You all have heard me complain about my up and down BSL.

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Veteran Member

Date Joined Jul 2009
Total Posts : 2042
   Posted 9/1/2009 4:12 PM (GMT -7)   
Here are the last two days BSL numbers and corresponding meals.


Fasting 236. Took my insulin, ate 2 eggs, 2 strips of bacon and two pieces of toast. Had water to drink.
Before lunch: 146. Lunch was a bologna and cheese sandwich. Took my meal insulin. Diet soda to drink.
I forgot to do a supper reading. Did take a meal insulin shot. Had 1/2 cup of pasta and a grilled pork chop. Diet soda to drink.
Bedtime...about 4 hours after supper: 91, took my Levimir (same as Lantus).

Fasting 131. Took meal time insulin and ate 1/2 a peanut butter sandwich.
Before lunch: 194. Took insulin and ate 1/2 a peanut butter sandwich.
Worked in yard a bit after lunch.
Just took my pre supper BSL: 218.
I have been drinking unsweetened, home brewed, ice tea all day today.

Now I can understand the bedtime to fasting increase as probable dawn effect. After that, well you can see part of the reason I am banging my head against the wall.

Based on conventional "wisdom" by all rights my BSL should be, if not normal, in the basement right now.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Regular Member

Date Joined Dec 2006
Total Posts : 401
   Posted 9/1/2009 9:22 PM (GMT -7)   
Hi:)  You might have the same problem I have. I can't tolerate bread. It really shoots my blood readings up. I found some 4g per slice bread that I can have 1 slice once in a while. Try giving up the bread and see what happens. Worth a try.

Veteran Member

Date Joined Jul 2009
Total Posts : 2042
   Posted 9/1/2009 9:55 PM (GMT -7)   
While I appreciate the advice it isn't bread that is the problem. My BSL does this yo-yo bit regardless of what I eat.

Tonight I took my normal meal time insulin and ate a cup of spaghetti and a piece of garlic toast made with the same whole grain wheat bread I always eat.

An hour, an hour mind you, after eating I started shaking, my heart rate felt like it doubled so I rechecked my BSL.

Are you ready for this........73. Popped a couple of glucose tablets and 1/2 an hour later felt better. First time I ever recorded a reading myself under 80.

Checked my BSL for a bedtime reading a couple of minutes ago. A nice 96......(well nice for me anyway).

Something is going on that no one can figure out. Of course no one seems to want to believe me. (No one in the medical community that is.) They all think that I am playing fast and loose with diet, or with taking my insulin or something.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Veteran Member

Date Joined Jul 2009
Total Posts : 2042
   Posted 9/2/2009 9:18 AM (GMT -7)   
Woke up this morning and my fasting BSL was 268. shocked

Come on, give me a break.

It's down now to 136, still high but a lot better.

Somebody stop this ride. I wanna get off. cry
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.

Lanie G
Forum Moderator

Date Joined Nov 2006
Total Posts : 6079
   Posted 9/2/2009 11:50 AM (GMT -7)   
Jim, are you seeing an endocrinologist?  Are you type 1?  Seems like you're on a rollercoaster.  Are you taking other meds that may be causing some of these high blood sugar readings?  Do you have gastroparesis?  Are you eating a steady diet in which you are not overloading on carbs?  By steady, I mean the carb content is relatively the same each day, so you're not causing a yo-yo effect because of the food you're eating.  I'm wondering why you're eating spaghetti and bread and covering it with insulin and then getting lows.  Maybe you're not figuring out the correct dosage.  I'm sure you're frustrated but you must know that those high blood sugar readings are not doing your body any good.  What does the doctor say? 

forum moderator - diabetes
diabetes controlled so far by low/no carb diet and exercise; no meds

Veteran Member

Date Joined May 2006
Total Posts : 547
   Posted 9/2/2009 11:55 AM (GMT -7)   
Sounds like you're on the same ride I'm usually on (and yes, I'd like to get off of it, too :-)

Sounds like you're on an intensive insulin regimen (long-acting plus short acting for food). I assume you count your carbs and inject based on your insulin:carb ratio for that meal? Do you also inject extra at that time to correct highs? Do you know if your Levemir lasts 24 hours or 16-20, like most of us? Have you tested in the wee hours, between 2-3, to see if your morning highs are actually DP or maybe you're going low and your liver is dumping glucose? Have you tested after some meals at the 2-hour mark, to see just how high you go? Do you know how much sugar brings you up how many points? Sorry for the Q's but, I can't remember if you mentioned in the past.

I replied to your "considering the pump" post with a great link to a "how to" site that easily explains how to use insulin the best way possible. If your basal doses and timing are not correct, it has an impact on everything else. It may be titled for insulin pumpers but much of the info comes from John Walsh's "Using Insulin" and applies to all insulin users, not just pumpers. Here it is again:

It's been my experience that, as a Type 1, trying to mimic a natural pancreas' function is an inexact science - more of an art :-) For me, insulin injections and testing have to mean something and the timing is important. It's more important to assess whether I'm trending up or down rather than if the number meets some guideline. I look backwards: how long ago was my last insulin shot& units? meal and number of carbs? BGL test? activity? stress? I look forward: how long till I eat? exercise? how many hours before bed? the insulin's action profile - Rapid or Levemir? I look at where I am: the BGL reading. How I feel. Based on the time of day and the answers to the fore mentioned questions.... I arrive at the decision to (not) inject: how much, and when or fix: how much and what the follow-up is - a snack or a meal. It may sound complicated to some but, this is the process I personally go through (require) every few hours of every day in order to best manage my diabetes. A test is a snapshot in time that leads to a decision to stay the course or alter it and in which direction until the next snapshot leads you to the decision again. Stupid roller coaster, I know, but one that we're not allowed off of. I just try to make the tracks as smooth as possible.

It's in your best interest, Jim, to understand how to manage the D yourself and not rely on any medical professional do it for you. As a Type 1, you have to manage it every few hours - no doc or nurse can do that. Read, learn, log...No one will know you like yourself :-)

Check out the site I mention. Do the basal testing and make sure that's right. Do the ratio testing afterwards. My ratios are 1:8-10, 1:12, & 1:8-10 for breakfast, lunch, & dinner for example. My correction factor is 1 unit for every mmol/L over a GBL of 7.0 (that's 126 mg/dL) and 1 unit for every mmol/L over a BGL of 10.0 after 9:00PM. I don't like to go to bed under 7.0 (126) - too much potential for overnight low and resultant high fasting. The testing and the logging are not rocket science but, do require effort. BTW, you do all this when you go on a pump anyway so, if you're still considering one, why not start now? (MDI is often called the "poor man's pump").

Lastly, I just have to comment on your food choices....we're not like a lot of Type 2s here who HAVE to watch their carb intake and severely limit them to avoid meds. We don't have functioning pancreas' and HAVE to rely on injected insulin to supply our metabolism with what's required. However... the rule of small numbers does logically apply: less carbs means less insulin, means less chance of BGL deviation, up or down. I do eat some of the no-no carb items/products that many Type 2s have to avoid (I find for me I NEED a certain amount of carbs to function optimally), but I still eat them in moderation and balance. For me, eating a pasta with bread meal would see me spiking, testing and adjusting for many hours afterwards. Because pasta, pizza, Chinese buffet for example are such spiky, long-digesting meals, many Type 1's will inject a % of the full carb count before eating and the rest 1.5-3 hours later, just to cover the digestion process.

I'll stop now :-) Hang in there and let us know how you make out.
- 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

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