When to dose


(Katie) #1

Okay so I’m honeymooning still which to be honest is so annoying. I’m six months since diagnosis and at first I was very diligent with my dosing and Inwas exact with my ratios and checking sugars eight times a day. Then my pancreas decided to turn on again and I haven’t had to dose as frequently for the past few months, which was nice, but it’s really weird. The problem is my sugar will spike when I eat to about 250-300 and then come down on its own in two hours every time to about 134. The temporary highs are making me really tired but I can’t really combat them because I’m scared of lows. Do I just wait for them to stop coming down on their own or start dosing before meals and keeping track of my numbers in case of lows? I feel like my life can’t really go on until my body is out of this phase because I’m just waiting for the other shoe to drop. Anyway, thanks for any input!


(Bill) #2

Hi Katie @katieanneharris,

This is a question for your physician to answer. Since you are so new to this, and since we have so very little information to go on, any recommendation that any of us might make has the potential to put you in danger of a severe hypoglycemic episode.

If your physician is very knowledgeable and experienced, he/she will want to work diligently to “preserve” as much of your original insulin production as possible. The general rule is (and it is a very general rule) the longer you can retain “any” beta cell function the less insulin you will need to take day-to-day over your lifetime. But, every person’s situation is unique. So, please call your physician and get in as soon as possible. The two of you can come up with a plan for how to proceed over the next several months.

Good luck to you!

Bill


(Dennis J. Dacey, pwD) #3

Hi Katie @katieanneharris I very much agree with @BillHavins comment that you should consult your physician.

In the meantime, keep a good and very complete log of foods, activity, insulin and BG values to bring with you when visiting your physician. Make certain that your log includes a "timeclock. A good physician should be able to spot possible interaction o background with bolus insulins and also identify “gaps” in insulin coverage.

You are still very new to managing diabetes and one of the things you will learn is that your body is continually changing and your insulin routine may drastically shift - this is “normal” and is not a negative reflection on your “very diligent” efforts. Smile, shrug, say “oh well” and try again.


(Charles) #4

I agree with everybody so far. I went thru what you are going thru. It’s a pain. But it does get better. What helped me was being very consistent with my diet. I ate the same things for lunch and breakfast. Dinner time I changed things up. But only at dinner time to see what the different foods would do to me. You’ll end up with a kinda list of things that affect you and others that really affect you and some not so much. I did all this with my endo approval first tho.i kept a log trying to figure out what was going on.
Needless to say, it fluctuated and changes over time. How much insulin you take and your pancreatic functions. It still does. Why ? It just does for me. No real rhyme or reason for me.

But don’t write off a food as very bad for you till you eat it at least three times. Sometimes it’s something else affecting you. For a while I could not eat any fruits at all! Now fruits don’t really bother me. Why? Go figure! Just put foods that really affect you on a not right now list. In a few months or years, you can revisit them see what happens.
Now lows, it’s gonna happen. Don’t be scared of them. You will learn to feel em coming on! Just be prepared for them. I called my cures ( not a great name, but it works for me). When they happen, and oh yes they will! Ya gotta do something to arrest the fall. What works for me maybe too much for you, or not enough for you. Unfortunately, you gotta figure it out by yourself. And yes your endo may not be happy with you “ cures”, but when you crash you gotta stop it and choices are made. I’d rather have to watch my weight than go to the hospital! But I told my endo what I did and still do. He was not happy with my choices but I kept and still keep my numbers under 5.9 A1C. Or about 115 to 122 for daily average. My weight pretty consistent, plus or minus 5 lbs mostly. But in the winter time I usually gain 10 then lose it in the spring! I can be more active then.
Soon you will be able to know if I eat this it does that. It takes so long to minutes to let it get into your system. Sometimes you can eat like a fruit roll up or very little of something else and your good to go. Other times you gotta go back at it and eat or drink something more. Again try to give yourself enough time for it to get into you and balance you out. I use a step system. When I feel it starting I do x, if it still continues I do y. If it keeps coming on I do z. X Y Z are not secrets, but like I said it’s what works for you.
Once I got a cgm, it helps so much, I drop low really fast. So I set my alarm at 80. It usually goes off and I know I have 15 - 20 min to react. Ya can’t always be ready to fix yourself, like if your in the shower, on the toilet, got your hands dirty doing something,etc.
But the cgm told me if I eat this I go up X. If I drink that I go up X amount. So a little science experimenting and I came up with the steps I use. You can do this with testing too. Just a pain to do. Your fingers get sore too!
Even now my lows come on a lot! I average three or four a day! Thank god for the cgm ( constant glucose meter)! It tells me when I go low at night. I use it to wake me up to fix the lows. It’s a pain, but like I said, I’d rather have to lose weight, than go to ER at 4:00 in da morning cause then. Some of those drops were a little crazy, so I changed to 80.

