I've been diagnosed with Type 1.5 diabetes...where do I begin to control this? My doctor immediately started me on a NovaLog during the day and Lantus at night. Am I experiencing the "honeymoon" period right now? My body seems to respond well, almost too well, to the insulin. My glucose levels are really high and then after 3 units of insulin I'm low...really low 50's. I'll eat approx. 45 carbs and 30 minutes later...I'm better but then I start dropping again...70s. I assume my sugars have been so high for so long that my body doesn't handle a low very well. I dislike this feeling of lack of control...what a challenge this is and I'm just one week into it. If anyone has advice to share...please do, I really want to understand how to manage this. Thanks!

[QUOTE=Klynn3266;3266953]I've been diagnosed with Type 1.5 diabetes...where do I begin to control this? My doctor immediately started me on a NovaLog during the day and Lantus at night. Am I experiencing the "honeymoon" period right now? My body seems to respond well, almost too well, to the insulin. My glucose levels are really high and then after 3 units of insulin I'm low...really low 50's. I'll eat approx. 45 carbs and 30 minutes later...I'm better but then I start dropping again...70s. I assume my sugars have been so high for so long that my body doesn't handle a low very well. I dislike this feeling of lack of control...what a challenge this is and I'm just one week into it. If anyone has advice to share...please do, I really want to understand how to manage this. Thanks!


It sounds as if your insulin doses just need some tweaking, which is quite common when one first goes on insulin.

Are you counting carbs and using an insulin to carb ratio for the Novolog? If so, your ratio may be off. I would particularly suspect this is the case if you keep going low within 1/2 hour to 1 1/2 hours after eating.

If you're waking up low, or having lows at other times that do not correlate to eating (like right before dinner after not having eaten for 4 or more hours), then it's possible your Lantus dose is a bit too high.

You can easily tweak the doses yourself...just don't try to tweak both types of insulin at one time. Either tweak the Lantus by reducing your dosage by 1-2 units and evaluating over the next several days (then tweaking again if necessary, and if you don't end up having too many highs), or tweak your novolog insulin to carb ratio...for example, if you're currently on 1 unit to 10g of carbs, try one unit to 9 g of carbs, evaluate over a few days and then further reduce (to 1:8) if necessary.

One of the ways to determine which dose needs tweaking is by fasting for part of a day. For example, don't eat breakfast one day, but test your bg every 2 hours until lunch. If you're not low during that time, then do the same thing, but skip lunch, testing every 2 hours until dinner, and so forth. This will tell you if the Lantus dose is too high.

Perhaps someone else (Mark, Blondy, Cora?) can pop in here and advise as to which to test first?

But don't get discouraged...it can take several weeks to a couple of months before you get everything titrated well enough so that you don't have this problem. Once you do get things figured out, your blood sugar levels should be much smoother.

Ruth

[QUOTE=arkoalta;3267802]Hi,

What is Diabetes 1.5?

T1.5 is basically T1 diabetes, but occurs in older people. They used to call T1 "juvenile" diabetes, but since you can get it at any age, that didn't make sense. So they call it T1. For many folks (but not all) T1.5 has a much slower onset. These folks have a much longer honeymoon period and often respond to oral meds , sometimes for years. Eventually, however, the insulin producing cells are destroyed by the autoimmune disorder and insulin is required.

As for getting better control, I agree with Ruth that you will have to fast to check your basals. Pick a time of day you want to work on (I usually start in the morning and then fast untill about 2 or 3 pm) and see how your lantus keeps your blood sugar stable. On another day, try eating breakfast and then see what happens over lunch and then go for a late dinner. On a third day (leave a few days in between each experiment) eat breakfast and lunch but then skip dinner and snacks and see what happens. If you can afford the test strips, test every hour (try maybe every 2 - 3 overnight).

Also, you will need to test a lot to see what your insulin to carb ratio is - that is how many carbs you can eat for a unit of insulin. Try to stick with foods that have a known carb amount on the label or amounts that you can measure.

In addition to all that (getting tired yet? LOL) you need to watch and see how much insulin brings you blood sugar down (insulin sensitivity factor). So if your blood sugar is 250, see how much one unit of insulin brings you down over several hours. This way you will know how much to give to bring yourself down no matter how high youare.

For example, one unit of humalog will bring me down 80 points.

Best of luck to you and feel free to ask lots of questions.

Cora