Replies to This Discussion

Permalink Reply by Zoe on June 7, 2012 at 9:35am

I put in a long answer to this yesterday and then my new laptop blocked the site and I just got it unblocked, so I'll try again!

We all make different choices about the amount of carbs we eat, but what's most important is that you are correctly dosing your insulin to manage your blood sugar.

First of all, you are probably overtreating your lows. A cup of milk is around 15 carbs which is probably more than you need. I generally use 2 glucose tabs (8 carbs), 3 if I'm seriously low. Glucose tabs are the best because they act quickly and are precise doses, but if you can't afford them, then try more like 1/C of milk.

Then, if you are having lows a lot, between meals, in the morning or before bed, you probably need to reduce your basal insulin.

You said you were "54 after eating a meal then two or three hours later 148". Why are you checking right after eating? You need to check before you eat. Then if you are low you have a couple choices: You can treat the low (don't overtreat!) and wait to bolus and eat. Or you can go ahead and eat and then check your blood sugar after eating and bolus as soon as you are up in range. Then check for results 2 hours after eating. 148 may be higher than you want, and if that is a typical result then you want to adjust your I:C ratios to take a bit more insulin. But 148 at 2 hours means you have enough insulin on board that should bring it back down.

You say "10-12 units of insulin can't seem to be enough to cover 45 carbs in a meal anymore like it used to. You don't want to take a set dose for your meals, but bolus according to an I:C ratio. That means this many units of insulin for that many carbs. To determine your I:C ratio just try trial and error until you find the ratio that works to keep you in range at 2 hours. You say 10-12 units isn't enough for 45 carbs. That's a lot of insulin for a Type 1. Are you sure you're Type 1? If so, are you taking long acting insulin as well as short acting? You need both to manage your blood sugar. I strongly encourage you to get the book Using Insulin by John Walsh as someone suggested and it will help you figure these things out like basal/bolus and I:C ratios.

Finally, the test to see how much insulin you are making is called c-peptide. But I don't know if that is so important (unless there is a question about your diagnosis). What is important is to learn how to figure your insulin doses to manage your blood sugar.

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Permalink Reply by nel on June 7, 2012 at 11:18am

Is there another concern here : rebounding after the low of 37, 54 to 198 ???

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Permalink Reply by t.clayton on June 7, 2012 at 11:34am

One thing I've found when correcting a low, if you have little to no insulin on board it generally doesn't require the 15g of carbs to raise your sugar to a safe level that they stress so much. One 4g sugar tab is usually enough to correct me from a minor low and two tabs if I'm close to or below 50 will correct me to the 90-110 range if I don't have any active mealtime insulin. I've never done the cup of milk or 8 oz of juice or 4 sugar tabs to correct a low or I'd spike high like you seem to be.

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Permalink Reply by Tom on June 7, 2012 at 1:22pm

hate to say this but because we're diabetic- expect fluctuations in our blood sugars

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Permalink Reply by Sweet Lady on June 11, 2012 at 5:35pm

I agree with you, Tom.

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Permalink Reply by acidrock23 on June 11, 2012 at 5:47pm

T1 since 1984. Ok, there's a few fluctuations but well, ya' know? ;-)

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Permalink Reply by garidan on June 7, 2012 at 4:06pm

I think you have to rise your BG target, it's too low.
You talk about 37-54 as normality, and 54 after eating ?
When you find a 37 why do you drink milk ? 37 is red alarm, you need your BG quick up, take sugar. Do you know low numbers have bad effects too ? Heart first of all.
Insulin has 3-6 hours action time, depends on insulin type and personal sensitivity, it's not over when you check BG, usually it will come down later more or less.
"processed foods such as packages of microwavable burritos seem to be what I survive on": between having bad carbs and no carbs there is a wise "middle point" to get good carbs.
I mean, carbs without all that bad fats which bring up your BG later in time, and bad for your health.
C-peptide is a blood measure of your natural beta cell activity. C-peptide is produced qhen your body produces insulin, so it measures your fasting natural insulin production.

Neither a healhy person as BG always under 100 .....

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Permalink Reply by garidan on June 7, 2012 at 4:12pm

Here there is a thread about normal BGs link

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Permalink Reply by acidrock23 on June 7, 2012 at 5:45pm

I like milk for hypos, I think the protein is good to have "on board" along with the lactose and I think it works pretty quickly? We usually only have skim on hand so maybe 10G of carbs but that's what I'm usually shooting for anyway. I don't think 100 is a bad target. I want the approach to the target to be smooth but 100 seems reasonable. If you aim at that and run low, turn your pump down a little bit and I think you can hit it without crashing out and feel pretty good?

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Permalink Reply by Sam Iam on June 7, 2012 at 7:36pm

I'll do 4-6 oz milk if I'm a little low at night.

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Permalink Reply by Super_sally on June 7, 2012 at 10:09pm

On the Dr. B diet approach it should be noted that all of the allowed carbs come from non-starchy vegetables and some from full fat dairy such as cheese (not milk). This does translate to a reasonable amount of veges - and teh nutritional benefit of vegetables is without doubt.

The Dr. B diet is effectively low carb, moderate protein and high fat.

Not everyone wants to or even should go as low as 30 g carb/ day. But lower carb really does help stabilise blood sugars for many of us.

Beg to differ Holger, but there is no proven absolute need to eat carbs (think traditional eskimo diet which was largely seal and whale meat and blubber). But there is an absolute need for fat and protein.

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Permalink Reply by CarbMom on June 7, 2012 at 10:22pm

My son was diagnosed about 3 months ago...so I am NOT AN EXPERT. But, I also wonder why you need to keep your BG under 100? My son't target is 80 - 180. We don't even correct for readings until they are above 150. At our most recent visit, most of his readings were in the 110- 130 range and they were very pleased. IN fact, when we went through a spell of low sugars (and never as low as 37) they decreased his insulin because he was always below 100 in the am and they didn't want him starting the day that low.

You mention that you can't afford an endocrinologist. If your insurance does not cover one, can you see a diabetic educator? Where are you located? What is your local hospital? Do they have a program for people who can't afford to pay? Have you contacted JDRF? I wonder if they know of resources that can help you? 5 months is not a long time. It seems like you need someone to give you guidance. Even if you can't afford the doctor, it seems like there should be some other trained professional that can offer resources with your logs etc that maybe won't be as much.

I feel for you and I"m very concerned for you. You're one of the ones that needs some kind of heathcare reform the most. We need lots of help to understand and get this under control.

I pray that you can get the help you need. If you can't find anyone to help you.... and you live in a town with a university or something, I would go so far as to call tehir endocrinology clinic and tell them your story and ask what resources they know of that could help you. Good luck!

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