Girlfriend Has Type 1 Diebeties

Diet and Nutrition
1

I was wondering if anyone could help me.

My girlfriend is in her early 20s and has type 1 diabetes. She’s 120 pounds and about 5 foot 8 and wears one of those pumps that puts the insulin in her.

Over the last few months her a1c has been 12 to 13. I’m pretty sure that’s not a good thing because her doctor gets angry every time she goes to see her.

I want to help but I don’t know how to get her on the appropriate track towards lowering a1c levels and I thought T-Nation might be able to help because she wants to add muscle and change her nutritional intake somewhat, but I’m not sure how she should go about doing this. I only really trust the advise given on this website. I’m not sure what her doctor tells her to do because I’m never invited into the appointment.

What sort of foods and supplements might be beneficial towards lowering an a1c level that is around the 13 range?

Thanks for the help.

Thanks for the help.

2

A1c for a diabetic should be below 7. She needs to talk with her Dr or a diabetes educator to work on a prper diet and insulin protocol to control her blood sugar levels. A1c gets raised from excessive glucose in the blood stream which in turn, glycates the hemoglobin. They use it as a marker to see how blood sugar control has been over the past 4 months. Blood cells typically survive for 120 days. A1C doesn’t lie. She needs to fix her diet. High glucose doesnt just do damage to blood cells. It also damages blood vessels, organs, and nerves. Thas how you get diabetic retinopathy, neuropathy, and kidney failure. But like i said she needs to talk to her Dr and get a referal to a diabetes educator. Nobody around here is going to give out medical advice.

3

I second what Helmet said - your girlfriend should be talking to a qualified diabetes educator or endocrinologist. I myself am a type I diabetic, and I can tell you that with an A1C number that high, you’re at a level where you won’t maybe suffer from negative side effects (neuropathy, etc.) - you definitely will. It’s not about supplements, it’s about taking ownership of your condition. Your girlfriend needs to be much more responsible with understanding how the foods she eats raise her blood glucose and how much insulin she needs to take to compensate. The dynamics of balancing food and insulin can be relatively simple if you simply utilize your glucometer as often as you should and invest the necessary time to learn how your body works. Good for you for trying to help since your girlfriend is placing her health in real jeopardy.

4

You need to remind her to check her blood sugars much more often. What type of pump does she have? Does she exercise? Does she always do her insulin before (or) after each meal? Is she trying to lose weight? Some teenage diabetics purposely keep their blood sugars high too lose weight. Diabetes is a serious disease that basically needs to be a part of that person. If you sometimes forget that she has diabetes, she is not taking the disease seriously. As her boyfriend, do your part! Remind her to check her blood sugar, do her insulin, count her carbs etc.

Also look for cues of being high and low. Does she smell funny? Is she peeing a lot or drinking a lot? She might be high. If her thinking is slowed, she is a little clumsy, sweating, shaking, etc she might be low. Tell her to check!

She needs to check more and more and more!!! Then do insulin to correct it.

5

Tell her to fixed her basal rates, check more often, and eat less carbs. I don’t think ive ever had an A1c over 7.0.

6

A1C of 12-13 is very high.

It almost sounds like she is either turning the pump off on purpose, hooking it up wrong or messing up the dose calculations all the time?

As stated by the others, the first thing she needs to do is check her sugar more often and learn to use fast-acting insulin in small doses to control it. This is not easy and the dangers of hypoglycemia never leave but as a type 1 she should now be carrying food with her at all times no matter what to help protect herself.

Type 1 is all about habits. People sometimes talk about diabetes burnout as an excuse to ignore the condition. I myself went through a stage in high school where I was, as I was diagnosed at age 2 and began to get tired of it, BUT the bottom line is you cannot let this happen EVER! Because the fact is type 1s HAVE NO CHOICE!!!

They are stuck with the condition and the less attention they pay to it on a consistent, daily basis, then the greater the odds are they CRASH HARD in the future. It is not pretty to see someone die slowly from diabetes-related complications.

