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Out of Control

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FreeSpirit

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6
Hi,
I'm new to this site and have come looking for some friendly advice!

My partner is type 1 (diagnosed at 16yrs and is now 29). He has been using a pump for a year and a half as his consultant gave up on injections as his sugars were ranging from 2.4 (sometimes less) and up to 30 (or more). He uses Novorapid.

The hospital have given him no support and have told him to 'play around with his insulin'. In some ways he has improved since we first met 3 years ago as he no longer blacks out but the downside is that I think he is becoming less aware of his hypo's & hyper's (I notice them way before he does). He has become very aggressive and violent at times (he is usually a very gentle person when he's feeling well).
I have managed to encourage him to change his diet (he ate lots of takeaways & ready meals etc) and now eats better but he feels that he should be able to eat what he wants as long as he gets his insulin rates right. I still think his diet could be better but he strongly disagrees and doesn't think low carb will make a difference. I agree that he needs to get the insulin levels right and know I can't force him to eat well (I can see how hard it must be to change) but the fact that he is feeling ill every day and his levels are all over the place, I am not sure how to help him. He has a very stressful job (owns his own business) and works long hours - sometimes until 4am, he has finally realized how much stress pushes his sugars up which is a start but he's not doing much to change this yet!
He has tried testing throughout the day and night (we were up 4 times a night mapping charts and food intake to show the hospital) and 6-8 times a day but they didn't even look at it. He tried eating exactly the same food for breakfast, lunch and dinner for a week to get his basal rate right but still can't seem to get his levels right.

Has anyone heard of violent mood swings and spiking bs on Novorapid? I did some research and one person seemed to have the same symptoms and felt very ill but since changing to another type of insulin feels so much better - has anyone come across this?
I'm not sure where to go with things now and what we could try - not helped by the fact that he is feeling unwell and is moody nearly all of the time and therefore hard to approach (& mostly not aware of his moods!). I know he is struggling and am desperate to help him.

Any suggestions would be very gratefully received!
Apologies for the long post!
x
 
Hi freespirit.

You have made the right decision in joining this forum. You should get all the answers you need - when everybody get's up ! :D

I see your partner is T1. I'm not much help really as I'm T2. Can I point you towards the TYPE 1 DIABETES posts. You might find something there that relates to the problem you have - and maybe some advice. Just be prepared for a long read.

Best of luck and hope things will improve for you both.

Ken :D
 
i'd give it a little while - save duplication. If you get no further replies then I would post there. check your messages ??

ken
 
Welcome to the forum, FreeSpirit.

What basal (background) insulin is your partner using and in what kind of doses?
 
Thanks for posting timo2. Hope this info helps:

His background insulin is:
Midnight - 3am = .55 units
3am - 7am = .7 units
7am - 12 midday = .6 units
12 midday to 6pm = .5 units
6pm - midnight = .55 units.

Bolus ratio = 1 unit of insulin per 7 carbs
Sensitivity 3.5
Total daily units range mostly in the 40's
 
Hi Freespirit

There are a few folks on this forum who have asked to be changed from Novorapid to Humalog or Apidra. Nearly all of them have experienced problems with high bg rises and hypos because of Novorapid's action. If you type Novorapid in the search box at the top righthand corner of this forum, you will be able to have a good read of all the messages. Also search Apidra.

The people who do ok on Novorapid appear to be kids and those who don't mind eating to its action on their blood sugar levels, such as bolusing about 20-30 mins before eating so that it gives the insulin more time to get going or eating smaller main meals and then a snack.

Probably being self employed and having loads of stress trying to run a business is not doing your boyfriend a lot of favours especially if he is having to stay up during the night to get work completed. It will throw his bodyclock out but on saying this, we all can strive on a certain amount of stress.
 
Hi FreeSpirit,

Ah, sorry, I missed the bit about the insulin pump in your first post. :oops:
Hopefully one of the pump users on the forum will be able to say if those basal rates are ok.

On the subject of low-carb, I'd say give it a go just for a couple of weeks. Most people are
won over once they see the (often vast) improvement in control that carb reduction brings.

All the best,
timo.
 
Ah, no problem timo, it was a long post!
He is reluctant to go low carb as he gets so hungry and carbs fill him up! What sort of things do you eat for meals? Can you suggest any good diet books for low carb - he gets stuck on what to have for snacks especially?
 
FreeSpirit said:
Ah, no problem timo, it was a long post!
He is reluctant to go low carb as he gets so hungry and carbs fill him up! What sort of things do you eat for meals? Can you suggest any good diet books for low carb - he gets stuck on what to have for snacks especially?
Click to expand...

Back again ! Try this link http://www.glycaemicindex.com/
I have found this site very helpful for sorting out low carb food and snack stuff. If you look around the site you will find lots of info. You will no doubt get other advice. You have to work out what is best for you and your partner. I know this works for me.
BOL
Ken
 
Hi FreeSpirit,

Here's a few snack ideas off the top of my head. All of these are low-carb and will see hunger off very nicely.

Macadamia nuts, brazils, pecans, walnuts.
Boiled eggs
Avocados (I get through quite a few of these)
Cheese - take a look at our 'What a friend we have in cheeses' thread for ideas.

Regards,
timo.
 
Thank you, you've all been brilliant. I felt a bit unsure if I should be posting as I'm not the one with diabetes but you feel really helpless when someone is having such a hard time and the hospital have been so hopeless.

I mentioned changing to a different type of insulin and he seems really interested in the idea, he has an appointment with his consultant next month so I hope he'll feel happy to mention it then.

