Hi I'm new here and a new T1 diabetic. Just wondering about a couple of things like why is my sugars in the low 40's at 2am even with me eating my diet correctly? And why like today, my sugars were up in the mid 200's I felt like crap- sweating, extremely moody, not able to see clearly? What can I do to make it stop? Lucky for me, my boss has diabetes so she has been watching out for me, but I don't want to feel like I have to have people always watching over my shoulder... Any imput would be helpful...
Thanks
L.

Try not to be discouraged, it is so hard to get good control, especially if you're newly diagnosed. Your pancreas is probably still producing some insulin and at times you'll find you're numbers are right in range and other times they will seem to be way too high.

If you are going low in the middle of the night then that is a concern. Are you eating something before going to bed? For now you probably shouldn't be going to bed with a blood sugar number lower than 140. You'll need to eat a snack that has fat and carbohydrates in it to carry you through the night. A peanut butter sandwich on wheat bread may be a good choice. Better to be a little high during the night rather than going too low.

Are you on a bolus, basal regimine? Are you using a shot of a 24 hour acting insulin and then having a shot with each meal? It could be that you are using too much of the long acting insulin.

Do you have a doctor that you are in contact with? You need to keep a good record of all your numbers and fax that or call it in to the office. They can help you adjust your insulins.

Also, please read as much as you can and try to learn how the insulins that you are taking work.

It sounds like you need a little more insulin with your meals during the daytime. What is your current ratio? If you are using a ratio of 1 unit of insulin to 35 carbs (for example) then maybe you need to change that a little to maybe 1 unit to 30 carbs, that will help bring your numbers down during the day. But only make a small change at a time and only if you continue to test your blood sugar often.

If I were you I would make sure to eat before going to bed, get that number higher than 140 and keep testing at 2 am for awhile to make sure it's not dropping. If it continues to drop then call your doctor.

Also, if you are testing 2 hours after your meal and your numbers are in the 200's then increase your insulin at your next meal and see if that helps. Also, you could lower the amount of carbs you eat at meals, that will help too.

It all seems very overwhelming when you are first diagnosed but if you read up on it and learn as much as you can then you will be able to handle most situations on your own. However, I'm here to tell you (and not trying to sound 'doom and gloom') that type 1 diabetes is unpredictable. You'll get your numbers under control and then 2 weeks later they'll run high again. It's a trial and error kind of thing and it's best if you try not to get too discouraged. The more you learn, the easier it will be.

Let us know what kind of insulin regime you are on, that will help a lot.

Hi what_to_do_next,

Linda 1629 has given you some fantastic advice. Diabetes is so unique to the individual that it only makes sense that it takes a bit of time to figure out what works best for you.

To do this, you have to learn and to measure. "What's not measured is not managed" (a common quote :-)

Try to take a priority interest in understanding what things affect your blood glucose numbers. It may seem burdensome at times but seriously, write down EVERYTHING you do/eat/inject/feel in a day. It will give you and your diabetic team the information and patterns you need to understand and manage your unique situation. A log would also confirm that you count your carbs right (you are subtracting fibre, right? :-) and are injecting accordingly and testing appropriately (timing is important).

For example: Note what time you tested, how and how much you counted for a meal (specifically what and how much you ate), how much Rapid insulin (at what ratio) and what time (5-15 minutes makes a difference), what your BGL is 2 hrs. after you started eating. Include exercise - and not just the structured kind - include shovelling snow, moving furniture, washing windows, etc. Exercise makes a BIG difference in many folk's BGLs so, watch for things that elevate your heart rate. That includes emotions as well. Did you have a confrontation? A stressfull day in traffic? Emotional rollercoasters also can play havoc with your BGLs. Make note of these things and their times.

It's all in the details. You need to write it all down 'cause, just like in a horseshoe game...'close' doesn't count. You won't always have to be so detailed, but it particularly helps in the begining when it's easiest to get overwhelmed and frustrated. I've been newly diagnosed Type1 seven month now and I'm still trying to figure some things out. I continue to log and continue to learn; gaining more confidence as I gain more knowledge.

Just a couple more things....
- If you're sweating....it PROBABLY means you're going "low". Test! And know how to properly remedy the situation (it's easy to go way overboard)
- Sincerely...having someone you work closely with who "understands" diabetes, truly makes you lucky. You don't say if she's Type1 as well, but understand that Type1 and 2 are very different indeed (in their requirements, mangement, lifestlyes, etc.).
- You NEED to eat a bedtime snack (Typical Type1 requirement) - it MUST include protein or fat! - especially if you are going hypo at 2:00am. Your dietician should have the how much and when to eat it included in your meal plan.

