cowgirl - you can't go back to work yet; not till you get some stability. The honeymooning period can really suck, especially when your doc is making so many changes to your regimen. I know there are some Type 2s that use long-acting insulin (Lantus, Levemir), along with other oral meds to help control their condition but, it's my opinion that a in a Type 1.5 (actually a Type 1), it's not the best combination. Again, I wish you could get an earlier appointment with your Endo. I'd like to see your doc try and do that rather than deal with the situation (far beyond) herself.
Night time lows are not uncommon but are a concern, especially if you're taking your dose at bedtime. (This is one of the reasons I split my Levemir dose). What time do you take your 8 units? Waking up with the high BGLs is usually a combination of a few things: 1) the sugar fix ramped up the amount of insulin in your system, 2) a low/hypo often causes the liver to do a glucose dump into the system as part of the body's fight or flight survival response and 3) everyone has a circadian rhythm/ bio-rhythm that naturally sees an increase in hormonal activities that prepare the body for waking. Insulin production is part of this process - so much so that the name they give for it is Dawn Phenomenon. Even without considering your met/Janumet to this equation, it's not hard to see how such high morning numbers are possible. (The morning numbers are often the most difficult to control for all diabetics).
When you were falling from 300 to 105, did you fix it with fast-acting carbs? (Yes, the 105 is within range but, a test result is just a snapshot of that moment in time. You were still "crashing"). ER folks just want their bed back. Once they've got you up to normal levels their job is done. It usually takes a physician to book you into a room - like an Endo might.
I'm really sorry to hear you're going through all this, CG. As a brittle diabetic (yes, an outdated term but one that they nonetheless use to describe my situation), I'm very familiar with the wide swings in BGLs and the frustrations with trying to find answers for them. It's the whole reason I started my quest to learn everything I could about
the human body and how it works. I wanted to find answers that no one person, place, or document could tell me. I had to learn about
how I worked (hey, I had to learn how to become an artificial pancreas so, needed to know how one worked
At this point, the only suggestions I might have would be:
- fix those lows immediately. When you feel dizzy & light-headed, eat those 15 grams of fast-acting carbs. Follow that up with another test to make sure you're in range. If not, repeat the process till you are. If you're not going to eat a meal within the next hour... have some protein/fat to carry you through. The sugar fix is just that - a fix until you can get some proper food in ya. Keep sugar with you always.
- read Gary Scheiner's "Think Like A Pancreas". It answered the majority of my questions and explained things in a very understandable way.
- if you're not already... test before and after every meal, bedtime, and for a few days test between 2-3 in the morning (this'll show if you trend down in the wee hours and may need a carby snack before bedtime to alleviate it). Along with the med and food entries, your Endo appointment should see him with all the info required to put you on the most appropriate regimen.
Hang in there. Cheers, Kris
- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)
"What's Not Measured Is Not Managed"
"It is impossible for a man to learn what he thinks he already knows"-Epictetus