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Hey everyone New Guy here .... not sure if that was the best title but lets see if I can type in a coherent manner today without creating a novel.
So about midway into the whole covid thing I thought it would be a fun thing to go out and catch me a case of that diabetes.. I was 46 at the time no health issues ever, athletic extreme sports kinda guy. I recall going from feeling ran down to barely getting out of bed, muscle spasms head to toe, got to the point that walking was getting hard, blurred vision (could hardly see by the time I hit the ER) well in my great wisdom, paramedic background, and a dash of stubborn ass ways. I wrote it off to stress and dehydration and just not eating right. so I did what i thought i should be doing. full meals as best i could Juices gatorade water etc just flooding myself trying to hydrate. took three weeks to go from normal to calling a friend to take me to the hospital. by the time I was able to get from her car into the ER alone since covid at that time prohibited her coming in. quickly went from the front desk to a room, last thing i rercall was yelling at the dr to give me something for the F'ing pain. woke up a few days later in the icu. doc said later i was lucky i made it that night or i wouldnt have made it at all. blood sugars were north of 1000 and i forget the A1c number but it was only like .7 off their max chart and that i was probably one of his worst adult cases in his career. back then I was routinely 600 + and felt like shit if i went under 400. slowly it came down probably took longer than it should have cause i couldnt tolerate normal levels. fast forward a couple years>>>>>> I routinely wake up in the 300s and get my day going and begin the rollercoaster all day every day. get my G6 trial and bring my average of 351 down to 206 over the first couple weeks, (of course the VA has to screw my script up so back to strips n pricks) that was 3 months ago still waiting on new sensors.

okay so there is the back story and long part.

Im on novalog and lantus
the nova log is on sliding scale that has a baseline of 8 on average its 12 units per shot. lantus they had me on 25 for the longest and just recently wanted me moving it up to 50 so the last few weeks i have been increasing by 5 units per week which has me at 40 now.

this past 5 days i believe, I started waking up in the middle of the night feeling that amazing foggy dizzy shaky feeling I have come to love so much, check my sugar and one night was 40 another47 and a couple 50s give or take. get up grab a little breakfast and some oj, then back to bed for a few hours only to be in the 70s. So 2nd breakfast it is, around lunch time its coming up a bit so I take my lantus as normal and a couple units eat again and within a few hours its dropping again. literally eating what when and how much i want just to keep my levels up. Im starting to feel like a hobbit with all the meals. the only change i have made is the lantus but if 25 units a day and multiple shots of my fast acting didnt control the roller coaster while eating right over all, i dont see the 15 units of lantus causing that extreme of a change. is something changing(internally or is lantus more effective than i am giving it credit for ? I have an appointment next week but its a VA doc so good luck gettiing even a call or getting seen without an er trip, so just figured i would see if anyone else has had similar experiences or insight..

sorry for the book but theres my back story and all that happy jazz!!
 

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Hi, Chuck. Welcome to our community.

Since I'm managing T2 with just diet and exercise, I'm no expert on insulin. However, our neighbor lady recently went through a bout where her usual fasting blood glucose of 130 or so (on metformin) shot up to 400-500 for several days. Finally an ER visit for her and they doubled her metformin and put her on Lantus. The Lantus had to be bumped up from the original dose (5 units?) and her FBG finally is down to her usual range, but she's still on the met and the Lantus.

OK, we're not doctors here. But we can ask questions based on some experience. When do you eat a big meal at night? Any snacking? Is it carbs or protein or both? My money is on too much Lantus too soon. Were they trying to bring down the 206? Are you still taking any fast-acting insulin? It just sounds like quite a bump in the amount of insulin you're taking. You could have some left in your system by the time you give yourself the next dose. Any other big changes in life like activity levels or major body stressors?
 

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Welcome to the forum Chuck. Sounds like a heck of a DKA ride you had been on. The roller coaster you're own now isn't much fun either. You were diagnosed with LADA (Type 1.5) I'm guessing. DKA is more typical in Type 1s / 1.5s, but we have had a couple of Type 2 members a few years ago, that got diagnosed as being diabetic after being hospitalized with DKA.

Have you seen a diabetes educator or nutritionists? What are your typical meals like? Are you aware of how many carbs you are eating at each meal and snack? If you could figure out your carb to insulin ratio (how much insulin is needed for the carbs you eat) and correction factor (how much does one unit lower your BS) would be a better method than the sliding scale on your bolus insulin - the novalog. If your doc or a diabetes educator can't help you with that, there's a couple of good books that could help - Using insulin by John Walsh and Think like a Pancreas by Gary Scheiner could explain it. Diabetes Solution by Dr Richard Bernstein is another good book that may be helpful. Some of it is available to read on-line for free. A reduction in carbs eaten should mean a reduction in insulin and a reduction in the big swings once you get it figured out.

Yeah, the body likes to resist that BS dropping back down after it gets acclimated to it being high. It will complain loudly at first, but being persistent about continuing to work the levels back down out of the danger zone, the body will give in a little at a time with less of a fuss and leaving you those terrible feelings. Your BS probably didn't get high overnight, so it won't get back down quickly either. Patience and persistence. is the best approach.

I'm Type 2, not on insulin, haven't ever been in DKA, so what I'm saying is not based on my personal experience, but what I remember others saying in the forum about what they did. I normally leave a disclaimer saying that you can take my opinion and a dollar a get a small plain coffee about anywhere. Looking forward to seeing more posts from you.
 
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