[Dimes]

Hi guys,

I was diagnosed about 4-5 months ago. My control has been pretty good up until recently. Now I'm having a bunch of swings, readings over 10 and as well as hypos from taking too much insulin. It seems like my insulin requirements are going up, but when I try to account for this and take a little extra I am ending up with hypos that are starting all new cycles of rollercoastering up and down.

Is it possible this is due to bad absorption after 5 months of injections? I use pretty much my whole stomach but should I be branching out to my sides, and or other places?

Is my honeymoon ending? And would these be typical symptoms of a honeymoon ending?

It's pretty frustrating after having had mostly 5's and 6's for a couple months to start seeing 10+'s on a semi-regular basis.

[Lizzie G]

Hi there Dimes....

You are not alone! I was diagnosed late September 07 and am having the exact same thing. Firstly I thought it was due to illness, then being away and changes to my routine, but eliminate those factors and the same thing is going on....

I previously thought the miraculously easy control was down to working out a lot, but now I am seeing high readings after food and a general observation that I dont handle carbs too well!. Like you I have seen a high reading and taken extra insulin, not realising that I am just peaking higher and that the insulin will work...just takes time (although my insulin:carb ratio has increased as well....all part of the natural death of my poor little pancreas!).

I posted on this site about 'high peaks' earlier today and had some great advice from the pros. What rapid acting are you on? If you take novorapid with meals it certainly helps to 'pre-bolus', and im going to look into making a switch to Apidra. If you look at my earlier post someone replied with a graph showing the activity profile of humalog (which I believe to be similar to Novo), this did a lot to improve my understanding of how it all works and made me realise that the 'pre-bolus' is the only way forward with some particularly carby foods...

Re your injection sites etc, Im not an expert by any means and am new to it myself, but overall it sounds more like you are just coming to the end of your 'honeymoon' and basically things are gettting harder. I really find swimming does help to an extent, and can replace a corrective shot if the timing works, but its been quite tough facing up to things getting more difficult to deal with!

Hope this helps and doesnt get you down, but to be honest I think hearing it bluntly and dealing with it makes for happier times going forward....good luck with it all x

[notme]

This could be a sign of the honeymoon period ending.

You might discuss with your doctor looking at your basal rate. If you are high before your meal and then going low two hours after you bolus for your meal, you may have increased your bolus too much for your meal to compensate for your before meal reading. It is a tightrope walk. It might be time for you to do a basal test and make sure you have those reading correct before you start tweaking your bolus amounts.

[Scratch]

Regardless of whether or not it's an issue about the last of the beta cells coming to an end, in my opinion it's a good idea to spread out the injection sites to a diverse range of subcutaneous areas.

I use all I can reach, arms, abodmen, ribcage under the pectorals, upper legs.

[Dimes]

Well I will be seeing the endo for a first followup in a couple weeks and will be sure to bring it up with her. Thanks everyone for your comments and support. I am going to try to get outside for a jog today and maybe that will help, and will try injecting in my side tonight.

Chris

[xMenace]

It's not very likely scar tissue, but fatty areas will absorb slower than muscular ones.

Honeymoon is a suspect.

Food is often a culprit too. As we get more comfortable with our regimen, we often take bigger risks with food, often unconciously.

[Dimes]

Originally Posted by xMenace

It's not very likely scar tissue, but fatty areas will absorb slower than muscular ones.

Honeymoon is a suspect.

Food is often a culprit too. As we get more comfortable with our regimen, we often take bigger risks with food, often unconciously.

Yeah I wonder about the mental aspect of eating and diabetes management. When I was newly diagnosed I was scared to even touch regular milk, and was just drinking soy for awhile. Found out a couple months in that regular milk really wasn't a problem for me. And settled into a very consistent couple months. Overconfidence may have been playing a part recently, but something else is going on as well. My lunch readings have never been off, mostly because I eat a small breakfast and usually the same 2 or 3 things, so it is easy to dose. Yet 2 out of the last 3 days I have been over 10 by lunch. Glad I'm seeing an endo soon.

