Hi
I'm new to the forum so I'll do a brief intro: my husband has type 1 (since age 18. About 20 yrs ago) and seems to be totally out of control of his blood sugars. I may get some of the details wrong but he takes levemir for overnight/morning basal and humalog for his bolus injections. He doesn't take a basal during the day because in the past injecting it twice has caused problems with overlapping effects. He does multiple daily injections, and this is actually many, many correction doses. He has never had brilliant control which we had always put down to problems with stress making his levels go high. Typically he roller coasters throughout the day between about 3 and something often in the 20's. He is up pretty much every night making more adjustments, I would say he is usually high in the night but he can often go low too.
In recent months his levels have got worse and worse. He has recently started the LCHF approach to try and improve things but I'm not sure if things have been worse since then. We cannot understand why after, for example, a lunch of Caesar salad (lettuce, dressing, Parmesan, chicken) his levels will shoot up into the 20s (and stay there for hours). His levels also tend to rocket after breakfast. He calculates his bolus according to the protein content of such a meal. As another example, yesterday he had no lunch at all and yet spent most of the day over 15. It will take hours and hours (I think maybe 6 hours or so yesterday) before they start dropping despite numerous injections. He then worried that he had over injected so then ate too much and spent the night mostly high again (and awake).
You may be wondering why I'm writing this rather than him. He refuses to ask anyone for help, as I think he thinks he needs to sort it out and understand it himself. He is very sceptical of the medical profession being able to offer him anything other than the standard advice so I'm trying to encourage him to access this forum instead, which I've recently discovered. He also, naturally, feels ill, utterly exhausted and miserable all the time - so he has a tendency to avoid thinking about it and just wants to switch off when he is home, either by trying to sleep or by watching something on the TV. He usually does not want to talk about it. He also says we never have time to talk because he thinks we need a decent chunk of time if we are going to talk, not just an hour here or there between dealing with the kids, and daily life etc.
I'm not quite sure what I'm writing for specifically, everything feels totally overwhelming. I obviously worry about his long term health (remarkably he's only had 'borderline retinopathy' flagged up on the past but that's been ok since, or maybe he's not telling me the real story). sometimes it's easier for me to not engage with it because when I do, it is too worrying and upsetting. He gets very irritable with his family. I feel hopeless and helpless. I sometimes make suggestions based on some thing I've read in this forum but I don't think he finds that helpful. He went down the road of getting a pump about a year ago and was approved but then decided against it (he doesn't really like the idea of it permanently attached to him and also thinks that it won't make any difference because the same issues will still be there, it's just a different mechanism for injecting). He has started recently started using the libre so at least we are saving his fingertips from multiple tests.
The things he and I have considered: stress is still a huge problem (he stresses about anything and everything. His work (he is a managing director of a very small company) is a constant source of stress and he always stresses at the weekend eg about getting somewhere in time, how to spend his time most effectively and feeling under pressure from work hanging over versus spending time on his family/on the house). I have wondered whether sometimes his levels go up for another reason and then that makes him feels stressed. He is so sleep deprived it is making him insulin insensitive? Dr Bernstein says something about your gut sensing that you've had a big meal and reacts by dumping glucagon because it thinks your pancreas is about to release a load of insulin? His body is permanently under stress from being so high and he's so tired so that's casing insulin resistance? Dawn phenomenon? Do his basal rates need looking at? Even if we tried to check his basal rate needs by fasting I don't think we'd get anything useful because his levels would shoot up really high anyway. Lack of exercise: he hasn't done any in ages because he feels so rubbish all the time. Should we consider asking the medics to add in metformin (my idea, not his). Should he not eat at all unless his levels are in target range? Is there anything you can do to stop his liver dumping glucagon?
I guess my main questions are:
we assume his levels are sky rocketing despite hardly eating anything because his liver is dumping glucagon either in response to stress or because he is getting no energy from his food. If this is the case, how is the LCHF diet going to ever work for him?
What can I do to help him to help himself?
What can I do just generally, or not do to support him? Just any help/advice would be very much appreciated.