As for the low-carb, I think I'm going to have to suggest the idea of cutting down on the bread etc a bit more slowly. I think he knows he needs to do more but is feeling guilty about having given up on sorting his health out recently. He does eat the things you suggested for snacks but he tends to go a bit mad and eat them to excess (not ideal when he has a bit of a food intolerance to some nuts!) so maybe he's not doing too badly - just a bit of refinement and cutting a few things out. It can't be easy to confront making so many changes.

Best wishes and thank you to everyone for taking the time to post
:D
 
Hi Freespirit,

The idea of a high carb diet filling you up is a very common one, and it does do just that but only for a short time. You remember the old joke about Chinese meals - you feel really full but then fancy another one an hour later? Well it's actually true - because Chinese food is primarily carbohydrate based and with little protein. It is protein that makes you feel full for a longer period, so in your partner's case I would suggest instead of dropping the carbs right down, try simply reducing them.

You can do this by still having bread, but use only Nimble or WeightWatchers which is half the carbs of "normal" bread. Cut down on rice and pasta and instead increase the protein portion of the meal. Halve the number of potatoes but make up the difference with another veg. That way you can introduce him to it gradually and, once he can see the difference it makes, I'm sure he will think again about carbs.
 
Hi Freespirit
I too live with a "difficult 2Diabetic. Look on the threads for last nights adventures
Might I add to the other advice you've had about meals.
If carbs are reduced, tou can increase fats by a LOT. It doesn't matter if they are saturated or unsaturated. Fats have the effect of satiety. In other words, not feeling hungry. cheeses are useful for this, they make good snacks too. I now have a box of those triangles in the fridge all the time.
I shop at Lidle, where thevariety of cheeses and cold meats is great. I stock up and they get used.
I'm a T2 and never hungry this way. I haven't eaten normal bread, rice or normal pasta for months.
 
I was interested to read these posts re Novorapid insulin - I too am on a pump and sometimes my post meal BG are high - yet if I do a correction bolus I then find I hypo a short time later. Might be worth me looking into this further.

Since really trying to watch the carbs I have found how much extra carbs there are in eating out foods - say a sandwich from a cafe would have approx 45-50gc compared to at home 30gc. This often catches me out!

With regards to Basal rates - my Specialist diabetes nurse has always told me that they should not fluctuate too much from hour to hour and to get the correct basal just start on one period of time say 7am - 11am and get this right then move on. Do this by fasting and then by eating carefully measured carbs etc. My carb to insulin ratio varies too throughout the whole day....and being a woman I just get it right then the hormones kick in and I'm all over the place again.

Wishing your boyfriend and yourself luck!

Nash
 
Hi Freespirit welcome to the forum

I’m an insulin pump user myself, and yes it does when going well give real advantages and flexibility to control… A very good book I can suggest is Pumping Insulin by John Welsh, it is the bible of insulin pumpers, and it enables you to get the most from your insulin pump.

As to eating habits, I think what needs to be remembered is that T1’s only miss the insulin part, and the body will utilize insulin the same as a non-diabetic, it getting the delivery and amounts of insulin required is the actually problem…

So yes on one hand you can eat what you like, but on the other hand you really need to know how to carb count and learn not only the different types of carbs react to yourself, but also the amounts of these carbs you can sort/deal with and keep with in the tolerances to maintain good control…

Setting the basal rates for a pump, can be hard going… I actually use 4 profiles on my pump…

2 different ones for home, a normal day and a housework day
2 different for work, one for when I’m working in the main larger kennel block and then another one for when I’m on the smaller 2 kennel blocks…

But sadly even after putting all the work into setting them, they aren’t set in stone, as a change in environment factors i.e. from summer to winter could mean that they need to be re-tweaked to maintain good control…

But I would put some of your concerns into both the pump and T1 forums as specific questions, and some-one should be able to give you more help…
 
Thank you so much for all your posts! I have taken all your advice to heart and its made me realize a lot - some things I hadn't thought of and some things we already do (which is also nice as it makes you realize maybe you're not doing everything wrong!!). Its really great to feel I've got some support - things had got pretty rough.
I was wondering how usual and to what extent aggression/violence is when having a high/low - I think its a hard subject to talk about as I know it must be difficult for a diabetic to come to terms with but any feedback would be helpful even if its just your own experiences.
Best wishes to everyone x
 
Hi again freespirit,

Aggressive behaviour is a common side effect of low blood sugars. The opposite is generally true of high blood sugars - feeling sleepy, lethargic, lacking in energy.
 
In the main, when my levels are highish or are fluctuating too quickly from high to low, then I become short tempered and can show depressive symptoms, and difficult situations and problems feel a lot bigger or intense to deal with…

Hypo’s generally confusion, but generally not aggressive in behaviour, but it has been known to be aggressive…

My husband is T1 as well, when he high he becomes tired and more quiet than usual, his hypo’s are in the main stupidity is shown, starts to make strange noises slurping his lips etc, and can be very difficult to get him to eat or drink anything…

But over the years there has been odd occasions where he has become very violent indeed, on one occasion when I got in from work and found him slumped on the settee semiconscious, I tried hypo-stop and he became very aggression and managed to grab my arm, and make a very good attempt at breaking it, at this point once I pulled myself away, I dialled 999, explained to control that he was diabetic and being aggressive so that the paramedics were warned to what to expect, unknown to me when this situation arises, they automatic call for police back up, I ended up with 2 ambulance crews and 2 policemen in attendance, the purpose of the police is if necessary they would have arrested and cuffed him so that the paramedic could then treat him with out fear of injury to themselves… All charges are actually dropped…

If you are ever faced with this problem, scared for your personal safety, don’t be afraid to phone for the paramedic explaining to control his aggressive behaviour, they sort the rest.
 
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