Yes Alex your words have helped, thank you. I’ve had so many lows in the past three months that I totally understand how being high is better than low. The lows are torture. I do trust my doctors so far, especially my primary doctor. During her residency, she almost killed a patient due to mishearing 50 units instead of 15! So she prefers to err on the side of life! Haha! You “old timers” have helped me tremendously as I’m learning that change is inevitable and perfection can’t be achieved.
I am type 1 and I am 13, i have the pump, omni pump, and I only use humalog now, my pump gives me little spurts of insulin every hour in stead of taking lantus. I put in my bs (blood sugar) from my DeX and tell my pump the carbs and it gives me insulin so I dont have to take shots.
Thank you ViviAnn, you “young timer” lol. I will definitely research using the pump. I can see how it gives us more freedom.
Yes it helps alot. And your welcome
Everyone has explained it really well above. I just wanted to add that we found Dr. Bernstein’s Diabetes Solution book and we’re using his low carb methods to a certain extent and it makes the blood sugars much more stable. It’s never a no-brainer, though. We’re always checking the BG number from the Dexcom (a literal life-saver!), and I don’t know if I could be as careful with my son’s numbers without it. In fact, I completely understand when moms say they run their kids between 150 and 200 because they are so afraid of lows.
With the Dexcom, we feel comfortable running his average between 100 and 120. We’re working on getting it lower. We started at a target of 150 because he’s a child. Dr. Bernstein recommends 83!! It’s a very limiting diet but people who do it swear by it. We’re not 100% on the diet at this time, but for an adult, especially, it’s a very good solution. So many people eat low-carb now that it’s very easy to tell a restaurant to leave off the bread, hold the bun for a hamburger, etc.
Dietitians and some endos will say diabetes is controlled entirely by insulin and not diet, and that would be true if the insulin was as good as that our own bodies were making (quick reaction, automatic glucagon release for lows) but we found that we had to control the food significantly to have a good result. As for time in range, when he stays between 70 and 150 we have succeeded in my book. We have gone for more than a day in that range. Doing Bernstein’s methods totally, people don’t go over 130 very often and they have almost no lows.
Lows are usually a reaction to too much insulin, and the “law of low numbers” is that less insulin leads to less severe mistakes. It’s easy to correct if you’re off by one unit. It’s harder to correct when you’re off by multiple units. Really serious lows are usually a combo of exercise and too much insulin. Dr. Bernstein does extensive testing for the basal rate using fasting (that’s the lantus for you). Dr. Bernstein actually recommends Tresiba for the basal and we love it! It’s really helped my son’s numbers be more steady. It also doesn’t make him sink down in the middle of the night. We’ve only been doing this for 7 months and we’re still on multiple daily injections. We’re out of the honeymoon so he has stabilized.
There are multiple approaches if low carb doesn’t appeal. Sugar Surfing people have had great success as well! Get the Dexcom or the Freestyle Libre with the MiaoMiao transmitter which turns it into a CGM. I only have experience with the Dexcom but my father in law uses the Freestyle and someone on the Type One Grit facebook group uses the MiaoMiao with great success. It’s such peace of mind to see your blood sugar 50 times a day instead of 4-8, not to mention not having to stick your finger all the time.
We do a finger stick below 70, especially when BG is changing rapidly. Keep in mind that the Dex can be 15-20 minutes behind the finger stick because the Dex is in the interstitial fluid instead of using the fresh blood. You can easily over-correct and swing from a low up to 200 if you’re not careful.
Dr. Bernstein has a ton of YouTube videos if you’re interested in his methods. He doses for protein which is a game changer and explains so much. Not all carbs are created equal. At least starting a carb meal with a protein is a very solid approach to slowing up the food’s reaction in your body. If you have gastroparesis (delayed stomach emptying), Dr. Bernstein has videos about that, too. Good luck to you!
Thank you, Christine, for the encouraging reply. I eat about 70g of carbs a day. My MD suggested lowering the Lantus and I rarely need Humalog. I’ve been running about 140-150 the last week or so, and and the lows are at a minimum. I feel much better, so your post makes sense. I will order Dr. Bernstein’s book today.
First off I would like to say good luck! Managing diabetes can be very difficult at times… I am relatively new on this forum, but I have had T1 for 43 years. The options for care have evolved considerably since I first started back in 1976. Looking through the replies I will try not to duplicate too much but would like to give a little advice. Even though it’s been said before I would like to emphasize the importance of finding s reasonably good endocrinologist/ diabetes specialist that will take the time to speak with you and explain things. Over the years I have been to several due changes in location, insurance etc… Most have been reasonably okay. One I told to kiss my A$##$. He wanted me to make a big change in my regimen and when I asked why he told me that “I am the doctor” with no other explanation.
