Type 1 Diabetes

[musolissa]

I am so glad I read this thread

I am type 2 insulin dependent and found people with GD think they understand but when it comes to certain things they have no idea, so have had no one to talk to about it.

I am taking novorapid and protophane, but the protophane is a PITA to manage, I can get the same reading with or without taking it generally and have major issues getting my reading under 5.5- Endos arent to bothered as its still an ok reading and my hba1c is 6%

People have mentioned using the pump to me, but the hospi doesnt want to as they havent decided on my treatment post pregnanacy. but more thank likely will still be on insulin

Carla- I found that until I got my novorapid levels sorted I would always be high if eating carbs and got into big trouble for starving myself (I was eating 3 very small completly carb free meals a day). The dietician told me what to eat and they worked my isulin out from there- took 2 weeks but I felt so much better for it

[Carla MP]

Hi Musolissa
Thanks for that....Im on actrapid and protophane at night and have had high and low readings...my overall was 10%!!
Last night I tested at 3am and levels were 4.7 then this morning at 6.30 they were 9.9... I really dont know what I am doing wrong or what else to do..Im high then low..Im so worried this is going to have an effect on my baby. I called my specialist and he re arranged my dosages so hopfully in the next few days they will start to level out.

can you tell me what your levels would be on a typical day and what doses you are on??
I think I may be doing something really wrong and not eating right ..well I dunno..I give up.

[mfcr06]

Carla

You poor thing.

It sounds as though you are experiencing the dawn phenomenon. It is a very common thing for a Type 1er. It can be difficult to stop and the protophane perhaps may need tweeking.

Honestly though, could you speak to your endo about changing from Actrapid to Novorapid. Keeping you on Actrapid would be making thing extremely difficult for you to control.

I know that Actrapid is the only shortish acting insulin "approved" for use in pregnancy, but I have never heard of another typer 1er using it while pregnant.

I was on Humalog last pregnancy and am now on Novorapid this time. They are both the very fast acting (faster than actrapid).

If your endo wont consider changing your insulin (to try and make things easier for you), I would seriously consider getting your GP or OB to refer you to someone else who has more of a progressive attitude towards a Type 1er who is pregnant.

We all need all the help we can get at the best of times, but more so when we are pregnant.

Also seeing a dietician who deals with Type 1ers may also help. But make sure they deal with Type 1 Diabetics and not generally Type 2 or GD.

I know that if I eat things like pasta or rice, my bsls are really hard to control (even with a pump).

Someone else on Reality Check recently got into the public Mater Diabetes Centre for an urgent appointment and I can highly recommend them. They are the ones who got me my pump after my old endo refused to let me get one.

They have endos there (one in particular) who deals with Type 1 and Pergnancy and I cannot give them a big enough wrap. Also the Princess Alexandra does a similar clinic and I know of someone else from the Gold Coast who goes there (she is on a pump I think) and is very very happy with the care she is receiving.

I know it would be a hassle travelling from the GC for those appointments but the care you would receive would be a little more progressive than what it sounds like you are receiving at the moment.

I forgot to mention that the Mater clinic has dieticians, podiatrists etc etc so it is basically a one stop shop.

Please dont give up as it is well worth the hassle in the end.

One thing that kept me going first time around was to keep thinking that I cant give up because if anything happened to my unborn bub that could have been prevented by me having better control, how could I live with the guilt after he was born. I know this is a terrible thing to think, but this is what I had to do to keep me focused.

Being pregnant and having Type 1 is hard, and women who dont have difficult pregnancies have no idea how good they have it.

Keep going and let me know if you need to vent. I am good at listening and I know where you are coming from.

[Carla MP]

Mfcr
Hey how are you?
Thankyou for all that. I think your right with the 'tweeking' I think it is a matter of trial and error at the moment. I am 9 weeks yesterday so hard to control and I thik Im freaking out a little too much. Last night was a little better. I am seeing my specialist on Wednesday so I am going to ask him about changing and see what he says.
I have panicked all through this pregnancy from the moment I found out. i know my diabetes is a serious issue but I think I need to calm down a little and focus on whats happening instead of expecting them to be perfect withouot effort.
I will kjeep trying...Im not giving up...this is too important to me.

