type1 fluctuating BS regardless of insulin/food intake

[Selina]

I have been diagnosed as having type 1 diabetes for a year now.I am 49 years of age.
I am finding that regardless of what i eat or how much insulin i take my BS are constantly going up, often going over 30.
also, even if i eat or drink nothing at all my BS continue to rise.
when i do take insulin before eating, sometimes for example, i'll have a 5ml jab and it covers the meal, but then having the same dose for the same meal will send me hypo, i am, therefore, worried.
other times i can consume a packet of sweets and my BS is not affected at all. why?
the insulin I am on is novorapid for meals and Lantus at night.

Also, i do not eat 'regular' meals, often only one a day,( not high fat/sugar)
i keep losing weight and my eyesight is often blurred.
Although I am a smoker i do not have a high sugar or high fat diet, carbohydrates affect my BS far more than sugary foods.
I'd appreciate your help on this matter and look forward from hearing from you.

Many thanks
Selina x

 

[cugila]

Hi selina.
Welcome to the forum.

If your Bg levels are climbing then you need to discuss this with your GP ASAP. There may be some other underlying medical condition which needs investigating. Your medication/dosing might need
a review.

Are you on any other medications probably not Diabetes related which could be having an effect on your Bg levels. As for blurred vision that would no doubt be a symptom of running high Bg levels, hyperglycaemia.

You need to address the above before looking at any dietary/Insulin changes.

Carbohydrates in the diet are more important to a Diabetic. They convert 100% to glucose when ingested, therefore any reduction in them can often result in a lowering of Bg levels, often substantially. Sugar's when listed on labels, are contained in the total carbohydrates numbers.

 

[noblehead]

Hi Selina,

Usually in type 1 diabetes, where BS rise continually, it can only mean one of two things, to much carbs or not enough insulin.

As Cugila has pointed out, best see your doctor to eliminate any other cause which may be responsible. I would suggest that you keep a diary of the food you eat, write down the total carbs and the units of insulin used, then monitor your blood glucose hourly and record these in the diary. Should your BS rise to much, either reduce the amount of carbs or increase your insulin by 1-2 units. Again, record your results and see if your BS stay within acceptable range.

Often a rise in BS without eating means there is not enough background insulin, in your case lantus. This may need a small increase again of 1-2 units. Smoking with diabetes is not advisable, as you probably have been told by your GP, likewise with packets of sweets, although small amounts can be eaten but you must cover with insulin.

Make a appointment to see your GP or DSN, take along your diary and show them your results, this way they can advise you on where you are going wrong. Whilst you are there, ask about the DAFNE course in your area, this course is for people with type 1, which shows you how to dose adjust (matching the correct insulin to the carbs consumed) .

Good luck

Nigel

 

[catherinecherub]

There is a calculator here for,

Total Daily Dose Calculator.

Basal Dose Review.

Carb Factor.

Correction Factor.

http://www.diabetesnet.com/diabetes_tools/

 

[hanadr]

Selina
I suspct there is an underlying pattern which you haven't found yet. Definitely see your doctor, but in the meantime keep a detailed diary, of EVERYthing you eat and when and all your insulin doses. If you do this, it can help your doctor solve the problem In any case, not eating regularly won't be helping. If your Bg drops and your liver generates some by gluconeogenesis, that could lead to unexplained highs. If it turns out you are a T2 after all, that mechanism can work very efficiently.
Losing weight and blurred vision can be symptoms of High blood sugar. Both should improve once you get control.
Hana

 

[iHs]

Hello Selina

I'm just a few years older than yourself but have been insulin dependent since the mid 60's.
For the likes of bolus/basal insulin to be successful, diabetics have to learn to figure out what their correct insulin to carb ratios are. Unfortunately this can only be found out accurately by using trial and error. As others have said, use a bg record diary and write down all your results, insulin injected and most importantly - the amount of carb that you eat for each meal. If you aim to do bg testing every 2.5hrs you will see where are going right and wrong. Many people get told by dsn's to use the ratio of 1 unit bolus to 10grams of carb. This is not always sufficient though so by doing lots of bg testing, people can see if they need to use more than 1 unit to deal with 10grams carb. At different times of the day, the insulin to carb ratio changes for lots of people. So you will most likely find that you will need a fair amount of bolus for your breakfast meal, slightly less to cover lunch and then more to cover evening meal. This is all determined by what your bg levels are and what you intend to eat.

As you are injecting Lantus (once a day?) it's likely that if you don't eat breakfast and don't bolus any insulin, your bg level will go fairly high, so do remember to eat regularly. Lantus is well known for not giving 24hr control so people have to rely on the bolus too to keep bg levels all ok.

Total Daily Dose of insulin is usually calculated using 1/2 to 1 unit of insulin per kg of weight. I go for 3/4 to play safe. Some people use 50% of TDD to work out basal, and then 50% TDD for the bolus. You can use whatever % you want as long as it's adequate to control yr bg levels.

 

[janabelle]

Hi Selina,
I've been type-1 since '89. I was put on Lantus in 2004, and from then on had erratic and inconsistent control of my diabetes. I could inject the same amount of humalog(rapid-acting) and eat the same things, but my blood sugar was never consistent, just like you're reporting now. I spent 4 years trying to find a pattern to it, blaming my female hormones, etc; but there was no pattern. Some days my blood sugar levels were through the roof for no reason, and on occasional days it would be dangerously low, without any humalog-I was at my wits end trying to find out why. During this time my general health deteriorated; I was unusually exhausted,in a 'cloudy' state- didn't feel like myself, and suffered pain and other symptoms.
It was in the summer of 2008 when my clever husband told me that he suspected Lantus, and not Humalog, was the problem. How right he was, and I'm so grateful to him for suggesting it. I'm aslo eternally gratefull to the Insulin Dependent Diabetes Trust (IDDT) for their invaluable info.

I changed to Hypurin Porcine Isophane in May 08, and as they say "the proof of the pudding is in the eating". My BG control has been stable ever since; I wish I'd been prescribed it when I was diagnosed. I have since been in contact with many people suffer the same probs on Lantus, many of them on this forum.

I had no help from my hospital diabetes clinic, despite the erratic control, and have since made a formal complaint against my consultant for incorrect record keeping. I told her my daily BG levels were going from 2 - 15 mmol/ml , and she wrote that I had good BG control in my hospital notes :evil: . I also saw 2 other diabetes consultants (paid £200 quid to see one privately!)during the time I was unwell, and a change of insuln was never suggested. I was, however, misdiagnosed with Fibromyalgia.

Many people get on fine with Lantus, but for a significant number of patients, it can cause extreme problems.

Jus