Hello from Providence RI

[knoxvillegirl]

Was diagnosed 7.5 years ago with T1, pumping since October 2001. Upgraded to Minimed 522 in hopes the sensors would soon be covered by my insurance, but no luck yet.

I have trouble with post meal spikes -- typically middle 200s. The past couple of months I've been relying more on dual wave boluses for mealtime (60/40, the latter for 1.5 hours) and that has smoothed out the spike to an extent. I was able to get my A1c to 7.3 down from 8.4.

Just started on Symlin yesterday, which is what led me to the site. My doc (also T1) raved about it, wasn't very detailed on how to take it. He's a bit laid back and I think he lets his more educated patients do their own thing.

I have a ton of questions about Symlin, which I'll post on another forum.

Wanted to say HI and THANKS for a great meeting space for T1s and other diabetics alike.

[notme]

Welcome to Diabetes Forums knoxvillegirl. I am glad you found this site and I know you will find lots of help. Welcome!!!!!

[gettingby]

Hi knoxvillegirl and welcome to the club. I'm sure you will find all of the answers you are looking for here.
I have family in North Smithfield who were just home for a visit.:)

[xMenace]

I have trouble with post meal spikes -- typically middle 200s. The past couple of months I've been relying more on dual wave boluses for mealtime (60/40, the latter for 1.5 hours) and that has smoothed out the spike to an extent. I was able to get my A1c to 7.3 down from 8.4.


Welcome.

My DE tried to convinve me that dual waving would fix my spikes too, but it only made them worse. I asked how could delaying insulin do this. It doesn't make sense. She stated it more closely matches how the body works!

Bull ****ing feathers!

There are actually logical ways to treat spikes. Here's my techniques:

- lower carbs. It sounds too easy eh? It works. For my breakfasts, in the middle of my highest period of insulin resistance, it's the only way. I now eat small breakfasts.

- eat slowly and spread foods out. I'll often eat my lunchtime fruit an hour or more after my sandwich.

- lower GI. Actually this has a very small impact. Carbs still work faster than my Humalog/Novorapid. (I've tried both)

- pre-bolus. The biggest impact I've found was bolusing 20-30 minutes prior to eating. My attempts at measuring action show that food raises my BGs within 15 minutes but insulin takes a good hour to reach the same levels.

- super-bolus. An effective last resort. I often borrow carbs from my basals then set a reduced temp basal for a few hours. This moves the insulin up front where it's needed more. This should only be tried after you've exhausted other techniques and are confident in your basal rates.

I've done controlled testing with standard meals. Work on one variable at a time to find what works best for you. Of course you also know about basal testing: skipping meals and fine tuning your basals so they keep you flat.

[morrisma]

Welcome to the club!

Glad you found us. I'm sure someone with chime in on the Symlin question at some point. I use my dual wave bolus when the fat content of my meal is high. The art is in guessing the ratio of course and then testing a lot to confirm you guess.

[RobiJo]

Welcome to DF.
You'll find lots of help and support here.

[princesslinda]

Welcome from one Knoxville girl to another!:D

[notme]

Ok....which is it knoxvillegirl? Knoxville or Rhode Island? :T

[kgm0612]

Welcome fellow Rhode Islander! Glad you found this wonderful forum. I know you will find lots of nice people and tons of valuable information here.

Karen

[jerryn]

Hello.. yeah this is a great site. And another forum member that doesn't live far from South Eastern, MA. Actually I'm about
3 miles away from the Bristol, RI Bike Path.

[jacobsam622]

Welcome to the forums great place to find info and support for diabetes. My Wifes family is from RI. I love the Newport Creamery well I did before Diabetes:(

[Tony]

Welcome to the forums from another Rhode Islander. It's a small world after all.

You will certainly find a variety of experiences and discussions here. I'm sure you will find a great amount of information and support.

[panda1076]

- lower carbs. It sounds too easy eh? It works. For my breakfasts, in the middle of my highest period of insulin resistance, it's the only way. I now eat small breakfasts.

- eat slowly and spread foods out. I'll often eat my lunchtime fruit an hour or more after my sandwich.

- lower GI. Actually this has a very small impact. Carbs still work faster than my Humalog/Novorapid. (I've tried both)

- pre-bolus. The biggest impact I've found was bolusing 20-30 minutes prior to eating. My attempts at measuring action show that food raises my BGs within 15 minutes but insulin takes a good hour to reach the same levels.


Welcome!

I too had trouble with post meal highs. I had tried tightening up my control when I was planning my pregnancy, and my pregnancy goals were less than 130 an hour post meal. I thought it was impossible, but I basically did the same things xMenace suggests, and I had no problem. I really found that eating no more than 45 carbs per meal was the trick. My last A1C was 5.3! I think if you don't overload your body all at once, that is the thing. Before my tight contorl, I was eating upwards of 100 carbs per meal.

Breakfast is always the heardest for me, so I had to find things that didn't spike my BG after breakfast. I now rotate between cottage cheese with cut up nectarine, and a South Beat Diet Protein bar with a glass of milk. If I am hungry later, I just eat a 15 carb snack mid morning. Also, Finn Crisps never spike my BG and they are a great low-glycemic snack.

Just some thoughts. They worked for me. Although, I have been told that being pregnant can make you achieve even the toughest BG goals! So not being pregnant, I guess you just need a lot of willpower! I'll let you know. I had a miscarriage a few weeks ago so now I am in the phase of eating every bad food in site until I start trying again!

[knoxvillegirl]

Ok....which is it knoxvillegirl? Knoxville or Rhode Island? :T

Rhode Island, born and bred. (Knoxville Girl is a song covered by the Lemonheads back in the mid-90s.)

Thanks for all the advice, re: post-meal spikes.

I oscillate between tight control and non-compliant burnout. Right now I'm somewhere in between -- everything in moderation. My A1Cs are typically in the mid 7s, would love to get them in the mid-6s.

I feel lucky that I didn't get T1D until my later 20s, and that I can clearly remember the freedom of not having it... But man! I am so completely sick of it!

Anyhow, I've been taking Symlin for four days, and am amazed by the results. My daily insulin totals are down over 20%, my PP BGs have been better than I've seen in years, and my hollow leg has been non-existent. It's also forcing me to test more often, which in and of itself, will help with tighter control.

[panda1076]

Do you feel sick/nauseous with the Symlin?

[knoxvillegirl]

Do you feel sick/nauseous with the Symlin?
Not a pukey nauseous feeling, just a feeling of fullness, like I might have consumed a couple pounds of lead weights. It's a heaviness, or fullness in my belly, like I ate too much and the food isn't digesting. Which is exactly what Symlin does.

I titrated up to the next dose today at lunchtime and feel fine. My BG 1.5 hours post [spaghetti] meal is 105. (~50 CHO plus bolognese sauce.) I will likely see a rise around the 3rd hour. If I got my carb count right, it won't be much higher than 150.

My fiance and I are also thinking about having a baby in the next year, so I'll have to go off Symlin and get in tight control on my own. I've done it before, and got burned out. Part of me hopes the Symlin will give me that kick in the pants and get in a better habit of testing testing testing.

But as you said, pre/pregnancy forces you to achieve those goals.

[UpNorth]

Welcome to the forums :)

[panda1076]

good to know. I did think about starting on Symlin too but the doctor said it wasn't approved for pregnancy and that her patients said they felt sick. So I thought I would just stick to the old fashioned way :) I know what you mean about burnout. But keeping a happy medium is just fine too. Good luck.

[Janlaton]

Welcome from a Tar Heel in Virginia who happens to be a type 2. Hope you find lots of information here on all your questions.:)

janlaton
40 years type 2