Type 1: Exhausted

[samantha13]

I've tried so hard this past year. I attended dafne in Feb and my average bg has gone from 12 to 9. Not great I know but I feel I've worked really hard to get it down that little. My last a1c in March was 8.9 and we hope to apply for adoption this coming year they want my a1c 7 or lower. I bought myself the libre to see if it can help but to be honest seeing the constant spikes after I eat is more disheartening than motivating. I'm always above the graph. I feel I'm constantly correcting at each meal. I tried pre bolusing for breakfast this morn for the first time. I had 35gcarbs and still spiked to 16. I just feel overwhelmed and a burden to my husband. This adoption lies on my shoulders and I'm constantly thinking about diabetes, checking my bg I just don't know where I'm going wrong. I did basal testing of my night time levimer twice last week and it seems to be the right dose think I'll check my daytime this week. Sorry for the long post I just needed to get it off my chest I feel so emotional. If I can't get control of this blasted disease we may never have our family.

 

[azure]

You need to cut yourself some slack @samantha13 Too much pressure can actually be counter-productive. Type 1 is hard - you're doing ok

You CAN sort this You can improve your HbA1C - it'll just take a little time and experimentation.

And you're definitely not a burden - to anyone!

How far in advance did you pre-bolus?

 

[samantha13]

My bg was 9.7 at 9am so I took 4u to correct and 7u for the 35g carbs. I kept checking for the arrow to go down on the libre but after 30mins it hadn't and I panicked with having the iob and ate then. 1hour post it was 16.2 and now it's 14.6

Should I have waited longer? I had it in the back of my mind that the libre can be 15mins behind so that worried me. I know weetabix was a bit carb heavy especially when my ratio is 2u to 10g in the morning I may need to change my breakfast.

Thank you for your kind words @azure but I see my husband who is normally easy going and laid back getting a bit down and he'd never admit it but I know it's because I'm not where we thought I'd be with my numbers.

 

[Juicyj]

Hi @samantha13

I agree with Azure, you need to ease up on yourself, getting frustrated or stressed won't help your BG levels.

Personally I find breakfast the hardest meal of the day as i'm more insulin resistant in the morning even with taking my insulin 20 mins before eating, so I purposely eat a low carb meal then, so omelette, bacon and eggs, yoghurt and blueberries that type of thing, I find carbs easier to manage later in the day as i'm more active and I don't spike as high, so maybe just focus on changing this one thing ? By the way I tried eating brown toast this morning and 2 hours later I was 13.6, so back to yoghurt again tomorrow !!

Try not to get frustrated you are doing brilliantly already bringing your HbA1c down, but don't let the morning readings over whelm you hun x

 

[azure]

Again, sadly there's no one answer as we all react differently so, tiring as it is, experimentation is the way forward.

For me, if I'd woken at 9.7, I'd have corrected for that alone (ie not bolused for any food, just a correction dose). Then I'd have waited until my BS was down to around 7, ideally below 7, then I'd have bolused for my breakfast and waited my normal time (which for me if I took Humalog would be 30 mins).

Many people have to bolus most in advance for breakfast. It's also when I need the most insulin.

(And perhaps your husband is frustrated with the diabetes on your behalf. Often it's only at times like this that the stupid Type 1 demonstrates what a pain it is to people who don't have it. So you're not the 'burden' - the diabetes is)

Edited to add that your 35g carbs was a perfectly reasonable breakfast, and I have around 45g carbs most days

 

[samantha13]

Thank you @Juicyj and @azure that's two things I'll definitely try..I can see that lower carb breakfast def makes sense and I'll wait for my correction to have worked beforehand. Will continue battling on. Nothing else for it thanks again xxx

 

[azure]

I'd also add that if I start the day high, then it's more of a struggle to get things back on track.

The fact your Libre wasn't showing any movement might suggest your BS was taking a while to fall, hence the spike.

On a day when you start at a BS of 5-7 you should be able to better see the best time to pre-bolus. I've never used a Libre, I just tested every 5 or 10 mins after bolusing. I then found that 30 mins was my 'sweet spot' for bolusing when I had normal sugar. If I was low, I'd bolus less in advance, and if high I'd do as detailed above.

