My newly-diagnosed type 1 wife has been on insulin for about two weeks now. She's been doing a great job learning about how to eat, exercise, use insulin, etc., and she's been quite dedicated in doing the right thing. And most days, it seems it pays off. Twice though, she has had days where her blood sugar goes unpredictably high, and once that happens, she becomes quite discouraged. This seems to be followed by high readings for about half a day or a whole day, even though she responds to the first high reading per the doctor's plan re: injection units vs. carbs. This leads to a very emotionally difficult day for her.
Anyway, I'm wondering if cortisol could be to blame. Is it possible that the emotional stress of one discouragingly high reading is causing her to release a large amount of cortisol that counteracts the otherwise-proper amount of insulin she takes? Does this sound reasonable?
The other possibility I'm considering is that she tends to respond to high readings by eating fewer carb choices than she would otherwise. That would seem like a reasonable reaction to a high reading to me. Even so, I'm wondering if that is counterproductive. By eating fewer carbs, she of course gives herself less insulin, given the structure of her carbs vs. insulin plan so as to prevent hypoglycemia. I wonder though if it's possible that her liver responds to a surprising lack of carbs in the meal by providing a compensatory release of glucose that it wouldn't have if she had eaten a normal moderate-carb meal, and if that happens, given that she hadn't taken insulin to counteract the liver's release, her blood sugar would of course go high.
For what it's worth, it seems that when she goes through a bad spell of high readings, it is the 2 hr post meal readings that are actually the ones that are within (or close to) the target range. The ones that are further out from a meal (right before bed, waking up, right before a meal) are the ones that tend to be high out of range. This is why I'm wondering if it is cortisol that is causing the problem. Also, on this particular days, there do not seem to be other factors (stress at work, physical exercise, etc.) that would affect blood sugar.
Of course, please share any other guesses as to why a type 1 would have unexpectedly high readings in spite of meticulous carb counting and insulin matching. Thank you.
Anyway, I'm wondering if cortisol could be to blame. Is it possible that the emotional stress of one discouragingly high reading is causing her to release a large amount of cortisol that counteracts the otherwise-proper amount of insulin she takes? Does this sound reasonable?
The other possibility I'm considering is that she tends to respond to high readings by eating fewer carb choices than she would otherwise. That would seem like a reasonable reaction to a high reading to me. Even so, I'm wondering if that is counterproductive. By eating fewer carbs, she of course gives herself less insulin, given the structure of her carbs vs. insulin plan so as to prevent hypoglycemia. I wonder though if it's possible that her liver responds to a surprising lack of carbs in the meal by providing a compensatory release of glucose that it wouldn't have if she had eaten a normal moderate-carb meal, and if that happens, given that she hadn't taken insulin to counteract the liver's release, her blood sugar would of course go high.
For what it's worth, it seems that when she goes through a bad spell of high readings, it is the 2 hr post meal readings that are actually the ones that are within (or close to) the target range. The ones that are further out from a meal (right before bed, waking up, right before a meal) are the ones that tend to be high out of range. This is why I'm wondering if it is cortisol that is causing the problem. Also, on this particular days, there do not seem to be other factors (stress at work, physical exercise, etc.) that would affect blood sugar.
Of course, please share any other guesses as to why a type 1 would have unexpectedly high readings in spite of meticulous carb counting and insulin matching. Thank you.