If you go slowly methodically, you can bring yourself up kinda gently and not so abruptly. But it’s a process. Over time you’ll figure it out. But it’s a slow go! Just keep with dr and go from there… I’m just kinda sharing how I got from there to here.

You’ll get there. But anyways Happy New Years!

Hope I helped some
Charlie


(tedquick) #5

Not really sure, and you need to check with your endo (or whoever is your diabetes health care provider) if you aren’t have glucose intolerance, which often happens when people are developing Type 2.
What happens is that while developing diabetes the first thing people lose is the ability to make enough insulin to counter insulin resistance. Normal pancreases make extra insulin in between meals. which is stored for immediate release when you eat. Since this can’t work any more the bg level zooms upward soon after eating, then falls fast as the pancreas’s insulin output catches up with the need, which finally lowers bg to a reasonable level.
As I said this is symptomatic of Type 2 onset, but sounds like what is happening to you. Best technique (IF I’m correct) is to eat fewer carbs. That will keep the level from zooming up so fast so your now better working pancreas can keep up with your needs much better.
The objection that people usually come up with when trying this techniques is that EVERYBODY needs to eat carbs, which is demonstrably untrue. What we need is the proper level of nutrition reaching cells throughout the body. If you don;‘t eat the normally prescribed amount of carbs, but increase proteins and good fats to use, the protein will convert about 40% of its’ calories to glucose, but very slowly. Fats will break down to provide ketones, the secondary source of fuel for our cells, but nowhere near the amount leading to keto-acidosis, which people ted to get confused about.
Worth trying, but I recommend you read Dr. Richard K Bernstein’s book, “Diabetes Solution” for further information on this idea.
In any case be VERY careful, and check with your doctor.


(tomlinn) #6

I am two years into my diagnosis and the honeymoon is over…but what i did find is that it is almost a trial and error disease and you will learn what works and what does not. I strongly recommend you get a continuous glucose monitor. The Dexcom has a useful alarm when you fall below a set point [typically 70], makes a terrific noise . I believe it is a life saver since i might not otherwise wake up to treat the condition. The Dexcom would assuage your fears of lows i think and has the added bonus of allowing you to bolus from the monitor’s BG readings. Fight on…
Tom.


(jjmnav) #7

Definitely want to discuss with doctor. See ‘You can manage the rise’ below:
From healthyeating.sfgate.com/high-sugar-level-after-meal-4348.html
If your doctor suspects that you have abnormal glucose levels, he might suggest doing a glucose tolerance test. You are given around 75 grams of carbohydrate after fasting for 12 hours. At one- to three-hour intervals, your doctor draws blood and analyzes your glucose levels. A normal fasting glucose is 60 to 100 milligrams per deciliter; your levels should rise no higher than 200 mg/dl one hour after eating and no more than 140 mg/dl two hours after finishing the snack. Most healthy people without diabetes have two-hour readings below 120 mg/dl.
You can manage the rise in your blood sugars after a meal through a few relatively simple, easy-to-follow steps. First and foremost, arrange your meals to include more protein and high-fiber foods such as vegetables and whole grains. Those digest slowly, limiting the rise in your blood glucose. Taking some exercise within 30 minutes of your meal, such as an after-dinner walk, can also slow your digestion. It also helps to limit your intake of high-carbohydrate foods such as refined grains and sugary sodas, and to select foods with less impact on your blood sugars. A tool called the glycemic index, or GI, can help you with those choices. Foods with a low GI have a lesser impact on your blood glucose than those with a high GI.