Adding on to @joe 's recommendation for Glucagon - there is now an inhaled version called Baqsimi. I’ve never used it but it sounds much simpler and less intimidating than the other form, which must be mixed.
People have their own preferences for what to carry to treat lows. Liquids work faster (as I was once told) so juice is an option, but for something solid I find Clif Bloks energy gels work well. I like the consistency of these much more than glucose tabs. Found them at a sporting goods store. I’ve also seen Gatorade gels at the grocery store. I haven’t tried them but imagine they’re similar.
I know you’ve got a lot on your mind and there are plenty of options for treating lows so this isn’t high on the list - just tuck that in the back as something to experiment with.
I was diagnosed long before BG meters, much less CGMS with alerts, and feeling somehow different or “off” woke me up. Getting a CGM will bee enormous peace of mind for both of you. BTW, while you’re waiting on or considering Dexcom there is one called Freestyle Libre. I keep a Libre(1) as “Plan B” in the event there’s an issue with my Dexcom or supply order (very rare in my case). I swipe the reader over the sensor in my arm and see my numbers and a graph.
The Libre2 has alerts you can set to sound so long as the sensor and receiver are within 20 feet - without swiping.
Oops! I went back through the thread and see she uses the Libre. Check out the Libre 2 though if you haven’t already.
Update on my wife’s supper BG.
4:30pm her BG was 130
She planned out her meal and total carbs at 34. She took 3 units of humalog based on her ratio of 1 unit per 12 carbs.
4:30pm She took 3 units and ate at 4:45pm
6:00pm BG was 134
7:00pm BG was 174
8:00pm BG is 239 and rising
She ate a folio cheese wrap with organic turkey breast and avacado mayo, had keto granola with unsweetened almond milk and a few siete chips.
Just don’t understand why it’s doing what it’s doing.
Hi @aftrshok . If I recall your wife just saw her doctor on Friday and got the new regimen. It can take at least 3-5 days for things to “settle in.” Her numbers looked great until the last one - how do they compare overall with her readings before the changes?
I’m not a medical professional but it may be she needs more basal insulin later in the evening. I use a pump, and am not familiar with Toujeo and its patterns, but I’ve read that some people split their basal insulin or adjust the time they take it to accommodate the times they run high. If it were me I would continue to keep detailed records and see if there are any patterns that stick out while waiting to check in with the doctor.
It would be hard to pin point a pattern before she made the change in meds. At that time she wasn’t taking anything to cover the carbs so her events were high all day long until early AM for the most part. She will continue to keep detailed records and see what the doc does next.
That makes sense. It seems the changes are starting off well.
Hi Brian! @aftrshok I have only been a type one diabetic for a year, but I have learned that I often have to account for more than carbs in with my insulin. Protein and fat will raise my blood sugar too. It is just a delayed rise. Most of the time the rise happens 2-4 hours after eating. I often have to give myself more insulin 3 hours after eating. I was a middle school teacher years ago, and am so glad your wife has a principal who is willing to accommodate her! What a blessing!
When she went to bed at 10pm her BG was 282 so she took 3 units and her this was her BG at 12am 242, 2am 222, 4:45am 212. Of course she didn’t wake up on purpose at those times, those seem to be her normal get up and use the restroom times. I hope once she gets her BG under better control that she doesn’t get up as much.
BG was 252 at 6:30, 3 units taken before heading to work.
At 11:00am it’s down to 158.
We are going to switch to decaf in her coffee as well as eliminate Skinny Syrup that we use. It has Sucralose in it so maybe that’s causing the sustained highs (0 carbs). She also uses it in her water all day. We’ve cut it and caffiene out before but that was when she was taking different meds and everything was out of whack all over the place, so we aren’t sure if that really matters in her case or not.
@aftrshok I’m a relatively new T1 (LADA as of last Nov), misdiagnosed my first 8 years as T2; last summer, meds stopped working, BG’s went wild. Reading your description of symptoms, I’m sitting here saying, “she’s me.” In my case my PCM didn’t get it, in your’s even your first Endo didn’t get it. Glad you got a new one that had a clue of what to look for, test’s to run, etc. I wouldn’t be surprised if the GAD comes back positive along with very low c-peptides.
I would think after she gets on insulin, gets it dialed in a bit, and gets her numbers down, the frequent bathroom breaks may reduce significantly. It’s good her principal is aware and sounds sympathetic, I recommend careful consideration of who she has/will advise, though it may be OBE at this point. Some don’t tell but a select few; others put it out in the open. Either way, there will be those that listen, accept, learn, and willingly help; other will listen to the rumor mill and pre-conceptions despite the facts. I think an “open book” and using it as a “teaching” opportunity is best (sounds right up her alley!); seems a great , but that’s up to her.
