BG Roller Coaster

My brother has been dealing with T1D since the age of 8. He is 25 now. He’s been having WILD BG issues for the past couple years with little to no change in diet (not great but not bad) or exercise (none) since the age of 16.

He wakes up in the morning and BG immediately skyrockets with no warning (will also do it throughout the day). Today, he corrected that skyrocket with an injection, and spent all day plummetting. Most of the time, the injection taken with the first meal of the day doesnt seem to work.

We dont know if its the insulin, lack of any exercise, use of marijuana, or what could possibly be making it go so crazy. He has been put on many different kinds of insulin and it seems to constantly go low or high throughout the day regardless.

Has anyone experienced this? We are desperate for some help.

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Hello @kellensiney and welcome to Type One Nation. Can a mediocre diet, no exercise, pot, etc make blood sugar hard to control? Yes it can. Can an awesome diet, a regular exercise schedule and quitting drugs help? Yes it can. Was there ever a time in my 43 years of T1 where I thought blood sugar control was “easy”, “regulated”, or “level”? No, no there wasn’t.

It’s hard to judge what you mean by wild, but I’ve been 430 and 53 in the last 30 days. Now if your brother has been in the emergency room with DKA 6 times this month or if he’s hitting 209 after every meal, we’ll those are really different things.

I keep a handle on blood sugar using a pump and a CGM, but there are plenty of T1s that just do shots and test. There isn’t a technology available to fix this if your brother isn’t willing to do the work. So if he is testing 1x every other day (very bad) or if he’s testing about 7-10 times a day (very good) it matters.

Burnout and depression are really common with T1 after some years and sometimes this is a matter of self neglect. Sometimes illness and injury make control harder and stress can make control very hard for me. If I had to guess from where I sit, your brother may be in need of some support from a doctor or therapist. Anyway, no offense intended, just a guess.

Anyway I hope your brother gets some support. We are here for you, or your brother if he wants to check the site out. I wish you both good luck :four_leaf_clover:

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Hi Kellen! @kellensiney,

I have found that increasing my basal insulin a little helps with increases when I wake up. A good way to check this is to have your brother skip a meal and see the effect on his blood sugar. If his numbers rise, he probably needs more basal insulin. Also, as much as I like to eat what I want, there are some foods that will shoot my blood sugar up quickly 2-4hours after I eat them and are very difficult to lower. Potato chips and buttercream icing are the two worst! I know when I eat these that I really have to keep an eye on my blood sugar for hours after I eat - and adjust my correction dose accordingly.

Also, I agree with Joe. Burnout is a real thing. Exercise (even just a walk every day) helps with blood sugar control and will make him feel better. I hope this helps.

Hi @kellensiney (I love your name, by the way). When was the last time your brother checked to see if his basal insulin dosage was good? It’s not unusual to need to change now and then, through no fault of anyone’s own - the body’s needs simply change.
Evaluating his habits would be good too. A new doctor wanted to make some changes to my regimen - pump basal settings, carb ratio, weight management etc. - but he said to do one at a time to know what made the difference. There may be multiple factors that would serve your brother well to change, so if he does decide to try the process of elimination I would encourage him to keep going rather than stop when he sees some improvement.
There’s a phenomenon (I hope that’s the right word) called Foot on the floor syndrome. I do find my numbers sometimes start to rise when I get out of bed although it’s not always the case. Here’s some Q&A I found in Taking Care of Your Diabetes that might be of interest - I’m sure you can find more info online.

People on the forum who take injections have sometimes found that changing the time of their basal insulin, or splitting the dose, has been helpful. I use a pump so can’t give any input there but it’s something he could discuss with his doctor. Hopefully he has a good endo who is willing to work with him to find the cause and solution/s that will help him get his numbers back on track. I would hope his current one has done more than simply try new insulins: while that may be the issue, if it’s not they should explore other options. If not be should look for another one.

@ Joe

I’m wondering about wild BG swings as well. When I first began to monitor this I’d typically top out about 225. Now I’m typically topping out at between 195 to 205. I’ve ordered some diabetic meals. The taste and portion size leave a bit to be desired but it seems to be helping. My last meal I topped at 193 and within 20 minutes after the topping out diwn to 169 two hours after eating. I think it was the fruit in addition to the meal!! That was the best part!!

Hopefully I’m moving in the right direction. The primary care dr considers it acceptable. She’s serving as my diabetes advisor until I meet with the endo on 8/25. While she thinks it’s acceptable, I don’t!! Hopefully the endo team can help me do better.

You’ve been at this 43 years. I’ve only been at this for about a month. Any thoughts or suggestions you might have are much appreciated. I think my goal would be to peak at 180 and come back to 130 or less within two hours.

Hi @RobFoshee I can keep my blood sugar nearly flat if I eat low to very low carbs. The only problem is, at least once in a while I like carbs! Right now I’m sick so even moderate carbs (I had 12 grams at breakfast) shot my blood sugar up to 230. On a “more normal” day I can keep the meal spikes to under 140 with “pre-bolus”. That is, taking my meal insulin and waiting 20-40 minutes and then eating. I suppose it’s a choice in a way, I am not overly concerned with a meal spike under 180, above that and I am irritated.

@ Joe,

Thank you for this information. I like carbs too!! I suspect the endo is going to prescribe low dose basal insulin to help stabilize things but we shall see.:grinning: As LADA progresses, I know I’m going to be needing ALLOT more in the future.

When BG gets above 180, “irritations” would be a good description. What I call “grotesque” is the so called “dawn effect.” No matter what I do BG is always 130 or higher first thing in the morning. I think the basal insulin likeky to be perscribed by the endo should help level this out. We’ll see. He’s the dr!!

I’m in the “club” now. No offense but I didn’t want to be. I don’t think any of us did!!:rofl::sob: You’ve been in the club 43 years meaning you know things a “newbie” such as myself doesn’t know. Trying to “reinvent the wheel” never made much sense. Your help here is much appreciated!!

@RobFoshee We have members in the 70 years t1 tier. I am just online often! I’m still learning! Come on experienced people, introduce yourselves.

@joe

I have been a Type I for 45 years. I am not 70 yet (hopefully I’ll get there). I use a FreeStyle Libre 2 and do regular old shots for lantus and regular.

A couple of things I’ll add.

** It’s all mental. You have to get on the program whichever his is, and accept that that’s life for you. Everybody’s got something. This is yours. Check BS regularly and take insulin as prescribed. You will feel sooooo much better if you do.

That said, it doesn’t always work out and you needs will change things up over time. Testing regularly will let him know this.

** The second, I heartily recommend he get a CGM as it makes things a lot easier and give you so much more info. It allows you to take steps when starting to go down so you don’t get low or too high. My fingers are happy about not being poked all the time. Possibly why your brother is not doing it? I know I didn’t like it.

You just have to roll with it. It will not be perfect all the time. In fact it probably never will be perfect with today’s technology. Roll with the punches and try not to get down on yourself when it’s not good.

when I was first diagnosed they told me “a diabetic has to be their own doctor”. True. True. Honestly most doctors I talk to know less than I do.