New to T1 -- How Long Does It Take To Get Better At This?

Hey everyone! I'm sure some of this ground has been covered, but I want to get all my fears and feelings of failure out there. I was recently diagnosed type I. I'm trying not to obsess over my numbers, but I feel like I'm failing miserably... Can you fail at being a diabetic? (Haha).

Here's the background: They originally thought it was type II and gave me Metformin, which I think squeezed my pancreas for all the insulin it had left because now that I'm on Humalog and Lantus, I have to take a ton of insulin... At least of the Humalog. I take one dose of Lantus in the mornings that is steadily increasing (at 15u this morning after I went up 40 points overnight). I have a really low carb ratio (meaning I take a lot of insulin for a little bit of carbs) and wonder whether or not it has to do with my basal. The only thing is that up until recently my basal was fine at 13 and I'd wake up at the same reading as when I went to sleep. Up until recently, I was doing an okay job with keeping my sugars in check using a 1:7 carb ratio, but last night I decided to try a 6.5ish and gave myself 7u for 46g of carbs (my reading was 105 before dinner) and before bed it had spiked to 252. I gave myself 3u to just get it into a more manageable number right before bed, woke myself up at 1:00am and it was 141 (much better), but in the morning it was 184. I guess that means my basal is off? Then what's really freaking me out is this morning I ate probably 10g of carbs for breakfast and took a whopping 8u just to see if it would bring my 184 reading down and account for my carbs, and three hours later it was 194. I've been having panic attacks at work, partially because I'm scared the insulin won't work for me and partially because higher blood sugars make me feel like doom is imminent (haha).

Basically, I was wondering how long it took you guys to get your BG under control. I want it to be perfectly under control because I've always been the kind of person who excels at things, but I know that's unreasonable. I just want to know if I should feel like a complete and utter failure for consistently getting at least one reading in the 200s per day. It's only been three months, but I hate myself whenever I get readings like that.

Also... Is it possible that insulin just won't work for me? It sounds like a dumb question, but it's my biggest fear right now (apart from the medley of diabetes complications I keep reading about lol).

Lastly, how many times a day should I test? My endo haggled with me when I said I wanted six or seven times a day and gave me five, but it's stressing me out. I feel like it's way too little. He told me to test waking, before lunch, before dinner and before bedtime, so that only gives me one extra test a day... I've been trying to experiment more with my insulin, so I've been going a low at least once every few days, and I'm stressing out because I feel like I'm using way too many test strips. :/

Sorry for the length. I just want to stop feeling inadequate. I'm killing myself trying to figure this out and having panic attacks pretty regularly. I know stress can make your readings higher, but it's a vicious cycle: I stress about not being able to get lower readings, which in turns raises my readings further, which in turn makes me stress. Ughhh. Diabetes is fun, no? /endrant

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Get an endo who has a clue!

RE: Testing

1 - Fasting/pre-breakfast
2 - 2 hours post meal
3 - Pre-lunch
4 - 2 hours post meal
5 - Pre-dinner
6 - 2 hours post meal
7 - Before bed
8 - 3AM check (especially important when new to the disease and trying to make sure you are getting the right evening basal. The 3AM check can also help determine if you have Dawn Phenomenon)

Add to this any testing needed if you are having lows or highs and you can easily be @ 10+ tests/day.

I would also suggest trying to limit your carbs to maybe 25g/meal as you start out. Try smaller meals, maybe a bit more protein (but watch the fat!)

Back to the endo for a moment. I might try laying out your reasons for wanting more tests in writing and ask for a more detailed response - - maybe ask for a meeting beyond the normal 10 minutes where the endo is rushed between patients. You might also argue that more testing especially as you are a new diabetic is important and perhaps you could move to 4-5x/day later.

In my world, I make the decisions after discussing with my endo. My endo never dictates to me. Keep fighting for yourself!

Hi Marie. The short answer is however long it takes. I've been at it just over a year and am feeling pretty comfortable finally. But, every day is a new adventure. Remember, you are now regulating the fuel supply to your body manually. Something you never have done before. The biggest thing for me was figuring out why I felt strange or tired or??? What was my body telling me. While I was going through this discovery process and trying to establish a diet and schedule I would test as much as 12 times per day.If you haven't already you should check out Blood Sugar 101. It really helped me through the process of figuring out my BG and food.

IMHO good D management starts with learning. BG, your body, carbs, insulin, exercize, schedule, diet and D in general. You really need to have a grip on so much to truly be in charge of your own well being. It just takes time. The stress and anxiety are from the unknown. Believe me, I understand that. As you learn more about D and yourself it will begin to melt away. You're right about perfection being unrealistic. Just too many variables. But, I think the old 80/20 rule applies here. If I can get the results I seek 80% of the time I can work through the other 20% if I have the knowledge I need.

For me TuD has been my lifeline. I spent many hours the first few months searching and reading posts and following links.It was the best stress reliever I could hope for. Virtually every question or problem I had was answered by multiple PWD who had already experienced it. I found knowledge, hope and understanding which I desperately needed. I have no doubt that you will get some great advise and support with this post. There are folks here much more qualified than I am to help you with the science and details. Learn all you can Marie. It sounds to me like you are on the right track.

I have to agree with everything Randy says. I am 3 plus years into this and it has become the norm for me finally. But you need to cut yourself some slack. You are learning more things about your body and how it reacts to food, stress, exercise etc. than most people ever have to think about. I am also like you in that I always try to do things perfectly. I loved predictability. It gave me so much comfort. Diabetes had taught me that none of us really has that in life. You really do need to take it one day at a time. Most will be good (once you figure things out) and some won't be as good. But places like this are a lifeline as stated above. The best piece of advice is to read and educate yourself as much as possible. Finally, follow your gut instincts about what you deem is correct for you. In most cases you will be right.

