anna.x
 
Hi jopar,
Thanks for yr reply and the suggestions you brought up...firstly, my insulin regime hasn't changed in approx 5 years and also, my clinic has tested for Addisons as my sister has the condition but it was ruled out...so unfortunately, no answers there!! However, I do appreciate your input.

Thanks to everyone else too and I will post tomorrow in response to your comments..and can I just point out that I already feel better knowing that I'm not facing this alone as it were, that there is help and support out there. :D

Wendy
 
Hi Wendy. Well I think the unawareness when having hypos might be to do with the fact you are having so many. It should come back the less hypos you have. The reason for this is your warning system kicks in initially but eventually after a short period can get worn out so you can only rely on the glucose metre. I had this when suffering multiple hypos years ago however it was only temporary.

Tell me what insulin regime are you using at the mo? Can your long acting insulin (if you use it and MDI's) be reduced? Are you drinking alcohol more often or anything like that? Also (and I know this sounds weird) but have you been eating more soya? This is because I have recently and had more hypos and realised that soya blocks one of the enzymes which releases carbohydrate. Lastly maybe because you are stressed and feeling some negative emotions right now you may be running around more in order to organise things for others etc. without even realising it.

I would suggest maybe reducing your long acting insulin and looking at your ratios again. Also going back to the basics of writing a diary etc to see if you notice any patterns. Sometimes when we write things down we see things that otherwise we wouldn't see doing in our day to day lives.

Hope that helps.
 
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