High blood sugar and mood

Since I was diagnosed 3 years ago, I’ve experienced several highs 300-400 readings due to eating out and not taking my insulin until the next day, or just forgetting here and there. Overall, my bs is controlled very well.
However, I’ve been wondering why higher glucose doesn’t bother me. I don’t mean DKA levels (which led to my hospitalization and diagnosis). I mean the occasional highs don’t bother me. I feel more relaxed, less anxious. Running lower glucose 80-120 leaves me anxious and waiting for my next meal. Whereas when my numbers are higher, I don’t think about food. I forget I have T1 and feel very carefree for that small window of time.
Can anyone relate or have an explanation?

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Hi @TiJoy . Several years ago I switched doctors, and since my numbers had been running in the mid 200s he recommended some changes. The changes worked, but I called his office one day because I was feeling my low symptoms although I was in the 180s and I was worried I would I have what we called an insulin reaction at the time. He told me not to worry - that wasn’t going to happen at that number: rather, because I was accustomed to being higher, my body was not used to this new normal (which he also wanted to tighten up) but I would get used to it in time. Sure enough, I did.
It doesn’t sound like you’re regularly running in the 300-400s but even so, your body be more comfortable there. I’m not a medical professional, and this is just my personal opinion, but when trying to improve numbers that have been high, maybe it’s better to do it in increments - aim for say 170, then 150, then 130, then 120 for instance so your body can gradually adjust. Those numbers are simply an example - check with your endo to see what you should aim for as you ease your way down.

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That makes sense, wadawabbit. True I don’t regularly run that high. Of course, lows are absolutely miserable. I wish I felt as stable between 80-120 as I do during the occasional highs. I will mention this at next endo visit. I find this board more educational than doctors, usually.

Joy @TiJoy, I’m not really surprised that you feel more comfortable, or as you write - more relaxed, when you are a “little higher” than when your BGL is running “low”. Perhaps the “less anxious” feeling when higher is more mental than physical - I know that when my BGL is hanging around 75 - 85, I find myself checking readings much more often than when I’m around 180.

This brought back memories of when I was in my 20s after bowling or attending a ballgame and stopping with the gang for pizza and brew and not taking insulin when I got home; I bet by morning I was well above 400. But this was when blood sugar tests were only done once or twice a year, decades before digital glucose meters. BUT, somehow I survived and I’m now in my 80s - just don’t let this happen too often; with insulin that doesn’t need refrigeration [unlike the stuff we took out of animals] it is convenient to have an insulin pen with you all the time.

Joy, enjoy life and don’t let diabetes hold you back, and please do try to effectively manage your diabetes to allow this to happen.

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@Dennis I hadn’t thought about the mental component (perhaps relaxing and just not worrying about T1) Overall, I do well, but I appreciate the encouragement to stay on top of things. :slight_smile:

Hi Joy,
I can totally relate. I agree there might be a mental/emotional component. I know that when my blood sugar goes low it often drops very quickly, so if it’s 80 to start I’m not going to have much warning before I feel sick. Like Dennis said, when my blood sugar’s below target I find myself checking it way more often, sometimes even going for a snack even though I’m in range, just out of anxiety. I always feel a lot calmer when my blood sugar’s between 120 and 150, especially before bed. It might not be the “ideal” target physically speaking, but for me the peace of mind is worth it. I just don’t have the control to feel safe with a lower target.

And the body definitely gets used to running high over time. There’ve been many times over the years when, after running in the 200s for a couple weeks, being in range made me feel just like my blood sugar was low. Anxious, hungry, shakey… It took a little while each time for my body to re-learn what a normal blood sugar felt like.