Sent from my iPad
I'm new to the forum so I'll do a brief intro: my husband has type 1 (since age 18. About 20 yrs ago) and seems to be totally out of control of his blood sugars. I may get some of the details wrong but he takes levemir for overnight/morning basal and humalog for his bolus injections. He doesn't take a basal during the day because in the past injecting it twice has caused problems with overlapping effects. He does multiple daily injections, and this is actually many, many correction doses. He has never had brilliant control which we had always put down to problems with stress making his levels go high. Typically he roller coasters throughout the day between about 3 and something often in the 20's. He is up pretty much every night making more adjustments, I would say he is usually high in the night but he can often go low too.
In recent months his levels have got worse and worse. He has recently started the LCHF approach to try and improve things but I'm not sure if things have been worse since then. We cannot understand why after, for example, a lunch of Caesar salad (lettuce, dressing, Parmesan, chicken) his levels will shoot up into the 20s (and stay there for hours). His levels also tend to rocket after breakfast. He calculates his bolus according to the protein content of such a meal. As another example, yesterday he had no lunch at all and yet spent most of the day over 15. It will take hours and hours (I think maybe 6 hours or so yesterday) before they start dropping despite numerous injections. He then worried that he had over injected so then ate too much and spent the night mostly high again (and awake).
You may be wondering why I'm writing this rather than him. He refuses to ask anyone for help, as I think he thinks he needs to sort it out and understand it himself. He is very sceptical of the medical profession being able to offer him anything other than the standard advice so I'm trying to encourage him to access this forum instead, which I've recently discovered. He also, naturally, feels ill, utterly exhausted and miserable all the time - so he has a tendency to avoid thinking about it and just wants to switch off when he is home, either by trying to sleep or by watching something on the TV. He usually does not want to talk about it. He also says we never have time to talk because he thinks we need a decent chunk of time if we are going to talk, not just an hour here or there between dealing with the kids, and daily life etc.
I'm not quite sure what I'm writing for specifically, everything feels totally overwhelming. I obviously worry about his long term health (remarkably he's only had 'borderline retinopathy' flagged up on the past but that's been ok since, or maybe he's not telling me the real story). sometimes it's easier for me to not engage with it because when I do, it is too worrying and upsetting. He gets very irritable with his family. I feel hopeless and helpless. I sometimes make suggestions based on some thing I've read in this forum but I don't think he finds that helpful. He went down the road of getting a pump about a year ago and was approved but then decided against it (he doesn't really like the idea of it permanently attached to him and also thinks that it won't make any difference because the same issues will still be there, it's just a different mechanism for injecting). He has started recently started using the libre so at least we are saving his fingertips from multiple tests.
The things he and I have considered: stress is still a huge problem (he stresses about anything and everything. His work (he is a managing director of a very small company) is a constant source of stress and he always stresses at the weekend eg about getting somewhere in time, how to spend his time most effectively and feeling under pressure from work hanging over versus spending time on his family/on the house). I have wondered whether sometimes his levels go up for another reason and then that makes him feels stressed. He is so sleep deprived it is making him insulin insensitive? Dr Bernstein says something about your gut sensing that you've had a big meal and reacts by dumping glucagon because it thinks your pancreas is about to release a load of insulin? His body is permanently under stress from being so high and he's so tired so that's casing insulin resistance? Dawn phenomenon? Do his basal rates need looking at? Even if we tried to check his basal rate needs by fasting I don't think we'd get anything useful because his levels would shoot up really high anyway. Lack of exercise: he hasn't done any in ages because he feels so rubbish all the time. Should we consider asking the medics to add in metformin (my idea, not his). Should he not eat at all unless his levels are in target range? Is there anything you can do to stop his liver dumping glucagon?
I guess my main questions are:
we assume his levels are sky rocketing despite hardly eating anything because his liver is dumping glucagon either in response to stress or because he is getting no energy from his food. If this is the case, how is the LCHF diet going to ever work for him?
What can I do to help him to help himself?
What can I do just generally, or not do to support him? Just any help/advice would be very much appreciated.
Sent from my iPad