Glad you’re here, hope your wife will participate too!
Definitely check with the endo or DNE. Depending on what the rest of her log looks like over the last several days, any patterns there will point to whether she might need a higher basal rate, for example, or maybe a tighter insulin-to-carb ratio at dinner, or both, or neither, because there is something else going on entirely.
The goal is to change only one thing at a time, and then give that one change a few days so you see a pattern, and then let that direct you to make the next change. It can be frustrating, but it’s the only way to get useful information. Changing multiple variables at once is obviously a problem for understanding cause and effect, and single data points are just subject to too many variables to make good inferences.
Is her BG higher than expected because: her ratio needs tweaking, her basal needs tweaking, she miscounted carbs, she’s fighting off a cold, she was feeling anxious or excited about something, she had an adrenaline rush to get her through a work deadline, she got less exercise than usual, she pushed herself super-hard in training that day, not all the insulin went into her body (sometimes that happens, like if you accidentally take the needle out too fast), the insulin went bad, etc., etc., etc.? Not to overwhelm you, but just to illustrate that with all those possibilities, you really need to look for trends to make good decisions.
As she gets more experience, she’ll start being comfortable with making adjustments herself, but while this is still new, lean on her medical team. We used our diabetes nurse educator (generally more available than the endo) a LOT when my daughter was first diagnosed. She was terrific — very knowledgeable and very responsive and very patient. Your wife is entitled to help like that, too, so if you don’t have someone like that in your arsenal, keep looking until you get one! 
She had some leftover beef roast for lunch today that I made the other night. No carbs in it but maybe a trace amount from salt, pepper, onion powder. It jumped her sugar from 160 to 223 in an hour. She hasn’t been below 160 since supper last night and that was before she ate. So how do we combat a spike in sugar that could be caused from protein and fats?
Heard from one supplier on getting a Dexcom. They ran it thru her medical insurance and let me say, can’t afford to do that. $1,700 upfront covers 3 months and then it’s $400 a month until she hits her deductible which than drops the price down to $200 a month. She has a really high deductible which makes this not an option.
@Tlholz I’m sure she’ll hop on here once she’s not so overwhelmed with everything T1 wise. I’m doing the best I can to help her and keep her from getting discouraged but it’s not been easy.
@srozelle I think we will let this ride before changing coffee, sucralose and see if her Endo changes her basal dose or her carb ratio at the end of this week. I agree, to many changes at once makes it hard to pinpoint anything.
It’s good your trying to be as helpful as possible. I’m grateful my wife does the same, and I probably don’t say so enough! I know my frustration level overflows frequently, while not aimed at her, she gets an earful now and then: I think she understands, probably need to explicitly tell her my appreciation more often. If your wife does likewise, consider the source and please be willing to discuss it with her at an opportune time (probably not when any outburst is ongoing!).
You’re doing the right things. Keep taking good notes, call your medical team as often as you feel the need (if you’re worried, just call. Better to ask and be reassured than to not ask and have a problem get worse!), and check in with us, too. We’re all here for you and your wife anytime. 
We are all on your side Brian @aftrshok seeing you working so hard for your wife. Diabetes management can be very difficult at times.
I doubt that the onion powder, salt, or pepper contribute to her spike in glucose level so, something else is at plat. It could be the meat, yet for me, to spike like that I’d need to eat a very large amount.
I don’t recall if any changes have been made in her background insulin doses. The human body needs insulin present at all times even when we do not eat carbohydrates. Without insulin, glucose level will increase throughout the day just from “normal” activity - this should be discussed with her doctor.
I enjoy a cup of coffee and am trying to figure out the caffeine. I enjoy “a spot” of Coffee Mate sweet cream - I believe it’s 5 carbs per Tablespoon which isn’t bad - them I discovered my “spot” was 7(!)Tbsp! I usually drink decaf - keep in mind if still has some degree of caffeine in it.
I’m going to rid in a few random thoughts here: you mentioned she was on a Keto diet. There’s a discussion on Catalina Crunch cereal - Catalina Crunch Cereal - Food - JDRF TypeOneNation Community Forum
I looked it up and it’s a Keto product and some found it raised their numbers, perhaps inexplicably. That sent me to Google Keto diets and this headline stuck out -
Why You May Have High Blood Glucose on Keto - Aaptiv
That’s a headline that stuck out and one article is not research; but it could be something to look into.
I had never heard of Folio wraps so looked those up too and saw the are gluten free. Some people must avoid gluten due to celiac disease, but “I’ve heard” (famous last words) that it may not be healthy to avoid it if there’s not a medical diagnosis for doing so - some people may choose to eliminate gluten when they do not really need to, and may be depriving their body of needed nutrients. Again - “I’ve heard.”
