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[IPk] Re: deja vu


I understand absolutely your sense that encroaching ketones stop one
thinking and planning clearly. It always seems to me that one of the
worst things about diabetes is that exactly those times when you need
to think most clearly about how to treat yourself are the times when
diabetes makes you feel physically least able to do so -

>Thanks for your suggstions. This problem is an ongoing one which has 
>occurred a few times in the last year. The problem is less that I get 
>"spikes" and more that my sugars just don't come down at all. There is

>definitely no chance of missed hypo's!! In terms of trigger foods, I 
>also think thats unlikely as I feel so permanently ghastly that I'm 
>actually eating very little - mostly chicken sandwiches and digestive 
>biscuits to allow me bolus for the carbs so I can get extra insulin 
>into me to deal with the ketones. 

This is probably a very long shot, and maybe something you've already
tried (if so please press delete!) but something struck me about the
foods you are eating. A while ago, there was a discussion on this list
about sensitivity to wheat - there were a few people who said that
although they did not imagine they would be diagnosed with coeliac or
with a wheat allergy, their insulin resistance seemed to get higher
when they ate quantities of wheat. 
At that time I experimented a bit - did not stop eating wheat entirely
(too fond of wheat containing foods) but changed my breakfast cereal to
avoid wheat, and also stopped eating sandwiches at lunch time - salad
or soup instead plus a plain yoghurt - and I did notice an improvement
in blood sugars and drop in insulin requirements - and HbA1c which had
obstinately remained around or above 8, finally came down to around 7 -
still not great, but felt important, also because the funding people
were implying before that I don't make good use of pump so maybe should
not be funded, and they wanted to see an improvement.
I have continued with a diet less high in wheat than before and the
improvements have been maintained. Also many but not all of my worse
patches are when I eat more wheat. Though I seem to be able to get away
with it better if I am being very physically active - sandwiches are
fine for me on hikes.
I understand that you want to ensure that you are getting carbohydrates
plus insulin to drive away the ketones. Also that if you are feeling
lousy, you need to be eating 'comfort' foods, that are different for
each of us, but wondered if experimenting with non-wheat containing
high carb foods might be worth trying? 
Last time I nearly slipped into ketoacidosis, I managed a narrow escape
from it, and from hospitalization, with some sweetened fruit drinks and
lots of insulin, under the direction of my GP.
Good luck, and hope you feel better soon

>To demonstrate my problem a little better - I'm running a continuous 
>temportary basal of 3u/h (normal highest basal 1.2) and topping up
>15 unit boluses every 2-3 hours and still staying high (around 16 -30)

>- - all on advice of consultant/DSN. I'm in constant close contact
>my team who are fantastic. I drop in to see them frequently (at least 
>once a week - but back in January spent three afternoons sleeping in
>diabetes centre!)and I have my DSN on speed dial (sad, I know!)

>I understand your point about being philosophical about the bad times,

>but ketones make it hard for me to think straight. The less control I 
>seem to have, the less its seems worth putting in all the effort. 
>I feel that unless I do something really drastic, I may well be
>on a slippery slope to DKA, again. It seems that within an hour of 
>taking a big bolus I can usually drop down to high teens, but if I 
>don't get in quick enough with another one, I start rising again. I 
>actually started to think that hospital sounds vaguely appealing 
>because at least I know I'll have the best chance of getting this 
>sorted so at least I can feel better.


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