Author Topic: Something new  (Read 275 times)

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Offline Quantum Learning

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Something new
« on: 14 December 2018, 03:28:58 PM »
Been a funny old year. BG's started rising back before the heatwave so finally admitted I needed to raise my basal (I was reluctant as I thought 80 units were quite enough  ::) ) so started off raising by 4 units every 3 days & ended up with 136 units, split into 4 injections every am. Got to where I was happy 3 weeks before my A1c end of Sept which came back as 47 yay!  DSN was very happy but doesn't want it to go down any more, I on the other hand want to get to as low as I can without hypos  :D
I had a FBC at the same time and DSN was very puzzled as it looked as if I was taking too much Levothyroxine even though she knows I've never taken it. She had a word with a GP who said to repeat the blood test in 2 months time. Just had the results & yes I've got an overactive thyroid, wonderful, just what I needed, another chronic life threatening condition  :banghead:
So GP started me on 15mg Carbimazole once daily with dire warnings to return immediately if I get a sore throat, great, right in the middle of sore throat season too  ::)
The curious thing is BG's are dropping unusually (not quite hypo yet) I've googled the Carbimazole & can't find anything relating to falling BG's & traditionally my BG's usually rise when it's cold (mind you, they usually fall when it's hot & they definitely went up in the heatwave, 37 degs in my garden for a few days, almost unbearable.) Although I am now wondering if the original rise back in the summer was actually the thyroid starting to play up as hyperthyroid is supposed to raise BG's.
GP has referred me to an Endo but last time I waited around 9 months as Endos are like hen's teeth around here.
So keeping a close eye on BG's in case I need to drop the basal again & looking out for a sore throat, not quite the Xmas present I was hoping for.
Type 2 dx Nov 2012 FBG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9%
Jan 2018 51/6.8% Chol 5.9
Sept 2018 47/6.4% Chol 4.8
Metformin SR 2g, Doxazosin 4mg, Lansoprazole 30mg, Fexofenadine 180mg Co-Codamol 30/500g  Amitriptyline 20mg
Toujeo/NovoRapid, Allergic 2 Levemir

Offline sedge

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Re: Something new
« Reply #1 on: 14 December 2018, 11:25:17 PM »
A pound to a penny that your thyroid's been doing it QL.  It affects all sorts of things in our body, and they then have knock on effects on other bits of us.  The only friend I had who had an overactive one had it removed as she was getting a goitre and already had the 'pop' eyes, so they whipped it out, when of course you instantly become hypothyroid for obvious reasons, so she took Thyroxine for the rest of her life.  Hence I have no idea how well or otherwise you might get on with the Carbimazole, or what the benefits or snags are.

Good luck with getting everything in balance again - did your GP say anything about a diabetic consultant though - because they all have to qualify as Endos before specialising in diabetes - and they all certainly know about hypothyroid cos that's very common in T1, both being auto-immune, but I dunno whether hyperthyroid is too, so they'd also be expert with that?  Might you get to see one quicker than 'just' an all round Endo who doesn't have specialist diabetes expertise?  Just a thought, anyway.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline himtoo

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Re: Something new
« Reply #2 on: 15 December 2018, 08:41:52 AM »
just sending a hug...........our bodies just dont give us much of a break !!
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6) 04/18 46 (6.4)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
Dafne grad. necrobiosis lipoidica on legs
laser treatment on both eyes 2002 and 2012, injections left eye 3 , wearing Noctura mask since oct 2014

Offline Pattidevans

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Re: Something new
« Reply #3 on: 16 December 2018, 10:13:06 AM »
Hi Q,


So sorry to hear of yet another health condition sent to plague you.  It does sound as though you are gathering a bunch of auto-immune conditions!  I recall we used to have a T1 member who suffered from hyper-active thyroid and took meds for it, though I don’t recall what meds exactly and she dropped out of the forum when she got a new and much more demanding job.


I would have thought that given the hyperthyroidism you would be a higher priority to see an Endo and I hope you are.


Regarding the massive amount of basal you are on... I know at least two people on a FB group who were on massive amounts of basal, but were able to reduce it substantially (one down to a quarter of the amount) because they used the Freestyle Libre.  Sometimes the liver will kick in releasing massive amounts of glucogen to counteract the insulin, thus creating a “catch 22” situation.  One of them used to post here.  I will PM her and ask how it worked for her.


Sorry it’s taken so long to respond, it’s just been a manic week and I don’t see it quietening down much this side of Xmas!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline Quantum Learning

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Re: Something new
« Reply #4 on: 16 December 2018, 11:53:27 AM »
Thanks everyone, I don't think my referral will be any quicker as the GP did look a bit abashed when he said how long I might wait.
Just booked a blood test for 7th Jan to be followed by a GP appt on the 11th as he seems very concerned about the possible side effects of Carbimazole and has only given me 32 to start with.

As far as the possible liver dumps go, I didn't really see much reduction in BG's when I was increasing until I hit the magical 136 units & then suddenly they were great. DSN was a bit concerned when I asked her to increase my script to cover the extra basal but I don't use much Novorapid (maybe 1 pen a month) as I still follow a VLCHF diet. Nice to have it available though as I can indulge a bit at Xmas instead of feeling guilty.  :D
Type 2 dx Nov 2012 FBG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9%
Jan 2018 51/6.8% Chol 5.9
Sept 2018 47/6.4% Chol 4.8
Metformin SR 2g, Doxazosin 4mg, Lansoprazole 30mg, Fexofenadine 180mg Co-Codamol 30/500g  Amitriptyline 20mg
Toujeo/NovoRapid, Allergic 2 Levemir

Offline Liam

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Re: Something new
« Reply #5 on: 16 December 2018, 12:35:24 PM »
Sorry I really don't know anything about overactive thyroid.