 

[Juicyj]

Try to think of all of this like a learning curve, it's about experimentation and knowing how your body responds, recording all your readings against food eaten etc will give you more knowledge in managing your condition better. Each one of us is different but knowing what works and what doesn't helps us to be more confident and achieve a better HbA1c. If it doesn't work today try something different tomorrow - you will get there

 

[samantha13]

I can't thank you both enough this morning @azure @Juicyj you've turned me from a crying mess back to my hopeful self I think I've felt the pressure building for a while and this morn it overflowed. I'm trying to do too much at once maybe. I'm going to focus on starting my day with a lower number and working out the right pre bolus timing with a lower carb breakfast. Thank you both xxx

 

[azure]

Yes - a plan is a fab idea

Improving control is hard, It's like chipping away at a lump of rock to make a statue. You need to plan out what bits to chip away at first

You've made a great first step by doing some basal testing Getting the basal right will lay a strong foundation for you to build on.

Another tip I've found helpful is to stick to the same two or three breakfast and lunch options most days. It saves a lot of brain effort and means I only have to think about the evening meal. Routine is also good when you're trying to improve control as it removes one variable - foods. if you can just think "Right - I'm having a sandwich and an apple for lunch" (just an example) and know how far in advance you need to bolus and how much insulin to have, then that removes a lot of worry and uncertainty. Yes, there'll be days when your BS is a bit off, but generally a routine helps, I find.

Never beat yourself up about 'bad' results. Try to work out the cause (if any) and then move forward. Nobody can be perfect all day, every day. We just have to do the best we can

You've already seen a substantial improvement in your HbA1C, so you're on the right path

 

[rockape37]

If your scanning your libre very frequently then you will see spikes. Your going to spike anyway even 2 hrs after your meal. Like as already been said cut yourself a little slack.

Another point to consider do your libre readings match your actual finger pricking readings? I bet they don't, some say that the libre is somewhat delayed to your actual blood glucose readings taken via finger pricking.

Maybe remove the libre for now to ease off the pressure on yourself, that could in itself lower your BG a bit as stress is a BG raiser.

Regards
Martin

 

[fletchweb]

What I find is as important as diet and insulin dosage (and very seldom gets discussed on these forums) is physical activity/exercise. It's easy to live a sedentary life focused on carb counting, numerous testing and insulin adjustments but you would be surprised how much easier it is to maintain a more normal BG Level if you're able to incorporate physical activity as part of your daily routine. I work on the top floor of my building so one thing I do to force that routine activity - I take the stairs - this averages out to 500 stair steps a day sometimes more if I have places to go - walking is a good one too if the weather is cooperating. Anything you can do to raise your level of physical activity (if you're currently living a sedentay life) will probably help. It can be frustrating - I've had diabetes for more than 50 years and I'm still learning Don;t put too much pressure on yourself. I'm sure you will work it all out.

 

[samantha13]

Martin @rockape37 I started my sensor 2 weeks ago this coming Friday and whilst hoovering just now I banged into the wall and knocked it off. I am so relieved. I'd become a bit obsessed with it and put pressure on myself. I'm going to give it a break for a week or so to see if I can make a difference with the advice in this thread. Thanks for your advice

 

[samantha13]

@fletchweb my husband is very much into fitness and I am the opposite! I am recently seeing the benifit of walking after breakfast and evening meal on my days off and am lucky to have his encougement. I'm going to try to increase my activity every day. Thank you

 

[slip]

I'll vouch for/second what fletchweb said. I'm certainly not as active as I use to be, but I'm no couch potato - I use to have okish control, this spring just gone instead of using the p&r to work I biked into town - it's only just over 2.5 miles and the weathers has been good, some days it takes me 10mins others a leisurely 20mins but my blood control has been so much better, in fact I am still cycling in - and will continue to do so. I was amazed at just how much of an improvement 5 or so miles cycling has done.

 

[rockape37]

Martin @rockape37 I started my sensor 2 weeks ago this coming Friday and whilst hoovering just now I banged into the wall and knocked it off. I am so relieved. I'd become a bit obsessed with it and put pressure on myself. I'm going to give it a break for a week or so to see if I can make a difference with the advice in this thread. Thanks for your advice

Knocking the sensor off was meant to be then lol.

Regards

Martin