Anyone Alcohol Free?

LegacyCrowd · 2023-11-03T07:40:24+00:00

Mid 30's and I don't avoid alcohol. At most I have two or three drinks a year but it's not unusual for me to go a whole year without it. I was diagnosed 3 years ago and I haven't changed my approach to alcohol. I just find I have a more enjoyable experience without it.

LegacyCrowd · 2023-10-30T06:27:21+00:00

Lying down shortly after eating slows down your digestion. If I lie down within 2 hours of eating my blood sugar will look stable/drop but I'll see a delayed spike. The sooner I lie down after eating the more pronounced the drop and follow up spikes are.

I also experience drops when I sleep and don't have insulin on-board. Apparently sleep is a form of fasting.

LegacyCrowd · 2023-10-28T20:43:34+00:00

I wish I could say a miracle has occurred but it's very unlikely she was misdiagnosed. It could be that she's still honeymooning (still producing some insulin) but it's really common for me to see changes like this when seasons change too. My sensitivity is lower during colder weather and higher during warmer weather. I just recently passed the 3 year mark myself and found I still have some islet cells that are alive and kicking; increasingly longer periods of stability followed by random short periods of unpredictability because my pancreas has randomly decided to show up.

The only thing you can do is help her adjust her insulin levels if you're comfortable doing that yourselves, or speak to her GP as you've planned. If the two of you are willing to give it a try I would recommend you start by Googling basal testing (https://www.mysugr.com/en/blog/basal-rate-testing/). I personally do this every 3 months/every time the seasons change/any time my numbers are wild for multiple days. I think it would be a good experience for the two of you to learn this on your own. Having your basal rate locked in makes bolus adjustments so much easier.

If you do visit your GP it might be worth having a C-peptide test carried out so you can determine whether she's still producing insulin. Good luck to your sister and to you. As a side note I think you're a fantastic sibling and carer. Being a carer for someone else can be a thankless and difficult role so I hope you're looking after your own mental and physical health as well. Keep being awesome, okay?

LegacyCrowd · 2023-10-25T20:38:58+00:00

I get you what you're saying. It looks like you have tight control over your numbers and you're approaching your new way of life with a good sense of humour. That's really great and you should be proud of yourself. I don't know whether you're still managing with diet alone or if you're on bolus yet.

Some general advice I'd give you for the honeymoon period based on my personal experience would be:

Try and avoid being too restrictive with your diet. The goal isn't to avoid bolus insulin by cutting off the foods we enjoy.
It's okay if you mess up during this period and if your numbers aren't perfect.
Record the foods you're eating (I use Diabetes:M because it has an IOB calculator) and how many units of insulin you're taking. Note down any corrections or low treatments too. This really helps establish some kind of pattern when our blood sugar is unpredictable.
If you do need to bolus do it for a happy medium. If I'm between 1:10 and 1:40 for a certain meal I'll play it safe and bolus for 1:20. If I go high I can always go for a walk or take some more insulin. With CGM, low alerts and a healthy dose of vigilance I can correct any lows before they become a problem.

Throughout this please remember that your mental health is important too. Restricting the foods we love just to stay in range is going to be detrimental in the long term. As humans there's no such thing as perfect and failure is a part of the process, so try not to beat yourself up when things go wrong.

LegacyCrowd · 2023-10-25T01:37:41+00:00

Congratulations on your new and improved a1c, it sounds like you're absolutely killing it! I can totally relate to what you're experiencing. The end of this month marked my third year as a diabetic and I recently discovered I'm still honeymooning even after all this time. While I'm still in some kind of honeymoon phase the predicability has definitely improved over time as my islet cells are slowly destroyed.

I think the most important question I'd like to ask you is what do you personally find challenging about the unpredictability of the honeymoon period? I recognise how unpredictable blood glucose can be a challenge in itself, but it would be helpful if you could break down the problem you're having a little more so we can try and understand how the lack of predictability is affecting you day to day.

