At 31, I was incorrectly diagnosed with T2D by my PCP, prescribed medication, and landed in the hospital with DKA 4 days later. My A1c was 15. After my brief stay in the hospital and a revised hypothesis (later confirmed with antibody tests ordered by my endocrinologist), I still had ongoing neuro symptoms and was rather shocked by the whole series of events. Nobody in my family is diabetic.
I threw away almost all of my food and rehabbed my diet. My diet collapsed down to a handful of meals in order to try to figure out how to manage my blood sugar, but by the end of 2021, I had started looking for new options (for diversity and joy). My mental health was not great, but definitely not the worst it’s been. I struggled with feelings of bitterness and resentment. I still do… I’m seeing a psychologist, but progress is slow.
Around the New Year, some pain in my wrists became semi-permenant. I’ve seen a neurologist and it is likely carpal tunnel, we will test tomorrow. On top of that, my carbs: units insulin seems to have shifted in the last two weeks. I expected it to shift (I had some function left, but also an immune response that was literally off the measured scale), but I’ve moved from 18-20:1 to 12-15:1 and while I didn’t know where I would end up, that feels pretty dramatic.
I just switched CGMs (Abbott => Dexcom), so I don’t have a full 30d stats block, but it’s currently showing a 96% time in target (80-140) with an average of 111 and std deviation of 15 and that’s pretty representative of what the other one showed. I had my A1c read for the first time since I was hospitalized this morning. Diabetically, unless my CGMs have been off, I think I’m doing ok (I really wish I could pull the average down another ten points though).
I realize these questions may be more appropriate for my doctors; I don’t take random responses on the internet as medical advice and will follow up, but I would appreciate any experience people are willing to share.
Does it ever get easier or just more normal?
Are the magnitude/timing of my carbs:insulin shift normal or concerning? Should I be expecting more shifts? How often? Do these shifts ever go in the other direction (I can’t see why they would)?
I’m currently in a position with my basal where I can either go up 10-15 points overnight at 7 units or drop 20+ points (and run the risk of hitting an alarm) with 8 units. I find it generally easier to keep myself lower when I’m on 8 (duh), but the nights are harder to manage. Any thoughts or advice here? My pens don’t do half steps, so I’ve been thinking about splitting it to half as much, twice as often.
Most of the graphs I have seen for “normal” blood glucose following meals show a sharp rise followed by a steady drop off and the targets I usually see discussed are 140 post meal and 120 a couple of hours later. That is generally not my experience. If I inject after the food is prepared and before I start eating, I am not usually peaking until 2+h have passed. This makes the 120 target 2 hours post meal feel challenging. I don’t really know what to ask for this one… is this diet? Do I need to change the timing of my insulin?
This is long… thanks for anyone who takes the time to respond.