Replies to This Discussion

Permalink Reply by Juan Carlos Vazquez on April 19, 2012 at 4:37pm

Hi Im Juans Mom, I had the same problem with him. What I do when he eats more carbs I make sure its balanced,for example if you eat 2 slices of pizza , I make sure he has a salad with a low fat dressing,never anything thats says lite ( artifical sweetners)then lots of water no diet sodas or juices, you should be fine. If your on a pump you should be able to a combo bolus where the pump can evenly distribute the insulin instead of giving to all at once. There are carbs that take longer to absorb then some and that causes one to take more insulin. Have you ever bought the book called Calorie King or go online its gives every carb including restaurant foods, i use that alot when we go out and even at home and that has helped control his highs and lows and drink lots of water

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Permalink Reply by Gayle Kodimer Mckenna on April 19, 2012 at 4:56pm

yes, i have the book, thanks. i use the combo bolus a lot; especially when eating foods high in fat like all the sweets i eat. but i'm so worried about going to low that i don't always bolus the full amount i should take for the amount of carbs i'm consuming. it's a bad habit, but i hate the feeling when i go low. although i hate the feeling when i'm too high too-such a juggling act we have to do!

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Permalink Reply by Aimee on April 23, 2012 at 9:24am

Hi Gayle,
My daughter is a type 1 diabetic and sometimes I am worried about giving her the full bolus amount when he eats foods that are high in fast acting carbs. What I have tried lately with success is to give the full bolus recommended (and usually even slightly more) and then do a temporary basal of 0% for 1-2 hours. I will then check her blood sugar after about two hours to decide if I need to do another temporary basal. Giving her the insulin up front helps reduce the spike in blood sugar and the temp basal keeps her from going low. Best of luck!
Aimee

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Permalink Reply by Gayle Kodimer Mckenna on April 27, 2012 at 1:40pm

that's interesting. i've never thought of doing that before. i'll have to give it a try!

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Permalink Reply by garidan on April 27, 2012 at 1:54pm

That is called a superbolus (link)

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Permalink Reply by Aimee on April 27, 2012 at 3:18pm

Thanks for the link, Garidan. That explains it really well!

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Permalink Reply by garidan on April 19, 2012 at 5:59pm

The relation between A1c and complications dates back to DCC study which now is pretty old.
It's true A1c is important, but in vitro (looking cells in a dish sort of) it was shown high bg has ossidative effects, so it's bad always.
There are still no clear studies on persons, but the guess is the steadier the better.

Someone writes it's better a slightly higher A1c but steady BGs than a lower one up and down.

For example, when BG is high retina vessels grow up, when you go low small vessels "die" causing small damages. Nobody knows I much time it takes at high or low for this to happen, but better to avoid it.

Isn't that your low BGs are due to insulin stacking ?
I find easier to control one single correction bolus than many small ones with overlapping actions which are difficult to calc.

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Permalink Reply by Gayle Kodimer Mckenna on April 19, 2012 at 6:05pm

my lows are usually due to:1) hormonal fluctuations (pre-menopausal), 2) delayed exercise hypo. i have a pump, so it tells me how much insulin i already have on board. i don't think it's due to insulin stacking. i know what i have to do; i need to reduce my carb intake, and especially, my sugars. it's just so difficult for me! if i took all the refined sugars out of my diet, i'm sure my swings would go away. i need an intervention for sugar addicts (especially sugar addicts with diabetes).

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Permalink Reply by drsoosie on April 19, 2012 at 6:22pm

I am like you diagnosed at age 46 and just turned 50. Unlike you I am MDI. For me, my relationship with food is totally different than it was before and at the beginning of this diabetic journey. At first I craved all the things I thought I could not have. Then I concluded that when I had them and roller-coastered, I found I hated how I felt more than my desire to have those foods. So gradually I gave up my consumption of most sugar and do the low carb thing. I will say at first it takes some getting used to. But after doing this for the past two years, I do find my blood sugars more stable most of the time. Not to say I don't get the occasional high, but when I do I don't freak out as much since they are less than they were before. As far as the lows, I still have some issues with that. It seems my exercise patterns really make me more and more insulin sensitive. But overall I feel pretty good about where I am at. I guess it seems like you have to figure out what is most important to you...eating the stuff you love and bolusing correctly for that or your concern about possible damage if you do go high. This disease is truly a balancing act!

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Permalink Reply by KCCO on April 20, 2012 at 6:44am

Hi Gayle. I'll tell you what has really worked for me as far as cutting back on the refined sugar/carbs--I drink a full 64oz of water a day, but I put the juice of 2 lemons in with it and one Stevia sweetener (the organic kind without any other added sugar--it's really not bitter at all). I have been doing this since about mid-February and have reduced my refined sugar/carb rate by at least 75%. I still need a chocolate bar to get me through some of the PMS, but I find organic dark chocolate on sale and save it for those occasions (ironically, it's in the butter compartment of the fridge with all my insulin). Also, I have been able to completely give up soda--diet or otherwise. For several weeks, I was having more lows and having to drink juice to bring me back up, but haven't had to do that for a while now.

I completely agree with the other poster who said diabetes is all about a balancing act. For me, I have to cut out all the fake chemicals and sugars to help my numbers (or at least as much as possible). I have an A1c of 6.4, but I'm about to start on the OmniPod and hopefully will see that number come down as my control gets tighter.

But I would strongly encourage you to cut out all that sugar. It's not good for "normal" non-diabetics, and it's definitely not good for us. At least do some research on it. Sugar isn't necessary for life and is highly addictive. I don't know about you, but my rebellious nature doesn't want to be a slave to anything--person, drug, chemical or otherwise. It's MY body and I will control it.

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Permalink Reply by Laddie on April 19, 2012 at 6:13pm

The problem is that you don't know what these fluctuations are doing to your body. Some people have outrageous numbers and still stay complication-free. Others have pretty good numbers and have lots of problems.

I've been at this for over 35 years and especially in the early years have had outrageously high and low numbers. However, given today insulins, BG testing, and technology such as pumps and CGMS, my personal opinion is that you are taking unnecessary risks if you are seeing daily numbers in the high 200's and 300's. I also think that such highs result in crazy lows when you try to correct them.

I personally cannot eat lots of carbs and match my insulin to it. I have been eating about 120-150 carbs per day for years and still have lots of highs and lows, but not too many highs above 200. But lots of lows in the 40's and 50's. I have great a1c's and no complications.

Right now I am eating much lower carb averaging about 50 carbs per day. I'm not seeing many highs above 150 and very few lows below 65. I feel good and find I am much less hungry and less tempted by crap food. But what's interesting is that my average daily BG number is higher according to my meter and my Dex. So my next A1c is likely to be higher. So am I healthier? I think so, but I don't know so.

Good luck as you figure out where to go from here. I definitely think you need to lower those peaks. But how low do they need to be? A lot of people say 140, but I can't eat carbs and do that without going low later. But I think you can make some steps to at least get your peaks down to the 180 number that has been recommended for years. After that you can re-evaluate and decide what your next step should be.

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Permalink Reply by Gayle Kodimer Mckenna on April 19, 2012 at 6:35pm

i'm so thankful to hear from all of you who have been on this journey and know what i'm going through! i know in diabetic years, i'm relatively new at this, and maybe i'm still in a little bit of denial that i need to change the way i eat in order to get to those magic numbers. i know i would feel so much better if i did!

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