Blood Sugars Problems

[Tricia452008]

I have been a Type 1 for almost 17 years and things for the most part have been good until recently. I am 23 now and starting to have problems with my diabetes. About 4 years ago i switched to Lantus and Novolog Pens and it was great. Then about 2 years ago i put on almost 30 lbs in that year alone!! I dont know why. I am going to school for my Masters in Nutrition and i follow my diet very closely. I eat a good amount of protein and exercise about 5 days a week. I make sure to take care of myself. I also began to notice that about 5 or 6 months ago my blood sugars starting getting a little higher than normal. Almost 9 months ago my A1C was 7.9 not great but it wasnt that bad either. And now my blood sugars seem to be on a roller coaster. I am high in the morning, go down a little by lunch then get high again after dinner and i don't know why. Can anyone please help me figure this out? is it my insulin? i know i put on the weight cause of my insulin. i put on the weight all in my stomach. but why are my sugars going up? I am on ALOT of insulin right now too...my doctor keeps uping it and i know IT is NOT helping me at all. Can anyone explain this?

Any suggestions on how i can maybe lose this stomach of mine? and how can i get my sugars under control? I am eating and exercising like a person who should have a A1c of 6.0 not 8 or 9....i should have great sugars and they are horrible.. what gives?

[JediSkipdogg]

Insulin does not make a person fat, however, one side effect of insulin does. I've noticed insulin increases hunger. So the more you take, the more you want to eat, the more you eat, the more weight you gain.

I would suggest looking at how many calories you are eating. Instead of eating say 3000 calories a day, drop down to 2500 or 2000 and see what that does. See if that helps put your levels under control too as the more you eat, the more out of wack they will be. Remember, food is what causes BG to rise, so the less you eat, the less your BG will rise.

[lgvincent]

Is it possible you have thyroid problems? My weight never changed until my doctor killed my thyroid and I've put on 30 pounds and just keep gaining weight.

[kidvid]

I went on a super low carb diet - like a "Bernstein" diet and lost 6 lbs in 2 weeks. For me the weight loss was unintentional. I was trying to control postprandial spikes. It worked amazingly well, and my TDD of insulin dropped a LOT. I just couldn't afford the weight loss, so my doc took me off it and I'm using semi-low carb diet and Symlin for pretty good results.

So if you want to look at one avenue - super low carb eating - Google bernstein + diabetes and find his website and book. Follow that diet and I'll bet your insulin use drops and your weight drops. You have to decide if it's worth it.

Good Luck!
Joe

[ProudNanaof5]

Tricia, I was dx in June 06. I was put on Lantis and novalog. Later I was put on Symlin. I have gained 30 lbs. It was mostly in my stomach and legs. But.........I was skin and bones when dx. My cells and muscles were depleted so when I started taking my insulin, I expected to gain weight. I had been on Bernstein's diet and still am to a point. I do splurge a little from time to time. Do you take your Lantis in morn or night? How much do you take. I was having great bs in am but as afternoon went on it started to creep up. I am dividing my Lantis up now. Right now I am taking 50/50 but that is just experimental on my part. My afternoon readings are ALOT better. Everything is trial and error when dealing with meds. And I am fortunate that I have a very understanding endo. Everyone is so different. And the BIG D is different with everyone. Good Luck.

P.S. I started shooting in my behind and my stomach and legs have gotten smaller.

[Tricia452008]

thank you everyone for writing back......I am not eating more...I am convinced my weight gain is because of my insulin...i was shooting my stomach...and you know that insulin when it is not used is stored as fat...thats what my endo said...weither it is true or not i guess i dunno...but my weight gain is from insulin...i am 99 % sure of that......

this is why i dont understand my crazy blood sugars and what is going on here.....i eat healthy and am on a low carb diet...not exactly bersteins but close....so i am careful....and it seems no matter how hard i try i cant get my sugars to stay low.....i exercise and eat well.....i dont know why this is happening....

