Sudden Change, "Honeymoon Over"?
While I don't post often on the forum, I do lurk, and this forum changed my life. It was here that I was introduced to low-carbohydrates among many other things, and I never looked back!
For the past 2-years, give or take, things have been great, 5.9 A1C, no issues or complications whatsoever. Being a diabetic is no longer a thorn in my side, until a few weeks ago. :sad2:
Suddenly though, things changed. More specifically on the 28th of April. It was like insulin wasn't doing anything for me at all.
It was at that point that I noticed my Humalog pen expired in February of 2019 so I opened a new box, April 2019 expiration, and while it was the end of April, technically it was not expired. Note, I have used expired insulin for years with no issues. I keep it in the refrigerator and once I open it, I keep it in a dark cool place for no more than a few weeks, never had any issues.
Still, no change. I had my doctor call me in a new prescription, picked it up, and started using that. Still, no change. I figured with an April 2019 expiration and it being the end of April, maybe something was up. New insulin doesn't expire until April of 2021.
While I generally am around ~50-grams of carbohydrates daily, on the weekends I splurge a bit. Over the years I have learned what to splurge on, foods that don't affect me as much as others.
For example, on Saturday nights I eat two pints of Halo Top ice cream, 120-grams of carbohydrates. This has been going on for years. I generally go low at night so I don't take insulin prior to eating the ice cream, I take it about an hour later. I take 7-units an hour after eating it, and I wake up at ~100. Prior to eating it, I'm around ~120, which is where I want to be before bed.
Now, forget it. I take the same 7-units, wake up around 1AM to discover I'm 300+, take 10-units, and wake up at 5AM around ~250, and take another 7-units, and then at around 7AM prior to my workout, I'm still ~150!
Another example, some weekends we eat Chinese food, and for the past few years I've taken 10-units for what I eat, and that's it, never had any issues. Very rarely I might have had a little bit more so if I'm ~170 an hour after eating, I'll take another 3-units, grand total of 13-units.
Since the 28th of April, I'll need about ~40-units to cover what 10-units once did.
Even throughout the rest of the week when I'm 50-grams or less with carbohydrates, which is usually six days per week, things are not the same. The times I used to have readings of ~90, which was consistent for years, literally like clockwork, I'm now ~150, having to take some Humalog to make up for it.
I take 20-units of Tresiba daily at 7AM and Humalog as needed. My average Humalog intake for the past 2-years was no more than 10-units daily with 50-grams or less carbohydrates. On my one or two splurge days, no more than ~30-units, if that.
I used to "brag" to my old nurse practitioner about the fact that I needed so little insulin and while she thought it was great, she always told me that the honeymoon would end.
Do you agree with that? Could that be the case? The same way type-1 hit me "overnight", does the honeymoon end overnight? There was no progression to this, no signs, no fluctuating readings, just one extreme to the other.
Nothing changed with my routines, life, or anything else. The only changes would be the expired Humalog, which I eventually took care of, and have the same results either way.
The only other change was the free samples of Tresiba that my doctor gave me. She gave me three pens and I'll assume they were refrigerated, but I don't know for sure. Either way, if I deduct 20-units daily and count-back, I was using these samples prior to the 28th of April with no issues, so I doubt that's the problem.
One last thing now that I'm thinking about it, but I doubt this has anything to do with it. I quit smoking cigarettes. I now use the Blu electronic cigarette device.
Assuming this is life now, is the answer to increase Tresiba little-by-little until things stabilize, and Humalog as well, when needed?
My next appointment isn't until August, which of course includes bloodwork. Previous bloodwork from a few weeks ago was great, everything was normal.
Could this potentially be something more serious that justifies an appointment and/or bloodwork sooner than later?
One thought that crossed my mind - look at checking your thyroid levels as they play a roll in your metabolic rate and digestion and thyroid issues can be one of those negative side affects of having diabetes.
So far my thyroid is fine but living with diabetes for as long as I have I have discovered that the later I eat in the day the more difficult it is to regulate my BG levels.
Food being digested while I'm sleeping usually has a negative consequence and for me. Personally I stop eating after 8 pm or I either have to give my self another shot of humulog or my BG levles shoot through the roof at around 3am - I'll wake up, mouth is really dry - test myself and whamo .... 22 mmol/l or 400 mg/dl.
So as a rule I stop eating after 8 pm - having thyroid issues can potentially delay the digestion of food until the middle of the night or eating late gives you the same kind of affect.
So if you are eating late or having thyroid issues this could potentially be the cause of your sudden BG issues.
Whatever the cause hopefully it's something relatively simple to resolve.
My last batch of blood work was done a month prior to this new behavior, on the 23rd of March.
I believe the results were normal as my doctor didn't mention anything.
I don't see T4 and T3 on this batch, she likely skipped it this time.
Prior to this was December of 2018.
T4, FREE: 0.9ng/dL
T3 UPTAKE: 28%
T3, FREE: 3.5pg/mL
THYROID PEROXIDASE AB: 4IU/mL
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