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Losing my control, starting to get worried now.

T

Tom_Birmingham

Newbie
Messages
2
Type of diabetes
Type 1
Treatment type
Insulin
Hi,
I am new to registering here, but I do use this forum as a source of information.

To cut a long story short, I am 28 and I have diabetes for the past 11 years. I am quite pleased to say that in the last 11 years I have had a good control with irregular hypos and excellent HBA1C results. I ignored my diabetes for the first 2/3 years but did control it and still managed to get good HBA1C results, I was in denial to a point but then bucked my ideas up when I left home and I couldn’t depend on my very helpful mother. Since then it’s been good. Unfortunately the past 2 months I feel have not been as good and I feel like my blood sugars are all over the place. I used to pride myself on my control but I don’t feel like I have it anymore and it’s starting to worry me. I have just bought a house with my girlfriend and if I am honest I have been in denial about these readings until today when I woke up at 5 am with a hypo, had something to eat which was a bowl of fruit and fibre and then went to sleep woke up at 7 and my blood sugars were 14.6. I dont think my diabetes is effected by stress, as I am not stressed - I just think I have lost my ability to manage my diabetes well.

If I give you a run down of the past week it might give you an idea of what is happening. I take 48 lantus, and usually apidra at 10/15 with meals. I haven’t done a DAFNE course; I know this could be my next solution. I have also booked in to see my GP for a background test as well as a chat as I am worried about this. I used to go to a hospital but as my blood sugars were so good the GP was happy to treat me at his practice.

Today

10:30 - 6.5 had 2 poached eggs, 2 slice of wholemeal and 15mml of insulin
Today at 7am– 14.6

Yesterday

10pm – 10.8
8pm – 12.0
6pm before insulin – 15.7
2pm – 8.0
Lunch time – 4.8

Saturday

5pm – 9.4
2pm – 9.9
12pm – 7.0
8am – 14.0

Friday

10pm – 4.2
6pm – 3.9, treated with dextrose
1pm – 8.8
11:30am – 11.6
7am – 6.6

Thursday

11pm – 6.9
6pm – 11.0
4pm – 6.7
12:30 – 5.4
7pm – 3.9 and treated again before breakfast

My 7 day average is 9.1, 14 day average is 9.3 and 30 day average is 8.8
As you can see it’s a mess, I can go further back if you want – but I need some advice, guidance and maybe some stories of support and positive change.

Yours,

A worried Brummie.
 
Hi Tom and welcome to the forum.

I am not type 1 and not on insulin myself so I can not really help with doses etc

You state that you have been able to control your diabetes well over the last eleven years but not in the last two months. What has changed? Is it a case of no longer being motivated? It does not sound like it. Is it a case of a change in your diet?

You are doing the right things in asking questions on this forum, booking to see your doctor and considering attending DAFNE.

Perhaps your doctor may be able to suggest changes to your medication regime that will work better for you. I have read on other posts that some people had to change to different type of insuline before they could regain control.

So stay calm, stay focused and disciplined and seek proper medical advise.

Hope things soon turn round for you.

Regards

Pavlos
 
I am not sure what has changed, I think I might be just losing my control by not concentrating – but I can’t really explain it. It’s as if the old regime doesn’t work anymore and I don’t have any solutions to find my control again.

Writing this out has gave me a new focus, I have called for my GP appointment to be bought forward and I am going to make a request to move my care to the diabetes centre in Birmingham Q.E. Hospital as I feel more educated when I am with diabetes specialists.

I have just spoken to the hospital, they have asked for me to refer myself back to them to start DAFNE at the hospital and have a full MOT.

I feel better already. The power of writing things out eh ?
 
Tom_Birmingham said:
I feel better already. The power of writing things out eh ?
Click to expand...
It can work wonders, and often reading things through can help you see it from another perspective. Best of luck to you - from what I hear, the DAFNE course is great!
 
Hi,

I think it's essential that you started carb counting because one can't really take insulin without reference to how many carbs you eat.

You seem to be taking quite a lot of insulin; certainly your basal is relatively high; how long have you been on Lantus? I found that it was not much good when I was using it; I now am on Levemir and split that so have some in the morning and some in the evening; perhaps you can discuss that.

Lantus in my experience never lasted 24 hours - at best about 18. So, if you are taking it and assuming that is does last 24 that may explain some of your problems.

On the bloods you've posted there is not really enough information to comment; you need to set out how many carbs and how much insulin you are taking for each meal and see what happens after that; DAFNE will tell you to check prior to your next meal. I would often check at the 2 hour mark though.