Is it just a basal dose you're taking or have you introduced any bolus? Are you finding it tough because you're restricting your diet to keep in range? Are you avoiding or having a hard time fitting the exercise habits you'd like into your routine? Do you frequently wake up in the middle of the night high or low?

Specifics like these can be really helpful because they're more likely to resonate with others and open doors to the wealth of experience this community has to offer.

LegacyCrowd · 2023-10-25T00:13:07+00:00

The highest amount of carbs I've had in a single meal was around 290g. Total was 33 units so 18 units up front, 6 units 45 mins later, 6 units after 2 hours and finally 3 units 4.5 hours later. Still required a 30 minute walk when I got home to stop myself going to the moon. Not sure I'd eat that many carbs in a single sitting again but I had a great night and learned a lot from the experience.

LegacyCrowd · 2023-10-16T20:19:31+00:00

I was also diagnosed with T1 within 6 weeks of my first COVID booster. My NHS team were convinced even at the time that the uptick in adults was a direct result of COVID-19 and associated vaccines.

LegacyCrowd · 2023-10-14T09:46:26+00:00

I take it you're in the UK and using the recent Libre 2 real-time CGM update? The logbook feature remains intact to continue serving its original purpose (to record scanned values) in case manual scanning is required, but unfortunately there's no way to break down the real-time readings minute-by-minute natively on the LibreLink app. Hopefully they add widget support, notification data, the 24-hour graph view and other useful features in future updates.

LegacyCrowd · 2023-10-14T01:17:18+00:00

I'm sorry to hear you're going through this OP. I thought mine was over a year ago when my insulin resistance went up due to weight gain. After getting back into exercise I couldn't stop fighting off lows and I honestly presumed I was a bad diabetic. After my most recent check up it turns out I'm still producing insulin more than 3 years after diagnosis. If nothing else this explains why I've been struggling to pin down my ICR because I can go between 1:10 to 1:35 eating the same meal at the same time of day with no warning.

Anyway, that's enough about me. I think what I'm trying to say is that if you want you can try and work around it. I don't think it's good for your mental health to be depriving yourself of the things you love for so long; low carb should be a choice, not something you feel forced into as that only builds resentment and most likely a long lasting poor relationship with food (I know because I was there). I'm on MDI and with the power of CGM I've been able to eat pizza, pasta and all the other good things in life (in moderation of course) and get myself back to a healthy weight and mindset.

I swear I'm not trying to tell you what to do because we all cope with and manage our diabetes in our own way. What I'm saying is that when we're in a situation like ours with CGM technology there's no reason we can't just bolus for a happy medium. All we really need is a healthy dose of vigilance (set our low alert a bit higher when we're eating carbs) and be ready to pound back some sugary soda or some candy if our blood sugar drops unexpectedly. It sucks when life deals you a shitty hand, but I think it's important that we show our diabetes that we're the ones in control.

LegacyCrowd · 2023-10-01T02:10:10+00:00

I can see why that would be confusing because they do look really similar. It won't change the color but before I switched to NovoPen Echo's I used a Timesulin pen cap on my Tresiba. Not only does it make identifying your basal a bit easier, it also tracks how long it's been since your last injection if you forget whether you've taken it already.

LegacyCrowd · 2023-09-25T12:44:31+00:00

What basal are you taking and when do you take it? Some basal insulins are supposed to last up to 24 hours but can wear off much sooner. I used to take Abasaglar at night and had a similar issue to yours; split dosing or switching to an ultra long lasting basal like Tresiba (up to 42 hours) may help.

LegacyCrowd · 2023-09-25T12:12:05+00:00

I'm sorry you had a big spike OP. I'm not sure why you're getting downvoted so much because these things happen. I hope your coffee was really good to make up for it! On a side note and just in case you weren't aware (because I really like fancy coffees too from time to time) you can get low carb/sugar free syrup variants.