Also try pay attention to how you feel both mentally and physically. Often it is tough to feel the lows but sometimes subtle cues are there. If I start getting emotional and upset over silly stuff I will check my sugar or just take a sugar pill if my machine isn’t handy. Also look at the time of day when things like highs or lows occur because that will help you to find patterns which can be corrected.
I can definitely sympathize with your aversion to the pump/CGM route. I used injections for 42+ years to attempt to keep under control sometimes more successfully than others. I got my first pump and CGM about 6 months ago. In a lot of ways it has made many things easier. The main thing is that I find the readout from the CGM will usually alert me to the possibility of a low sugar episode before I would notice it. It’s not 100% reliable so I put things into context before I treat a low, What level of activity, when and what did I eat last, how do i feel? If you ultimately decide to go in that direction do as much research on them as possible. Look at other threads on this forum
you may have missed an opportunity to reply “… and you are fired”. but KMA is pretty good as well. nice job.
First, let me tell you I have had T1D for 49.5 years. And although others have said their insulin requirement varied over the years, mine has not. Except for the four times I was pregnant, my total insulin requirement for the day has remained between 19 and 26 units (depending on how much I eat). My pancreas stopped making any insulin decades ago. But I am very sensitive to insulin. Others who are not so sensitive or who eat more can need 60 or even 100 units per day.
You asked about what if you were not eating anything. When I have had cataract surgery and my two colonoscopies, I had to fast beforehand. Those times, my endocrinologist suggested reducing the basal rate on my pump by 1/2. Typically I take about 12 units per day as a basal rate (the amount I used to take of long-acting Lantus before going on the pump). So cutting the rate in half would be 6 units per day. However, stress can raise the requirement. My requirement increases about 50-75% when I am stressed.
As to low carb diets, I have always eaten a fairly low carb diet (since 1970). But carbs are not the only thing that can raise blood sugar. When I add cheese, which has no carbs, I have a high blood sugar for the next 4-5 hours, and I have to double my normal meal dose.
I have no idea what my longest period of remaining in a “healthy” range was. But since I seem to be so reactive to stress, not very long! On the other hand, I have no complications yet from my diabetes. When I was working, my A1C’s were in the 6.0-6.9 range. Once I retired, they went to the 5.5-5.9 range. I was doing nothing different, but I was under less stress!!
I hadn’t considered the mental/emotional component on bg levels. For now I have the endo and nurse who were recommended when I was in the hospital. They’ve been okay, I guess. I don’t even know what I’d be looking for. But they do respond quickly when I message them. I will keep a more open mind about the pump/CGM option.
Hi @TiJoy and thanks for participating in this community. I was diagnosed in 1963 and am doing well. My eyes, kidneys and heart are all fine, and while I have been having some cramping in my feet that may or may not be due to the diabetes (my dad had that problem too but was not diabetic), no nerve issues to speak of. I had my very first case of what I call “PRE-KA” the beginning of this year (a term I coined because I came very close but didn’t quite go into DKA) that was due to a damaged pump cartridge. I’ve used a pump for 20 years now and this is truly a first so don’t let that scare you away.
You asked whether the body needs insulin aside from when we eat, and it wasn’t until I started pumping that I discovered it does: our bodies make a constant supply of insulin - called basal insulin - which may vary from time to time during the day, with stress, illness, increased or decreased exercise, and other factors. When you start on a pump your doctor will determine the basal rate/s you need. I myself have 4 while others have more, or less. Having several (if you need to) does not mean there’s anything wrong with your body - it just has its own varying needs. There may be some trial and error involved in setting them so don’t be surprised.
I highly recommend finding an endocrinologist certified in diabetes treatment, as well as a nutritionist to help you learn to count and manage carbs, etc of you haven’t already. Your doctor may have a diabetes nurse educator (DNE) who can also help manage your care.
Wishing you many happy healthy years ahead.
welcome. I was diagnosed 3 years ago at age 69. I have not had the time to review the other responses but suggest the following: 1. find a good endocrinologist 2. get a pump [i use an omnipod and will build a loop soon so that it mimics an "artificial pancreas’ 3. I use Fiasp in the pump which does seem to work a bit better than Humalog [pumps use only fast acting insulin] 4. Get a CGM. I use dexcom. it has the advantage of an alarm which will sound when you go low…critical at night. 5 Subscribe to ADA, and also type 1 on flipboard. 6 find a local support group. 7 contact the nearest center for diabetes researcn in your area. Lots is happening in the area and you should try to stay abreast of developments. 8 remember that you are the doctor here…it all boils down to your own decisions 9 exercise regularly…the effects persist long after you complete your exercise regimen 10 avoid stress to the extent you can …learn to meditate for example, count your blessings, sleep soundly [CGM really helps here] and remain optimistic. You are young enough that i beleive you will be able to experience a functional cure. Tom
Thanks waddawabbit and tomlinn, these experiences and perspectives are very helpful
Hello, I am new to all of this as I am currently on my 3rd day in ICU from being DKA. I am 24 and was diagnosed Sunday morning with T1D.They are releasing me tomorrow and I just had a few questions. I do HVAC work and am very active, I currently don’t have any insurance so I will be paying cash was looking into the G6 and the pricing of the sensors. Can you get more than 10 days out of one sensor? Will T1D effect me working in the heat of the summer? my sugar reading after dinner tonight was 275. kinda high I think there upping my dose to 12 units tonight ill see in the morning how it works. I’m going home tomorrow just some insight on what to do or look out for would be helpful. Thanks everybody
Hi Chase. I’m new myself so I can’t offer too much. There are some regulars on this board who should be popping in soon. It’s great you found this forum so soon after our dx. Good luck with everything.
