Egad!

[Intrigue]

I must admit that my frustration level is increasing daily! Last Monday I was diagnosed and started out with a BS of 433, which went down to 336 after one day of insulin injection. I am allowed 180g of carbs daily on a 1400 calorie diet and I count everything I put in my mouth. I check my levels before and after meals and at bedtime. I drink at least 8-10 glasses of water per day. I started out on day one with 5 Units of Novolin and am now up to 40 Units. Even with all that, I STILL cannot get my BS's to stay below 300! It is now in the high 200's when I awaken every morning, but jumps above 300 after breakfast and jumps all over the place during the day...usually ending around 325-350 at bedtime. I really miss swimming at my gym, but my doctor says I cannot exercise until my levels consistently remain below 300, as my body is already under enough stress. As someone mentioned in a previous post, this may be because I am still regulating my thyroid hormone since a thyroidectomy two months ago, but other than that, is there anything else I can do? Today the doctor mentioned trying a different medication -- Lantus. We're going to discuss that on Thursday when I see him.....perhaps that will help.

Ok, I shall officially cease whining. ;) Just needed to vent, gang....any insights or advice would be much appreciated. Thank you!

[kiwi]

As a type 2, are you on any oral medication?
Did your doctor give a reason for staring on insulin right away?
You are getting off to a great start, learning how to count carbs and test. Keep that up.
Do you have a Diabetic Team?
When your blood sugar levels are up you could be making ketones. You test for this by getting a urine sample and then inserting a dip stick which will turn a certain colour depending on the level of ketonses. Although these strips only test one family of ketones, they do give an idea. When ketones are present (usually when levels are over 13.5 or over 200) and you exercise, you will produce more ketones. Ketones are bad and will cause your levels to rise further. This is potentially lethal especially if you end up in Diabetic Keto Acidosis. However, DKA is more common with type 1 diabetics.
The type of insulin you are taking is affected by exercise. If you were to exercise within 90 minutes of taking this your levels will drop fast. This could be a good thing if you are not making ketones. However, you can also become quickly hypoglycemic which is not a good thing.
If you are quite insulin resistant, ie you are making insulin but your body can't use this efficiently, hence the high numbers, you will probably need a long acting insulin like Lantus. Long acting insulins are called your Basal insulins. Lantus is a good one as it is not affected by exercise. Basal insulins are necessary to keep your body able to use the rapid insulin as well as keep your numbers in a better long term check. They also help with the Dawn phenonemon (early morning high numbers). For a type 1 if the basal insulin is not enough, then it becomes very difficult to keep the numbers in range with the short acting insulins. Once the basla is right, then the rest falls into a better place.
Once you begin the day with good numbers it is a lot easier to stay in a good range. Highs and lows becomes a dangerous roller coaster which is taxing both mentally adn physically.
You are so newly diagnosed, I am sure this is information overload.
So.. keep on learning, counting and testing.
Hopefull you will be back exercising soon, I know this will make you feel better!
Ask to have a diabetic team.
Ask if you should be taking any oral medication like metformin, avandia even Byetta.
Keep on posting.
Good Luck
Hope this helps.

[trpack]

When I was first diagnosed the doctor told me that the goal was to get the numbers close to where they should be in 4-6 weeks. I remember the goal for my 3 week appt was to break 200. I was put on some combination oral medicines that both made my body make more insulin as well as use it. The amounts of this were changed a couple of times and then the type of medicine was changed until things started getting somewhat in line. I looked back in my log book and the numbers were pretty close to what you described at the same time frame. Keep working at it and working with your doc. It may take some experimenting but you will get there.

[Intrigue]

I'm currently on Novolin, both NPH and Regular, but have heard Lantus is much more reliable, so hopefully he will change it. I was on Metformin, but after three days I was puking my guts out, so the doctor stopped that and hasn't replaced it with anything.

Your post raises another question. The doctor currently handling my diabetes is a primary care physician. Since I also have hypothyroidism due to my TSH levels being sky high after the surgery, would it perhaps be better to find an Endo who could handle both the Hypo and the Diabetes? What type of doctor handles your diabetes? I'm glad to know someone's numbers were about the same as mine...that's encouraging!

Thanks again!

[Cyborg]

You should be seeing an endocrinologist for your diabetes.

[am1977]

Sorry that you are feeling a little frustrated right now- I know the feeling :rolleyes:.

It does sound like your regiment needs further adjustment, especially seeing that your readings are still too high. It sounds like you need more of your basal insulin. I would definitely bring this up with your doctor and discuss how you can get your readings down.

I know it can be very difficult at first, but you will be ok. I think we all learn as we go...

Hang in there :wink:

[trpack]

What type of doctor handles your diabetes? I'm glad to know someone's numbers were about the same as mine...that's encouraging!

I currently work with a great , but bossy, small town doc. The closest endo to me is in another state and about 200 miles away. I live in the kind of place where I could walk out my back door, into the woods, and go for days without seeing a person or a paved road. If all things were equal I would definitely work with the specialist but I also wouldn't replace the relationship that I have with my present primary. She has called me, from her home, at 10:30 in the evening to discuss my numbers. We run into each other on our nightly walks around town, but most importantly she listens to me. She gives the medical advice, I discuss how that will fit in with my lifestyle, job, family, etc. and we come up with a plan to keep me healthy. I would have a hard time working with somebody that didn't include me in the discussion. So most importantly for me with my limited selection is to have a doc that I am very comfortable with and that I trust.

[seacomp]

I am allowed 180g of carbs daily on a 1400 calorie diet and I count everything I put in my mouth. That's a massive amount of carbs for someone just trying to get control.

[labob]

After I was diagnosed last December, I was put on Lantus (slow-acting insulin), Humalog (fast-acting insulin) and pretty hefty doses of glyburide (which cause your pancreas to squeeze out more insulin). With all that, it still took a few weeks for my numbers to settle down. So be watchful (keep checking regularly, as you have been doing), make the adjustments that you can (I agree that 180g of carbs per day sounds a little high), but also, be patient. I stopped taking insulin after a few weeks, gradually reduced the dosage of glyburide I was taking, and eventually swapped out glyburide for a low dosage of Actos (which helps your body use the insulin that it still produces). Your body has been under a lot of stress, probably for quite some time, and it will likely take a little while for it to adjust. Make sure you keep good records of your readings, though, and keep your doctor informed. If you aren't where you want to be (most of the time, anyway) in another week or 10 days, though, you might want to consider more radical adjustments to your diet as well as additional changes in your medication.