I'm confused about my shots and diet

[PatrickBelaga]

First off, I was diagnosed with Type 1 Diabetes July 24th of thise year.

I hear all these accounts of other kids my age (16) taking 1, maybe 2 shots a day.  I'm confused because right now I'm taking 3 shots per day and my doctor said it very well may increase to 6 a day due to my very involved physical activity.  I don't quite understand why this is necessary.  I'm relatively averse to getting a pump just because they creep me out and seem bad for sports.  

I also have questions about what my future diet will be.  Since it has only been a few weeks I am still relatively high and coming down to normal slowly, I am on a rigid diet and meal plan.  I have to eat at fairly strict times and I have a small choice of things to eat.  I hear of type 1 Diabetics eating a wide range of foods in moderation and don't understand why if I ate a slice of pizza everyone would freak out.

I drove to the hospital with 950 as my blood sugar and it has been about 2 1/2 weeks and I'm still struggling to keep it down.  I am all over the place.  It seems like within one hour I can feel hypoglycemic and just 2 hours later I'm at 350.  Every little peice of food seems to send me soaring in one direction or another, with this absolve itself?

[hntrstv4]

I don't know your particular situation, but my son was diagnosed 2.5 years ago at the age of 3.  When we first started his insulin regimen it was very similar to what you described.  I am guessing Novolog and Novalin in the morning, Novolog at lunch and Novalog in the evening if I remember correctly.... it will get easier as the doctors see how you react to the insulin.... My son is 5 now, and he gets a shot everytime he eats more than 15 carbs, and has one shot that he has to take every night at 8pm.... Don't worry, it will get easier.... but keep in mind it will never be easy if you ever have any questions just ask.... I have been dealing with my sons diabetes for a while, and I could help you if you need it

[JDRF-VOL-SG]

I don't know what kind of schedule your doctor has put you on, but the rule of thumb is to start off with a dose of insulin that is too low and then gradually increase until it is right for the newly diagnosed patient. Too much insulin is dangerous. So right now, the diet is strict because if there is no variation in the diet, then the doctors can figure out quicker what your own personal 'insulin-to-carb ratio' is, or in other words how much insulin YOU as an individual need to cover carbs that you eat. Once that happens, then the doctor probably will give you a mathematical formula that is perfect for you and you alone. Then, you have more flexibility. You can then eat pretty much anything as long as you know how many carbs are in that food and you do the math to figure out how much insulin it takes for your body to properly metabolize those carbs.

There will always be some (maybe a lot) of variation in your glucose levels... that is normal. But ideally, at mealtimes and when the insulin peaks (achieves its peak strength in your body after injection), it will return to normal once your dosage is figured out. But normal can be anywhere between about 70 (although this is on the low side and some doctors use 80 as the low end of normal) to about 126 before meals. AFTER meals, 'normal' changes, for all people's blood glucose goes up for a few hours after they eat.

As for the possible 6 shots a day... physical activity tends to cause the body to dump adrenalin, and adrenalin acts as an insulin blocker in addition to giving you a temporary release of energy. So it is pretty normal to find that blood sugar levels go up briefly after exercise. The tough thing is that if you take insulin to cover that high after exercise, then many people find that they drop low after a few hours when that adrenalin subsides but the insulin is  still acting. So then you find yourself drinking Gatorade or juice. It really is a balancing act, and so many factors make changes in your blood sugar all day long that all we can do is to try to normalize the number for a couple of hours before it changes again. This is normal for type 1 folks, so don't despair or feel that you have a 'bad case'.

The other thing that you will discover for yourself is that some foods digest quicker than other foods. Foods containing fats such as pizza or french fries digest slowly because of high fat content, and I personally find that these foods sometimes cause a drop in glucose levels at first because my insulin kicks in to do its job while they are still digesting, and then later on I run high in glucose because the insulin is petering out and the food is finally digesting.

You sound like you are very intelligent... I think that in time you will figure out your own body's reactions and will know exactly what to do for each situation. Just take each test as one thing at a time for now, and deal with each instance alone. It will get easier as you learn more and more how your body reacts to each food and each activity. The important thing is not that the level is high right now, but that you can take a bit of insulin and that it normalizes in two hours. Your just have to adjust a lot all day.

There are many philosophies on how to best control diabetes, and some doctors believe in simplifying to as few shots a day as is possible. But I personally believe that it is best to take as many as is necessary to keep the levels returning to normal as many times a day as is possible. For active people, it may indeed take more 'normalizing adjustments' than for folks who are sedentary. But the active lifestyle is healthier, so it is worth it. Your doctor sounds smart. You are not only trying to figure out how much insulin it takes for your body to lower its glucose levels, but you are also trying to figure out how much your body needs in the way of carbs to correct lows right now. If high after fixing a low, it may be that you just overdid the carb correction OR that your insulin had already peaked so you didn't need to eat quite as much as you did, OR that your liver dumped some emergency sugars that caused you to pop back up to too high after the hypo episode. So complex are we... so many factors affect our blood sugars.  

Psychologically, it is easier on you to just relax and take it one test at a time. Don't worry if the number is high during one test and low at the next. Just do what you need to do to normalize that one reading. Take mental note of what you did and what the results are the next time you test. Slowly you will figure out what works best. As you and your doctor do the trial and error to figure out what works best for you, you just have to test a lot and adjust a lot. In time, it will get easier (kind of like learning to brush your teeth), and it will keep you healthy. Keep your chin up.