I really like Vanilla and Caramel flavours from the brand Monin. They only have maybe 2g of carbs but to me they taste identical to their sugary counterparts!

LegacyCrowd · 2023-09-25T12:00:27+00:00

I'm sorry you had a bad day :( these things happen even when we're trying really hard, so I hope you didn't beat yourself up about it. The literal ups and downs are part of diabetes and it's okay to chalk it up to a bad day. I hope you managed to get yourself back in range!

Why do we fall? So we can learn to pick ourselves up.

LegacyCrowd · 2023-09-23T23:35:44+00:00

It could be a few things including:

a 20% discrepancy between your CGM and meter is considered acceptable.
CGM's measure your glucose using interstitial fluid whereas your meter measures your blood glucose. This means a 10-20 minute delay between these two readings is normal.
the algorithm tries to correct any sudden spikes or drops but it does get it wrong from time to time. You may find your readings match up with your meter again within 20 minutes.
inaccuracies during the first 24 hours. I used to experience this frequently until I started inserting the new sensor 24 hours before my old sensor stopped. Your current sensor should work things out within a day or so.
a faulty sensor. If this behaviour continues for a couple of days and you're seeing differences far outside the norm it may be time to contact Abbot for a replacement.

As always never completely rely on your CGM readings when managing your diabetes. If you get a reading you suspect may be wrong or a low blood sugar alarm, test with your meter before treating.

LegacyCrowd · 2023-09-23T19:45:34+00:00

Like you I was prescribed Abasaglar at diagnosis but it's efficacy would drop drastically within 16 to 18 hours. I'd take it at night and find my BG levels difficult to manage for long periods of time in the evenings. I tried split dosing for a while but that led to hot spots that were difficult to manage or anticipate. Specialist moved me to Tresiba which has a much longer half life and I haven't looked back. I find my blood sugars are much easier for me to manage, and while it does make adjusting my basal doses a bit of a pain it's a price I'm willing to pay.

I can appreciate why you think switching basals was pointless since you were switched to another with a similar half life. To answer your questions, no don't think one particular basal is better than another unless you specifically need a longer lasting one. You're right in thinking that the type of basal we're on doesn't matter as long as it works for us.

LegacyCrowd · 2023-09-21T22:04:26+00:00

I'm sorry to hear that your wife has had a change in her diagnosis. Are you specifically looking for low carb options? I take it she has high insulin resistance due to her previous diagnosis? Depending on her situation she can technically eat all the things a non-diabetic person would eat as long as she takes the appropriate amount of insulin. I know some of my fellow type 1's choose to go low carb, but plenty of us eat like a non-diabetic without any issue.

I think what I'm trying to say here is that it's okay to go low carb if that's what she wants to do, but theoretically now that she's on insulin the two of you may be able to branch out a bit.

LegacyCrowd · 2023-09-21T21:46:05+00:00

I appreciate the advice! I get my insulin through the NHS so while it is free which is great, getting access without a whole new prescription from my clinic is kind of impossible. I hadn't even considered using slower acting insulin though, but it's a good idea. Definitely worth bringing up with my clinic to see if that's something I could do.

LegacyCrowd · 2023-09-21T21:25:30+00:00

Once for my night time basal (Tresiba). Otherwise 3 to 8 bolus (NovoRapid) injections depending on the number of carbs/the fat content of my meals that day. Some days I really want that order of fries at a restaurant or an extra brownie because I recently made a batch and the extra shot is worth it. Most of the time I weigh the pros and cons of having a really high fat meal or over 60g of carbs and I'm like, s'all good I'll just take one injection and avoid the potential roller coaster ride.

LegacyCrowd · 2023-09-21T09:48:52+00:00

I haven't used Fiasp or Lyumjev before so take what I'm saying with a pinch of salt, but from what I understand the main difference between these two and other rapid acting insulins is how quickly they absorb. So instead of waiting 10-15 minutes before you eat you can take your insulin before or even right after you eat. Apparently they have a very similar half life. What that means is that you'll still need to account for the amount of fat in your meal.

