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Nightmare diabetes appointment

Discussion in 'Type 1.5/LADA Diabetes' started by smidge, Dec 10, 2014.

  1. donnellysdogs

    donnellysdogs Type 1 · Master

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    Yes I agree all the way through with everything. Amazing that her dad who is a fit, builder gets levels in the lower 3's too.

    She has a huge way to go. Many of the girls in the unit have been in before. When she says about hating the fat (still a size 6) I do state that her internal organs and brain and bones are repairing themselves before any fat goes on but even at a size 6 she hates her body. I personally think from speaking a lot to her that she will be in the revolving door with this disease. I have pointed out to her about her texts etc so she can physically see how bad her brain was working compared to now...so she can perhaps accept that her brain is repairing itself 1st from the nutrients. She has gained 2 stone from the carb laden diet so far but whether she will sink over christmas when allowed out is going to be different... Very hard getting her past the causation of the anorexia, this is just not happening...

    Her dad with low levels did not realise anything about needing food or getting any signals to eat at times of feeling drunk. It was me telling him he needed to that he took notice of...
     
  2. donnellysdogs

    donnellysdogs Type 1 · Master

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    Me too since adding fat in to my life long lower carbing. This has significantly helped me and no whacky knock out hypo's for 4 years now. Previous one was from bolusing for a high reading but was wrong.. Cos I did the test cos I felt low, corrected and bam... I wasn't low it was showing a higher reading cos of food on my fingers....

    Adding the extra fat in to my diet has enabled my brain more with hypo's. Except of course on this occasion!! Although I knew, and did everything I could I was out cold.
     
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  3. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    She could very likely be laying down fat, if they have her eating such a very high calorie diet. Her body should catch up in due course, but she may actually "achieve" a bit of a pot belly for a time. This can heal arming for her.
     
  4. donnellysdogs

    donnellysdogs Type 1 · Master

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    She just hating the fat piling on .. 80% carbs 20% other on her diet... 2st in 5 weeks!!! She just can't accept the fact of a thicker skin over her bones. She thinks every 1lb has gone to pure fat doesn't think that she is feeding her organs too.....

    Sad.. Very sad...
     
  5. LucySW

    LucySW Type 1 · Well-Known Member

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    Back to topic of balancing low BS with avoiding hypos?
     
  6. donnellysdogs

    donnellysdogs Type 1 · Master

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    Yep.. Don't eat chinese!!
     
  7. noblehead

    noblehead Type 1 · Guru
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    And don't inject 14 units upfront DD :)

    Do you not find with Chinese food that you get a delayed bg rise due to the fat content, I have to split-dose for such meals so give half upfront and the rest 2-3 hours later, I would have thought on a pump you would use an extended bolus for such meals.
     
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  8. LucySW

    LucySW Type 1 · Well-Known Member

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    Yes.
     
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  9. donnellysdogs

    donnellysdogs Type 1 · Master

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    No, the normal dosage up front, but then when I go to bed 5hrs later I stick on a tbr till morning as the carb value is so much higher and the shot it effectively knocks my basal out of sync hours later.
    Like christmas because I will allow xmas cake, etc etc all day long although I bolus normally which obviously is a lot extra it makes my basals for the day totally out of balance.. So have to switch to 250% tbr till I return to my normal salad n meat n veg etc..so this was reason for upfront bolus...
     
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  10. smidge

    smidge LADA · Well-Known Member

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    So, a bit of a mixed bag of results from my fastings with my new insulin regime this week. Much improved, with 4 days being 5.5 to 6.9 and, interestingly, no BG rise in the late afternoon/evening as I was expecting given that I've moved my evening basal back from 6.30pm to 10pm. The other 3 days were double-figure - well, one was 10ish, one would have been at least that but I woke in the night and hammered it down with a unit and a half of Apidra and the other was a whopping 14! No real handle on why such an inconsistency - the Insuman is clearly better at controlling this than the Levemir, but not perfect by a long way. I think the bad fastings were following a late tea - so just maybe it's the timing of the evening meal that is the issue - not sure why it would be as I give the same bolus for a meal eaten at 6.30pm as I do for one eaten at 8.30pm, so it should reduce the BG by the same but relatively later no? I hope it's not this as my job simply doesn't give me the flexibility to eat at the same time every day.

    Anyway, I'll play around with the doses a bit and see how it goes over the Christmas period when my routine will be all over the place. So far, Insuman is looking better for me than Levemir.

    Smidge
     
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  11. Scardoc

    Scardoc · Well-Known Member

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    Not saying the low carbing doesn't help but it's all different strokes for different folks. I have never required assistance with a hypo or had one I would even begin to describe as "debilitating" and I eat more than the recommended levels of carbohydrates.
     
