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What the heck is wrong with my body?

Discussion in 'Parents of Children with Type 1' started by emm142, Aug 8, 2012.

  1. emm142

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    Bit of a vent / pity party / 'please help me!' post.

    Everything is crazy with diabetes. I go above 360 a lot of days (probably about 1/4 or 1/5). Lows happen infrequently but randomly. I'll be in range after a meal one day, and in the 400s the next. I know D isn't supposed to behave, but I feel like what is happening with mine is abnormal.

    From what I read on here, most people who check 12 times per day, wear CGM, bolus very frequently for corrections when outside of range, don't overtreat lows, log carefully and pump with Apidra are able to achieve an a1C below 8. My last a1C was 7.9 and things have been a LOT worse since then, so I'm assuming I'll be above 8. Possibly closer to 9.

    I don't get it. I'm so freaking frustrated. This will probably be blamed on depression etc but I swear this is the one thing that I deliberately try not to let slide (I'm not saying my care doesn't get any worse, because I'm sure it does, but it's not like I'm skipping boluses or corrections and I'm changing my basals every few days).

    I really don't know what to do. I'm going to post in this threads my list of diagnoses and the meds I'm on, and maybe someone will be able to flag something up which could be causing the BG crazies.

    I have:
    T1 (obviously)
    Hypothyroidism (TSH at lower end and T4 at upper end when last tested)Allergies (treated, only mild symptoms)
    Depression (treated but still symptomatic)

    I'm taking:
    Citalopram 30mg daily
    Levothyroxine 125mcg daily
    Cetirizine hydrochloride 10mg daily
    Dianette birth control pill daily
    Apidra in pump
    Lantus 11U daily (around 50% of overall basal)

    Has anyone noticed any of those meds interfering dramatically with BG? Anyone got any ideas for stabilisation? Right now I feel like low-carbing might be my only option. I might also try switching back to Novolog, since although Apidra works faster it's possible that it's making things worse.

    I'm so frustrated. You can probably tell. ANY ideas welcome; I really appreciate it.
     
  2. heamwdevine

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    Maybe you need some more basal right now?
     
  3. StillMamamia

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    :( I'm sorry you're feeling so frustrated.

    A couple of thoughts (and keep in mind we've been in DSNAFULAND for a few months now, so my thoughts are probably worthless:eek:):

    - I think (ETA: meaning, this is my own theory) there are subtypes of D types. There. I've said it. Like Type 1.subtype c, or something like that;

    - we should be able measure (with a meter) hormonal changes, particularly cortisol and adrenaline). I would bet my non-existent millions that would account for a lot of the SNAFU going on;

    - in your particular case, all I can offer is my usual advice: work one period of the day, and figure that one out. How about you post here a few days' BGs just for that one time period and the experts on board will give you their thoughts?

    - one of our endos once told us we have a tendency to use basal to cover up bolus errors. Could this be happening? Or the opposite, really?

    That's it. We're struggling hard right now, and it's frustrating. I cannot imagine how actually living and dealing with D is, so, Emma, big hugs your way. You will figure it out!
     
  4. DsMom

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    Not an expert of any kind on your conditions or on pharmacology...but just a thought...Even if it's not one single medication you are on that may be impacting your BG...could it be a combination of any of them?? Perhaps a pharmacologist or doc could answer that? Have you started anything new lately?

    I'm so sorry you're having such a hard time. You're certainly doing all you should and can do for your D...I feel your frustration!:( Keep investigating...and don't blame yourself. You'll get to the bottom of it eventually!
     
  5. DsMom

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    This is really helpful advice (I think you may have given it to me once, too:))! It helps to cut down on that overwhelming feeling of EVERYTHING going wrong when you just focus on one time period at a time. You get that right, breathe a sigh of relief, and move on. A MUCH easier way of tackling such a difficult problem.
     
  6. Christopher

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    Just wanted to say sorry you are struggling. And I agree with Julie, it may be the combination of meds that are causing some of the problems. But how to solve it I don't know. Has your diabetes team been any help?
     
  7. Tigerlilly's mom

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    Sorry things have been frustrating for you.

    I suggest you speak with your diabetes team and have them assist you. It could be a combination of your meds, could be hormones, could be the color of your shirt;)....;)

    ask your team if you can email or call them daily with your numbers and have them help you change your basals and or ratios...sometimes it is easier and alot less stressful to step away and have someone else help you come up with a solution. You have a team to help you, you don't have to figure out everything on your own.

    Keep your chin up and take one test, meal, day at a time and it WILL all come together at some point.
     
  8. Lovemyboys

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    That does sound really frustrating. I just wanted to say that if you wanted to low carb it for a while, it doesn't have to be a permanent decision. Maybe just until things calm down. We have learned a lot about the way our little guy digests things (and how important it is to bolus for protein) once we started on a lower carb diet. Now we feel more confident that if we did want to add some things back in we could predict a little better how his body would handle it.
     
  9. jilmarie

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    Are you taking your birth control pill continuously?
     
  10. Lisa P.

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    My only thoughts, and only because you and Selah oddly seemed to have the "same" diabetes for awhile:

    1. What you are seeing looks a lot like why we stopped pumping. I know I've said it before and it may not in any way apply to you, but it was the unpredictability and inconsistency that got us.

