THE WORST BLOOD SUGAR IN MY LIFE 

Pre bolus and carb counting are the GOLDEN way to good control man. Even on MDI you can have a decent graph just by pre bolusing and counting those carbs!

Thanks for discussing this stuff. After 15 years of so-so management (manually testing and injecting, but also generally 6-8 A1c), I have tried to make changes to the way I eat. Or rather how poorly I would eat and lie to everyone about why I was droopy or not showing up to events and things. And suddenly a month in, I had an episode that must have been a severe low. And the deal is I’ve had a TON of lows in the past month. I woke up in an ambulance and didn’t remember anything. Bit my tongue badly. It was a mess. So discouraging. That was about 2 weeks ago and now I’m running 300-400 routinely (American levels - I don’t know what those are in British #s, but it’s really high). Out healthcare is so jacked here I can’t afford a pump or continuous monitor. Let alone manual test strips and insulin. So it really feels like I’m on my own. Also, DONT eat the chickpea pasta. It’s as bad as the regular stuff. Spaghetti pasta is the way.

Hey Jamie, I have LADA, but I feel your struggle. I had some crazy high blood sugar levels last year (and they’re still not where I want to be yet), and there are a few things I have noticed help me a lot. First, as others have mentioned is pre-bolusing. The amount of time I wait between the bolus and when I start eating varies depending on how high my blood sugar is at the time and what I’m eating, but in general, I try to wait 10-15 minutes. Second, some days I’ll eat a zero carb lunch (and I have been eating an omelette every morning for some time now) just to prevent any spikes. Third, for carb counting, another RU-vidr made some good videos about it. She also uses an app that she recommends because it shows pictures of portion sizes with the nutritional info right there, and you can make recipes and it’ll tell you the carbs for what you made. Here’s the video: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE--dq5xs2sD9E.html Fourth, I noticed that my insulin ratios change depending on the time of day. In the morning, my body is releasing a lot of stored glucose, so I crank it up. At lunch, it sort of depends on if I’m high already, but I usually go high after lunch. At dinner, my long-acting insulin is in full effect and I am more sensitive to fast acting insulin (so I sometimes have a tendency to go low in the evening because I overestimated how many carbs I was eating). So that’s a tricky game to play. Also, your body converts something like 60% of the protein you eat into glucose about 2-5 hours after you eat, so even zero carb, all protein meals and snacks will cause your blood sugar to slowly creep up, but don’t bolus for that beforehand or you’ll go low. Just be aware and maybe correct for it a few hours after you eat. Finally, don’t beat yourself up too much. Give yourself some grace. Maybe your body is changing how insulin resistant you are and you need to change your ratios again. Maybe the general stress of, well, everything is causing your cortisol levels to increase your insulin resistance. Whatever is going on, your “high” and “very high” indicators are pretty strict. 10.0 mmol/L (180 mg/dL) isn’t that high, and 13.9 (250) is high, but not life-threatening. I have mine set to 300 (or 16.6) and 400 (22.2), which makes me feel a lot less stressed out all the time. Gradually I’ll start to tighten those down again, but my last a1C wasn’t too bad. Bottom line: you’re doing great.

Hi Jamie, it can be frustrating but by a process of elimination, you will eventually be back on track. One simple but important tip from me is the timing of your bolus. Do it to late and you are bound to spike. As diabetics we all know this but sometimes forget the importance of doing it correctly. Good luck, regards Rob

I know such a drag carb counting but so so worth it! Just a cup measure is enough for a lot of things. Mainly just do that for the rice and pasta. Watch a bit of Matt ftf warrior on RU-vid about retroactive analysis. Finding it so good. Is really helping my son and I manage his diabetes. Also make sure your prebolus is enough as that makes a big difference. Read a bit from a article from the book think like a pancreas. Don't eat all meal at once , stagger it over an hour. Have to say that has helped a lot with big spikes at breakfast on days exercise won't happen in the morning . Don;t know about you but find more insulin is needed in the morning , slightly less lunch and much less at dinner to avoid those evening hypo's as your body gets more insulin sensitive as the day goes on. Just some thoughts. Is a BIG challenge, best wishes !

Back to basics, carb count , to much data can sometimes be a hindrance 👍 best of luck

Hi Jamie.. For best advice on diabetes control without a shadow of doubt...whom you presumably have heard of is Dr Richard. K. Bernstein. Personally I would invest in his book 'Diabetes solutions ' and watch his monthly podcasts on you tube.. 👍