FUDiabetes

Blood sugar insanity

When I see that I’m on the way down from overcorrecting a high, I catch it with glucose tabs. They act fast enough that I don’t go too low, and the quick action of the glucose also helps me quiesce the BG oscillations—the glucose action is completely finished in under a half hour, which helps me flatten the roller coaster. If I took too much glucose and bounce higher, I can wait to see where it levels off before deciding how much insulin to take to bring it into range. If the glucose finishes and my GB turns down again all by itself, that means I still have too much active insulin so I take another (probably smaller) dose of glucose to catch the second fall without overdoing it.

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I often do this, too. The problem this morning is that I was 6.4 and when I checked ten minutes later was 4.4, at which point I treated it as low, but the next dot was 3.6 and down from there.

I’ve wondered that, but this whole weirdness has been going on for almost two months now, it’s just this past week has been particularly bad. It’s also the weird combination of highs and lows. Usually sick means just stubborn highs for me. My allergies have been quite bad lately, though, and two months ago I did start an increased dose of allergy shots, so I wonder if that combination basically makes me “sick”
(as far as my immune system is concerned) for two months…

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Are you still traveling/not at home/on the unusual schedule of lots of exercise and then not so much?

Nope, that’s back to normal now, although my job (teaching) has always involved periods of unpredictable activity, but I’m back to “normal” unpredictability there. I’m trying to keep my activity roughly the same such that on days I’m not active I do some exercise. Now that I have a Fitbit again it’s easy to do, since I just try to hit 10,000 steps a day, and if I don’t do that naturally through the course of work, I’ll do something like go for a walk or go on my stationary bike.

It’s so odd, becuase the night before last I was entirely in range overnight and through the morning, then it was chaos during the afternoon and overnight and all through yesterday, and then last night I was entirely in range again (except low this morning, which Dex missed). We’ll see what today holds.

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@Jen, I really wonder if this is not the cause for your recent difficult times.

We have been having a horrendous time in the past 2 months, which I am thinking are primarily due to a lot of exercise but with a lot of variability on the exercise, the time of the day, the amount etc. I am realizing that the amount of exercise variability affects even all of our other ratios (ICR, CF etc.), so it’s not only basal that is affected (for us) but also meal bolus dosing, corrections etc.

I am not 100% sure of what I am attributing the source of our troubles to—but if I am right, possibly this could be your problem too?

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Yeah, I definitely think it plays a role. I don’t know how to figure out how to deal with all the variables. Food, exercise, hormones, seasons, stress, illness. Ugh. I’m using literally all the tools in the toolbox that I know of, and still struggling. I’ve even tried to go back to a higher carb diet, thinking that maybe my lack of bolusing for protein was part of the problem (every time I try to bolus 50% for protein I go low, no matter the type of timing I tried, so I just didn’t do it), but I am getting horrendous spikes from carbs (like now, currently sitting at 20.2 mmol/L despite taking 15 units of insulin, half with my pump and half with an IM injection) and lows at other times—even without any obvious exercise. Last night I woke up in the middle of the night at 2.0 mmol/L after doing an IM correction for a 19.1 mmol/L reading (again, tried to cover some carbs). At times I feel like maybe it’s just my schedule and intermittent exercise, at other times I feel like something else must be going on because it’s just so ridiculous with the amount of around-the-clock effort I’m putting in. If it’s my schedule and activity level I’m not sure what I can do about that; as someone who can’t drive and who has a job that’s not just sitting behind a desk, that’s not likely to resolve anytime soon. And, while some of my job duties are new, I’ve always had a variable schedule as part of my job and the fact that I use public transit, and I’ve never had quite this much difficulty in controlling things most of the time.

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Oh Jen! I’m sorry it’s so rough. I am hoping that soon things will settle down. Sounds frustrating.

EH has felt the same lately, no matter what he changes, with the daily life variables you mentioned, he’s running up against bad control. So, you’re not alone.

I do think that appreciating your own efforts is important. With all the work you’re putting in, you’re doing better than you’d be doing otherwise! So you deserve a pat on the back for your continued efforts.

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So I’ve been gradually tweaking my basal rates, and three days ago upped my metformin dose to 2,000 mg/day. I was taking 1,000 mg/day, but my doctor actaully prescribed 2,000 mg/day and said I could increase the dose if I wanted to. Between the two, it’s been like magic. The past two days have been back to normal for me: I still have highs and lows, but nothing like the extreme swings I’ve been having up until now. Here’s hoping it keeps up!

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Yay! That’s great news. I’m glad things have stabilized. And thanks for sharing the info about what changed and worked.

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@Jen, I was diagnosed with insulin resistance in 1998. That was 53 years after my diagnosis. I started using oral T2 meds along with my insulin. I had gained weight, and my insulin doses were increased. The medication I used for many years was Avandia, but it did not help very much. My BG was more stable, and I stopped gaining weight, but I needed to lose weight. I started using Metformin, 2000 mg per day, and it helped me so much! In a little more than a year I lost all the weight I had gained, and I stopped the Metformin for almost a year. Then I started gaining weight again, gradually. I Have now been using 1000 mg of Metformin for a few years, and the insulin resistance seems to be very much under under control. I an eating an average of 150 carbs per day, and am using an average of 34 units of insulin in my pump each day.

