type 1 diabetic, sugar fluctuates drastically

[ruchika handa]

I m 26 yrs old indian female, married with 1.5 yrs old daughter.

I was recently diagnosed with type 1 diabetes one and a half months ago. I started taking insulin novomix since last one month. My highest sugar reading was 469. After starting insulin, my average sugar reading is 250 – 350. It is reducing slightly day by day. My problem is that my sugar fluctuates drastically. For ex – if it is 116 sugar reading in morning at fasting, I take insulin 18 units plus medicines amryl 2mg as advised by my doctor. Then, after taking breakfast, it suddenly drops down to 56. Then I take lunch and on checking my sugar before dinner at 8 pm, reading becomes high again like 307! I take 10 units insulin before starting dinner.

MY QUESTION is why my sugar still fluctuates so much. Also, am I taking the right dose of insulin in morning and late evening. Do I have to take insulin life long.

It is worrying me since I have a family and I have already consulted few doctors. This forum is the last resort and I am really banking on each one of u whoever can give me answers to my questions. Thanks n have a good day.

[Forum-vol-wak]

I am not a physician, but a mom of a diabetic.   When my daughter has fluctuating numbers we check her blood sugars more often, I then fax her numbers to her endocrinologist to have him adjust her numbers.  She has been diagnosed for over 6 years and we still have to adjust her numbers.  I can tell you that it is an on going thing that will happen; the foods you eat can also affect your numbers.

I would ad you r doctor about seeing a nutrionist they can take the foods that you7 eat and like and put that in your meal; plan to help you be more consistent in your meals and numbers.  We have found that this has also helped our daughter have better control of her blood sugars.


  You are also probalably still in the honeymoon phase, which means that your body is still producing insulin that would also account for the low.  

You did not state id you take insulin at lunch.  

You might want to talk to your doctor about going on a pump.  The pump has defiantly helped to stabilize our daughter’s blood sugars.

[Marisa829]

Hi Ruchika,

I remember how frustrated and worried I felt when I was first diagnosed as a Type I diabetic about 13 years ago.  In the beginning, everything is particularly confusing as your body is adjusting mentally and physically to the newness of being diabetic.  But, please take heart! With proper care and a competent doctor or medical team you trust, you will be able to adjust and live a happy and healthy life with your family.  The downside is, in the beginning (and perhaps at different phases in your life) you spend some time trying to figure out your how much insulin your body needs and what type of diet and exercise schedule will work for you.  All these things combined take some fine-tuning, but it is not impossible, it just requires some attention and patience.  

I"m not a doctor so I can't tell you what dose or type of insulin to take.  No one here can either, but we can offer advice about how we've learned to listen to our bodies and make our own adjustments.  For example, you said that after taking your morning insulin and eating breakfast that your blood sugar level fell.  That tells me that your morning dose of insulin is either too high or perhaps you're eating a very light breakfast.  If you already eat a substancial breakfast and your blood sugar is falling afterwards, the insulin dose is probably too high and you definitely need to tell your doctor these patterns.  You might already be writing down the your blood sugar levels with the time checked plus any hypoglycemic episodes in a notebook, but if you haven't started doing so already, this is going to a very handy tool that helps your doctor figure out how to find the best dose of insulin for you and your schedule.  If you are eating a very light breakfast, you could think about making it a more substancial meal and see if that helps keeps your blood sugar stabilize throughout late morning and into lunchtime.  Another reason your blood sugar might be falling is if you're very active during this time of day, which means that once again, your doctor either needs to lower the dose of insulin or you need to have some carbohydrates from breakfast helping you along the way.  

I know I keep saying "your doctor can change the dose" a lot, but this is because your diabetes is so new.  Once you feel a bit more comfortable with the whole thing, your doctor can teach you a way to adjust the insulin yourself by either lowering or increasing the insulin in small doses based on the patterns of your blood sugars.  Still, regular consultations with a good doctor, preferably a specialist, are a must!

Once again, please take heart! What you're going through has happened to us all, it's definitely a balancing act that we learn with practice.  There's no reason to be scared that you won't have a good quality of life, but do find a doctor you trust because the sooner you can get those blood sugar levels under control, the better you'll feel.  In the meantime, be patient with yourself as you'll probably need a few weeks to find the right routine, dose of insulin etc. that works for  you.  I hope your family is being supportive, please reassure them that you'll be fine but that you must be attentive and patient.  Please keep us informed of your progress! Wish you all the best!!!

[Smithy]

Take everything you hear with a grain of salt, but I think drastic sugar fluctuations are pretty normal when starting out with the disease. Of course, I wouldn't really know since I was 2 years old when I was diagnosed. However, as you age and change your daily life patterns, things change and you can always be confronted with rollercoaster rides of glucose levels. What's important is to be on top of it. Doctors are good for a while, but--in my somewhat cynical view--nobody other than yourself will ever better be able to know your condition: a non-diabetic doctor will never be able to truly understand the disease, and other diabetics will never be you.

In your particular case, I am first concerned that you say you take Amaryl. If in fact you are a type 1 diabetic, you should not be taking Amaryl. I would say to find yourself a new doctor if he/she thinks that Amaryl is appropriate for juvenile diabetes. But, perhaps there is something I don't know.

Otherwise, just cautiously play with your carbohydrate intake and your insulin dosages. Yes, I agree that a doctor should be consulted about this at first, but eventually you should be running the show. If the cost of blood strips is not too much of an issue, test yourself every hour. Note how insulin works on you. Everyone absorbs it at a slightly different rate. Note how carbohydrates affect your sugar. Learn what foods are made of. You need an insulin carbohydrate ratio. This way you can balance your food/insulin intake.

There are countless little things you will discover on your own. Years ago, I asked my dietitian, for example, if coffee had an impact on sugar levels. She said "no, it has no calories, but be careful about the milk you add to it". Of course, as it turns out she was not fully informed. I knew that coffee made my sugar go up slightly, regardless of what was added to it. I later found a medical article that explained caffeine is an insulin inhibitor. Meaning that caffeine had a mild effect of reducing the effectiveness of my insulin and thus would slightly increase sugar levels.

Discover your relationship with your disease. Listen to your doctor. Listen to tidbits like mine. Experiment a little. Find out what works for you.

[ruchika handa]

DEAR VOLWAK, MARISA, SMITHY,

THANKS A LOT FOR YOUR INPUTS....THEY HAVE SURELY HELPED ME TO REGAIN MY CONFIDENCE BACK AND I AM DETERMINED TO FIGHT BACK DIABETES. I HAVE EXPERIMENTED WITH MY INSULIN DOSES AND NOW MY SUGAR LEVELS ARE MUCH MORE IN CONTROL. YOU ARE RIGHT - I ONLY AM THE BEST PERSON TO KNOW MY DIABETES AND HOW TO CONTROL IT. CHEERS N GOD BLESS U ALL.