Thankyou for all your help, Its great having someone to talk to about this and having someone who knows whats its like......I guess its hard on people who dont have it to understand.......
Thanks so much......
So how are you feeling? Not long to go for you!!

[mfcr06]

Good to hear you have an appointment with your endo so soon.

I would also perhaps ask him/her about going on to Levemir or Lantus as your long acting insulin. I have to be honest, protophane is not worth the hassle.

I am good at the moment but I have had a really rough time being pregnant this time around (terrrible morning sickness to 27 weeks and then a severe asthma attack at 28 weeks which saw me in hospital for 10 days).

It is definitely harder 2nd time around.

My son in 2 and a bit and is full of energy and wants to be on the go all the time. I also work 3 days a week aswell. Perhaps I should start to slow down a bit.....

Before I had the asthma attack, I was not really well (struggling to breathe does that funnily enough) and my OB said that we were only going to aim for 34 weeks and then get the bub out. Since my asthma has settled, things have improved and by OB said that we could probably aim for 36 weeks. When she said that, I nearly cried because I am soooooooo over trying to control the damned diabetes side of things as well as all the other stuff you have to deal with.

Anyhow, whatever happens, I will be just glad to have it all over and have this baby arrive healthily.

My son was born at 34 weeks and really dont see the problem with No 2 coming at 34 weeks aswell. The only down side would be the lengthy stay in special care for bub, which makes it difficult.......especially with a toddler.

I really cant wait for the birth (c-section) and even though I had a really tough time with the last one, I know it doesnt last forever and everything heals and things get better.

Have you decided where you are going to have your bub yet?

[mfcr06]

Musolissa

I would be asking your GP or endo for a Type 1 Diabetes antibody test to make sure that you aren't officially a type 1 diabetic. I have heard of heaps of Type 2ers and GDers who are misdiagnosed and are in fact Type 1 Diabetics.

[Carla MP]

Hey ladies
Can anyone tell me their typical day of bsl's? And units of insulin to co inside

[mfcr06]

OK, this may be a bit difficult to follow (because I'm on a pump) but I will do my best to explain.

Basal rates (background insulin)

Midnight - 1.4u/hr
2am - 1.95 u/hr
4am - 2 u/hr
12.30pm - 2.5 u/hr
3pm - 1 u/hr
7.30pm - 1.9 u/hr

Bolus/corrections

3am - BSL - 5.6mmol
6am - BSL - 7.3mmol Breaksfast - 30g of carbs - 7.25u of Novorapid (5 units to cover cabs and 2.25 for to correct BSL). My target BSL is 5.5mmol.
8am - 6.1mmol
10am - 4.9mmol
12noon - 5.0mmol - 30g carb (5 units to cover carbs which was reduced to 4.75units by the pump to increase BSL to target to 5.5mmol)
2pm - 6.9mmol. No correction required as Novorapid still has 1hr left to work its magic.
4pm - 5.4mmol.

I dont always test every 2 hours, but I have been on medication (prednisone) for my asthma that really throws control out the window and I'd prefer to be on top of it.

Usually I test before I eat and then 2 hours after to make sure I have the insulin:carb ratio correct so I dont get too much of a rise post meals.

I am waiting for the results of my last HBA1C which I am hoping is below 6.2 this time.....

Dont get disheartened if your BSLs arent similar to the ones I have put here. It would be IMPOSSIBLE for you to get this tight control being on multiple daily injections and on actrapid and protophane.

I have actually shocked myself looking at this, pretty good even if I do say so myself. AND every day isnt like this, I can go hypo and hyper with the best of them......

[mfcr06]

Sorry, the above bsls are for TODAY. Not every day is like this. Work, stress, etc etc can have varying effects on bsls and no 2 days are exactly the same.

[musolissa]

Sorry I have not been on internet for a few days....