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That’s fantastic that metformin is working so well for you. It seems lots of T1s benefit from it. There’s even a thread on this site about it.

Unfortunately, my BG has gone out of whack again, but this time it’s just running high, so I think I just need a basal increase.

I suspect a large part of my control issues are related to female hormones, Graves’ disease (I swear I think my thyroid produces more hormone some days/weeks that others), and the fact that I’m using about three topical steroids for chronic allergies. I think if those three things were taken away, I wouldn’t have nearly as many fluctuations in insulin dose.

I’m sure I have a little insulin resistance, too. Metformin hasn’t affected my TDD much at all. Eating under 50 grams of carbs, my TDD is around 45 units on average. But that varies hugely, based on food, activity, hormones, and other factors (such as today I’m running high all day, so my TDD will be higher).

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I’m considering just giving up until my endo appointment next month. Only half kidding… Sigh.

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Hang in there @Jen! The worst days are often followed by the best!

Cheering for you. - your friend Michel

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Thanks! I just get so burned out sometimes. This has been going on for two months non-stop, and badly like this for three weeks. And every time I think I’ve fixed it I flatline for a day or two and then just go back to square one.

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Ugh. I’m sorry. EH has had some days like this lately too. Super high BG despite careful carbohydrate counting. Some stuff just seems to be impossible to guess.

Yesterday: Low carb dinner, injected 8 for just squash and a white wine, then added an additional 7, and still woke at 156. Upon waking today took 6 thinking he would get breakfast, but after 90 minutes he was still at 129 so he didn’t eat any carbs (other than some half and half in the tea)…anyhow, unpredictable for sure. Less exercising because of travel seems to play a role, but it’s so wild sometimes.

You are certainly winning the prize, but I wish it was for something more fun than the zaniest BGg day. I’m certain it does not feel good. :frowning:

Sometimes I want to eliminate all possible variables, and give up on trying to be unlimited, and be completely limited in a completely predictable manner. But I know even that won’t work all the time.

I know that we sometimes get on the case of endocrinologists here at FUD, but I’m wondering if there isn’t a special specialist who might be able to shed some light on what you are experiencing? I’m not really sure how the healthcare works where you’re at/in your situation. But I am always hopeful that somebody else will have the answer out there.

I am proud of you for your continued effort to do your best. -hugs-

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My endocrinologist is fantastic, so I’ll definitely bring it up with him if it’s still a problem when I see him.

I’ve actually begun to really wonder if the topical steroids I take for all my allergic issues are wreaking havoc. I’ve been taking htem for years, and they aren’t supposed to have an effect on BG, but maybe now that I’m low-carb and aiming for really tight control I’m noticing that they do. I’ve forgotten to take these medications on some days and I’ve noticed that my BGs tend to be better.

Last night I went to bed at about 17.4 mmol/L after having done an IM correction and running a +100% basal rate. I didn’t take any of my steroid medications. Overnight my BG came down to normal and then went low. I woke up at 2.4 mmol/L at around 3:30 AM. I treated with six glucose tablets, and since then it’s been a flatline at around 5.4 mmol/L for the past four hours or so.

Since I skipped my medication, I woke up stuffed up wtih a sinus headache and my hands itching like crazy, and I’m sure I’ll have asthma problems today. But I did some googling last night and it seems there are alternatives to steroids (I’m on an inhaler, nasal spray, and cream), at least for the first two. They are not standard treatment (according to Wikipedia), but I’m going to see if I can find a doctor willing to switch me over and see if that helps.

This whole situation also reminds me a lot of when I was diagnosed with Graves’, which I still have, so I’m also wondering if my thyroid is out of whack again. But the steroid thing just seems to make more sense based on the few experiments I’ve done of skipping them and my blood sugar seemingly normalizes.

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@Jen
Not likely the same as you are using but in the ballpark to give an idea maybe?

https://www.omicsonline.org/the-effect-of-topical-steroids-on-blood-glucose-profile-in-diabetic-patients-2155-9570.1000133.php?aid=1159

The Effect of Topical Steroids on Blood Glucose Profile in Diabetic Patients

Received: December 08, 2010; Accepted: February 21, 2011; Published: February 23, 2011

Purpose: To investigate the effect of topical steroidal eye drops on blood glucose levels and glycemic control among diabetic patients.

Conclusions: The use of topical steroids by diabetic patients appears to increase blood glucose levels and interfere with glycemic control.

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Thanks! I have used steroid eye drops briefly in the past, but at the moment I’m using a steroid inhaler, nasal spray, and (strong) cream. I’ll have to do some research when I get home and see if I can find anything about these affecting blood glucose. There are lots of anecdotal reports of these medications affecting control in forums and Facebook groups (specifically those in which people aim for tight control).

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It’s interesting, though. This morning in the half hour since getting up my BG has jumped up by 2 mmol/L (36 mg/dl) without eating anything. So hopefully that’s just a “feet on the floor” thing and not a sign that I’m going to continue rising all day.

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