So frustrated...advice?

Technology & Management
1

Hi,

I’m Ashley. I’m new here. I was diagnosed with TBD just 2.5 years ago when I was 23 years old.

I’ve maintained fairly good control ever since then…until recently.

My post meal blood sugars have been outrageous. My eating habits have remained the same. I’ve been using the same amount and type of insulins (Lantus in the morning, apidra with meals) and for some reason my post meal BG has been running an average of 235-285. That is 2 hours after I eat.

I’ve tried switching my Lantus to the evening instead of morning. I’ve tries changing my carb to inulin ration from 1:15 to 1:12. I even tried 1:10 this afternoon and still ended up with a 240 after 2 hours.

I’m so frustrated. Is it normal for your insulin sensitivity to change after having diabetes for a while? Any idea on why this may have started all of a sudden or what I can do to correct it?

I called my endo today for an appointment, but can’t get in for a month. I really don’t want to let the high BG go in for that long.

Any advice is appreciated.

Thanks!

Ashley

2

My only thoughts right now given that your carb ratio doesn’t seem to be changing the outcome at all is that you might need more lantus or to split it up.

When I started on Lantus we tried for a year to do one dose but my endo had warned me 90% of people need to split it into two doses (one AM, one PM) even though it’s supposed to be a single dose insulin; they said while that’s ideal it doesn’t work for everyone.

3

hello Ashley,

so I am not a doctor, so you might want to try this question with a cde or endo, now that’s out of the way.

typically your body stops making insulin completely 3 mo to 3 years after diagnosis it can be very long and everybody is different. if you had really slow onset, maybe you were making a lot of your own insulin this whole time, if you were then your bs control could have been awesome and easy until now (and when you said that, it is what sparked my thought).

the general rule out of the “Think Like a Pancreas” book is: you have taken enough short acting insulin if your bs is no higher than 50 mg/dl at 2 hours than it was when you started to eat. so if you started at 150, then at +2 hours you got a 200, that means your fast acting was enough. This works pretty good for apidra or any lispro, does not work for “regular”. you can just keep increasing fast acting ratios until it works (only if you are totally comfortable, because it can be dangerous). the book by the way, is an excellent read in my opinion.

so yeah you can also have changes in sensitivity from stress, caffeine, irritations and inflammation, changes in sleep, jobs, housing, taxes, if you are also taking any kind of steroid, pregnancy, issues and problems with your adrenal gland, etc.

you could also take a look at the kind of carbs. for me, rice, potato, white bread and cereal raise my blood sugar faster than my humalog can bring it down. so when I know what I am eating, I take my insulin 15 minutes before I eat any of those. pasta, pizza, Chinese food, ice cream, my sugar rises slower than the humalog so I use a special recipe for those foods (I pump and it’s called a “square wave” bolus on mine). for more information check carb types for “glycemic index”

you wouldn’t want to change lantus injections, unless your bs is rising or falling when you are not eating. that basal insulin won’t help your post meal numbers at all.

I get rammy sometimes so if it’s cereal (for example) it is good to actually measure serving sizes. I tend to unconsciously increase how much I pour out over time so the scale doesn’t lie.

cheers no worries, everybody’s sensitivity is different. it also changes as you get older. I had a 1:8 in the morning and 1:12 in the evening. I changed my exercise habits and now it changed to 1:10 mornings and evenings. go figure. this is part science and part luck: so good luck!