Need some thoughts, guidance, and whatever else you can give me!!!

Hello all... I am in need of tips, tricks, or opinions on how to control my blood sugars.

A little background. I am considered a Type 1.5. I was first diagnosed with T2 in 2001. At that time, I was put on Metformin. I eventually ended up on the highest dosage and was maxed out. At that time, I had tests done where it was confirmed that my pancreas was not producing insulin any longer. As a result, I was placed on insulin. As the years went on, I was placed on a pump versus traditional injections.

Recently, a CGM was added. This perhaps was the worst thing ever. I knew my readings were bad, but I was blown away by the wild swings.

A typical day for me is going to bed at 10ish pm. My reading at that time is typically around 160. During the middle of the night, my levels will drop into the 50-70 range. I awake at 5:00am. At this time, my levels are 150. I will typically eat a banana and go into work. When arriving at work around 7:00ish, my levels will be 300-400.

I will battle the entire morning with my blood sugars, usually taking 30 units. By lunch, 11:30, my levels are at 120-140. I will eat a sandwich with wheat bread, a small bag of veggie chips, a light yogurt, and a Diet Pepsi. So, my carb intake is around 60. At 2:00pm, my levels will be back up to 400. By the time I leave work at 5:00ish, my levels will be down to 100 or lower.

My insulin/carb ration is 1:6. What really blows me away is my A1C is a whopping 12.2. This indicates that my levels are in the 300 range.

I also suffer from gastroparesis and PTSD from serving in the military.

I am tired of living my life this way and feel I am doing everything I can to control this. However, I never feel good, am exhausted, and recently have been having possible issues with my heart. I am scared to even go to the doctor. I am in my 40's and want to see my children grow to be adults.

Any advice, comments, or thoughts would be appreciated.

Lanie,

Thank you for the kind words.

I am still on the pump. I use the OmniPod. The CGM is a Dexcom G4. You are correct about the CGM. It only takes blood sugar readings every 5 minutes. It shows trends on your blood sugar levels. The issue with it is with the violent swings, it cannot properly reflect my readings. At times, it will be off by 100 or more. I am going through 200 units of insulin in just over 24 hours.

I am seeing an Endo. She is knowledgeable and is trying her hardest to figure this out also.

I know I am having Dawn Phenom. The strange thing is when I work out, my blood sugars actually increase, rather than decrease.

Lanie,

The purpose of the CGM is to continuously track my blood sugar levels. I was pricking my fingers up to 12 times a day.

With the gastroparesis, my body does not digest the food like others, meaning food sits in my stomach longer than others. This is bad for a couple of reasons. One is bacteria can grow. Two is it causes rise in my blood sugar. The CGM is important for this also. When I eat, there is a huge delay before the food causes my blood sugars to rise. The CGM alerts me when this happens.

I also use the CGM to identify what foods cause rapid increase in blood sugars in both simple and complex. For instance, pasta makes my blood sugars soar and it is hard for me to digest, resulting in me vomiting. Beans make my blood sugars increase rapidly. Fried foods in general are very hard for me to digest so I try to avoid them all together.

Banana for breakfast, wheat bread and chips for lunch? Diabetes is a carb intolerance and the only way you're going to get control, like really good control, is to cut carbs. I would aim for 50 a day then try to cut it down even more to 20-30. You can have a quest bar or one of the lower carb Kind bars for breakfast, wrap your sandwich in lettuce wrap or have a salad for lunch and eat a simple protein with veggies for dinner. Snack on cheese and almonds and have Lily's chocolate chips from whole foods if you want something sweet. Google ketogenic and low carb recipes. Every comfort food has a low carb alternative, I promise. Good luck to you. It's a difficult adjustment at first, but so worth the better health. My last a1c was 5.5 and I expect it to be even lower next time I go.

Hate to jump in here but being on the pump also I might be able to help, how is your carb counting going? do you measure your foods? do you have a scale at home? remember you can adjust your Basal settings to what suits you best and other settings that you need to change, but remember it will take a couple of days for you to notice the difference and your I:C Ratio probably should be adjusted for certain times of day I have 5 different settings, my lunch I:C Ratio 1:20.

Carb counting is your main control mechanism, but cutting it out completely you do not have to do (you are not on a diet)since you are on the pump and get Insulin hourly, my carb intake is usually around 200-250 carbs a day and my last AIC 6.4 and my weight is 145 lbs

Since the pump is kind of a new thing (I know it has been around for a while) but the medical profession doesn't really know much about it make sure you have Diabetic Nurse Specialist that does know about it to help you also, so you can be in touch with them daily if need be