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Re: [IP] Adults suddenly out of control . . .

I was diagnosed type 1 19 years ago. I was about 40 years old so did not
have to go through the ups and downs of growing up using insulin. I
practiced tight control once I learned how my metabolism and insulin
worked. I would say that at least for the first ten years my A1cs were
normal or near normal. I was told by more than one endo to loosen up my
control because of frequent hypos, every now and then severe. During
this time whenever I checked my AM BG it was always in the 60s.

I don't remember the exact sequence, but about 5 years ago my control
began to slip. I had already lost hypoglycemic awareness. It was also
harder for others to tell I was low, for instance I would be talking
business on the phone, comprehending and making sense, and test and my
BG might be in the 30s. But my A1cs were going up, I think maybe 8s and
9s, maybe a few 10s 0r 12s.

All this time I had been on 4 shots a day, NPH/R am and pm, lunch and
dinner R. Adjustments no longer seemed to work. Finally 3 years ago my
AM BGs were in the mid 250s no matter what I did. And this includes
taking into account "dawn phenomena" and morning rebound from nocturnal
hypos. I was working closely with a good endo and he switched me to the
pump and my A1cs presently are in the 7s and 8s.

I apologize for this long winded history. The point I want to make is
that I believe that Diabetes beats you up no matter how well you handle
it. I also believe that NPH (and R for that matter) injections result in
erratic insulin delivery. It may be that the system as it gets beat up
handles the erratic delivery less well. At any rate I think the reason
that T1s run into control problems down the road is plain old wear and
tear. Good balanced control slows it down but doesn't eliminate it.
Thank goodness for the pump.


email @ redacted wrote:
> In a message dated 5/10/2001 7:40:55 PM Mountain Daylight Time,
> email @ redacted writes:
> >  I just went on the pump one year ago exactly
> >  after experiencing many lows during the night causing seizures and black
> >  outs.  My Diabetes has always been in very strict control and had been
> >  extremely easy to manage until 2 1/2 years ago.
> What I've learned in the last six months (since my 10 yo daughter was dx'd)
> about "in control" and "out of control"  blood sugars seems mostly to be
> about kids & teens, growth spurts, puberty, rebellion, etc. etc. . . . I've
> been under the (apparent) illusion that type 1 adults who had "figured out"
> good control would pretty much be able to maintain that over the long term.
> Recently, I've seen several posts like the one quoted above that seem to
> indicate that people can have good control for years and then suddenly and
> inexplicably have problems maintaining good control . . . Is this a pretty
> common experience?  Does anyone have any insight they want to share on this?
> I'd like to think that they'll have a cure before Katie gets very far into
> adulthood (and I pray for that daily), but I also know how many of you were
> told DECADES ago that a cure was only 5-10 years away . . . SO I feel that
> while I hope for the best, I need to prepare for what being an adult with T1
> will be like for my daughter . . .
> Lyndy
> (who's anxiously awaiting delivery on MONDAY of Katie's Animas R-1000A pump!!)
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