Sunday, December 10, 2006

Mystery control theatre

Well, we have the internet now, but it's taken me a long time to get caught up on everything. We're still unpacking and arranging things. I'm starting to feel the pressure to get everything done now - cards, gifts, decorating. Wow, it's already the 10th!

I've encountered a new problem. I normally run low from 5-7pm (75-80), but lately I've been running even lower (65-70), and I've had to go to a 1/20 ratio for dinner or I end up battling lows all night . I seem to be "normal" (1/14) after 10 and I still have the spike around 11-11:30. My insulin sensitivity has never varied before - it's always been 1/14 all day unless I'm stuck in a car or an airplane, and then it's 1/12 all day. Friday night I accidentally took my Lantus at 6:30(pm) instead of 6:00 (forgot to set an alarm) and that night 1/14 worked fine for dinner.

So! My theory as to why this is happening is that the Lantus is lasting more than 24 hours. It's the only thing I can think of that makes sense, and it is possible. Of course I have been terrible about logging with my spreadsheet lately, but this started within two weeks of going on the Lantus. I would rather not tell the pump trainer about it, though, because (1) I think it will go away when I'm not on the Lantus and (2) I know myself best but others tend to misinterpret. I'm not nearly as complicated as a typical Type 1 as long as I'm still making insulin, so the "usual" explanations for these things don't yet apply to me. But I have the impression that people will go to those first because that's what they're familiar with. I really want to avoid spending weeks testing rates and having bad numbers when I don't need to. I already know what my basal patterns are. I have had trouble getting people to believe that I ran low between 5-7 without ANY insulin and did so since before I was diabetic. Unfortunately, I'm not sure if the trainer will listen to me or if I will have to smile and nod and then go home and adjust it myself. I am afraid they will look at my numbers (especially those hypos) and make judgments that aren't correct for me (but would of course be correct for someone else).

I know the other option is adjusting my Lantus down, which my last endo totally approved. It would probably be fine because I don't need as much Lantus as I'm taking, but since I'm so close to getting the pump, I'm not sure it's a good idea to go adjusting things right now. I think I'd rather stick it out until then.

You may have divined that I have a control problem. As in, being a control freak. It's true - I don't trust anyone else to make control decisions for me. Partly because so far they've always been incorrect decisions! My last endo was one of the best doctors I've ever seen, and while he offered guidance, he put me in charge of control decisions. This approach works well, and I've been able to make decisions to improve control that would require way too much time for a medical professional. I think it's significant that I haven't had any severe hypos - and yes, I'm still making insulin so it's a lot harder, but I could have them if for example I hadn't figured out to do a dual wave bolus before I even knew what one was. Sorry if I'm not explaining this right - I am not trying to brag or anything, just give enough information for people to see that I do know what I'm talking about.

Frankly, one of my biggest fears is having to be admitted to a hospital.


In Search Of Balance said...

It's true that Lantus can hang around for over 24 hours... I've experienced that too, when my pump was broken. Also, it seems unlikely since your lows are only in the evening, but moving and all the extra physical activity (and unusual physical activity) that it entails just killed me. My sugars were absolutely bizzare. And I got lots of evening lows....

Hospitals are scary, but you seem to be doing brilliantly :)

Lili said...

Thanks, Beth! I should have specified I take the Lantus at 6pm. In fact, I think I will update that.

I'm terrified of hospitals because they use a sliding scale and usually they take away your pump and insulin! I think a sliding scale might kill me.

Awww, thanks!

Chrissie in Belgium said...

Me too, me too - I am scared to death of hospitals. I am sure I will never get out alive. Me too, I am a control freak. You know your body best. Doctors follow the general rules and they do not work on everybody. Rules have to be tweeked to fit the person. I have never used Lantus - I went directly from Insulatard to the pump, so I cannot advise you. Furthermore, I am always reluctant to advise another b/c we all react so differently. Except, follow your own gut feelings. YOU KNOW YOURSELF BEST! Lili, thank you so much for the link help!!!!

Lili said...

Thanks, Chrissie, I think you know I agree!