So Frustrated.

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Diabetes Treatment As there is currently no cure for the chronic, Diabetes mellitus – the emphasis must be on treatment and management to avoid complications. Please use this section to discuss how you carefully control and manage your Diabetes. Please let us know what is and isn’t working for you. Feel free to discuss all areas of treatment and management of Diabetes including diet, exercise, weight loss, insulin usage, oral drugs and more.


So Frustrated.


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Old 02-07-2013, 04:05   #1
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Default So Frustrated.

Hello all. I decided to join the forum because I'm so sick of my diabetes being out of control and I want that to change.

I've been a type 1 for 10 years, so you'd think I'd have it down by now. I'm 20, female, in college and at a healthy weight (140lbs, 5' 7") though I'd like to lose a little. I don't really have any other health problems, but diabetes has given me plenty of complications I'm sick of dealing with.

Basically, I would be extremely grateful for any tips to get my blood sugar stabilized and in a normal range--or at least better than now--as quickly as possible. Here are some things to give you an idea of my past, and what I'm doing currently:

-I'm on Lantus and Humalog, using pens.
-I really don't want to use a pump, but I'll reconsider if I can't get my blood sugar significantly better in the next few months.
-My last A1C was 8.4, about a month ago.
-I can't remember the last time my A1C was under 8.
-The highest it's been was 9.9, and that was last year. I was really lazy about taking my blood sugar then, but it scared me as it should and now I take my blood sugar about 5x/day.
-I eat healthily, though I haven't always. I eat a mostly vegetarian diet with plenty of fruit (and some veggies. working on that)
-I'm NOT very active. I'm extremely busy, and I know that isn't an excuse, so short exercise suggestions might really help.
-I've had a terrible sleeping schedule for at least the past 6 years, but that's changing-- the past few weeks I've been getting 9hr/night pretty regularly.

Anyways, I've been trying really, really hard lately to get my blood sugar under control, but my first attempts have been met with yo-yo sugars, and a ton of hypos. For a very long time I was taking 12u Lantus 2x/day, and using a 1:10 Humalog ratio but that obviously isn't working.

I feel like fixing the Lantus dose first is a good step, and then focusing on Humalog ratios, but everything I've tried over the past few weeks with Lantus (quite a few things, I can list them if anyone's interested) have had varying bad results.

WHEW. Sorry for the wall of text! Anyways, I would greatly appreciate any advice, and ideas for first steps to take. I'm determined to get this under control.

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Old 02-07-2013, 05:18   #2
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Hi, Brinna, glad to hear from you. I'm barely a Type 2, so I can't advise, but some of our type 1's will come along soon. But I'd ask you to point your computer to Blood Sugar 101 and spend some time reading what Jenny Buhl keeps on there. She is type 2,but researches and gives her references and updates it all the time. Diet is the secret for those of us either type as well as meds for some of both types. You can get it under control and avoid the frequent complications and it sounds like that's what you are trying for. The good news is you can gain control and most likely lower the doses of your meds.

Hang on, type 1's will be along soon with a lot more info for you,




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Old 02-07-2013, 20:32   #3
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Hi Patdart, and thanks so much for the resource! I've started reading some of it and am going to try to get through as much as I can. Thank you for the encouragement and I hope to hear more from some Type 1's soon!

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Old 02-07-2013, 23:48   #4
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Welcome Brianna! Another T2 here but in addition to BloodSugar 101 there are two good books on using insulin that you may find useful: Think Like a Pancreas and Using Insulin.

Other than that I would second that notion that since the largest factor in blood sugar is diet, that is the first place to make changes. We have a few vegetarians here who have managed to tweak their diet so that their blood sugar is easier to manage and they can take less insulin. I have found that "a good diet" and "a diet that helps me control my blood sugar" are not always the same!

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Old 02-07-2013, 23:59   #5
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Hi Brianna. I have been a T1 for 43 years, I was diagnosed when I was less than 2 years old. The best book I have come across is Dr Bernstein's Diabetes Solution. It is a long book but he really tells you what you need to do to maintain great control. He has a very strict regimen but just reading the book fills you with a ton of information which will allow you to make more educated choices. A lot of us here do eat a low carb, high fat diet which really helps control your sugars. Obviously, going low carb, you will need to adjust your insulin accordingly. People here will be happy to answer any questions you may have.

