Getting good control is a balance of a few things that she can control: Food, exercise, insulin and testing.
There are random factors that she will not be able control too well (illness, infection, hormones, stress, medication side-effects, insulin resistance, injection site problems). But balancing diet and insulin is the primary challenge.
Some people do well to use a glucometer more than 4 times a day. Others say their management improved significantly with a constant glucose monitor like Dexcom (includes alarms for low blood sugar while the person sleeps), or the frequent glucose monitor Freestyle Libre. Knowing where one's blood glucose level is at any given moment, and being able to predict where it might be going, are key to good management.
As far as insulin, most people don't have significant adverse reactions to the insulin -- though some do have genuine allergies. Perhaps to the insulin or preservative, or to latex used in the stoppers. These are not common, but I don't know what you mean when you say she feels horrendous. You'd have to be more specific.
There are several insulin manufacturers and several different brands that she could try.
Basal (long-acting) -- could be Lantus / Tujeo / Basaglar, or Levemir, or Tresiba.
Bolus (short-acting) -- could be Humalog, Novalog, Apidra, Fiasp, or the inhalable Afrezza.
There are older versions called R (Regular) and NPH; and a few other brands. So, if one doesn't work out, she can try another. I felt tingly on R; and Lantus made my mouth taste like band-aids. I switched to Levemir and haven't had any significant problems. Some people find that their long-acting is not working for 24-hours, so instead of one injection they might split it into two for more even coverage. There's techniques like that which a doctor may or may not help her use.
No clue what your daughter is eating, but there are a number of dietary approaches that she can try. Many Type 1 diabetics claim "you can eat whatever you like -- you just dose for it." Some portion of diabetics do okay with this, but some portion get stuck on a roller coaster of glucose swings trying to fix it each day. Dosing is not an exact science by any measure. People go low from too much, or high from not enough. The more insulin one uses, the more complicated the situation can become. Some people practice "carb counting" where they learn the amount of grams of carbohydrate in the foods they prefer to eat, and then they can better estimate the amount of insulin to take for each meal, with a "carb ratio." Some people do a "pre-bolus" where they inject their rapid-acting insulin about
15 or 20 minutes before eating to try and counteract the sharp rise in glucose from the carbohydrates. Most people do reduce their carbohydrates to a sensible level, though, to try and avoid some of the hassle. Some people may do a mini correction between meals if it becomes obvious they did not take enough to compensate for the glucose.
There are doctors who are excellent, but too many medical professionals are not very good at giving advice to diabetics that is effective, or even accurate. Some have expectations that complications are inevitable, for example; or that it is dangerous to have an A1C near normal, for another example. Like I said, a lot of adults are misdiagnosed based on doctor's general assumptions about
what a diabetic looks like without proper testing. The doctors' dietary advice tends to be generic, and sometimes they give patients dosing advice that they are supposed to adhere to for long stretches until the next appointment. When what the patients need is to be educated about
how to best handle their own care and decisions. A diabetic educator may or may not be helpful to your daughter -- it's worth experiencing, but the quality of the info depends on who is giving the talk.
One method of care that has grown in popularity over the last decade is Dr. Bernstein's Diabetes Solution. It involves a carbohydrate-restrictive diet that adds more protein and vegetables (than fat). Many adherents report that they get much better control each day, have more confidence about
their health, and have a better understanding of diabetes management thanks to Bernstein's work. (He's an 83-year-old Type 1 diabetic since he was 13.) www.diabetes-book.com/read-online-diabetes-solution//www.youtube.com/channel/UCuJ11OJynsvHMsN48LG18Ag/videos?view=0&sort=p&flow=grid
Others have dietary approaches that are quite different (ie. lo-fat vegan, high-fat keto, etc). Regardless, diet is a huge component of diabetic care, and can be a challenge for some people who feel compelled to eat foods that are difficult to manage (pizza, soda, chinese food, etc). And keeping a record of meals and pre- and post-meal glucose tests for a while can help to figure out patterns of cause and effect.
There are tons of diabetic support groups online -- big and small, for nearly every region, demographic and style of treatment. Websites, apps, and social media all have people willing to listen and discuss options. They don't always agree, but most everyone means well. There are new people there every day, just like her, brand new with lots of questions. Steer her towards any of these if she is on Facebook or the web./www.facebook.com/groups/LADASupport//www.facebook.com/groups/LADATYPE1.5DIABETES//www.facebook.com/groups/210509455804121/www.reddit.com/r/diabetes/forum.tudiabetes.org/community.beyondtype1.org/home/www.diabetes.co.uk/forum/category/type-1-diabetes.19//forum.typeonenation.org/www.facebook.com/search/groups/?q=type%201%20diabetes
Post Edited (JDT1D) : 2/28/2018 10:14:25 AM (GMT-7)