So my suggestion is to have (force if you must!) her to read the responses in this thread (print them if you need, please as someone who is also afflicted I am more than willing to try to help).

Remember though, no one can be with her all the time, and at some point (preferably tomorrow and forever into the future) she has to begin taking the initiative to work to control her condition or face the consequences.

Also if she has specific questions please point her here to this thread and have her post them for us to answer! As good as a doctor can be, sometimes the best help comes from people who are having the same experience. And in fact, some doctors offer crappy, unrealistic advice because frankly they don’t have to deal with the condition themselves and treat us like they can tell us to do this and that like it is some kind of cake-walk. Others just don’t care that much about the people and care more about keeping their business. I don’t know how good her doctor is but certainly type 1-to-type 1 communication should do nothing but help her, if she is willing to take the initiative.

Finally pertaining to supplements I can suggest a few things she could try to get into, but they are not “quick fixes” (there is no quick fix for hyperglycemia outside of insulin) and will only be beneficial when used long-term. My last A1C was a record low 5.5 but it has taken years of work and trial to get to this point and it is never easy to maintain- ever. However I would prefer to see her/you make some kind of conjoined post first before I rant any further to let us know she is going to be able to take the steps she needs to take to get back on track.

8

[quote]Haymaker33 wrote:
I was wondering if anyone could help me.

My girlfriend is in her early 20s and has type 1 diabetes. She’s 120 pounds and about 5 foot 8 and wears one of those pumps that puts the insulin in her.

Over the last few months her a1c has been 12 to 13. I’m pretty sure that’s not a good thing because her doctor gets angry every time she goes to see her.

I want to help but I don’t know how to get her on the appropriate track towards lowering a1c levels and I thought T-Nation might be able to help because she wants to add muscle and change her nutritional intake somewhat, but I’m not sure how she should go about doing this. I only really trust the advise given on this website. I’m not sure what her doctor tells her to do because I’m never invited into the appointment.

What sort of foods and supplements might be beneficial towards lowering an a1c level that is around the 13 range?

Thanks for the help.

Thanks for the help.[/quote]

If she has a pump then she is likley already seeing an endocrinologist.

She should have a proper diet, but at those levels and with a pump I think she is probably beyond advice that you may get on this forum for the typical fat type II diabetic. Seriously.

I do agree if things can not be improved she is likley to be blind, and on dialysis before she is 50, maybe in her early 40s.

If she has not gone to an endocrilogist then do so. If her diet is bad fix it.
Consider going to a MAJOR teaching hospital in your area if things do not improve for a second opinion.

Do not give up hope, but some people just get a very aggresive type of type I diabetes. Very often those affected seem fairly normal in their 20s but are disabled by the time they are 40. It is sad. Not trying to scare you away, but you should know what you are in for should you marry her.

9

First of all, does your gf have a desire to improve her glucose levels? A person must be motivated to achieve a healthy A1c. If she is genuinely trying to gain control of her glucose levels here’s what to expect:

With an A1c that high, it’s more than likely that she will not recognize the symptoms of hypoglycemia. This needs to change. The tighter your control, the more prevailant hypos will be, so make sure she is able to recognize the symptoms of low blood sugar (you should too, as you may end up saving her life). Usually the first and most common symptom is fatigue.

She has to be able to count carbs in order to admininster the proper amount of insulin. This may seem like a pain at first, but after a little practice it’ll become automatic.

This essential boils down to how much insulin she’s using. You can very well have a crappy diet and still maintain normal glucose levels provided you know how much fast acting insulin to inject. The increase in insulin required to lower her A1c will also help her gain some muscle she’s after.

This has been said before, but test often, especially, when you are just starting to get aggressive with your insulin regime.

10

[quote]Haymaker33 wrote:
I was wondering if anyone could help me.

My girlfriend is in her early 20s and has type 1 diabetes. She’s 120 pounds and about 5 foot 8 and wears one of those pumps that puts the insulin in her.

Over the last few months her a1c has been 12 to 13. I’m pretty sure that’s not a good thing because her doctor gets angry every time she goes to see her.