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Old 02-07-2013, 23:59   #6
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Hi Brianna!

Patdart gave some good advice. While I don't have an exact DX, I spent some using lantus and novolog before getting control; last a1c was 5.3 and been off meds since last April.

Ill tell you how I worked things out. Going off standard ADA diet of about 240g carbs per day as starting point. I would pick one meal, lets say breakfast, and drop one serving, 15g of carbs, from that meal. So from 60 to 45. I would take my bolus and make sure to keep track of PP numbers to make sure everything was ok. I would hold at this level for one week to make sure everything was good. If I saw a decrease in fasting numbers below my threshold I'd adjust basal 1-2 units and wait a couple extra days so everything was balanced. Then repeat.

Took about four months but it was worth it.

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Old 02-08-2013, 00:53   #7
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Hi Brianna, welcome to the forum.
Another T2 here so don't have any advice to give. I just wanted to chime in with my welcome.

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Old 02-08-2013, 19:15   #8
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Thanks to everyone who provided book suggestions I looked all of them up and read what I could on Amazon previews and they all look incredibly helpful. I'm going to see if I can find any at the library (poor college student here!) before trying to purchase any, so hopefully I'll have some luck there.

Regarding the low carb diet, how low would most of you recommend? I feel like I'm not eating a ridiculous amount currently; I'm shocked that the "standard" is 240 carbs/day. I'd say I eat 80 - 120 carbs/day on average. Like I said I eat mostly vegetarian but do occasionally eat seafood (almost exclusively at restaurants).

For my insulin, I'm still really struggling with the Lantus dosage. I had changed it to 15 in the AM and 10 before bed, which worked at first but then began causing lows every night (weird because it's less than my old dosage). I cut it down to 15 and 5 and I still was going low! Last night I tried eliminating the PM Lantus entirely-- blood sugar a few hours before bed was 80 and right before was 84 so it wasn't going anywhere. I woke up at 350. I know about the Dawn Phenomenon but what makes no sense is that I'm going severely low with only 5u when 12 was fine before.

Thanks to all for the support and tips so far!

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Old 02-08-2013, 20:44   #9
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Quote:
Originally Posted by Brianna View Post
Regarding the low carb diet, how low would most of you recommend? I feel like I'm not eating a ridiculous amount currently; I'm shocked that the "standard" is 240 carbs/day. I'd say I eat 80 - 120 carbs/day on average. Like I said I eat mostly vegetarian but do occasionally eat seafood (almost exclusively at restaurants).

For my insulin, I'm still really struggling with the Lantus dosage. I had changed it to 15 in the AM and 10 before bed, which worked at first but then began causing lows every night (weird because it's less than my old dosage). I cut it down to 15 and 5 and I still was going low! Last night I tried eliminating the PM Lantus entirely-- blood sugar a few hours before bed was 80 and right before was 84 so it wasn't going anywhere. I woke up at 350. I know about the Dawn Phenomenon but what makes no sense is that I'm going severely low with only 5u when 12 was fine before.

Thanks to all for the support and tips so far!
I've been aiming to eat no more than 40 carbs in a day. You have to make sure to up your protein and fat if you do this... I'd recommend reading about the keto diet.

For Lantus... I only take it once a day, 80u, and my fasting numbers still aren't where the doctor wants them. Maybe take all of it before bed...that's what I'm doing right now.

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Old 02-09-2013, 00:06   #10
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You are probably going low because most Drs put diabetics on high doses of basal. So if you are eating lower carbs, then the basal that used to cover some of your meal is now too much. It is hard to get a really good basal dosage, you have to really go without eating for a full day. The basal should keep you steady all day long without bolusing or eating. Also, once you lower your basal, it typically does not last as long. Companies that make insulin could say their insulins lasted 24 hours because they did the study on large doses. With many insulins, the larger the dosage the longer it's duration. So now that you are taking less, skipping the night dosage will not work. Maybe try lowering your morning dosage and still take some at night. Also, it takes a few days for you to be able to tell if certain dosages are working. So once you make a change, give it a few days before changing again.

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