Howdy!  Can anyone help me?  I'm so confused!  Hailey was dx 2 months ago with T1 and has not hit her "honeymoon" yet.  Everyday she has highs and lows.  Is that a normal battle?  Right now she is on the sliding scale for insulin.  But I hear there is more freedom with the carb to insulin ratio.  Could anyone please explain the pros and cons of the carb:insulin?  Right now I feel pretty silly and stupid.  But I need help!

Thanks for your input

Heidi aka proudmama

I think they have you on the sliding scale probably just to start and get a feel for her insulin needs.  The honeymoon usually starts when when you start to give insulin, the few existing beta cells kick in and produce extra insulin.  I think from what I can remember it usually starts anywhere from 1-4 months.. But this of course is different from person to person.  This is a great site that a couple of people introduced me to http://www.diabetesnet.com/ . They also have some great books on there.

Best of luck to you and Hailey!!

Ditto on what Kenny said. Initially there will be alot of ups and downs as you figure out what her needs are and whether she has a honeymoon period.  Just remember you are new at this and learning and you are doing a great job.  www.childrenwithdiabetes.com is also a good site for you to check out.  You are not alone in this!

Here is what I would do. I would eat the same thing in small amounts every two hours matched with insulin until the blood sugar stabalizes. For example, one could eat a slice of raisin bread with peanut butter every two hours. For two days, such a diet will not hurt you and then the blood sugar should normalize. Keep in mind when you eat, your liver stores that food as energy in your liver. Further, you could see the liver releasing that energy in the form of glucose for up to 48 hours. Third, insulin works like a water valve in controlling the release of liver derived hormones that drive up your blood sugar. With too little insulin, your liver starts releasing hormones which raise your blood sugar, and also your body creates excessive fatty acids, which require more insulin. If the diabetic has a steady stream of insulin and eat small amounts, expecially while stabalizing the blood sugar, that works so much better. Also exercise like walking steps works what is known as the soleus muscles. When the blood sugar is elevated, but you know you have enough insulin, walking steps or some other intense exercise will allow the leg muscles to draw up glucose into the muscles. I prefer this method over injecting additional insulin. I sometimes exercise three hours of intensive exercise without stoppinig. I do realize, almost no one but me would do this, but this is one reason I have such good control.

I'm currently in my honeymoon phase as well. Or as I like to call it the "farewell tour". When I started getting lows I adjusted my ratios from 1:15 up to 1:20 and finally up to 1:25 which was where I stopped. I think my tour is getting near it's final leg because I'm at around 1:20 right now.

I just keep things simple. I use only lispro, inject every two hours and the amount depends on activity and food consumed. I have done this so long, I don't even think about it. I just have a sense of how much insulin I need. I never use long acting insulin because it is just not effective at stimulating the various organs including the brain. I have reviewed study after study and the increased blood flow and the ability to deal with lipids is way too low. With short acting insulin, my cholesterol hangs around 100 to 120. It has other benefits too such as keeping good muscular strength and  protecting the kidneys from hyperfiltration, which is the fear of most diabetic doctors.

I never measure food or count carbs because I know exactly how much too eat, and I hate eating too much anyway, and hate even more gaining even one pound. I like to stay fit because I want to remain attractive for my spouse and being fit brings me lots of happiness. Go now time to work out for 90 minutes.

But see I think that is what is so great about this disease.  There a ton of methods to treat it.  Some of which work for others, and some that don't.  I think it is so great you found something that works for you. 

I think Kenny makes an excellent point.  Every diabetic is different and it is hard to say that one particular method would be best for everyone.  I can't imagine trying to manage my Type 1 Diabetes without counting carbs and carefully monitoring everything that I eat.  That's just how I am able to be an in-control-diabetic.  

It is true each one has a unique body. Some make some insulin, some make none at all. I use a combination of lots and lots of exercise and I have no choice but to inject insulin every two hours, unless I want to enter the never never land where diabetics go when they don't take enough insulin. I am sure I will go there one day, but I am not ready for that bus ride yet. One thing that makes us different is some people will observe and become their own scientists by gathering information from their own experience and make adjustments in their lives. Some will just laugh off those hospital trips when they have not taken care of themselves or overdosed. However, one consistent pattern comes back through years of my research. Diabetics with the greatest scientific knowledge about this disease have the greatest success. We know from studies done on lab rats and mice that insulin speeds the flux of glucose in and out of the brain, which explains why the brain activity of diabetics slows and speeds depending on the glucose level. We also know that inadequate insulin or inadequate food will lead to protein degragation. So diabetics can't starve and remain healthy either just to avoid insulin injections.  We also know on studies with the animal models that diabetic rat kidneys will enlarge and within a few days of insulin the kidneys will shrink back to normal. Even the thymus lies at the core of the immune system will shrivel without insulin and give the diabetic rats insulin and within 9 days the thymus restores to full function. We also know that without insulin, the intestines will enlarge and gain weight, that the diabetic will start having excess absorbtion, but with insulin the intestines shrink back to normal.  We even know that the prefrontal cortex of the brain will be impacted with too little insulin, which explains why some diabetics get so irritable. But once the blood sugars normalize, these same people will often become very pleasant to be with. I remember my mother was a holy terror while I was growing up. She had insulin with too little insulin made by her pancreas and never had it treated until she started throwing up night and day. The story of my mother is a another really sad tale. But my point for everyone here. We may have differences, they will really be quite small. And to say everyone is different is just blowing off what someone might be saying. I have heard the same stuff from doctors. Before you are so sure everyone is so different, why don't we look at how we are all alike. The brain and our organs needs insulin and it is that simple.  There is in fact and explanation for every spike in your blood sugar, every mood swing you experience and every organ that may malfunction. Everyone one of you could research diabetic papers written by researchers. I suggest original research papers and look at the what if research. What if I gave this diabetic rat insulin, would his sexual impotence return? That study has been done and an insulin similar to the body taken 24-7 around the clock did return the impotent rats back to normal. It works in human males too. So when you go to the doctor and he or she suggests something, ask him or her if they could cite a scientific journal which validates what you are saying. Not some article funded by a profit oriented drug company, which is just trying to make a buck, but something concrete.