[ProudNanaof5]

Tricia, As I commented before it is trial and error. I started out with bs being 250 -500+. As my eno tried increasing and adding they are in the 80 - 116 range. Quite a change but it has taken time and it will not be an overnight ordeal. So be patient and don't give up. :hmmmm:

[JediSkipdogg]

Vince brought up a very great point about the thyroid. When is the last time you had that checked?

Also, when you continually inject in the same spot it causes slight bruising (even non visible) and can lead to excess weight in that area and minor scar tissue. I use to only inject in my arms and very rarely my legs. This lead to my arms being fat. Then when I went on pumping, my arms went to normal so now you see my muscle and my lstomach is now heavier than it use to be. And that change only happened when I started pumping.

[grace girl]

I would definately have your thyroid checked, just to be sure.
My next thought would be to totally rule out the possibility of infection. I had some major roller coaster blood sugars a month or so ago that I couldn't explain...turned out I had an infection that I wasn't aware of.

If you rule those things out, my next thought would be to take a look at how your lantus is working. I've pretty much run the whole course with my Lantus, and I've learned that it is a different experience for everyone. I had erratic numbers regardless of the dose when I took it at night, also when I took it in the morning. I've recently split the dose and I've had the most stable blood sugars since the day I started taking it. For me it wasn't working full force until it peaked 4 hours after I took it, and it was running out about 20 hours after the shot. Left me with little or no basal for quite a bit of the day, and plenty of erratic numbers to show for it.

Just a few thoughts. There is a reason you're going through all of this, it just sometimes takes some serious investigative work to find the answers.
I wish you luck! Keep at it and you will find it!

[Tricia452008]

I am going for blood work at the end of the month so i will make sure to check my thyroid.......

and what do you mean you split the dose grace girl? cause i have been steadily increasing my insulin dosages for over a year to the point that i am on 50 units of lantus ....do you mean that your shooting some at night and in the morning? maybe that is what i need to help me cause i have been increasing for over a year and no results...in fact my sugars seem to have worsened over the year.......

[lilituc]

If you are taking a large number of units in one injection, you might want to split it up since that can contribute to uneven absorption rates. Also watch out for scar tissue or lumpy areas, because that can also interfere with absorption and cause erratic numbers.

Do you look for patterns? There are some helpful tools out there like John Walsh's Smart Charts which can help to illuminate patterns so you can figure out where the problem areas are and which dose needs to be adjusted. Other things you might want to look into are - do you have Dawn Phenomenon? You might need to take more insulin with breakfast. Are you eating a high-fat meal? You might need to take half at the beginning of the meal and the rest later. When are you taking the Novolog - after the meal, before the meal, how many minutes before the meal? This is a long shot, but is your insulin going bad? Do you keep it somewhere warm?

[Tricia452008]

where can i get these smart charts? as for the insulin...it stays in cool places.....i always shoot at least 10 mins before a meal and i always check my blood before and after meals....i do wake up with high sugars i do not eat high fat meals....low carb and protein that is what i eat.......

[lilituc]

where can i get these smart charts?

They are here (http://www.diabetesnet.com/diabetes_tools/index.php) - you can order them or download the sample for free. The Enhanced Log might help also if you have weekly patterns. Or there could be other tools out there; these are just the ones I know about.

[Tricia452008]

thank you everyone for your help...i have soooo much to tell my endo now thank you!!!

[grace girl]

[QUOTE=Tricia452008;150642]I am going for blood work at the end of the month so i will make sure to check my thyroid.......

and what do you mean you split the dose grace girl? cause i have been steadily increasing my insulin dosages for over a year to the point that i am on 50 units of lantus ....do you mean that your shooting some at night and in the morning? maybe that is what i need to help me cause i have been increasing for over a year and no results...in fact my sugars seem to have worsened over the year.......[/QUOTE

Split dose: take your total dose and divide it 50/50, taking one shot in the morning and one at night...12 hours apart. There are a lot of other threads here about it...I just started it after having spent several months doing a LOT of testing and looking for clues. If your lantus is running out increasing it will not fix the highs your having. I tried that route...at one point my lantus dose was so high that I was barely taking any humalog for meals and still going low all the time, yet I was still having unexplained highs.

