Newly diagnosed Type 1

Hello everyone.  Let me just start by saying I am 9 yrs post op.  VBG / RNY Bypass.   I have maintained my wieght for the last 9 years with not a single problem, except my gallbladder had to come out.  

Now a few months ago I started feeling very tired, I was not eating, and just felt weak.  It got so bad on Easter Sunday that I could not get off the couch.  I went to the ER and was admitted to the ICU with diabetic  Ketoacidosis.  I was not diabetic (that I knew) before this.  Noone in my family is either.  

Now here is where I could really use some help.  I am on 3 units of NovoLog before each meal and 10 units of Lantus at bedtime.    The Lantus seems to be doing fine.  I am having a problem with Low Blood Sugars after taking the NovoLog.   Within an 1 1/2 to 2 hrs it is dropping bad.  Like down to the 40s. 

I know this is a fast acting insulin and I need to eat within 15 minutes.  I am doing that.  I am eating anywhere between 30 and 45 gr of carbs with each meal.    Could malabsorption be an issue with why I seem to be getting to much insulin?    My endo suggested taking it after meals but that does not seem to be helping either.  

Any thoughts would be greatly appreciated.  I am so new to this and I am just trying to figure it all out.   

I am sorry that I can not help with your question but I just had to say thank you for answering my question for me with out even having to post.  I have been feeling really off these past few weeks and I was jsut coming to post to see if I could develop diabetes after RNY.  My Dr did blood work last week and the office Called and made an apptment for tuseday for when they open.  i am going nuts not knowing.


Thanks

Nikki

Oh I hope everything works out for you.  This really stinks.  I will tell you a little more about how I felt so you can compare.   Like I said I was very tired all the time.  I would fall asleep sitting up on the couch.  I could not eat.  I actually thought it was something with my pouch.  Like scar tissue or something.   My mouth was very dry and I could not get enough water.   Even my eyeballs were dry.   And I was urinating constantly.  Also and this is what sent me to the hospital.  My heart was pounding with the slightest movement.    And  I would get light headed.  

Hope some of this info helps you out.  And again.  Good luck. 

 Could you drop your mealtime insulin down to 2 units? Maybe not wait a full 15 minutes before eating? I became type 1 diabetic at the age of 35(6 years ago), and it hasdefinitely been a challenge for me as well. At first I was running low alot, but now I seem to be running high.

My doctor actually thought of dropping it down but then decided on the after meals.   I think I will ask him about lowering it again at my next appointment.   

When you first found out how long did it take till you had your levels even out?   It has been almost a month now and I am still so up and down.   I seem to be eating constantly.  

Does it get any easier?   Yesterday I was running low after lunch (65).  Not too bad but I think I feel the best when it is around the low hundreds.   But then before bedtime I was at 291.   It this very high?  

Thank you so much for responding.  I really appreciate it. 

Hey there.  I've been a Type 1 for 17 years.  I wonder why your doc didn't cut you back a little.  My doc would rather me run high than low (although neither is preferable).  Even now depending on the time of the month, how much I'm exercising, etc. can affect how much meal time insulin I take.  I hope that you get better control.  I know how bad low blood sugars feel.  I recently had to switch from taking Lantus at bedtime to morning.  Occasionally I would wake up in the middle of the night EXTREMELY low...like 30's.  I was always scared that eventually I wouldn't wake up.  No problems since switching it to the morning and didn't even change the dosage.  Good luck!

Oh thank you so much for your response.  I actually just had another low tonight and was coming here to see if I could find any more information.   I checked after dinner and it was actually high, 215 then an hour and a half  after taking 3 units of the NovoLog  it was 49. Can you please tell me what is considered "very" high.   Sometimes I am in the mid 200's.   The same thing happened yesterday at lunch.  I did 3 units then ate almost a whole slice of pizza.  Now that should have been enough.  I then went for a short walk and it dropped to 66 in less than an hour.  I do think it needs to be lowered.  I am calling my endo tomorrow.

That is funny you should mention that about the Lantus.  My doctor wants me to wake up during the night to test.    He says if I wake up with really bad dreams to make sure I test.  Weird.  I usually wake up in the morning in the mid to low hundreds.  Oh another question, sorry.  How do you know you are low in the middle of the night?  

Isn't Lantus a fasting insulin?   How does that work if you are taking it during the day?   Do you still take another insulin? 

Sorry for all the questions.  This is so new to me.  Last month I knew nothing about diabetes.  I think I am handling it pretty well but these lows get to me.  I get all depressed when it happens, especially after having a couple good days.  

Thank you so much. 

Lantus is not fast acting.  It typically lasts for 24 hrs but some people I know have to take it more than once a day.  I am lucky in that when my blood sugars are low, I feel it.  My heart races, I feel shaky and it actually wakes me up.  The problem is by the time I get to that point, it's VERY low.  It's better to catch it before it gets that bad.  I've also heard about the bad dream thing.  I think people get stressed out during nightmares and blood sugars can dip. 

"Very high" to me is subjective.  I hit the 200's atleast a couple of times a week just due to struggles of my own.  300's would be a HUGE concern to me. I feel best when I'm below 130 but above 80.  There are people who keep in the 70's or lower and feel fine, but not me.  I know that it's easier to maintain tighter control on a pump but I just haven't made that choice yet. I take 15 units of Lantus in the morning and take Humalog with meals (sliding scale depending on carbs).

You just found out about the Diabetes and I applaud you for asking questions and taking an active role in your treatment.  You're going to figure all of this out.  Your taking very low dosages right now and I suspect that in time you'll need more.  You're in a "honeymoon period" right now I would imagine.  Just keep good track of what you eat and what dosages you take.  I'm sure your doctor and you will get all of this figured out.  :)  You can PM me anytime!

i woudl talk to the doctor about taking the novolog based on the number of carbs you eat. If you have a low carb meal, then 3 units may not be needed. Typically they say 1 unit per 10 to 15 grams of carbs, depending on your sensitivity. But again talk to your doctor before making changes. Already saw that you were taking it after you eat, I have to do that too at times.

Now although they diagnosed you as type 1 - being insulin dependant for a period shortly after diagnoses, the pancreas could still produce some insulin - espeically if it has a help mate of insulin getting injected. This is the last ditch hurrah before it goes totally out. NOt sure if this is what is happening, but its an idea.

Been type 1 for 26 years - if you have more q's PM me if you'd like

Oh thank you so much for your response.  I actually just saw the doctor a few days ago.   He has lowered it to 2 units.   I told him I do not eat enough, LOL.    He says that once we get my levels stable I will be doing exactly like you said.   I will be doing the insulin based on what I eat.  I will probably be taking it after meals.  Even if I plan on eating a meal of 30 -45 carbs it may not always work out that way. 

OH maybe that is why I drop so low some times.   The other day I ate 28 carbs (mini muffins) and did 2 units.  Within an hour I dropped to 49.  That was a horrible feeling.   Being I am going low so often he also says I may have to adjust the insulin based on what my sugars are before eating.  He has me testing 8 time a day right now.  That is worse than the actual shot. 

If my pancreas does eventually give out totally does that mean will have to take more insulin some day?   My primary doctor has me coming back next week to do more blood work.  Right now my AC1 was a 12.4.  High I know.  And I think he is gonna do the cpeptide level again.  

I just want to thank you guys for all the info.  It really helps.  I don't even know anyone with diabetes to talk to.