While we might be different, we are the same. We need insulin to be healthy, and some people uptake glucose through the muscles faster than others. It has a lot to do with the sub units of the cells called the mitochondria and the foods we eat, and the amount of exercise we partake in.

ok. All I was saying.. There are a lot of young people out there just learning. And their doctor may have put them on a regimen very different than yours. Yes we all need insulin and I'm not questioning that. Nor am I saying our body’s needs are different. What I am saying, while your diet and exercise and medicine works terrific for you, it may be something very different than some people on here have been told. And for a young new diabetic to hear someone preaching their way is the best, it confuses them.

I have been diabetic for 11 years; I don't exercise ever and never have. I am on an insulin pump with apidra insulin. I eat whatever I want and whenever I want. My A1c is 6.1, my kidney functions are normal, my cholesterol is normal. This, works for me. So like I said before, I'm glad that works for you. Keep it up!

I personally would rather live a happy, healthy life then to boggle my mind with all these hours and hours of facts and science and lab rats etc. I'll leave that stuff to scientists and my doctors....

I don't remember how long it took, b/c it's been 25 years.  I do remember how frustrating it was trying to figure out how much I needed.  The one thing I have learned, though, is that the worse thing you can do is worry yourself sick about it.  It is something that takes a little time to get down, and once you think you are perfect, you will get mad or sick, or not sleep enough, and then your blood sugar either plummets or skyrockets.  There is no such thing as a perfect diabetic.  Also, what works for one person doesn't work for another. 

My boyfriend bought me the book "Think like a pancreas", from Amazon.com, and it changed my life.  I have been moved from one insulin dispensing technique to another without additional information.  I was last sent to a diabetes eduacator in 1984.  The book has some great examples, charts, and graphs that helpped me significantly.

One thing this book mentions is that if it is a certain time of the month, a girl / woman's basal rate of insulin (the base rate with a pump or the long term you take) changes at different times of the month.  Your daughters age wasn't mentioned in your post.  This is something that drove me crazy and I couldnt' figure out why I would get a basal that worked for a week, and then I would either have highs or lows.  I still have to adjust my insulin every week for overnight, but at least I know it's coming, I adjust, and then I am good for about a week or so. 

Think Like a Pancreas great book, I actually have a signed copy by Gary S.  Yippee - amazing guy.  He has also trained and helped manage some of the top diabetic athletes in the world.  He gets it.

ProudMamma I think this post went a little off track.  But I wanted to answer your questions the best I can.

From what I have heard the "hooneymoon" stage or as Clark V says the Fond Farewell... is not something that happens to everyone so keep that in mind.  It happened to me, Clark, Kenny and others and is common but not everyone.  Just to keep in mind.

Are up Highs and Lows normal - I would say yes.  Especially when your daughter is so new to insulin treatment.  People who have had diabetes 20 years and try pump therapy sometimes it takes months to get the right insulin adjustments.  That is the challege we face.  No day is the same for most.  Different foods, different activities, different sleep... lots of variables all can change the needs of insulin.  That is why a strict schedule of eating and taking insulin is needed for some to get the best control.  Limiting variables basically.

For a growing daughter it might be even harder.  Her insulin needs will likely need to be adjusted the more she grows, she will need more food and more insulin.  I have heard stories from some diabetic parents that monitor their child closely that they noticed by each week or even day the insulin needs changing from their kids.

As far as an insulin to carb ratio.   You need to see what her insulin requirements aree before your Dr. can go in and make suggestions on ratios.  At least that is what I think.  Testing the waters first before jumping in.

Heidi I hope this helps.  I am not an MD by any means so take what I said with a grain of salt.  Suzanne mentioned a great site for you www.childrenwithdiabets.com  you can chat with parents in your same spot that are more currently dealing with their childs needs.

Take Care,

Bill

Before our daughter began on an insulin pump, we were doing both..  Counting carbs for the meal insulin dosage, and sliding scale for blood sugar corrections..