Are all 'high's explainable?

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Permalink Reply by Richard A. Meade on August 27, 2009 at 10:33am

Highs you speak of are difficult to explain. I have found that when they occur it is impossible to stop them even with a correction bolus. you are a victim of hormones other than insulin. There are stress hormones that will happen some time after a severe low. When you have such a low the pancreas sends a message to the liver as glucagon telling it to release glucose into the blood which it does for several hours until it is told to stop after which you go back to normal. Then if you are under an insufficient insulin dose your body then generates another trigger to the liver to do it's thing giving you another high. This is the so-called Dawn Phen. you hear about. The trick is good control, stop lows from happening and take enough night insulin without causing any lows.then. The main problem at night is undetected lows.

I'm assuming that you are counting your carbs right and you are dosing the bolus right. Try to get on a pump. your life would be so much easier. Dick Meade PS. Get the book called Using Insulin which explains it all. your going the have diabetes for a long time so learn all you can. I have been diabetic for 56 years

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Permalink Reply by Katie Zeller on August 27, 2009 at 12:08pm

Well, he doesn't have a pancreas, so that bit is eliminated.... Does have the liver, though....
I have Using Insulin and Think Like a Pancreas... There's just so much to learn, so fast. I'm amazed at how people can manage this and a regular life as well!
After 56 years, I guess you are proof it can be done.
We'll start testing closer to dawn.... maybe we'll learn something.

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Permalink Reply by Kelly on August 27, 2009 at 10:44am

I am so sorry but all I can say is welcome to diabetes. It could be stress, cupcakes, other medication, carb overload, planets not aligned. Actually it sounds like she may have dropped throughout the night and her liver kicked out glucose. Whatever the case may be, sometimes it just happens and it's ok. As a diabetic with a mother who is not, my only advice would be not to place blame when lows & highs happen. It certainly isn't something we do on purpose, it's just part of the dance and we are never, ever perfect. We are trying to control and uncontrollable disease. Give yourself a break, too. You are doing great. :)

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Permalink Reply by Katie Zeller on August 27, 2009 at 12:10pm

Thanks Kelly. I know they happen. My anal little self just can't abide things that don't line up and behave properly. I'll learn....

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Permalink Reply by Ray Marino on August 27, 2009 at 1:37pm

Very well put Kelly ! I wrote an article once on the," Dance".
Gerri, could you explain why you have to eat breakfast right away,
I think it has something to do with the Liver, but I forget most of it.

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Permalink Reply by Gerri on August 27, 2009 at 1:45pm

Hey Ray,

Yep, having to eat breakfast right away is because of dawn phenomenon--liver dumping glucose in the morning. Seems counter-intuitive to eat when already high, but I've learned that this make BG even higher in the morning. Correct, inject, eat helps.

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Permalink Reply by Ray Marino on August 27, 2009 at 1:51pm

So I guess the eating part stops the liver from dumping. What makes BG even higher
in the morning ? Not thinking too clearly today !

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Permalink Reply by Gerri on August 27, 2009 at 2:30pm

Yes, exactly.

The liver dumping glycogen in the morning as we're waking up is a natural process. It's getting the body geared up for the day after rest. Lowest BG is around 2-4 AM. Some people seem to have a greater liver dumping response than others. Of course, people without diabetes have insulin to keep BG level at normal levels so their fasting BG is fine.

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Permalink Reply by Gerri on August 27, 2009 at 11:49am

Never tempt the diabetes gods by thinking you've got it figured out:) They hate that & send high BG to remind us we're mere mortals.

I replied to your last comment on "Is a low-carb diet a must?" to mention gastroparesis regarding V's lows after breakfast. I have this & it makes BG all the more unpredictable. Like V, I inject after meals. Anyway, you can read it, if you like, on that discussion.

Eating dinner & going to sleep shortly after can account for high fasting (aside from Dawn Phenonmenon). Don't know if V has high fasting frequently. He's not awake to correct highs, or to really know how evening food is effecting BG.

Some truly are inexplicable, but mine that are I've attributed to:

Stress/hormones (being stressed sends me soaring)
Not getting enough sleep (maybe this is a stress type effect)
Sleeping in (this gives me high fasting BG. Endo says I've overslept my basal)
Gastroparesis
Not timing insulin correctly
Miscalculating carbs
Insulin nearing expiration
Meal too high in fat/protein
Eating meals too close together

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Permalink Reply by Katie Zeller on August 27, 2009 at 12:04pm

We normally get up about 2 to check during the night, and the BG has been fine. I hate to start getting up twice a night... We both need a little sleep. Maybe we'll try check later, like 3:30 to see if he's going low then. I could just sit up all night and poke him every half hour.....
I'm going to start tracking the fat content of dinner....
And he did sleep 15 minutes later than usual this morning....
Is there any way to get more time in a day to keep all this straight?
Sorry, I shouldn't complain....

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Permalink Reply by Gerri on August 27, 2009 at 12:20pm

Horrible getting up in the middle of the night to test. Hate that. No sitting up all night poking him. You both need the rest.

15 minutes won't make a difference. Between the blasted gastroparesis & dawn phenonmenon, I have to stick to a very regular schedule, which goes against my nature. Have to eat right away in the morning to prevent BG from going even higher.

My best morning numbers are when I eat lower proteien & not much fat for dinner. Hoping V never experiences this, but I've had dinner digest 8 hours after eating. Thankfully, this only happens with dinner.

I don't want more hours in the day since it will mean more time devoted to diabetes:)

Hope V appreciates what a wonderful partner you are!

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Permalink Reply by Brenda on August 28, 2009 at 5:39am

Katie, don't ever apologize for complaining. Diabetes can be overwhelming. You sound fairly new at this.......it does get better. It becomes a new normal. Did you know there is a special place in heaven for moms of T1s? I tell my mom this all the time! She loves it. (I just turned 50 and was dx in '74.)

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