I'm desparate and need some answers.

[teddy_bear]

hi, I'm 19-year-old girl, a diabetic for 4 years mow.Although I try really hard, I don't seem to get my diabetes controlled.I often have blood glucose ranging between 250 and 350 for some hours in the day. That happens because I don't check my glucose often.I also eat too much without having my insulin injected.I inject it after I have eaten. And the third problem is that I just can't help eating cakes, chocolates and so on. I just see them somewhere in the kitchen and although I say to myself " you know that you will suffer horribly after you eat this, don't you.", I do it.A whole day with horrible blood glucose comes next.(250-350...even more) Every day I am about to become a new person. Every night I am let down by myself.
So I need the answers to two questions that will help me understand where I am and find the right path again.
1. Do I have to check my glucose before every meal?
2. What are the ranges of the blood glucose I must stick to?
Please help me.
I'll be very grateful

[JDRF-Team-gg]

Dear Teddybear,

I am so sorry to hear that you are having these difficulties.  It's a hard pattern to get out of, but you have already taken a huge step in the right direction by coming to us for help.  I am a mom of a 16 year old girl who has had diabetes since she was 21 months old, so there's a lot that I can relate to when it comes to food issues.  I am not, however, a medical professional so any information I give you should be verified with your healthcare team.

Part of obtaining good blood glucose control is being aware of where your blood sugars are during your day.  The only way to know this is by testing your blood at least 6-7 times a day.  Yes, it seems like a lot, but this information is necessary for accurate insulin dosing prior to eating.  Is there some reason why you don't like to test (possibly sore fingers?)?  There are some blood glucose monitors that only require a tiny drop of blood and it can be gotten from other parts of the body besides your fingers if you want to give your fingers a break.

You may also want to discuss going on the insulin pump with your endocrinologist.  The pump can give you the freedom of administering what they call "correction boluses" to help bring those high bg numbers down.  My daughter has had her pump for 18 months now and she loves it.

Having the wrong foods in the house is totally counterproductive to your cause.  You don't mention if you're still living at home or on your own, but whoever does the grocery shopping should leave the unhealthy food choices at the store.  Not controlling what you are putting into your body for fuel, (otherwise referred to as food!), as you have stated, has a direct effect on your bg numbers.  We have been pretty successful using Weight Watchers in my house.  You are not denied your favorite foods and they teach you about portion control, which is key.  Check out their website @  www.weightwatchers.com for more information.  Their recipes are not just for people who need to lose weight (and I don't mean to infer that you do!), they're for people who want to make healthy food choices during their day and understand the right and healthy way to eat.  There magazine is great and filled with exercise and food ideas that have helped us have fun with food & fitness at my house.  

Once you get your bg's under control (a good target # is 120), you will feel much better physically and then you'll be more likely to succeed at tackling the other issues that you've been dealing with.

Please consider contacting your local JDRF office and inquire about programs that they may be sponsoring that could help you.  I believe that meeting and speaking to others who deal with the very same issues that you do, especially when you have diabetes in common, can be very rewarding and comforting.  

Don't try and tackle everything at once, Teddybear...start off with something like checking your bg level more often and move on from there.  YOU CAN DO THIS.  It's obvious that you care about your health and so do we at JDRF.  Please let us know how you're progressing.

[jdrf team dm]

Dear teddy_bear,
Thank you for reaching out to JDRF. My son has had type 1 diabetes for almost 29 years. He too had a lot of problems with testing bs's and diet. We are fortunate that as he got older, he seems to have a better understanding that not having good control can lead to complications. Nutrition plays a large factor with people with diabetes. I am not a physician but a volunteer and can give you some information on my own experience.

Are you seeing a diabetes educator or someone that can help with meal planning, counting carbs, etc? JDRF-Team-gg has posted vey important information. I agree with her, don't try to solve everything at once. In order to help with your diet, you need to know your blood sugars. Testing more is very important. gg is right that there are monitors that are not as painful.