Hi @Chasebarber Chase, I happen to design HVAC systems and have spent some time in attics and machine rooms so it’s nice to meet you and Welcome to TypeOneNation.
I am not going to lie. Yes it will affect you. Diabetes affects everything eating and exercise. Carbohydrates make your blood sugar go up, insulin and insulin plus exercise makes it go down. Everything else is a function of practice.
Please consider getting the book “Think Like a Pancreas “. It’s got a lot of info.
There are cheats for all CGM sensors and people have reported various results and even some practices but they mostly come down to telling the transmitter you are starting a new sensor and then connecting it back on the old sensor. Your best bet is to call DEX and asking them straight for the cash cost with no insurance. Try bargaining with them they need your money as bad as you need their sensors.
Heat is a funny thing I usually need less insulin in the summer. Others more. What’s important is keeping your blood sugar good.
Fast acting insulin starts to work in 5-25 minutes and keeps working for 3-4 hours. After dinner your bs goes up and then comes back down. If I ate a carby meal my bs would be higher than normal at +1, +2, and +3 hours after it and wouldn’t come back until 4 or a bit more hours. Your post meal blood sugar can be controlled by adding exercise or by eating slower carbs (lower glycemic index). You can look up carbs and glycemic indexes for foods on google.
Good luck hope to hear from you
Ive never had trouble in the heat, I live in Texas and do better than most in attics and such. Just make sure you stay hydrated, if your blood sugar gets high you’re going to be prone to dehydration from peeing out the sugar and ketones. Lots of hydration tends to slightly lower your BG and dehydration raises it.
Its going to take you a few days to get your insulin and diabetes dialed in, and then a few weeks to get it more dialed in, then months, years, decades. Ive had T1D for 15 years and I still learn new things everyday, I still get occasional unexplained high blood sugars no matter how much knowledge, experience, and attention I apply. Nobody has mastered it, all we can do is manage it and not let it manage us. Remember that this isnt a race, its a marathon that you’re going to be running for the rest of your life. You are going to make mistakes: high blood sugars, hypoglycemic crashes, forgot your insulin, accidently took it twice, getting normal sick and having high BG, waking up on the kitchen floor to discover you ate half the kitchen. There is a whole lifetime of frustrating “what did I do wrong” moments ahead, and most of it doesnt really matter and gets forgotten. What matters is the goal.
The diabetic goal is the A1C, your average blood glucose over 90 days. Mistakes happen everyday, and your average is a lot more realistic than a snapshot of a single moment, on a single day. But that’s not the main goal. The main goal is a lot simpler, and I bet you already know it. The main goal is to live a happy and fulfilling life. Managing your diabetes and avoiding complications will probably further your enjoyment of life, both today and tomorrow, but you mustn’t lose perspective that diabetes is just another small facet of a greater world you navigate everyday.
P.S. Get insurance. I got a pump this year, so far insurance has paid out over $25000 for my diabetic supplies, pump, and doctor visits. We arent even halfway into the year. My yearly premiums are only $2600, it definitely pays for itself exponentially if you have T1D; normal 24 year olds, not so much.
If you have to pay cash, Walmart Pharmacy sells over the counter(no prescription needed) insulin(Novolin R & Novolin NPH)for $25 a bottle, syringes for $10 a 100ct box, and test strips for cheap. The test strips and syringes are quality, but the insulin sucks. You have to bolus(Novolin R) an hour before meal and it’s way slower than Humalog. You have to basal(NPH) at least 3 times a day.
It sucks, but that insulin will keep you alive if you need it. Dont ever go without supplies!
Also keep in mind pharmaceutical companies often have programs available to help people get their medications if you are willing to do the paperwork.
Actually Chase @Chasebarber and Edward @SpecialEDy, the the Humalin and Novolin insulin are really good - they do just what they are designed to do.
I used these insulin formulations, and the much more crude animal derivatives for forty years, maintaining an HbA1c 6.5 or below, before the first rapid-acting insulin, Humalog, was approved for use on April 6, 1996. The Humalin and Novolin are just a little slower to impact glucose.