I know you are taking a lot of basal insulin but you are having good results from that. The only suggestion I would have made was to try Metformin but of course you are already on in, so no extra help there.

Have you tried covering protein with rapid acting I insulin? Maybe your basal is covering the body making glucose from it?
DX Type I 1994.    Novorapid Animas Vibe pump
HbA1c 3/10 10.2%, 7/10 8.1%, 12/10 7.5%.
2/11 7.8%, 8/11 8.6% 9/11 8.3%.
3/12 62 (7.8%). 10/12 67 (8.3%)
4/13 63 (7.9%) 6/13 59 (7.5%)
1/14 71 (8.6%) 7/14 59 (7.5%) 11/14 (6.7%)
3/15 56 (7.3%) 12/15 49 (6.6%)
Ramipril: 10mg Quetiapine: 550mg Metformin: 2000mg

Offline sedge

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Re: Something new
« Reply #6 on: 16 December 2018, 02:29:08 PM »
That's a good point, Liam!

QL - it was scientifically proved a good many years ago now that the body can extract glucose from all 3 food groups when it needs to - hence why undiagnosed Type 1s start losing weight rapidly before they are diagnosed - the body can't extract enough glucose out of carb keeps going, by using the scant amount of insulin it's still producing itself by adding it to it's other resources to convert the protein and fat the person eats - when that still isn't enough it starts converting body fat but also body protein when the fat isn't enough to fuel the organs.  So, 'blubber' first cos it isn't essential to life and it can't extract very much energy from it, followed by muscles - ie protein.

It was said that when the body gets to the state where it will do this, one should first try treating the weight of protein on the plate with 50% of the dose of insulin the person would need, for that weight of carb.  So if you need 1u to deal with 10g carb, try 1u for 20g of protein.  For fat, start at 1u for 100g.

Worth a try?
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Quantum Learning

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Re: Something new
« Reply #7 on: 16 December 2018, 08:37:32 PM »
Definitely, I do need something to cover my breakfast even though it's only 2 rashers of bacon & a scrambled egg cooked in butter, I just didn't know how to work out how much for just fat & protein. I use 4 units to 1g carb usually.

That's a good point, Liam!

QL - it was scientifically proved a good many years ago now that the body can extract glucose from all 3 food groups when it needs to - hence why undiagnosed Type 1s start losing weight rapidly before they are diagnosed - the body can't extract enough glucose out of carb keeps going, by using the scant amount of insulin it's still producing itself by adding it to it's other resources to convert the protein and fat the person eats - when that still isn't enough it starts converting body fat but also body protein when the fat isn't enough to fuel the organs.  So, 'blubber' first cos it isn't essential to life and it can't extract very much energy from it, followed by muscles - ie protein.

It was said that when the body gets to the state where it will do this, one should first try treating the weight of protein on the plate with 50% of the dose of insulin the person would need, for that weight of carb.  So if you need 1u to deal with 10g carb, try 1u for 20g of protein.  For fat, start at 1u for 100g.

Worth a try?
Type 2 dx Nov 2012 FBG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9%
Jan 2018 51/6.8% Chol 5.9
Sept 2018 47/6.4% Chol 4.8
Metformin SR 2g, Doxazosin 4mg, Lansoprazole 30mg, Fexofenadine 180mg Co-Codamol 30/500g  Amitriptyline 20mg
Toujeo/NovoRapid, Allergic 2 Levemir

Offline sedge

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Re: Something new
« Reply #8 on: 16 December 2018, 10:06:29 PM »
Protein - so divide by 2 = 2 units per 10g,QL.  See what happens thereafter - ie test on the hour for a few hours after and see when you get back to the premeal reading.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Pattidevans

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Re: Something new
« Reply #9 on: 18 December 2018, 10:42:23 AM »
Maybe your basal is actually covering for your bolus needs?  Have you tried basal testing?  There are instructions of how to do this on our website here https://www.diabetes-support.org.uk/info/?page_id=120 about half way down the page where it says How to discover (or adjust) your basal insulin dose
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline Quantum Learning

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Re: Something new
« Reply #10 on: 18 December 2018, 02:41:53 PM »
I'll try it but I'm quite happy with the results at the mo. I get up between 8 & 8.30 & don't eat till around 2pm and my BG's stay between 5 & 7 all that time. I don't get hungry in the mornings so fast for around 16 to 17 hrs every day. When I test before my evening meal it's usually between 5 & 7. When I test before I go to bed it's still usually between 5 & 7.

I think tbh at the mo with the hyperthyroid I need to focus on that as the symptoms are very similar to a hypo, palpitations, shaking hands etc & it's there nearly all the time. I keep testing when I feel really bad but BG's are still usually between 5 & 7. Mind you as you know my meter is pretty rubbish so I sometimes have to use 3 or 4 strips before I believe it  ;)

My daily diet is 2 rashers of bacon & 1 scrambled egg cooked in butter for breakfast, evening meal is meat or fish with salad. tea or coffee with double cream throughout the day, a piece of cheese if I get hungry between the two meals.

I am hoping once the thyroid is under control I will be able to drop the basal somewhat but will have to wait & see.
Type 2 dx Nov 2012 FBG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9%
Jan 2018 51/6.8% Chol 5.9
Sept 2018 47/6.4% Chol 4.8
Metformin SR 2g, Doxazosin 4mg, Lansoprazole 30mg, Fexofenadine 180mg Co-Codamol 30/500g  Amitriptyline 20mg
Toujeo/NovoRapid, Allergic 2 Levemir