Trouble with Blood Sugars


(Hannah Stanford ) #1

I am going to list a few troubles and questions I would like y’all to answer. I love the support that y’all provide for me and it reassures me when others are having these specific problems so we can work through it together! It is very disappointing to have problems with diabetes and not have many answers. Certain foods and amounts of insulin doses affect people differently. I know diabetes is not always a negative and that there are positive aspects to it, but I’m having trouble seeing them. I always try taking care of myself to my best ability!

I have tried to keep a routine of eating breakfast between 8:00-9:30 a.m., lunch between 12:00-1:30 p.m., and supper between 5:00-7:30 p.m. Unfortunately, I am having trouble keeping one or two routines due to unforeseen circumstances or just because I end up having to eat late. It is also quite difficult to eat a snack in between both periods of breakfast and lunch when I really do not need one. Does anyone have a set schedule on when they eat three meals a day, as well as, snacks?

It is honestly so frustrating and difficult to keep my blood sugar in range (70-150), especially at night after dinnertime. I ate stir fry with brown rice (32 carbs) for half a cup and ate most of my roll (23 carbs), but only counted 13 for it, even though I ate more than half. I get panicked really easily because do not want blood sugar dropping too low, but also do not want it going too high. Anyways, counted 43 carbs taking between 7-8 units for food with correction counting since blood sugar was 242. Almost two hours later, it’s down to a reading of 75 with 2.75 units on board (still floating around). I just don’t understand how even when you count correctly or count a little bit under, how blood sugars still tend to drop faster! This does not happen all the time, but very much quite frequently. I’m pretty sure we’ve all had to deal with this, but it gets to the point where it’s almost hard to work with blood sugars whether you took enough insulin, did not, or took a little under for the blood sugar to be in range. Does anyone else have anxiety about counting too much or even panic when you think it is going low? I know it isn’t healthy worrying, but it seems to happen every now and then.

What kind of troubles do y’all have and how did you overcome them? Keeping an open mind and faith that everything will be okay does the trick, but there is still some concern left about keeping the A1C in range and the blood sugars in the ideal range.


(Sal) #2

Are you on a pump or manual injections?


(joe) #3

@hanstan hi Hannah,

if you’re anything like me, then 4 grams of really fast carbs will raise your blood sugar about 20 mg/dl. in somewhere around 15 minutes. your entire range of 70-150, or 80 mg/dl, is 16 grams of carbs… plus your meter, when it says 150 - your actual blood sugar can be 120 to 180 mg/dl (that’s a span of 60 mg/dl) just due to allowable meter error.

if I move… just a little, my insulin can work between 20% and 100% more than if I am sitting in front of a computer.

in order of importance in impossible variables
minor differences in activity
meter error - food label error- guestimation error

are my big ones

you said “stir fry” as soon as you add fats (the oil in the stir fry) a very fast carb such as rice does some weird stuff. Fats will slow down the absorption of carbs. this is why (for me) ice cream can take 3-4 hours to absorb and pizza 4-8 hours. If I even thought of a bolus for pizza and take it all at once, I’d drop like a rock and you’ll see me sipping kool-aid for the next 2+ hours.

fast insulin ain’t so fast. It takes 20 minutes to start and hangs out for at least 4 hours. if you eat a really fast carb, say glucose" or even for me rice, no amount of insulin will stop a very bigh high in the hour after eating, due to the carbs absorbing faster than my insulin. if I take more to compensate… crash. mix it with oil or milk fat… now the insulin absorbs faster and I am low. same exact carb count.

diabetes is a science experiment but it helps when you realize the wonky things we are working with (cgm, blood sugar meters) and you mix in the way insulin works, and you divide by how many times you walk up the stairs. it’s easy! it’s like riding a bike!.. except the bike is on fire and you’re on fire (you get the picture and the joke I hope).

please please read “think like a pancreas”. good book.

as far as eating - I travel for work so no only is my activity level all over the place but so is my meals. I don’t snack. my only schedule is there is no schedule. I use a pump because for me it stinks less than shots.

good luck


(Dennis J. Dacey, PwD) #4

Hi Hannah @hanstan, I agree that this is a wonderful place for each of us to share with others not only basic information about diabetes management but also some tricks-of-the-trade and little bits that haven’t made it into the teaching manuals. @Joe brought a few smiles to my face with his response and responded much as I would - yes, an on-going science project for me too. I’ll add a couple of thoughts.
From what you wrote, it is obvious that you use a pump and that you are familiar with many of its features - but, have you tried using the prolonged bolus features? For the meal you described, a meal that would have delayed absorption of carbs and combined that required insulin with a correction for your 245, I would have used a “Dual Bolus” on my MM pump; that is, as I began eating I would have infused enough insulin to cover the correction++ and done a slow infusion over the next 30 or 60 minutes for the balance of your 7-8 units. I wing it on how much insulin is in my initial infusion.
Look up your specific meter on the American diabetes Association site [diabetes.org] to see its accuracy; I did some editing on what was posted in their Diabetes Forecast Magazine articles.
I agree with what you say about diabetes isn’t always negative; when I was overcome with diabetes as a HS sophomore I wasn’t expected to live into my 20’s [few did in those days], yet I’ve outlived more than a third of those who graduated with me 60 years ago.
Once you get a pretty good handle on how foods effect you and when you have your pump basal rates fairly accurate, your meal schedule will not need to be really rigid. Your basal rates are, I believe, the key and should allow you to go an entire day, in your set BGL range, without eating or administering a correction bolus.

Keep asking questions


(Hannah Stanford ) #5

@Zale I am on an insulin pump known as Omipod. Do you take manual injections with a syringe or pen or do you also use an insulin pump?