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Question:

From Southbridge, Massachusetts, USA:

I have had type 1 diabetes for 15 years today and cannot say that I have taken extremely good care of myself for a few years. I am 29 now and am realizing the limitations of mortality, etc. Essentially, I want to see my children grow old and am worried.

I started monitoring my glucose levels again after about a year of doing nothing and am coming up with surprising results. I run pretty high all the time. Ranges from 212 mg/dl [11.8 mmol/L] on the low end to 329 mg/dl [18.3 mmol/L] on the high. I have tried exercise to bring it down with no luck and once was able to bring my sugar down from 329 mg/dl [18.3 mmol/L] to 115 mg/dl [6.4 mmol/L]( then to have it plunge to 57 mg/dl [3.2 mmol/L] which may have been as a result of the morning 10 units of NPH kicking in). Am I abnormal? Have I built a tolerance to the insulin (I take 5 units of R morning and night and 10 units of NPH morning and night)? I was tagged with the title "Garden-Variety" when I was diagnosed 15 years ago. I feel as out of control as I did then. It sure pays to monitor I realize now.

What can I expect my life expectancy to be at this rate? I don't intend on continuing this way but wonder.

Answer:

You are not alone in your questions. I think that you are feeling what a number of people feel about having diabetes. Although it may have taken you a while to get there, it sounds like you are really interested in better blood sugar control. You need to have a partner in this endeavor. Preferably, you need a diabetes team to work with that can help you to understand, monitor, and act on the sugar results you get. It is not uncommon for people with type 1 diabetes to have marked fluctuations in their glucose levels. Although you are taking NPH and Regular insulin, there are number of ways to take these insulins, as well as several other insulin regimens with different insulin products. You need to have a serious talk with your diabetes care provider in order to have the best insulin regimen for your care. This takes into consideration your schedule, life style, self-care skills, activity, frequency of hypoglycemia, and your HbA1c results.

Once you have invested in the need to treat higher blood sugars, the care you get allows you to have gradually better blood sugars over time. It just doesn't happen overnight. Make sure you are working with a diabetes care team than can give you the help you need. Talk with them about these issues. It is always better to have lower sugars, as opposed to higher sugars. Even with fifteen years of poor control, you can begin to have better blood sugars today. Your overall medical condition, as evaluated by your physician, is a better indicator of your medical prognosis. Such things as the presence of heart disease, nephropathy, neuropathy, and retinopathy are indicators of your medical status. However, for the most part, these conditions all do better with better blood sugar control. I wish you the best in getting your sugars into better control. You have made a great step forward in realizing how important it is.

JTL

DTQ-20001223183624
Original posting 4 Jan 2001
Posted to Tight Control

  
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Last Updated: Tuesday April 06, 2010 15:09:18
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