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12XGrandma
Total Posts: 37
Registered on: ‎04-12-2012

Fluctuating glucose readings

I can eat the same thing for a meal two days in a row. Same amounts. Take the same smount of insulin. Have the same activity level during the day and be 121 two hours after the meal on one day and 195 on another day. How am I supposed to figure out how much insulin to take to avoid going too high or too low. The 121 is good. I liked that one. The 195 not so good. I should have taken more insulin, but based on the day before, I took the same amount. Is this "normal"?

trisha01
Total Posts: 6,395
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Registered on: ‎10-31-2009

Re: Fluctuating glucose readings


12XGrandma wrote:

I can eat the same thing for a meal two days in a row. Same amounts. Take the same smount of insulin. Have the same activity level during the day and be 121 two hours after the meal on one day and 195 on another day. How am I supposed to figure out how much insulin to take to avoid going too high or too low. The 121 is good. I liked that one. The 195 not so good. I should have taken more insulin, but based on the day before, I took the same amount. Is this "normal"?


 

12XGrandma,

 

Are you Type 1 or Type 2? It is hard to tell, since you are posting on both boards, and you don't have it in your post nor in your signature.

 

For how long have you had diabetes? What insulins are you using? How much long acting are you using? Are you on a sliding scale; or do you count carb grams - using an I:C ratio?

 

Trisha

 




Trisha

IDDM (Type 1 Autoimmune) 30+ years ~ Currently using MDI & Minimed CGM ~
Check out my diabetes blog!

  All brittle means, is that one has great fluctuations, which is pretty much hallmark for Type 1's. Some more so than others. - me
  First light brings a new day, new hope, new wisdom, and a chance to start fresh again. - me

If everyone were dealt the same amount of cards, there would be no challenges in life. Challenges are part of life's lessons, to teach us to grow in all aspects, and to learn what we need to learn, to make it in this world. Life was not meant to be fair. -me



~ New Type 1 Info ~ Insulin, Test Strips, Lancets, and other meds ~ Kidney Damage Info ~


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12XGrandma
Total Posts: 37
Registered on: ‎04-12-2012

Re: Fluctuating glucose readings

I don't know if I am type 1 or 2. I have been diagnosed with both. I don't fit either profile, though I fit type 1 better than type 2. I was diagnosed in 2005 at age 55. I had gestational diabetes but was never overweight. I was never tested afterward and in 1998 I had an A1c of 7 and was told I was glucose intolerant and to watch the sugar and sent home. All fasting tests after that were below 100. However, in 2005 I was sick a lot and a PA decided to do some blood work. I was then diagnosed as type 2 based on the random test of 293 and the A1c of 7. My random tests were often over 200. The treatment for type 2 wasn't effective and I was put on Lantus in the morning and Novolog with meals. I seem to produce a small amount of basal insulin but not the after meal insulin which is why my fasting tests were always good and the random ones weren't. I am not insulin resistant. I am very sensitive to insulin and use a juvenile pen that allows half units. I take insulin at a ratio of 1:20 right now, though I was at 1:15 for a long time. I took 3-4 units of Lantus, but had to eliminate it this spring. However, I will put it back in soon as the before meal numbers have been increasing to a level above my target. My last A1c was 5.4.

trisha01
Total Posts: 6,395
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Registered on: ‎10-31-2009

Re: Fluctuating glucose readings

[ Edited ]

12XGrandma wrote:

I don't know if I am type 1 or 2. I have been diagnosed with both. I don't fit either profile, though I fit type 1 better than type 2. I was diagnosed in 2005 at age 55. I had gestational diabetes but was never overweight. I was never tested afterward and in 1998 I had an A1c of 7 and was told I was glucose intolerant and to watch the sugar and sent home. All fasting tests after that were below 100. However, in 2005 I was sick a lot and a PA decided to do some blood work. I was then diagnosed as type 2 based on the random test of 293 and the A1c of 7. My random tests were often over 200. The treatment for type 2 wasn't effective and I was put on Lantus in the morning and Novolog with meals. I seem to produce a small amount of basal insulin but not the after meal insulin which is why my fasting tests were always good and the random ones weren't. I am not insulin resistant. I am very sensitive to insulin and use a juvenile pen that allows half units. I take insulin at a ratio of 1:20 right now, though I was at 1:15 for a long time. I took 3-4 units of Lantus, but had to eliminate it this spring. However, I will put it back in soon as the before meal numbers have been increasing to a level above my target. My last A1c was 5.4.


 

First things first, did you stop the Lantus on your own? Or did your doctor? The Lantus should not be stopped all the way on your own. Just keep decreasing it if needed. The general rule of thumb for decreasing, or increasing it back, is 20%, and no changes for at least 3 days. All Type 1's are insulin sensitive, some moreso than others.

 

You might wish to take that I:C ratio to 1:25 or 1:30, for awhile, especially if you start the Lantus up again. Seasonal changes are normal for most Type 1's. We decrease basal in the spring, and increase it in the fall.

 

Since you were never tested for which type of diabetes, that really needs to be done. However, since you were Dx'd some years ago, the tests may not tell anything, for you. They are designed for newly diagnosed folks. But it is worth a try.