[shiftzor]

I have been told to inject into stomach and thighs by my endo, I do half and half, breakfast + lunch in stomach and dinner + lantus in thighs (when possible). I doubt it has anything to do with absorption of insulin, most likely due to the reasons above. The body is hard to predict, it could be as simple as going down with an illness like flu/cold etc or even stress.

[Side note]
A stomach bug has put my bg all over the place, can't give myself enough insulin.

[jenniferS]

What about using 1/2 units to help. I know using half units helped me get tighter control, but I might be misunderstanding the problem. AS I too am new to the world of diabetes.

[shiftzor]

Originally Posted by jenniferS

What about using 1/2 units to help. I know using half units helped me get tighter control, but I might be misunderstanding the problem. AS I too am new to the world of diabetes.

Well I think its more important to carb count and have an insulin to carb ratio. Yes half units can help if you have a high insulin to carb ratio.

[Mich]

Hi Chris,

As I read your posts, a little thought began to trickle into the old brain: Google Symogi Effect and see what you come up with.

Every now and then over the years, I've gone on a tight control binge and gotten myself into the Symogi pattern. It's a series of highs and lows caused by overcorrection. You get yourself a little too low and your body compensates by releasing stored glucose from your liver. Then you are too high. So you overcorrect and get yourself a little too low again and... It gets to a point where you don't know exactly where you are or what's happening.

The correct response to the Symogi Effect is to take a breather from tight correction (not your basal though) for a while...maybe a half day. Eat sparingly and let everything settle down. Then you will know where you are and can resume regular earing and correcting.

Chris, you are in prime honeymoon time, and Jennifer it sounds like you are correctly going slow with your half unit corrections, but I just thought I would mention this as a possibility.

And here's to both of you for being on top of it!

Mich

[DarthDiabetes]

Originally Posted by xMenace

Food is often a culprit too. As we get more comfortable with our regimen, we often take bigger risks with food, often unconciously.

This I learned tonight, yes I do believe this is a big one to remember.

[Dimes]

Originally Posted by Mich

Hi Chris,

As I read your posts, a little thought began to trickle into the old brain: Google Symogi Effect and see what you come up with.

Every now and then over the years, I've gone on a tight control binge and gotten myself into the Symogi pattern. It's a series of highs and lows caused by overcorrection. You get yourself a little too low and your body compensates by releasing stored glucose from your liver. Then you are too high. So you overcorrect and get yourself a little too low again and... It gets to a point where you don't know exactly where you are or what's happening.

The correct response to the Symogi Effect is to take a breather from tight correction (not your basal though) for a while...maybe a half day. Eat sparingly and let everything settle down. Then you will know where you are and can resume regular earing and correcting.

Chris, you are in prime honeymoon time, and Jennifer it sounds like you are correctly going slow with your half unit corrections, but I just thought I would mention this as a possibility.

And here's to both of you for being on top of it!

Mich

Ok thanks for that. I definitely have trouble once I have a hypo, as I invariably bounce way back up due to either overcorrection, or that Symogi effect, or a combination of the 2.

I'm swinging up and down again today, was 16 after breakfast. I was feeling a bit low before going to a job interview so I had a small grape juice, which it appears I didn't need.

As far as I can figure it out, the following things might be happening
-not getting enough exercise, giving me high bg #'s
-having a very unpredictable schedule at the moment, due to looking for a job.. also this causes the temptation not to overdo it on insulin b/c I don't want to go low during interviews, on trains, etc..
-honeymoon ending
-bad absorption of insulin
-loss of discipline with regards to diet, possibly subconsciously
-possibly stress as a factor?


This weekend I'm going to try to get really disciplined and try to get on top of it.

Thanks for the comment Jennifer. Right now I think my insulin requirements are going up, so the half-unit thing isn't much of an issue. But until last month I was considering getting a half-unit pen as I seemed to be more sensitive to insulin. (there was a big difference between 2 and 3 units for breakfast) This is something that leads me to believe my honeymoon is ending.

[Subby]

Another thing you can try, if this is an absorption issue, is longer nibs on your pen if possible. Absorption may improve with a deeper injection. But also I think just trying another area, like the upper butt, is a great way to see if maybe sites are a culprit.