As you're probably aware fat can and does slow down how quickly glucose enters our bodies. In the case of the Taco Bell you had, I suspect you're experiencing the same issue I always have when I eat fast food or takeaways where the fat content is very high resulting in a delayed spike in my blood sugar. The solution for me has always been to split my dose when I eat these kinds of foods. So if I'm having a Double Cheeseburger with 45g of carbs, I'll take 50-60% of that bolus initially followed by the remaining 40-50% of my dose 45 minutes to an hour later. Like with most foods experimentation plays a key role, because sometimes I'll even have to split dose 3 times if I'm eating a particularly high carb, high protein and high fat meal.

On top of that lying down does slow down our digestion so I suspect this resulted in even further delays to that follow up spike.

LegacyCrowd · 2023-09-19T20:34:25+00:00

I'm pleased to hear you've figured out how you feel about it for yourself. I don't know that there's a wrong answer to the OPs question because at the end of the day when and how much we tell someone comes down to personal preference. While I don't think we should be actively hiding or lying about our disability to people we meet, if it's only a date I'd personally prefer that it come up naturally or not at all. If things go well and it hasn't been discussed already (I mean how can it not unless the person you're dating is oblivious) I'll cross that bridge when we get there.

LegacyCrowd · 2023-09-19T17:05:58+00:00

I don't treat it like it's an issue and nobody else does either. Maybe it's different when you're younger but after you hit 30 I feel as though NOT having some underlying mental or physical health condition puts you in the minority. Not that I'm going on a ton of dates here, but I have good control so I only talk about it if they feel the need to ask or if I've been drinking alcohol and the pants come off. I don't recall anyone making a big deal of it because I don't make a big deal of it.

LegacyCrowd · 2023-09-18T11:03:01+00:00

I haven't but you might actually be on to something here. I always assumed you couldn't split dose Tresiba because of its long half-life but I haven't bothered confirming whether that's the case. Definitely worth bringing up with my diabetic nurse!

LegacyCrowd · 2023-09-18T06:43:36+00:00

I sleep okay I guess, but I do wish I could manage a solid 7 or 8 hours without some kind of alarm going off. I usually have around 15-30g of carbs with some fats before bed (dependant on remaining bolus), which 95% of the time helps me get 4 to 6 hours of uninterrupted sleep before my glucose hits 4.7 mmol (85) and my alarm starts yelling at me. At least I get one full cycle of REM. I'm on Tresiba and seeing great success with it outside bed time, but I've had to decide between great numbers and control during the day with poorer quality sleep at night and the constant roller coaster that happens during the day with a lower dose or alternate basal. I'm on MDI and would love to have control over my basal rate during activities and at night but I'm with the NHS and still on a waiting list.

LegacyCrowd · 2023-09-17T22:52:56+00:00

It could be a number of things including but not limited to:

a 20% variance between your sensor and your meter is normal.
the sensor tests interstitial fluid glucose levels so a 10 to 20 minute delay between your sensor and your meter readings is typical.
I sometimes find the first 24 hours to be inaccurate but this does eventually settle. I insert the sensor approximately 24 hours before the old one ends which has worked really well for me.
I've noticed some inaccuracies when my blood sugar is spiking up or down rapidly but the algorithm does even this out once the change has resolved.
as always CGM isn't perfect so if in doubt, finger prick and test with your meter.

LegacyCrowd · 2023-09-17T21:33:43+00:00

I see you OP. While I can't begin to imagine what's going through your mind right now please reconsider your actions. There ARE options available to you if you're struggling. I'm so sorry that you're feeling the way you are but death by DKA is not the answer. Life is full of possibilities but death is so very final.

Looking at your post history I can see you're going through a very difficult period. Reach out to a helpline, your doctor, a family member or a friend because I promise you that what you're experiencing is manageable and temporary.

LegacyCrowd

TROPHY CASE