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All reasonable answers so far, but a hidden feature that may be missed by most is the time delay factor. Many understand that when you are trying to raise bg at all, but particularly when raising from hypo levels, it takes 20 minutes for the food to START raising bg levels, slowly at first. If you use a CGM it gets worse, since once bg levels raise it takes another 20m minutes for it to raise glucose in lymphatic fluid, which is what the sensor needs to read. This can confuse things so that when low you rush to put fast carbs in but they don’t show up in sensor readings for what seems forever while in panic mode, so we keep eating carbs and then wonder why we go high shortly after. Like we’re always advised, eat 15 grams of carb and WAIT for about an hour before thinking about eating more, as long as low bg symptoms don’t get worse. Much better to raise bg 40 or 50 if you were at 70, for instance, than to raise it 150 or more from panic, followed by ,mountain peaks and valleys while trying to get sytabilized for a day or 2.

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@bsteingard thank you for replying. I do need to tune in and give myself more time to adjust to what’s normal and healthy.

@tedquick Thank you for sharing that. I did not realize it takes 20 min to start raising bg levels and another 20 for lymphatic fluid. I learn so much here.

Joy,
I was diagnosed just over a year ago and I also find myself comfortable with a range of 140-180. Most of this is because I also go low fairly quickly - from 100 to 80 in less than 30 minutes even if I am sitting still. Because I mostly live at this higher end of the range, I often get to 250-290 when eating - either before my insulin kicks in or because I underestimated carbs/fat.

In speaking my new endocrinologist (LOVE HER!), she also reiterated what @wadawabbit said - start to slowly live at a lower level: take a correction bolus to get to 150, then 140 with the ultimate goal to live at 120. She also suggested increasing my I:C ratio by .5 (I am a MDI user so I use a spreadsheet on my phone for my overall calculations to help.)

When I go low (under 75 for me) and if I don’t have down arrows, I only eat about 4-8 carbs to bring my sugar back up. Enough to stop the shakes but not enough to get me to my goal. The reason for this is as @tedquick said - timing. I learned fairly quickly that I am more impatient than I ever realized because I am watching my CGM like it is going to strike a bell “Out of Trouble and Good To Go” - this doesn’t happen. It can take me 60-90 minutes to get back into an acceptable range from a low and I’ve learned to slowly add carbs and not just 15 carbs which everyone always refers to. I have a fairly high I:C so 15 carbs is equivalent to 2-3 units of insulin.

From one newbie to another, good luck and trust your doctor along the great life experiences you get here from the ‘old timers.’ I always assumed most T1D lived at 110 and am finding out that a good portion of us are living at 150-180 - and everyone has a good reason for their choice. The goal is to stay healthy and become an ‘old timer’ on this board.

Best of luck!

MF

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@MFBarry thank you for replying. I relate to the impatience. My lows come on quickly, also. And I’m very symptomatic which is distressing. Thank you for the reminder in your last paragraph.

Oh yes, I’ve been through that panic eating too! I’m only one year into T1D, so have a lot to learn. The miserable part when running very low is having to WAIT for so long for the food to kick in and the sugars to rise - the CGM keeps alerting me that I’m low, and I’m like “I know! I know! Hang in there!”

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Yes, understood. That’s why Dexcom warns us to NOT rely ONLY on the CGM when running low readings. Doing a fingerstick to verify where you ACTUALLY are reflecting what your body is operating at the moment. Still takes 20 minutes to get there, but a lot better than waiting 40 minutes and overdosing on glucose in the meantime.

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I agree with what you said, Tedquick.

I switched from Medtronic to Tandem/Dexcom a few months ago and find the Dexcom sensor vastly more accurate. As a result, I do significantly less fingersticks than I did with Medtronic. Nonetheless, I do finger sticks in two circumstances:
(1) if I have reason to question the accuracy of the Dexcom reading, and
(2) when I need a faster reading than I can get from the Dexcom, such as when treating a low BG.

I’m lucky in one regard. I sweat profusely and feel jittery when I have a low. Accordingly, if I treat with about 15 grams of carbohydrates, I can usually feel if it is taking effect about 20 minutes after eating the carbohydrates (because I start feeling normal again). Sometimes I don’t bother with the fingerstick if I feel ok. However, I would always do a fingerstick before consuming more carbohydrates if I still felt sweaty and jittery 20 minutes after the first 15 grams. Otherwise, as you say, I’d likely start yo-yo’ing on carbohydrates and insulin.

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