All my support and encouragement to ya, what_to_do_next. This is a fantastic board for support and information; everyone's been very helpful to me. You can do it. Grab the bull by the horns :-)

Cheers,
- Vikingirl

Thanks you guys for responding to my questions, it's still all real confusing especially when classes are starting- I'm in a honor's program in college. My mom's trying to help, but that can be frustrating at times. I don't seem to think that my dr. really knows what he's talking about and don't even get me started with the nurses! I am looking for another dr. to see if I can be put on the pump. Linda, I do take four shots a day and my current ratio, I think is one unit of insulin to every 25-30 carbs???- still not sure. I think where a lot of my issue is deals with counting the carbs correctly, but thankfully I go on Monday to my CDE. I just feel like I am poking myself to dealt with needles- is testing more than six times a day too much? My dr. told me that I didn't need to test but two or three times a day along with a bunch of other totally useless information- I learned more from different websites than him! Oh, and vikingirl, I think the reason that I was swearing was because I live in Florida and it's been REALLY hot lately- you can break a sweat just thinking about going outside! Thanks again for the info! Maybe one day I'll have at least part of this disease figured out!

L., Type 1 for almost 1 month!!!

I would recommend that you get a copy of the "Diabetes for Dummies" book. It is very clear and down-to-earth and is a very good presentation of a complicated subject (not like many of the other dummy-type books). It has a companion cookbook, too, if you want that.

On the web, the best site is ( removed - no websites - please read and follow the posting rules section titled "how to share information" ) If you want to educate yourself, the book is the place to look. And, of course, come back here often. I've learned a lot more than I've contributed by reading the threads here.

I've heard from a few newly diagnosed type 1's that they didn't have much of an idea of how much insulin they should be taking. It sounds like a lot of docs just have you go off into the world with a set amount of insulin to take and tell you to balance your meals. I think I understand what they are doing but I don't necessarily agree with it. What they are trying to do, I think, is just get you out there and get you to start taking your injections and then later they set you up with the dietician to show you how to count your carbs.

At first, they really aren't too concerned with how high your numbers are, they just want to get you comfortable with what you have to do without bogging you down with too much information.

In time, you'll be able to just look at a plate of food and be able to tell how many carbs are in it. You'll know exactly how much insulin to take based on what you eat. It won't always be perfect but you'll be close enough most of the time.

Another thing you'll learn is that you can take more than 4 shots a day if you want. If you eat dinner, for example, and then someone brings out dessert later....you can have some, just take another shot. My daughter doesn't like to take more than her 4 shots a day but if the food looks good enough then she will. I only ask that her shots are at least 2 hours apart so there is no overlapping of insulin.

No, I don't think testing more than 6 times a day is excessive. Especially since you are newly diagnosed. My daughter still tests about 7 times a day and she's going on almost 2 years. And if fingertip testing is starting to get to you then look into forearm testing. It's much less painful and can be done for all your regular blood sugar tests. Just don't use it if you suspect you're low. Fingertip testing is more accurate so use that when there's a problem. But...it's not that much of a difference where you can't use forearm testing for all other times of the day. The OneTouch meter has a lancet that you can use for forearm testing and it's very easy. You can also use the palm of your hand.

The carb counting is the most important thing to learn. Once you know that and know exactly what your insulin to carb ratio is then you'll be able to eat whatever you want and take the insulin to cover it. Your insulin to carb ratio will probably change a lot over time. For some people it's 1:5 and for others it's 1:35. Generally they say that if you take 15 units of Lantus at night then you should be taking 15 units (total) of your mealtime shots for the day. But that's just a general guide and may be more or less depending on what you've eaten that day.

I think the pump is great and we're looking into one too but they are a lot of work in the beginning. Lots of carb counting and lots of adjustments. Don't be too discouraged if you can't find a doc to recommend one just yet. They may want you to get used to everything before you go that route.

How are your numbers at night? Are you still having those lows? That would be my biggest concern right now.

Hi Linda,
Yes, I am still having my 2am lows, but last night I either don't remember it or it didn't drop so suddenly, though my AM sugars were in the 60's, but I am trying various snack items to see what will get me through the night. It's a juggling act to say the least!!!

L.