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Permalink Reply by Ira on March 29, 2011 at 7:19pm

Rocket, from your explanation this sound very dangerous. I can understand why you are freaking out. 200 carbs and no change WOW. Since you will not see your endo for another month why don't you try a glucagen hypo kit or glucagon shot and see if your BG goes up? You might want to think about a continuous glucose monitoring system (Dexcom or the new minimed revel pump) Just some options...Best of luck

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Permalink Reply by ROCKET on March 29, 2011 at 8:06pm

was able to get an email through to my endo... I was told not to go low for a month and to see a gastroenterologist about possible gastroparesis.I always get gastroparesis pushed on me because I have been diabetic for 18 years. Wow that was helpful. They tell us to lower our A1C so I work my butt off and get it all pretty and then they tell me to run high!?!? you know what I hate diabetes

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Permalink Reply by Tom T on March 30, 2011 at 6:20am

It is ironic, isn't it?

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Permalink Reply by Jay on March 30, 2011 at 12:04am

30 years ago when my type 1 diabetes began, I could always tell a low was coming by my numb, tingling tongue. That warning sign stopped happening about 5 years in. Now, the lightheadedness and confusion are the first signs. I always carry Sweet Tarts candies with me as they contain dextrose (the fastest acting "-ose" around) as their number 1 ingredient and no fat or protein to slow things down. (and on sale at 69 cents a roll way cheaper than glucose tabs). I learned early on that each candy in a role raises my blood sugar 10 units per deciliter. In the days when I was trying desperately to stay in range, I would plummet sometimes and get caught in a mental whirlpool of confusion, not able to think what to do even if I was holding a candy bar in my hand. It was scary but I conditioned myself to remember to "take 5" Sweet Tarts. Even if I was at 40, I knew that would get me up to the point where I could at least know enough to eat or drink something more. I seldom play it that close these days (and as a result my HbA1c isn't very good) but I keep a roll of Sweet Tarts at work, in my car, by my bed and a part of a roll in my pocket at all times. I'm sorry to hear that the warning sensations of hypo may never return. I may have brought it on by going so low for so many years.

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Permalink Reply by Donna H on March 30, 2011 at 3:45am

I see two different issues here -- Hypo-unawareness and treatment of lows. Admittedly, I have neither problem as I am keenly aware of my lows and I am efficient at treating them. I cannot really help with the hypo-unawareness but as for the treatment of the low, I'm curious at what foods you are using to treat your lows. There may be more effective options out there. I think everyone is different as to their responses to different carbs. For example, I use skim milk to help raise my carbs. It works well for me -- as do raisins. But I know others who swear by peanut butter crackers or juice. For me juice would spike me out of control and then I'd just come crashing down again once it is done doing it's dirty work on my BG. For others I know a juicebox is their go to choice.

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Permalink Reply by MidwestMommy on March 30, 2011 at 7:37am

I think it depends on your treatment too. If you are on MDI and doing a once a day Lantus shot, then your are committed to that dose for 24 hours -- this is where the protein/carb combo advice came from I believe, and it makes sense because you can't shut off the Lantus you injected last night. Pumpers can adjust their insulin on the fly so they may not need the protein component.

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Permalink Reply by MidwestMommy on March 30, 2011 at 7:31am

Rocket --

Sorry for your frustrations with the nurse. Hang in there!! The mommy in me has to ask - do you know if your insurance covers cgms? I have used both the cgms systems for 3 years - let me know if I can answer any questions. It's another device but holy cow is it ever helpful. My daughter is a teen and she feels her lows when awake, but very rarely when alseep. So much of this disease is a guessing game - how many carbs in that restaurant salad, how many carbs in Grandma's secret apple pie recipe, LOL, and cgms helps us deal with those uncertainties.

I would also call your gastroenterologist and ask the nurse about if there is anything you can do about the delayed absorption. I don't know if there is, but it might be good to talk to them.

:)

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Permalink Reply by MidwestMommy on March 30, 2011 at 7:41am

Rocket --

Are you on MDI or pumping?

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Permalink Reply by ROCKET on March 30, 2011 at 5:31pm

I am on the Ping. I have a cgms but I just switched insurance companies and they wont cover the sensors. My basal rates for the most part are right on cause I camp out in the lower 100s until crap/stress happens and then I crash. Since the lows are not specific to a certain time of day I cant exactly change my insulin too much. I absolutely hate being high so I dont know what I am going to do. For those asking about carbs... I usually treat with grape juice or tabs and then after I am back up I have a half a pb&j, cup of milk, 15 carbs worth of a payday...usually something like that

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Permalink Reply by MidwestMommy on March 30, 2011 at 6:09pm

I think you should appeal the cgms decision. With your factors, it is absolutely medically necessary that you have cgms coverage. Your doctor should be able to write a letter that will help with this. Don't let the insurance company scare you off, some of them automatically reject cgms requests, and then see if you appeal. Sad to say, but it saves them a lot of money because not everyone appeals.

Most insurance companies won't approve unless you have multiple lows under 50, and if you are hypoglycemic unaware you have much better chances. If your doc gives you an official HAAF diagnosis, that's even more reason for them to cover it. What insurance is it? Maybe some others can chime in. This is a big hot button of mine...insurance companies that don't want to pay for cgms. Drives me nuts.

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Permalink Reply by Heidi Gilroy on April 2, 2011 at 5:43pm

I got a CGM to deal with hypoglycemia unawareness. It was really bad. I could be 25 and really not "feel low." Now that the CGM catches my lows, I have noticed that I am actually feeling low in the 60's. Maybe your endo can give you a continuous monitor for a couple of weeks to see when they are happening. When you stop yourself from going so low so frequently, this problem will likely go away.

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