Not sure what I’m doing wrong. Advice?

Twiddles
By Twiddles Latest Reply 2017-12-11 09:59:21 -0600
Started 2017-12-06 07:42:50 -0600

So I have been a type 1 diabetic for 18 years and I don’t remember my blood sugar ever being this wonky. I will give an example of a typical day for me
Lantus: 32 units before bed
Humalog: 1 unit/ 10 carb and 1 unit for every 25 over 150

Morning bg 210 (this has an explanation)
Breakfast = 36 carbs, 6units if insulin

Lunch time bg 250
Lunch = 44 carbs, 8 units of insulin

Snack is usually 0-15 carbs no extra insulin

Dinner bg 375
Dinner 65 carbs 0 units of insulin (yes that is zero)

Bedtime bg 495
32 units of lantus

12 am bg 48
2 am bg 57
530 am bg 52

If I don’t take any humalog my bg readings are the same except I don’t have lows during the night. I accidentally forgot to take any insulin for 2 days and my blood sugar was still the same during the day even after a milkshake for a snack. I don’t know what to do and my insurance is catastrophic insurance so I would like some advice on what to try or what to discuss with my dr since I can’t afford to go more than once or twice.


12 replies

Vhm
Vhm 2017-12-10 18:29:22 -0600 Report

I am unfortunately focusing on only 1 part of your post - as in, "How do you accidentally forget to take any insulin for 2 days"?

Twiddles
Twiddles 2017-12-11 09:51:34 -0600 Report

Because the fast acting doesn’t work, I often times don’t take it as it’s $430 a month and doesn’t do anything. I was getting ready to take my lantus and something happened that side tracked me. After it was taken care of, I thought I went to bed thinking I took the lantus. When I woke up my blood sugar was where it’s always at so I didn’t think about it. When I went to take the insulin the next night it was already dialed in so I knew I forgot.

Gabby
GabbyPA 2017-12-10 07:10:47 -0600 Report

I am not type 1, but I follow Adam Brown who is and one thing he does is limit his carbs per meal to no more than 40. He tries to spread it out evenly. You may want to check out his book, Bright Spots and Landmines.
As a type two, I restrict my carb intake because of my insulin resistance. It could be that over the years, you may be developing a resistance as well, but that doesn't really explain the night time lows. Have you talked to your doctor about it?

Twiddles
Twiddles 2017-12-11 09:56:46 -0600 Report

My doctor informed me I must be eating in between and not telling him.i live in a small town where doctors are not that good.

DiabetesKnow
DiabetesKnow 2017-12-07 16:32:26 -0600 Report

Try an insulin pump with a CGM. Works for me and my last A1C was 6.4

Twiddles
Twiddles 2017-12-11 09:59:21 -0600 Report

My insurance doesn’t pay at all for pump supplies or glucose monitoring unless it’s accucheck or something like that. So that’s not an option unless I win a small fortune. But thank you.

Twiddles
Twiddles 2017-12-06 23:26:18 -0600 Report

I take the The insulin before I eat. It’s literally like the fast acting does nothing until I go to sleep If I take any fast acting after 11 am I struggle with night time lows. My blood sugar was 500 before dinner yesterday and the only insulin I had onboard was 10 units of fast acting. I took my lantus and woke up with a reading of 57 in the middle of the night. I’m not sure if I need to focus on something specific to try and fix it.

Type1Lou
Type1Lou 2017-12-07 11:22:08 -0600 Report

You might want to ask your doctor about adjusting your bolus carb to insulin ratio based upon time of day. I have 3 ratios and take more insulin for my dinner than for my breakfast or lunch…but we are all different.

Type1Lou
Type1Lou 2017-12-06 17:02:27 -0600 Report

Back in 2010, when I was on MDI, (Lantus and Novolog), I started getting more and more really scary nighttime lows. (Type 1 since 1976) My endo changed the time of day I took my Lantus from bedtime to morning. Even though Lantus provides a relatively steady 24-hour level of basal insulin, it does have a slight peak right after injection. Although this worked OK, I finally decided to give pumping insulin a try in 2011. I'm now sorry I waited so long to try an insulin pump. Pumping has given me greater control with more flexibility and less overall insulin…but it is a more expensive option. What I've discovered in my 41 years as a Type 1 is that our disease is never totally predictable…it would be so much easier to manage if it were! Also, as we age, our body and metabolism changes and we must often make adaptations in our diabetes management routine to adapt to these changes. I used to be able to eat more carbohydrate grams per day than I can now, even though I'm more active now. A great book that helped me understand my diabetes and gave me great insight on what to do is Gary Scheiner's "Think Like a Pancreas: A practical guide to managing diabetes with insulin" Mr Scheiner is a Type 1 diabetic himself as well as being an exercise physiologist and Certified Diabetes Educator. (The sample day you provided has me baffled…sounds like your Lantus dosage may need to be adjusted downward or maybe even split into 2 doses but that is a decision for your doctor to make with your input. I agree that what you are doing now is definitely not working well.)

WASHED OUT
WASHED OUT 2017-12-06 15:30:51 -0600 Report

Are you treating after your meals or estimating prior to the meals? It works better for me if you try to stay ahead of the curve on eating. Insulin lowers your BG and food takes it up but there is a lag time that has to be figured in before insulin begins its lowering curve. The closer you can get the food up curve to the insulin down curve the better it works.

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