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I feel hypo when my blood glucose is normal and only well when it is high. I feel very ill when my doctor tries to keep my blood glucose normal. Am I hooked on a high blood glucose? https://twitter.com/healthcare_mall
When you have had poor control for several years, the brain and other tissues in the body can adjust to a high concentration of glucose in the blood. As a result you may feel hypo at a time when your blood glucose is normal or even high. The long-term outlook for people in your situation is not good unless you can re-educate yourself to tolerate normal blood glucose levels without feeling unwell. This is possible but requires determination and an understanding of the long-term dangers of a high blood glucose.
Your problem can be overcome by regular measurement and a gradual lowering of your blood glucose so that your body has the chance to adjust to the lower levels. You must believe that, however unwell you feel, no harm will be done if your blood glucose remains above 4 mmol/litre. It may take up to six months for this re-education process to take effect, but it will be worth it.
I find that my control is only good for one week a month and that is the week before my period. Why is this and what should I do about it?
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In some women the dose of insulin required to control diabetes varies in relation to the menstrual cycle. Your question implies that you become more sensitive to insulin in the week before you menstruate and you probably require more insulin at the other times in your cycle. There is no reason why you should not try to work out a pattern where you reduce your insulin dose in the week before your period and increase it at other times.
The variation is due to different hormones coming from the ovaries during the menstrual cycle. Some of these hormones have an anti-insulin effect. The same sort of effects may occur when a woman is taking oral contraceptive tablets (the Pill) or is pregnant. You should try to make adjustments in the insulin dose in order to compensate for these hormonal changes and to keep the balance of the blood glucose where it should be. Your diabetes clinic doctor or diabetes specialist nurse is the best person to turn to for exact advice on how to make these adjustments.
I have been using Mixtard to control my diabetes for some years. I take 36 units before breakfast and 24 units before my evening meal. My blood tests are normally pretty good except for bedtime when they are often as high as 15 mmol/L. My doctor says my control is not good enough and wants me have more injections each day. What is your view on this?
Twice daily injections of insulin are usually a compromise. It sounds as if your evening dose does not supply enough short-acting insulin to cope with your evening meal, though the long-acting component of Mixtard is able to provide enough overnight background insulin. A fairly simple solution would be to ‘split the evening dose’. You would have to take a dose of short-acting insulin before your evening meal and some background insulin at bedtime. The doses would have to be adjusted depending on the results of blood tests. This new arrangement would have the added advantage that you could vary the pre-meal dose of insulin depending on how much you wanted to eat.