T1 for 11 years. Things just became harder

(Larissa H.) #1

Hi all, I was diagnosed with Type 1 diabetes back in 2006 when I was 39 years old and pregnant with my first daughter.
In the early days of learning how to live with T1, I frequented message boards quite a lot where I gained a great deal of knowledge and perspective from other folks struggling with Type 1. As time went on though and I found my way, I stopped my visits as I returned to just living my life armed with the “tools” I needed. Fast forward to today, and I’m back!
I’m in my early fifties now and just received my highest A1C ever of 7.0. Now, I know what some of you are thinking right now - why the heck would I be so disappointed in a 7.0? Well, to put it in perspective, my A1c’s have been in the 5’s and 6’s for years, as it appears my beta cells were still providing a tiny bit of insulin. I know 7 in general is still good! Some T1’s really struggle to get there, but for me personally it is troubling and I could use some perspective and support again.
Some specific info I’m looking for - what other women with T1 have experienced with aging and hormone fluctuations (hello menopause :tired_face:). I suspect the “change of life” may have something to do with my control.
I should add here that I am also one of those relatively rare T1’s these days who does not use a CGM or pump (mdi’s and a meter- works for me) That said though, I am definitely now thinking about the “new” innovations! :laughing: I would like to hear about what others here are using these days. I’ve balked at pumps in the past as I am fairly active and don’t like the idea of stuff attached to me. But Perhaps it’s time to let go of those hang ups and need encouragement.
Anyhoo, I look forward to connecting with you and whatever advice is offered!

(joe) #2

@Larissah HI Larissa,

Welcome to TypeOneNation. so it’s your first A1c over 7 - congratulations on all the hard work over the last 12 years. I think it’s a good bet that your own pancreas was helping out a little bit, because it is very hard to achieve in the 5-6’s without getting severe lows and lows very often. The reason is because without automatic regulation, using only synthetic insulin means wider ranges, and this is why the optimum range is suggested as “below 7”.

lots and lots of people use pens or syringes. no one wants to have a pump hanging off them, it’s just that pumps “suck less” then pens for me, especially because I’m active.

since I have to depend 100% on injected insulin, a pump allows me to tune in my real basal requirement… change my basal mid-day if I am more or less active, and adapt to travel and changing time zones without getting up at 2:30 AM for a basal shot.

other than that, a pump is useful because I can spread out a meal bolus to account for a fatty meal better matching fast insulin absorption to a meal that may take 3 hours to absorb.

the choice is yours, of course, and many people stay with pens/syringes for a variety of reasons not the least of which is cost.

so without your own insulin, the cost of aggressive insulin therapy will be lows, the best tools are your bs tester (+/- 10% accuracy) or CGM (+/- even worse accuracy) , and your ability to match basal and bolus to what you need. the range of normal blood sugar is 67-100mg/dl (a delta of only 33 mg/dl or like 5 skittles) and food packaging information exaggerations, blood sugar meter errors and with activity making +/- 75% differences in your basal rate… you see that an HbA1c of 5.0% is very, very risky. Also, since it’s an average, it’s isn’t even a great way for you to judge yourself. a 6.5% A1c can also coincide with 40’s to 400+mg/dl quite often.

Please reconsider how hard you are being on yourself, and consider our best tools are very prone to error and our best insulin is no awesome substitute for the real thing.

I hit 6.2% to 6.8% for the last 10 years, mostly due to testing and my pump.

please also let us know how you are doing.

(Russell) #3

That’s great news about your A1C and overall T1D management. Obviously, so far you’ve found a regiment that suits you.

That being said, I’d suggest that you at least consider and investigate the use of either or both a CGM and insulin pump. (NB: I’ve been using the Omnipod for well over a decade and the Dexcom G6 for several months). In particular, I suggest you look into the Omnipod, especially since you mentioned that you are active. As a competitive athlete and generally active person (swim, bike, gym, hike, kayak) I find that the combination of pump and CGM better enable my activities, rather than hinder them in any way. The convenience of not having to stop and test (or worse, in my kayak NOT having been able to test) and always know my blood sugar levels, means that I can focus on the activity and not guess or worry about my levels. Similarly, at work, I no longer have to escape to take a shot or test. It’s easier for me to carry the PDM and CGM receiver.

Sure there are pros and cons. No technology is infallible, and you need to be mindful about how and where you attach the devices, and how you use them. Most importantly, these are tools to assist you in managing the disease, and must be used accordingly.

Not having to use syringes has been a godsend and I also don’t miss pricking my fingers multiple times a day. The fact that I can adjust both basal and bolus dosages intra-day to account for diet and exercise regimens has made it much easier for me to manage my activities. My last A1C was 6.1, and for most of my life, mine generally run less than 6.5. Yes, I was able to manage this prior to my having the pump and CGM, but having these tools has made it easier for me to understand how my body reacts to the combination of diet and exercise, and therefore successfully manage my diabetes.

Best wishes.

(heather) #4

Hello i have been usimg the dexcom g5 for about a year and i love it it helps me manage my sugars way better than when before i had it im also not on a pump im too afraid of it messing up while im sleeping and give me too mucn and end up dead or something lol i have heard thoigh that they make wireless pumps now u could look into thst as well good luck

(Patti member with T1d) #5

Yes, absolutely you’ll have blood sugar fluctuations from hormone changes as you go into perimenopause. I researched online any info I could find on the subject of T1 and high sugars from “the changes”, there’s very little out there, and after talking to two other T1 friends who had the same scenerio as me I finally understood. As your estrogen goes down at times, that will cause insulin resistance. As your estrogen/progesterone goes up, you’ll have insulin sensitivity, hence Blood sugar drops. I use a Medtronic pump & Libre CGM. I was finger testing every hour to catch the erratic fluctuations, I finally started using the Libre last year. It’s a matter of testing very often to stay ahead of changes; using a pump is ideal because I changed my basal drips rates much higher for when it was needed along with a bolus to get highs back down. My two friends were able to use hormone therapy to even out their blood sugars during their time of change. That’s the ideal fix, but not for me with past breast cancer , so it’s daily highs and constant checking with my Libre. I hope this helps because it’s so frustrating when past years have gone so well and then you can’t seem to have a rhyme or rhythm anymore to your control. I am 56, was diagnosed at 29, on shots for 10 yrs, went to a pump, and now also on Libre the past year

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