Hi Marie! First off, take deep breaths and cut yourself some slack! This is still all so new to you and I remember how overwhelmed I felt at first. I was diagnosed 25 years ago at the age of 27. Like you, I was first thought to be Type 2 and put on oral meds which didn't work...which lead to my endo and Type 1 diagnosis.

You sound like you're on track and gathering all the info and tools you need to take care of yourself. Please know though that you can't beat yourself up when your control goes haywire...easier said than done I know. The thing is that there are so many factors out of your control like the weather, hormones, stress, and what people around here call "diabetes gremlins" because sometimes you just don't know why things go haywire. So first and foremost, don't blame yourself. There is no such thing as a "perfect" diabetic.

Your instincts about testing frequently are spot on. Have another chat with your endo and push again for a prescription for test strips written for 10 to 12 times per day. You may have to be a little pushy to get what you need, unfortunately, but you have to advocate for yourself. I'm not a confrontational type person, but when it comes to the cost of test strips, I will demand what I know I need. My prescription is written for 10 to 12 times a day but sometimes I test as often as 14 to 15 times if I'm having control issues.

Good luck and chin up! You will find lots of good advice here. :)

Hi Marie,
I was wondering the same thing this morning. I was dx 4 months ago and it has gotten better, but will I have to think so hard everyday about what to eat and what to inject or will it become second nature. I'm guessing that we will have good days and bad days. I noticed high ins:carb ratios in the beginning too and it was depressing. I felt like I must have done some real damage to my body to be so insulin resistant. I found with the use of a CGM I was better able to see what was going on. I have a pretty consistent dawn phenomenon which makes me go up 30-40 just by getting up and going. Caffeine also raises my BG, driving in traffic, and watching my kid play soccer(she's a goalie on a comp team). These are issues unrelated to carbs causing my BG to spike. Get a CGM, see if you can get a trial. Complain about lows if your endo isn't listening. They don't like lows. Get extra test strips. Shawnmarie's idea is a great one. You need to test more and you are stressed about using too many and that's making it worse. Start exercising when you feel like you can handle another component. It helps me so much. Only time I feel normal again actually is after being on the treadmill, even though it makes me test that much more.It will help your ins:carb ratios.
Sorry my iPad isn't letting me edit. Anyway you will have the occasional 200 number. You just have to test and correct quickly, but watch for stacking. It's a lot and a bummer. For some reason I feel I can do a better job and feel better about D when I read this forum. So I do. You aren't alone. Good luck!
M
I agree w/ Mike Ratrie's chart except I have one that comes up w/ 12 tests as a minimum, rather than his 8, and I don't usually bother testing at 3:00 AM. I find that the end of an insulin bottle generally doesn't seem to work quite as well as the beginning so if there's something to that, it could make a difference? I also sort of expect "change" which generally manifests itself as numbers not being where I want them and I have to figure out how to fix it. It's hard not to think "I screwed up" but it may just be an ongoing wave of change? Even "bad" results, particularly taken into context with other results, can still be GREAT data to use to figure out where the changes have happened and whatthehecktodoaboutit. And then give yourself a bonus for doing a good job figuring it out.
Oh yeah, re the endork, if he's only begrudgingly giving you 5 strips/ day, I would fire him and get someone who is more attuned to your desire to figure out what's going on. A few years ago, before I had a CGM, I was ina martial arts program I'd do for 1 or 2 hours at night and ran 2-3 miles and lifted weights @ lunch and tested 17x day for a couple months of that, because I didn't want to run out of gas.

Short answer: if the insulin wasn't working for you your bg would be 1000+ and you'd be in DKA. You may have come into this with some false preconception (probably the one most popular among the public) that if you take insulin then everything works out automatically. Abandon that preconception, it was never true, in fact adjusting doses in response to bg's is a task that takes constant dilligence and attention and planning. And BTW a task that you are doing great at!

I think you're doing great. Just for reference I've had T1 for 30+ years and you know more than I ever did when I was a kid.

Do not compare your numbers with anyone else's and feel bad. I got in that trap for a while. If necessary just turn off the computer and don't look at those websites that predict doom and gloom at 140. I look at the numbers that you worry about, and I think you are doing great, probably better than 80% of T1's who have been doing it much longer than you!

Thanks everyone! I just feel like I should be better at this. Do you think the Lantus would just stop working overnight? Haha. I took 3 units to correct the 194 at 10:30 and I tested at 1:30 and it's 192. What the heck!? I mean... I did eat a low fat string cheese, but it only had 3g of carbs in it. I just want to know what my body is doing. I'm glad you all are being nice to me. My dad has T1 and he keeps telling me it's no big deal to run high in the beginning as long as I'm making progress towards my goal, but his A1C is not the best so I like to hear from a few other people who don't seem to think I'm doing horrible. I like being able to rant here, too. Today when I texted my mom about how I can't control my BG and said "fml" she went off on me and told me it's like I'm beating her up. I can't handle people expecting me to just be happy. I can't count how many times people have been like "Be happy it's not cancer". It isn't helpful. It just makes me feel guilty for being upset.

We ALL have been through tuff stuff and WTF readings. Your dad is right. Highs and lows will happen. Just keep learning from them, correct them and move on. You have a great spirit and attitude Marie. Your confidence will grow as this all becomes more familiar to you.

Hi Marie, and welcome! I am glad you found TuDiabetes. Others have given you excellent advice here. It takes quite awhile to get things under control! I have found the best books are "Think Like A Pancreas," "Pumping Insulin," and "Using Insulin" (the last two by John Walsh). Those might help for the basics. I also wrote a blog for the newly-diagnosed Type 1 that I hope is helpful. Finally, testing 5 times a day is just not enough to get things under control and also to accomodate exercise.

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