    It may have been a physiological problem, but there's also a chance that we just hypermanaged so much and the CGM and pump played into that, so that we just overplayed it and made things much worse.

    2. I have noticed that when we get highs sometimes we need less basal, even though all other indicators say we shouldn't (e.g. creeping up late in the curve, etc.). I'm beginning to think the body is very complicated and that if there is a larger amount of insulin on board than is needed it goes into a feedback mode that creates insulin resistance of some kind. I wonder if there is something with the alpha cells and diabetes that might contribute in some.

    I'm not familiar with your particular medicines (after my time!) but estrogen and seratonin do interact with glucose metabolism and, I believe, insulin sensitivity. It seems to me if possible you should find a really good -- really good -- GP who can put these pieces together for you somewhat. I'd start asking around seriously to find a brilliant doctor that has a lot of experience and can really do you justice. You shouldn't have to work so hard to feel well!

    I'm sorry it's so darned hard -- exhaustion can't help at all!
     
  11. Lisa P.

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  12. RomeoEcho

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    How long have you been on the bc pill? And is this coinciding with any particular point in your cycle? Your body's response to pills can take many months to stabilize (6-12) and if this is a semi-recent addition it could very well be a factor. Also while the hormone fluctuations may become less and more predictable on the pill, they are still there. Is it possible that this is a factor?

    The other two things I would be suspicious of are the depression and allergies. Even if your care is not slipping due to depression, it can be stressful, which we all know causes weird bgs. I have food allergies, and after an exposure, I see an incredible spike in bg and insulin requirements so if your body is reacting to something, the immune system overdrive can make things very difficult.

    I would try increasing basals. Most of the above are things that effect general sensitivity and a too low basal rate makes the effects of food much more dramatic. Good luck and hang in there. We all have times like this and they always get better eventually, even if it is incredibly frustrating and stressful at the time.
     
  13. Lisa P.

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  14. Marcia

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    things you are doing right-testing often and paying attention. Why not go low carb for a little while to at least remove one variable from your situation? I would just do one variable at a time, though, don't switch from apridra and go low carb. By lowering your carbs, you can determine your basal rates and tweak your carb ratios.
     
  15. Ali

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    Look at your sets. Are you using steel? Try changing the set out every 48 hours. Try taking some of your basal as a shot. Agree with looking at one thing every few weeks and tweaking slowly. It may take three months to sort out. So set changes, basal testing, try to eliminate lows first, set your target goal higher-so not 100 but 120, plan or slower corrections etc., just try to slow everything down. Then look at highs which will probably involve some changes in bolus delivery or eating.Sometimes running a bit higher but steadier is much easier to deal with and ends up with better A1cs. Also if you have a research/ Medical School and hospital near you try and see someone there. They are the best with people with more complex issues and often have financial help. Your hormones and meds are probably another huge issue. You may need adjustments in your BC pills. So sorry, for what it is worth I spent ten years way above 8 another 15 above 7 and only the last ten in the low sixes, and I am healthy. :cwds:ali Added-the low carb issue is a good idea also.
     
  16. Chippy28

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    Emma, you've gotten some great advice so far. I just wanted to mention that the idea of going back to Novolog might be a good thing to try. When I tried Apidra, I had wonderful results for a few months and then slowly but surely, my BGs became completely unpredictable. Some days my BGs were beautiful, but the next they would be all over the place especially with horrible highs that wouldn't budge. My routine wasn't changing, I was eating fairly predictable foods, and I wasn't dealing with a honeymoon or hormones. I tried changing my basals and my ratios and that just seemed to make things worse. Plus, the Apidra didn't seem to be working as quickly as it had been, in fact, I felt like it started to last as long as Novolog did. So, I finally gave up and decided to try Novolog again and within days by BGs were back to "normal".

    Anyway, I'm not sure if it will work for you, but I thought I might share my story just in case. Good luck and I hope you are able to figure everything out. :)
     
  17. Ali

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    Chippy has another good thought, you may need a different insulin.:eek::pal
     
  18. Lee

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    I just want to touch on allergies - I know you didn't list it, but Zyrtec makes my step-dad's blood sugar skyrocket, while Allegra makes Coco's go through the roof. Allergy meds, if you take them, might be something to look at.
     
  19. mmgirls

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    You know keeping all your settings (except maybe duration?IOB) is the easiest thing to do.

    I remember about 2.5yrs in that things just stopped working. I was making big changes and nothing was helping, I was at a loss. I called the endo and talked things over and they made some more changes and still nothing.

    I happened to go to a JDRF meeting and was talking about different things and another mother said that one insulin simply stopped working for her child, and a simple switch is all she needed.

    I walked out with a sample of the other insulin and in in a few days I was fighting off the lows, ending up with settings fairly close to what they where before all the BIG changes.

    Althow most of these "fast" or "rapid" acting insulins should be interchangeable in strength, they do have their own duration/tail and PH.


    The PH thing is to biggy here. Your personal "bodily" responce to PH of a product.

    I hope it is something simple like this even thow I love Apidra's rapid action and short duration, if it is no longer working for you then, try something else.
     
  20. Heather(CA)

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    Can you post some numbers with times? 11 units of Lantus seems pretty low?

    When things are crazy for us I tend to feed Seth easy to judge carbs for several days. Then test before and three hours after every meal. I usually get a clearer picture of what's going on by doing that :)

    (((((HUGS)))))
     

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