 

Below is a chart that shows which tests are needed.

 

*********

 

When you (in general), or your physician, is doubting the type of diabetes you have, a chart is below, for the tests that are needed. To print it off, log in, and on my post here, click on options at the top right, scroll down to print, and it should let you print this post off, without printing all the posts on the page. Take it with you to your physician.

 

 

These are the tests that are mentioned at www.labtestsonline.org . This next link is the exact link of these tests, in case the doctor is not familiar with them (some aren't).

 http://labtestsonline.org/understanding/analytes/d​iabetes-auto/   If you can, print this off and take it with you.

 

Test Abbr Description Comments
Islet Cell Cytoplasmic Autoantibodies ICA Measures a group of islet cell autoantibodies targeted against a variety of islet cell proteins One of the most common islet cell autoantibodies detected at onset of disease. Detected in about 70-80% of newly diagnosed type 1 diabetics.
Glutamic Acid Decarboxylase Autoantibodies GADA Tests for autoantibodies directed against beta cell protein (antigen) but is not specific to beta cells Also one of the most commonly detected autoantibodies in newly diagnosed type 1diabetics (about 70-80%).
Insulinoma-Associated-2 Autoantibodies IA-2A Tests for autoantibodies directed against beta cell antigens but is non-specific Detected in about 60% of type 1 diabetics.
Insulin Autoantibodies IAA Autoantibody targeted to insulin. Insulin is the only antigen thought to be highly specific for beta cells.

Detected in about 50% of type 1 diabetic children; not commonly detected in adults.

IAA test does not distinguish between autoantibodies that target the endogenous insulin and antibodies produced against exogenous insulin.

 

 

Testing is the only way, nowadays, for doctors to know for sure.

**********

 

The doctor can also do a c-peptide test. People of all ages are being diagnosed with Type 1.

 

P.S. Forgot to answer this part of your question.....Of course we have fluctuations and sometimes very extreme ones, we wouldn't have to worry about being Type 1 otherwise. The 'betes gremlins, insist on having their way, with us.

 

Trisha

 




Trisha

IDDM (Type 1 Autoimmune) 30+ years ~ Currently using MDI & Minimed CGM ~
Check out my diabetes blog!

  All brittle means, is that one has great fluctuations, which is pretty much hallmark for Type 1's. Some more so than others. - me
  First light brings a new day, new hope, new wisdom, and a chance to start fresh again. - me

If everyone were dealt the same amount of cards, there would be no challenges in life. Challenges are part of life's lessons, to teach us to grow in all aspects, and to learn what we need to learn, to make it in this world. Life was not meant to be fair. -me



~ New Type 1 Info ~ Insulin, Test Strips, Lancets, and other meds ~ Kidney Damage Info ~


Responder
12XGrandma
Total Posts: 37
Registered on: ‎04-12-2012

Re: Fluctuating glucose readings

You have been very helpful. I was tested early on and all antibody tests were negative. However, I was told that there is a small percentage of type 1's where that is the case. Thank you for the info on seasonal fluctuations. I have never had anyone to talk to before about these questions and have tried to do all of this on my own. It is sometimes quite overwhelming, especially when things go along fine and then all of a sudden something unexplainable happens.

 

I stopped the Lantus on my own because my doctor doesn't know how to treat my type of diabetes. Her assumptions don't work with me. Originally she told me to test once a day in the morning. Obviously that doesn't work. She assumed I had type 2 because of my age and the lack of antibodies. A different doctor changed the diagnosis to type 1. My doctor lets me adust things as I see fit because shes doesn't know how. She is the third doctor I have tried. I work with a RN/CDE who knows more and she thought I should probably stay on the Lantus, but if I do, this time of year, I go too low before meals and she couldn't explain to me why I should stay with the Lantus. The only endo. available with my insurance is such an arrogant, egotistical, man that I refuse to work with him. He doesn't want to listen to me at all. He does ask if I have read his book. I am too well controlled to interest him. Maybe I will e-mail the doctor who diagnosed me with type 1 about the Lantus. He knows more.

trisha01
Total Posts: 6,395
Topics: 315
High Fives: 696
Blog Posts: 62
Solutions: 74
Registered on: ‎10-31-2009

Re: Fluctuating glucose readings


12XGrandma wrote:

You have been very helpful. I was tested early on and all antibody tests were negative. However, I was told that there is a small percentage of type 1's where that is the case. Thank you for the info on seasonal fluctuations. I have never had anyone to talk to before about these questions and have tried to do all of this on my own. It is sometimes quite overwhelming, especially when things go along fine and then all of a sudden something unexplainable happens.