OK my BSL Fasing- 5.0-6.2 depending on food the previous day, 2 hr after meals between 5 and 7, usually around 6

I have Novorapid during the day
Breakfast- 0 or 6 depending if I have carbs in my breakfast (the premanent m/s means most of the time I cant eat carbs for breakfast)
Lunch 8
Dinner 12

Bed- protophane- 38 and I dont think its doing anything at all as I forgot 1 dose and my reading was exactly the same as with the protophane

I also have an issue that if I am asleep and I have a low I sleep through the lows, and I have low symptoms very early (i.e. 4.3) I had a reading of 4.3 and no one was able to understand me I was seeing black, shaking, hot, and flet like I was movinng in slow motion. The Endos have no idea why that happned with such a "normal" reading

As for the possibility of me having type 1- not very likely as I have PCOS and we know Im IR. I am insuline dpendent as I cant tolerate metformin in any form and I have a high fasting BSL no matter what I do. But I have an excellent Endo and Educator so once baby is born I think they will be looking into it all a lot more (I didnt have a great deal of time between finding out Im diabetic and then falling pregnant- just enough time to establish fasting BSL issues and metformin issues).

I was thinking of asking if I can change to another long acting insulin as I really dont think the protophane is doing anything and and I dont want to keep increasing the does just to keep them happy- high insulin load is not good for the baby when its born. I have another Endo appointment in just over a week- so I will check then I think

Carla- just keep pushing through. I also remember being told that something to do with pregnancy that we can get an unusually high fasting reading- something to do with the liver, it feels starved so it produced something that sends our morning readings high

[mfcr06]

I just got the results of my latest HBA1c today and I am stoked.

It was 6.3!!!!!!!

Even after the horror run I have had so far!!!!!!

I just needed to tell someone!!!!!

[melbel]

Thats so cool FI. I get my new pump and CGMS on Monday....rock on!!

[musolissa]

Congrats on the great reading mfcr

I had an interesting morning- my baby is measuring 4 weeks ahead according to a biometry scan I had today. He is in the 90th percentliefor his size.

I see the Endo and OB on Tuesday and I will be discussing this- I think it adds more weight to a medication review

What is CGMS?

[mfcr06]

Thanks Guys.

Mel - I would love to get one of those CGMS for a couple of days soo see what my control is "really" like over night, but I dont think you can get them on trial anywhere here.

Musolissa - Continuous Glucose Monitoring System. They are kind of like an insulin pump (as in attached to you all the time) but monitor your blood sugar levels constantly and doesnt give any insulin, just read bsls. They arent real time either (please correct me if I'm wrong Mel) it all has to be down loaded after the time you have it attached for.

[melbel]

No this one is real time Fi. It will send the data straight to my new pump and can be read from pump screen there and then. it is one of the new minilink ones that are about the size of a 20cent piece stuck on your belly and it communicates by infrared with the pump. It doesnt tell the pump what to do just uses it as a data storage place. I still have to do all the thinking bits (damn it!!). But it has alarms you can set for high and low readings (you set the limits for how tight you want the range to be) so i can get really really tight control hopefully!
Mind you its not cheap (over a grand) but if it helps me achieve my baby then it will be worth it.

[Carla MP]

mfcr06...that is fantastic...good one.I WISH.
Well I went to have my endo appointment after I saw my GP again and burst into tears at the readings I am getting. If I starve myself they are ok...CANT DO THAT!!! So now endo has me on Actrapid (normally on) for breakfast and lunch...started me on Novorapid for dinner and still protophane for bed time...OMG..Im so confused. One says one thing, the other says another so pick up Novorapid tonight. Hope it does the trick but I feel like I should be on one NOT 3....its making things so difficult not to mrntion frightening. Well we will see how things go for the week. Going back to GP next Friday for an update and scan referrals as Ill be almost 12 weeks when I go to see him....well the following week will be anyway.
I wonder when I will get my levels tested..hopefully not this week.....

Hi to all...sorry no personals....on my way out the door!
xoxoxo

[mfcr06]

Damn it Mel, I have a Cozmo........

Hopefully by the time I need to upgrade, CGMS will be available from every pump company.....or else I could just change brands.......

Carla - hmmmmmmm, I dont really know what to say about the 3 insulins.........hmmmmmm.

Perhaps a 2nd opinion from another endo would be a good idea........ Can't hurt!

[melbel]

yeah I have a cozmo too....swapping to minimed cos my 4 years is up!
hmmmm...3 insulins????...yeah I would be seriously considering a second opinion as well Carla.