I know you’re overwhelmed and I just gave you some links to add to your lengthy list. I’m not a medical professional, just sharing some possibilities - you never know when you might come across something.
Have you seen a nutritionist? They can shed some light on what I just shared - possibly shooting them down - and help make sure she’s getting the nutrients she needs, whatever eating plan she chooses to follow.
I know you all might not want to read this much info every day but it helps me get a better feel for what’s going on pattern wise by discussing it and typing out her numbers. Plus you all have lots of knowledge and experience in dealing with T1D.
These are yesterdays numbers for here, not bad compared to other days but still not ideal.
5:00 = wake up 214
6:30 = 254
6:30 = 3 units Humalog / 15 units Toujeo - coffee with 1 tbsp butter, 2 tbsp heavy whipping cream and 2 tbsp skinny syrup
9:00 = 189
10:50 = 158
11:35 = 182 - 1 unit Humalog for correction
12:34 = 176
2:00 = 223
4:40 = 167
4:45 = 4 units Humalog for 33 carbs at supper - she had a cheese wrap with turkey meat, 12 siete chips
5:50 = 114
7:20 = 148
8:30 = 181
8:45 = 3 units Humalog for correction and carbs from snack of crackers and cheese
9:15 = 205 bed
11:30 = 190
Overnight it climbed to 330 and when she woke this morning at 5:00 it was 281 and at 6:30 it was 315 (she had a cup of coffee just like yesterday)
That’s where we are at so far today, she’s calling her Endo and see what he thinks. Overall they weren’t ideal numbers but she stayed out of the 200’s for the most part if you through out the high events.
Looking back at her logs from the past 5 days, it doesn’t seem like the Humalog drops her much per hour except for at supper time and then has the delayed rise.
I’m starting to think if she has too much fat, that she has a delayed rise which I’m seeing in her logs.
@Tlholz She tells me daily how much she appreciates my help and support. I wouldn’t have it any other way. We are both in this together.
@srozelle She keeps excellant notes, part of her being an exremely orgainized person with a touch of OCD…LOL
@Dennis Thanks!!!
That was my thought as well, she only had about 5oz of the roast.
They haven’t changed her background insulin dose yet, she’s calling today.
@wadawabbit Ummmm that’s a pretty big “spot” haha
I read the second link last night that you posted. I’ve study so much on Keto and I’m not sure what to believe anymore with what anyone says. I am starting to think she will have to change how she eats and possibly move away from being a strict Keto since she is T1D. She has not met with a nutrionist yet because all they tell you to do is eat 30-50 carbs per meal 3x a day, at least the one’s in my town do. The one at her new Endo might not be the same but they are 1.5 hours from here.
As long as your wife is on board with it, share as much and as often as you like. We get it, and it IS helpful — for some personality types more than others — to process in writing for others’ feedback.
I agree that it looks like progress, and I expect your wife will get some good suggestions today. Keep us posted, and on behalf of spouses everywhere, thanks again for being there for her!
@srozelle Yep she’s on board for sure, she’s not afraid of sharing her experiences and will openly talk about it with people. Especially those that are in the same fight as her.
I think she might of over-corrected this morning. She took her normal 15 units toujeo and she took 5 units of humalog (4 was on her sliding scale and she did 1 extra for the coffee) dropped her from 318 to 118 in an hour and show going low on her monitor. She’s going to scan every 30 minutes so she can make sure she doesn’t get hit with a surprise hypo event.
Oh let me add this, as much as me sharing about her numbers etc, being about her. It’s also for me as well. I’ve been worried about her for awhile and more so lately. This site and everyone here that I have met so far have kept me from being so stressed out and giving me a place to ask questions, that’s something I don’t have around here. There is no one I can bounce ideas or my thoughts off of about T1D, except for here.
She just texted me and her BG is 65 and dropping. She has juice to drink but is alone in her class with kids right now and I think she’s a little scared.
She ended up in the nurses office and her BG is coming back up, 75 now, it was down in the 50’s.
So sorry that she was misdiagnosed and has gone through all this! Going on a pump improved my T1D adult daughter’s quality of life and her blood sugar control. I would recommend the TSlimX2 pump (which is used with the Dexcom G6 CGM). My daughter currently uses it. (She had previously used a Medtronic pump and OmniPod.) The TSlimX2 is the best pump she has used and, in our opinion, is the best pump on the market now. Yes, it has tubing, but the tubing is not as big a deal as people think it is – especially for an adult. If she gets it, have her buy an insulin pump belt to wear around her waist (under her top) to hold her pump and tubing.