Jasmin2000
Well-Known Member
- Messages
- 184
- Type of diabetes
- Type 1
- Treatment type
- Insulin
Hi all, here's a conundrum that has flummoxed my GP and DSN.
Two years ago my A1c was 7.2 despite a low carb (30 g) diet and regular exercise. Once I got a CGM I could see exactly what was going on - I was getting BG spikes that plateaued at 10-12 for 3-4 hours several times a day, that were not due to carb intake. My DSN/ says it's likely due to counter-regulatory hormone responses (CRR) (epinephrine, glucagon, cortisol, somatotropin) - but responses to what he couldn't say.
In the last few months the plateaus have become way more frequent and higher, and I use fast-acting to try and push the BGs down. But the double whammy is that these CRR responses are incredibly insulin resistant. I used to inject about 10 units fast-acting throughout the day for my carbs, but now I'm injecting 20 units over each of the 3-4 hour plateaus just to keep the BG at 6-8. Increasing basal from 12 to 20 makes no difference to the plateuas and brings a danger of hypos once the hormones have subsided.
The only way I've been able to keep BGs down is to inject a large bolus of fast-acting and burn ca. 1000-2000 kcal on an excercise bike or a long walk/jog - but sometimes even this has no effect on my BG, which I don't understand as it should exhaust my glycogen reserves easily - where's the glucose coming from?
Anyways, would be grateful for any suggestions, questions or insights. Thanks folks.
Two years ago my A1c was 7.2 despite a low carb (30 g) diet and regular exercise. Once I got a CGM I could see exactly what was going on - I was getting BG spikes that plateaued at 10-12 for 3-4 hours several times a day, that were not due to carb intake. My DSN/ says it's likely due to counter-regulatory hormone responses (CRR) (epinephrine, glucagon, cortisol, somatotropin) - but responses to what he couldn't say.
In the last few months the plateaus have become way more frequent and higher, and I use fast-acting to try and push the BGs down. But the double whammy is that these CRR responses are incredibly insulin resistant. I used to inject about 10 units fast-acting throughout the day for my carbs, but now I'm injecting 20 units over each of the 3-4 hour plateaus just to keep the BG at 6-8. Increasing basal from 12 to 20 makes no difference to the plateuas and brings a danger of hypos once the hormones have subsided.
The only way I've been able to keep BGs down is to inject a large bolus of fast-acting and burn ca. 1000-2000 kcal on an excercise bike or a long walk/jog - but sometimes even this has no effect on my BG, which I don't understand as it should exhaust my glycogen reserves easily - where's the glucose coming from?
Anyways, would be grateful for any suggestions, questions or insights. Thanks folks.