Since you have reached for help, tells me you are very serious about getting control on your diabetes. I might suggest, if you would like to have an additional direct source is http://www.jdrf.org/index.cfm?
fuseaction=home.viewPage&page_id=C6E5B392-BCDA-CE38-061DD7DA28768850
This is The Juvenile Diabetes Research Foundation, one on one support team. It is through e-mail and not an open forum.
I would also like you to see the postings here, as I'm sure there will be some. The comments posted by everyone have been most helpful.

teddy_bear, many people, myself included, with a chronic illness can suffer depression. The fact that you are reaching out for help shows that you are serious about getting help.Please don't be so hard on yourself, It's not an easy disease to deal with, but I know you can do it.

Hope to hear from you soon,
dm

[teddy_bear]

dear friends,
thank you for your advice.
I already explored the WeightWatchers site and I think that I'll get some good ideas from there:]
I already know some things about calories and the amount of carbohidrates I need and the amount of insulin I need for it.
From two days now I am much more considerate to my diet. I check my blood glucose 3 times a day and feel better.I am trying to lose weight too. I am trying to get 1000 calories a day(this will be just this week) and of course, I get less insulin because of this(and my glucose levels are fine).
I believe that I can really get better. But your support means a lot for me. Thank you.

Actually I am from Bulgaria and here it is the healthcare system is different from yours.I am interested how this problem is solved in a country like yours.
Is it very expensive to be a diabetic in the US?(I mean is your insurance more expensive than that of the other people)
And do you buy your test stripes apart from the insuranse? Are they expensive?

[JDRF-Team-LRS]

Wow, Teddy-Bear!
I admire your ability to ask for help and to begin to use it so naturally.  AND, I admire your ability to visit with us and to express yourself so richly in English.  :-)  

Diabetes is expensive to manage in the US and insurance covers varies.  Some insurance plans cover almost all expenses including strips and others require some additional payment by the patient.  And people without insurance must pay a lot.

Are you thinking that 1000 calories a day for one week will "get you started" in the right direction?  One piece of advice we often get is to make our changes slowly so that we can maintain them for longer.  That way, even tho' the pace may feel slooooow, we are more likely to succeed.

I'm sure you're going to be successful, dear Teddy-Bear, and I hope you'll stay in touch.  You can likely offer helpful comments to others here over time.

[galzee]

Teddybear,

I am so glad that you could benefit from the advise given to you.  I need to caution you on the 1000 calorie idea, though.  You should be seeking out the advise of a registered dietician or join weight watchers (you can even join and follow their program on-line)and let them instruct you as to the target number of calories that's right for you.  Each of us is different, and I don't want to see you give up too soon because you weren't getting enough calories, and lost your willpower.  Especially with diabetes, you need to make sure that you are getting the proper daily nutrition to sustain youself.  I only want the best for you to succeed.  I hope that this is practical for you, as I am not sure what resources you have available to you.  

Keep up the good work and let us know how you're progressing!

[teddy_bear]

Dear friends,
You were right about the 1000 calories. I was hungry like hell for two days and I couldn't stay on that diet any more. But now I switched on 1500 calories and I feel better. Yesterday I had some problems with the blood sugar- around 230, but today it's around 130 which is relly an acheivement for me! Of course, my goal for the near future is to stay under 120, but for now I'm happy:]
thak you one more time.I wish you all you wish:]]

[TonyAlmeida]

You should target for 100 - that's perfect and hardly anyone hits it that I know of.  80 to 120 is the range to be in, although newer guidleines state that the closer to 70 you get (without going under) the better.  My diet is 2000 Calories - basically 83 Carbs a meal.  I know what it's like to lose my vision (temporarily) when I was first diagnosed, so resisting the bad things is now every easy for me to do.

If you're only on Humalog/Novalog and Lantus injections - you might want to look into an insulin pump.  Since I got mine, my blood glucose levels have remained consistant in the 80-90 range.