 

I stopped the Lantus on my own because my doctor doesn't know how to treat my type of diabetes. Her assumptions don't work with me. Originally she told me to test once a day in the morning. Obviously that doesn't work. She assumed I had type 2 because of my age and the lack of antibodies. A different doctor changed the diagnosis to type 1. My doctor lets me adust things as I see fit because shes doesn't know how. She is the third doctor I have tried. I work with a RN/CDE who knows more and she thought I should probably stay on the Lantus, but if I do, this time of year, I go too low before meals and she couldn't explain to me why I should stay with the Lantus. The only endo. available with my insurance is such an arrogant, egotistical, man that I refuse to work with him. He doesn't want to listen to me at all. He does ask if I have read his book. I am too well controlled to interest him. Maybe I will e-mail the doctor who diagnosed me with type 1 about the Lantus. He knows more.


 

12XGrandma,

 

Approximately 10% to 20% of Type 1's will never show antibodies. Sometimes, it also takes awhile, for antibodies to make their presence known. To further add to the situation, the longer one has diabetes, everything has already been killed off, and only rarely will antibodies be seen again - if at all. The timing of that has to be perfect, and as with all things diabetically speaking, nothing is perfect for Type 1's, and never will be. Just a sad fact of 'betes life. Everything with diabetes is YDMV (Your Diabetes May Vary).

 

Those of us that have been 'betic since days before meters even, also had to go it alone. I didn't get my first meter until 1987, shortly after they became available. Once we all found the internet and sites like this one, we all became more educated, were no longer alone, and have learned from each other, and still do learn from each other.

 

Just keep this in mind....Lantus, or Levemire, is our lifeline. During stages of *honeymoon*, one may not need any insulin at all, until that part of the honeymoon is over. Some will have a honeymoon, and some will not. Honeymoons can also last, from just a day, to a few years or longer.

 

Find a new doctor would be a strong suggestion for you. Do email, or call, or visit the one that did type you as Type 1. It may be fruitful to do so.

 

Keep hangin' with us, and we'll always do our best to help.

 

Trisha

 




Trisha

IDDM (Type 1 Autoimmune) 30+ years ~ Currently using MDI & Minimed CGM ~
Check out my diabetes blog!

  All brittle means, is that one has great fluctuations, which is pretty much hallmark for Type 1's. Some more so than others. - me
  First light brings a new day, new hope, new wisdom, and a chance to start fresh again. - me

If everyone were dealt the same amount of cards, there would be no challenges in life. Challenges are part of life's lessons, to teach us to grow in all aspects, and to learn what we need to learn, to make it in this world. Life was not meant to be fair. -me



~ New Type 1 Info ~ Insulin, Test Strips, Lancets, and other meds ~ Kidney Damage Info ~


Responder
12XGrandma
Total Posts: 37
Registered on: ‎04-12-2012

Re: Fluctuating glucose readings

I am thankful that I didn't get this until there were meters and flex-pens. I am a retired teacher and about 15 years ago I had a student who seemed to need to use the restroom way more than normal. I called his mother and she said she thought he had a UTI and was going to take him to the doctor. I asked her to have the doctor do a glucose test while they were there. Turned out he had type 1 diabetes. He was 10 and I was amazed at how well he adjusted. Things have improved a lot even in the last 15 years.

Super Advisor
Dennis1947
Total Posts: 813
Registered on: ‎10-31-2009

Re: Fluctuating glucose readings

Well, I wouldn't count On very much from these Dr.'s.. and due to all the time it takes to Help one Get Dialed in? It's just too costly for the one's that Know how to do it anyway..

- May ask for a Referral to see if your health Care provider has a CDE available..

-And Get the Book- THINK LIKE  A PANCREASE

- And you might be fortunate enough to have the opportunity to Have Very good Control , like your Having Now for A long time, maybe thru using a Strict Low Carb meal Plan and Exercise.. and sticking to Using that Glycemic Index for what you eat.. and only need to 'Bolus" with Insulin for Higher Carb Meals..

-And Yes, Testing quite often is Required to better Control - Ave Min of 6-8x a day..as explained in the book

 

This Diabetes is a Very Complex Disease and No shoe fits all and it's all Guess work and trial and error

Then when you get things Dialed in? That won't last long and have to keep at it, constantly Changing..

But have to Know How to Change things..

Get the Book to help start the process..

 

And ? We'll leave the Back door open for you!

 

:smileywink:

 

 

Super Advisor
Pam01
Total Posts: 2,227
Registered on: ‎11-02-2009

Re: Fluctuating glucose readings


12XGrandma wrote:

I am thankful that I didn't get this until there were meters and flex-pens. I am a retired teacher and about 15 years ago I had a student who seemed to need to use the restroom way more than normal. Iars.


Grandma - Your post reminded me of a middle school math teacher I had. His class was after lunch and I ALWAYS had to use the restroom. He had a reputation of being mean, but he always let me leave class. This was in the 70's when I was still on 1 -2 shots/ day and didn't adjust for carbs. 504 plans were unheard of and I don't know if my teachers even knew I was diabetic. I wish I had thanked him, andwould not be surprised if he knew full well about diabetes.
Pam

Diagnosed Type 1 at age 16 months, over 45 years now
Minimed pump and cgm since July '09. Metformin (insulin resistance), levothyroxine(thyroid), losartan (BP)

I have traveled cross country, and to Canada, UK, Kenya, Mexico, Jamaica, Equador/Galapagos islands, and lived in Egypt for a year.