One thing I'll mention, too, if yours is running out and you've continually increased it that could explain part of your weight gain...more insulin, more weight.
Everyone here will recommend that you read "Pumping Insulin" by John Walsh. Even though it's written for pumpers, the information is relevant for those on MDI. I would strongly recommend reading "Think Like A Pancreas", by Gary Scheiner. He talks just as much about MDI as the pump, and there are tests in the book that you can do to test your basal rate to see if it's correct for you.
I personally think that getting your basal rate fine-tuned is of utmost importance, and if it's not, nothing else is going to be right.

[Tricia452008]

thank you for your advice.....any suggestions or reccomendations before i start splitting my dosage? it really makes sense now that it could work.....i mean the way i am and my sugars are maybe 2 doses instead of 1 is what i need....

[lilituc]

Remembered something else - if you are eating a *lot* of protein in a meal (like an 8 ounce steak), around 30% of it could get converted to carbs, causing a spike 4-12 hours later.

[Tricia452008]

I am not eating that much protein in my meals no more than 3 oz.....and i seem to get higher an hour or 2 after the meal not 4

[lilituc]

Everyone here will recommend that you read "Pumping Insulin" by John Walsh. Even though it's written for pumpers, the information is relevant for those on MDI.

Actually, I would recommend "Using Insulin" which is John Walsh's book for MDI. ;)

[Tricia452008]

I am definatly going to read those books :smartass:

[BlueSky]

I have been a Type 1 for almost 17 years and things for the most part have been good until recently. ..... I am high in the morning, go down a little by lunch then get high again after dinner and i don't know why. Can anyone please help me figure this out? is it my insulin? i know i put on the weight cause of my insulin. .......
Like you I have been T1 for a long time (29 years). And the first 15 were easy. I could eat what I liked and BG control was good. Then things started going downhill. After much agonising over what could be causing this, I can only conclude that other components of the counter-regulatory system (that controls BG levels) deteriorates over the years. For, example, we eventually lose the ability to produce amylin, which causes bigger post-prandial spikes.

Doctor's don't seem to understand this very well. No one explained it to me. But the bottom line is that we have to start doing things differently to achieve satisfactory control. I found that cutting out most carbs in my diet has enable me to get the HBA1c back down to 6.5%. :cool:

[ProudNanaof5]

Tricia, dividing my Lantus 50/50 means that I take 28 units daily. But I now take 14 at 6am then I take another 14 at 6pm. 50/50 means 50 percent in morn and 50 percent 12 hours later. So if you take 50 units daily you would take 25 in morn and then 12 hours take the other 25 units. Didn't want you to think you would take 50 in am and 50 in pm. I think you knew that but wanted to be sure. Good Luck...

[2high]

Hey again Tricia :)

As much as I hate to admit it, Jedi is right when he says insulin does not make you fat, however it DOES cause u to retain fat more than you normally would. The tricky thing is, its a vicious cycle. The more you weigh, the more insulin you are likely to need. The more insulin you are on, the harder it is to lose weight.

Its a ***** alright!

Katie

[It Ain't Over]

i have been steadily increasing my insulin dosages for over a year to the point that i am on 50 units of lantus ..in fact my sugars seem to have worsened over the year.......

I have been treating for type 1 for a long time now and there is one thing that I have learned for sure, and that is when my BG start to roller coaster, and they do at times, I need to to lower the basal. With a high basal you find yourself taking larger regular shots and so you go low.. Then you over eat and go high, ala - roller coaster. Weight gain and higher insulin intake go hand in hand.