I had an appointment with my endo this week as I have been concerned about my blood sugar levels for a while. Since I got back from vacation, I have been running a bit higher than usual for some reason and with my bloods running a bit higher I have been feeling awful. Ironically, during vacation I was running low all the time. I wonder if I just killed more of my pancreas by having to correct all those lows and once I got back to my desk job, the reduced insulin production is starting to show.
Usually, if I’m running a bit higher for a while (due to going out to eat or just eating at weird times on some days), my numbers tend to generally fix themselves after a couple of days back into my usual routine. This time, they just haven’t, whether I take more insulin, eat less carbs, go for walks, I have just still been seeing very odd numbers so I’m just trying to figure out what is going on. I eat the same thing every day (unless I go out to eat, which is rare) and my activity is pretty consistent so I expect to see numbers that are roughly the same. My numbers are still controlled, but they’re running higher than I want, which worries me as I don’t want them to just keep getting worse. I started to see quite a few fastings and pre-meal numbers in the 130mg/dL range, which is not normal at all for me. I am very strict about having good pre-meal numbers as I don’t have a pump to make small corrections if I start out slightly higher than I like. I can take an extra half unit, but sometimes end up too low and have to correct.
I brought in my Dexcom data and we got an A1C test as I had not had one done since I started on insulin 4 and 1/2 months ago. Not surprisingly, my doctors thought my Dexcom chart and A1C were great. They said no one in their practice has a Dexcom graph that looks as good as mine and it is amazing for a type 1 to be able to accomplish that. They also thought it must take a lot of work and must be a full-time job to accomplish that, which is very true.
My A1C was 5.8%, which is very good and very close to the estimate given by Dexcom (which I was surprised about as the Dexcom usually says I am lower than I actually am). With an A1C of 5.8%, they were more concerned about lows, which I don’t really have very much as I designed my diet to avoid both highs and lows. I eat a moderate amount of carb (a little over 100g a day as I like exercising a lot), and I eat a moderate amount of protein and fat to both delay the release of carbs into the bloodstream so I don’t spike and hold my glucose levels stable between meals. This is so I don’t end up tanking a couple of hours after meals, having to correct a low, ending high, starting high before the next meal, having to take more insulin to cover starting high, ending low, having to correct the low, and ending up on the diabetes roller-coaster ride.
I explained to my doctors that fastings and pre-meal numbers in the 130s are not normal for me and I eat the same thing every day so there’s no reason to see these pre-meal numbers. Plus I have been doing extra walking and whatnot to help my numbers out a bit more so that’s why I am still in range. Otherwise, I probably would have been out of range a long time ago. Luckily, I have good doctors right now that listen to me instead of seeing that everything looks good and sending me off on my way with no changes. They thought the issue may be that my basal may be a bit under-dosed right now for my current weight. I have gained 8-ish pounds or so in the 4 and 1/2 months of starting insulin, which is a pretty good amount of weight to recover, it’s not too excessive. Therefore, they told me to make a small adjustment of one unit to the basal to start off and see how much of a difference it makes. So far, I haven’t really seen much of a difference. I am assuming it may take a few days to build up levels of the new dose in the bloodstream before I start noticing an effect. Hoping it helps my bloods get back to normal as my body doesn’t like me running around the numbers I am currently at. We’ll see what happens. Trying to stay positive and not keep stressing about it as I know the stress will only make my blood sugar levels worsen.