[mcgruff]

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.

 

[Adjitater]

The answer to the question is a dificult one to answer as there are numerous reasons that could cause this. Women in general sometimes have a tougher time with it as they have more horemones that change on a monthly basis which do cause glucose in creases. Cortisol is another posibility and not at all out of the question. The key is to know that they are going to happen and to not feel guilty about the fact that something went wrong. What she needs to concentrate on is how to fix the upset. Do you know what your wife's correction sactor is. Acorrection factor is needed to get your glucose where you want it at any time of the day.

For example my correction factor is 20 so lets say I am coming to dinner time and my glucose has spiked for some unknown reason but I am going to eat. Well lets say that my glucose was 180 and my goal number is 120 that means that no matter how much I eat and and how much insulin I take I need to add 3extra units to what ever my bolus was. in order to get to where I need to be. So on her next appointment you should ask her to talk to her Dr. about it and have him help her determine by testing what her corection is.

And please let her know that she is not alone. Every type 1 diabetic goes through this what did I do wrong stage and the truth is that we dont do anything wrong. The human body is so complex and has so many things going on that we have no control over that when one of those mechanisims goes bad like the pancreas the best wen can do to mimic how it works is a poor job in comparision. I wish you both and hope this helps.

 

[Prayance]

I think it is almost impossible to answer this question for sure. I got 25 years diabetes type 1 and I am a woman. It is common problem to me the fact that when I got stress my blood sugar goes up or suddenly way down without a reason.
For example, when I got any kind of exams, I eat as usuall and then my blood sugar is 300 out of 120 or 30 out of 120. In both cases without any logical reason..
Inform your wife that the days of her period would be a mess especially at the start as well..
The only short of "solution" I found is not to stress. And I mean at all. In any case this is not a solution because there is no "magic button" not to stress, but let her know that if there is anything, any activity hobby tv whatever that makes her to relax, she can use it for her own good. For example, if her blood sugar is high, go for your favorite activity only 10 mins are enough to help. At least in her psycology
There is nothing to feel sorry about. Human body is complicated and women's body even more. So for me at least, doing funny things and have family and friends around, it helps.
I hope that you will be fine, and happy, because after all we have only 1 life to leave as better as we can

 

[breezeonby]

Until you see your doctor you can figure your own correction factor using the 1800 Rule, the information that I am giving to you is from the book "Using Insulin" by John Walsh. Divide 1800 by the total daily units of insulin. Example, your use is 45 units per day, take 1800 and divide by 45 which equals 40, that means that one unit of insulin will drop your blood glucose 40 points. Say your wife is getting ready to eat, she tests and is at 200, if you want your blood glucose to be 120 before eating, then you will need to correct the reading by taking 2 units of insulin, this would drop her blood glucose 80 points and add 2 units of insulin to your mealtime dose. Try and remember that the correction factor is only as good as your tracking the amount of insulin taken per day.

Diabetes can be very confusing at times. Sometimes we don't understand and I think that is the nature of the beast. You can always correct a high by using the correction factor. But you don't want to stack doses. You then must figure out how much insulin is on board and correct accordingly. If your wife tests before bed and say she tests at 200 and your target range is 120 then she needs 2 units of insulin to bring down the high. If it has been 4 hours since her last injection of insulin, you can safely give her 2 units of insulin and her blood sugar should drop 80 points.

Many T1 diabetics use a pump and they are able to control their blood glucose much easier than using MDI.

 

[onaughmae]

I agree that a pump is the way to go. It most closely mimics the way your pancreas is supposed to act. Can stress make her blood sugar go high? Absolutely. I know there are times at work when I am really stressed and busy that I will have to stop and test, even though I have not eaten or I am not about to eat...because sometimes my blood sugar will be climbing and I will need a correction bolus. Hormones also can mess with your blood sugar, especially at those *special* times of the month. Sometimes you just wont really know why...all you can do is take a correction bolus and fix it. Its easy to say "dont get stressed about it" but thats not so easy to do. The more comfortable your wife becomes managing her diabetes, the easier it will get for her

 

[mcgruff]

Thanks for the feedback. I would suspect that it is her cycle that is to blame. By the way, is there any good resource for how women's cycles affect blood sugar levels in type 1 diabetics, such as how estrogen and progesterone levels affect glucose release by the liver and/or uptake by the cells?

 

[Adjitater]

Thanks for the feedback. I would suspect that it is her cycle that is to blame. By the way, is there any good resource for how women's cycles affect blood sugar levels in type 1 diabetics, such as how estrogen and progesterone levels affect glucose release by the liver and/or uptake by the cells?

You might try the Mayo Clinics web sight. They have tons of information on many things.

 

[Rosa]

I haven't posted here for a while but I read this forum & find it to be very helpful. Stress does indeed raise blood sugar. Also, I'm on prednisone for a muscle disease and that too raises it. Can't win for losing. Three times my sugar went over 600 and I had NO symptoms. When it goes low however, I surely feel it. I want to look into a pump. My GP says that's only for Type I diabetics but I don't think that's true. Any info on the pump greatly appreciated and good luck to you all. I HATE this disease! I can't have anything I like.

 

[onaughmae]

I haven't posted here for a while but I read this forum & find it to be very helpful. Stress does indeed raise blood sugar. Also, I'm on prednisone for a muscle disease and that too raises it. Can't win for losing. Three times my sugar went over 600 and I had NO symptoms. When it goes low however, I surely feel it. I want to look into a pump. My GP says that's only for Type I diabetics but I don't think that's true. Any info on the pump greatly appreciated and good luck to you all. I HATE this disease! I can't have anything I like.

I use a pump. I have the best control now that I have ever had. You know, I was sick recently and had to take prednisone. I hated to take it because I would rocket by blood sugar over 500 in the past. This time, my endo prescribed injections of NPH insulin to be given with each dose of prednisone. He said the NPH was good to use for it because the peak times of the drugs matched. He had me take 1 unit of NPH for every mg of prednisone...and it worked like a charm. I got no spikes from it. I am definately going to remember that for the next time I need to take prednisone!

 

[PowerPumper]

Any insulin dependant diabetic should be able to get a pump. Slap your endo in the head please!

This time, my endo prescribed injections of NPH insulin to be given with each dose of prednisone. He said the NPH was good to use for it because the peak times of the drugs matched. He had me take 1 unit of NPH for every mg of prednisone...and it worked like a charm. I got no spikes from it. I am definately going to remember that for the next time I need to take prednisone!

Good to know. Thanks!