On the meal list your said that at 10:30 - 6.5 had 2 poached eggs, 2 slice of wholemeal and 15mml of insulin. At a guess your toast was 30 carbs and you took 15 units of insulin; so what happened after that? That is a ratio of 1:2 (insulin/carbs) - which is quite low (I'm similar) but the standard advice is to assume that insulin will act at a ratio of 1:10.

If you are on a 1:2 ratio then you might want to speak to your Dr about going on Metformin too; which is something I've found very useful.

You also need to work out what your correction doses are when you're off target; i.e. what 1 unit of insulin will do to your blood sugars if you don't eat anything. You would then factor that in when you prepare a dose for the carbs you are about to eat.

Less carbs makes everything easier as well; there's no way I could eat Fruit & Fiber now; it would spike me very quickly and then the insulin I took to cover it would probably drop me into a hypo.

Why not buy the Think Like A Pancreas book? It is aimed at a US market but is pretty useful.

Regards

Dillinger
 
Your results for Thursday and Friday were not too bad, but higher over the weekend.

The fruit and fibre to treat the hypo would have put your blood quite high as I'm assuming there was no insulin taken due to the Hypo.

DAFNE, or your local equivalent, is a good way to learn more about carbs and the effect they will have.

You also said you just bought a house and although you may not be feeling stressed the pressures of house buying, it could inadvertently be effecting your blood readings.

I would also recommend Think Like a Pancreas.


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Hi, I'm type 1 myself and aged 30. My control was always great until I had my 2nd child 3 years ago. Since then I had really erratic readings. I did the dafne course in December and I found it quite boring 1st few days. I hav to say tho it has changed my life for the better! I used to eat n take set doses of insulin whether I was hungry or not. Now, I'm me 1st. I eat what I want when I want and I am very confident with my carb:insulin ratio requirements.
The highs u r getting could b false readings from ur hypos or could b dawn phenomena?
I would highly recommend the dafne course. U dnt Nd to wait for a referral, u can phn ur closest diabetic clinic and ask to be put on the waiting list.
Gd luck x


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Tom, don't be fooled by what stress can do to your diabetes control as many of us know from experience it can effect things.

You said that you have recently bought a house together with your girlfriend, this alone is a stressful event what with dealing with solicitors and estate agents......... not to mention the money spent and the effort used to make the house a home, it might just be that you've taken your eye off the ball a little and the stress of everything has inadvertently effected your bg control, just my theory as you did say you had very good control up until recent times.

Anyway I think your doing the right thing going back to the care of your hospital diabetes clinic, they are more adapt at dealing with these issues and hopefully they will enroll you on the next DAFNE course, the book Think Like a Pancreas that's already been mentioned is a fantastic book and a highly recommend that you should read it.
 
I agree entirely with Noblehead :) Good luck
 
Hi. What sort of weight are you? It is always a bit more difficult to get the right insulin balance if overweight. I'm just guessing but let us know. You obviously have had a lot of experience with your insulin but I agree with Dillinger that your units seem a little high which could imply some insulin resistance has crept in? Metformin could help a bit there as well as good carb control
 
Hi Tom,
Firstly, get yourself into a routine. Eat the same meals each day for a week. You'll soon figure out your insulin to carb ratios. Test before and after every meal and write it all down.

The most important thing to get right before playing round with your fast acting insulin is to get your basal right. If that's wrong, you'll never get your fast acting right. For every 1.6 mmol/l change in overnight levels adjust your basal by 10%, but don't have fast acting or food within 4 hours or so of bedtime.
 
Hi tom I can totally sympathise with you. I'm 32 and been type 1 for 14 years.

Until recently I was quite complacent with my bg's. But since january I've been trying to do better. I'm amazed at the difference with just regular testing and writing down my levels, by just
knowing where I am with it all seems to have helped!!!

I too am on lantus (currently 34 units) I am trying to carb count but notice my ratios vary throughout the day. I definately need more insulin in the mornings!! I don't think there is an exact formula that fits!

Have just started reading "think like a pancreas" too! This has helped me understand a lot more of how it all works! Carbs, insulin and how many other things can effect your readings!!

Just remember you can't go back and fix those readings (which aren't too bad!!!) and your already trying to sort out your future readings so are half way there. Hope the forum helps it's been great got me just reading about others experiences!!

Good luck!


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Hi, I was just reading your story Tom and the comments everyone has put and I am having the same issues at the moment.. Need to get back on track AND look in to the book 'think like a pancreas'

I also should contact my DSN and chase up the DAFNE program..!!



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