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  12. Diamattic

    Diamattic Type 1 · Well-Known Member

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    I may be the only wondering about this but in that article linking Hypos to CV events i can't find anywhere that defines what reading is considered 'hypo'. I am wondering if they mean severe, unconscious events because they mentioned that only 14% of T1D and 18% of T2D experienced a'hypo' event within the 5 years of monitoring.

    I find it hard to believe that only 14% of T1Ds experienced a BS in the 2s, or 3s.. those numbers seem like they would be very common.. but unconscious events, ya i can see only 14% of people experiencing.

    Without reading the paper, which i plan on doing later tonight after i get access to it (finger crossed) I assume they mean like, real, full hypos below 2mmol/l

    What do you guys think hypo means here? lol
     
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  13. Brunneria

    Brunneria Other · Moderator
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    They might mean hypos that required intervention from a second person. Or a health care professional.
     
  14. Diamattic

    Diamattic Type 1 · Well-Known Member

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    I think that is most likely, which means that keeping a low A1c is very possible without needing assistance. It seems very plausible that someone can stay within 4-7, with only a couple readings lower or higher. If you shoot for 6s i think youre best off.
     
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  15. iHs

    iHs · Well-Known Member

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    I am sure that Aventis csrtridges are the same shape design as Elly Lilly who do a nice 0.5ù pen......
     
    #175 iHs, Dec 23, 2014 at 11:33 PM
    Last edited by a moderator: Dec 23, 2014
  16. Diamattic

    Diamattic Type 1 · Well-Known Member

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    I wasn't able to get this particular paper, but was able to look up some other papers on the subject and found that the other papers collected data by reviewing hospital records, so 'hypoglycaemia' meant that a person was admitted to the hospital for either inpatient or outpatient treatment. Those people were then selected for the study and followed.

    So they don't mean hypos like - oh my sugars are 3.5mmol/L they mean like unconscious call an ambulance hypo.

    Some papers mentioned that when the body experiences a bad hypo somethings happen that allow for any built up plaques in the arteries to dislodge which can cause the CV events.

    Ill have to keep an eye on this paper and when its available in my account i will certainly read it haha
     
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  17. Diamattic

    Diamattic Type 1 · Well-Known Member

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    Also, i was thinking about a bit more and everyone has to remember that when research says things like "a 50% increase in risk" or whatever the percentage that sounds much worse then it actually is.

    For example if you risk before the event was 1 in 20, thats a 5% chance, now if that risk were increase by 50% (which sounds like a lot) you new risk is 1.5 out of 20, which is 7.5%.

    The key is to understand that initial risk first before worrying that its increasing and look at the other risk factors that play a role in CV events, such as hypertension, family history, cholesterol numbers and if you're still worried try reducing the other factors as much as possible.

    Also this study only accepted people 30 yrs and older, i would think the CV events were likely more probable as the people got older as it is in normal life. Just something to watch out for i guess, seems like low carbing may be the way to go if you're really worried or an insulin OD.
     
  18. smidge

    smidge LADA · Well-Known Member

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    Hi iHs - yes, the Aventis cartridges do fit the Lilly Humapen Luxura HD and it is a really good pen - I was using this for my Apidra for 4 years. Unfortunately, when I started having issues with my levels, it was pretty hard to convince consultants, DSNs etc that it wasn't because of the pen, so in the end I decided to change to the new JuniorStar pen that Aventis have brought out. I actually really like it and now use them for both my Apidra and Insuman insulins. My only slight gripe with them is that the body of the pen is very short, so my finger sometimes gets in the way of the plunger going all the way in and delivering the full dose. It's not a big problem but just means I have to be a bit careful how I hold the pen.
    It might be a problem to someone with bigger hands though.

    Smidge
     
  19. smidge

    smidge LADA · Well-Known Member

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    Well, my new insulin regime seems to be working much better for me. My fasting levels are considerably improved - only one double-figure fasting in the last week - and that was Boxing Day, so probably a result of random eating at random times! Overall, my Libre data shows that I had two double-figure spikes over the whole Christmas period and that I had three times when my BG dipped a little low (a couple of 3.6s and one down at 2.9). Other than that, I had a period of time in the 8s because I deliberately under-dosed as I had a three hour drive to do. All my other Christmas readings were within my target range of 3.9 to 7.8. I dread to think where my levels would have been over Christmas on my previous regime, so i'm very happy with the Insuman as my evening basal for the time being - still a little tweaking to do, but I feel like I'm getting there!

    Smidge
     
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  20. elaine77

    elaine77 · Well-Known Member

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    It all sounds so confusing when everyone discusses ratios and being on a basal/bolus regime I'm not sure I could manage it as I don't understand it at all.

    I take mixed insulin twice a day and my levels are nearly always between 4 and 6, fasting at 5 and with the odd spike over Christmas.. Maybe I'm still producing a bit of my own insulin then coz it can't be this easy to keep levels in range....
     
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