I want to help but I don’t know how to get her on the appropriate track towards lowering a1c levels and I thought T-Nation might be able to help because she wants to add muscle and change her nutritional intake somewhat, but I’m not sure how she should go about doing this. I only really trust the advise given on this website. I’m not sure what her doctor tells her to do because I’m never invited into the appointment.

What sort of foods and supplements might be beneficial towards lowering an a1c level that is around the 13 range?

Thanks for the help.

Thanks for the help.[/quote]

She should really go to a registered dietitian who’s also a certified diabetic educator (CDE). I’m an RD, but I’ve only dealt with diabetics briefly in an inpatient setting.

Appropriate nutrition and exercise can get A1C down. I know that, but an RD CDE really knows the proper timing of exercise with meals and medications.

11

If you study the philosophy of Chris Shugart, the right choice will emerge: you need to dump her. She’s a “toxic person” and could interfere with your quest for hardcore health maximization.

12

wow…lots of good advice here!

my wife is a type 1 diabetic, and has had periods of good control, and lately had shitty blood sugar control (A1C at 13). she has gastroparesis, which is nerve damage to her stomach, most likely due to poor control prior to us meeting. this is very hard on her, because her stomach empties about 10 times slower than normal, which resuslts in her throwing up a lot, and making it unpredictable what her blood sugar will be, etc.

however, my wife, and i’m sure many other diabetics are like this, try to do “normal” things, which means they’re not managing their diabetes.

fortunately, my wife has taken up yoga, and is trying to eat better, which i’m trying to encourage. one of the things that we’re doing, is focusing on preparing more meals together, and making it more of a ritual for us. it helps that i’m in the process of getting myself back in shape right now. however, they are times when we both get irriated with each other, since it looks like i’m harping on her for eveything, and i think she’s not trying as hard as she should be…

this will be tough for you, since she’s “just” your girlfriend. she will most likey be resistant to you telling her how to manage her health, so you need to be rather delicate about this. i’d suggest picking up some basic daibetes books out there, and helping educating her about diet and exercise.

there are several supplements that my wife has found success with (that i got her on, and NO doctor suggested)…

alpha lipoic acid/chromium picolinate: helps her insulin sensitivity (she probably needs 1/3 of the insulin she did before)
acetly l carnitine: helps with diabetic neuopathy
benfotiamine: helps prevent glycation
b-complex/vict c, etc: makes up gaps in nutrition

i’d also suggest omega-3’s, since they would reduce inflamation

from what i’ve seen, the biggest thing that helps is consistency…eating the same thign at the same time, checking blood sugars consistenly, exercising at the same time…managing diabetes is like a job, where you don’t get a day off.

13

I’m a type 1 diabetic and I wear a pump. Having an A1c of 12 or 13 is… a difficult thing to do… I can’t imagine what I would have to eat or do to make my A1c go up that far. I would have to guess that she is either not giving her self boluses when she eats or perhaps she is turning off her pump as the high blood sugar will allow weight to fall off you. Of course I do not know anything about her then what you said here.

She doesn’t need supplements she needs to get her diet straightened out. If she is using her pump to lose weight then she may need some counsuling to help come up with some better goals.
Her doctor could refer her to a nutitionist. My nutritionist helps me with my diet and my basal and bolus insulin so I can keep my BG numbers in tight control.

I have some questions though, What do you see her eat? Do you ever see her check her blood sugar or do anything w/ her pump when she does eat?

When it comes down to it there is really nothing you can do for her if she does not invite you to help her or if she is not willing to help herself. Having the will power to do what you need to do to control your diabetes to what makes all the difference. If she chooses to not do that there are consequences.

14

Hey i read your post, good thing your wife has a good husband to point her in the right direction. Little advice though try to take it easy on her i know i hate it when people glare over my blood sugars, its a pride thing and doing so would prob just make her lie about them. Other then that just be supportive and try to stay on track with your healthy lifestyle!
Goodluck!

15

just out of curiosity, what are the doses of those of you that are diabetic?

my wife takes about 14 IU’s of Lantus at night, and then 1:25 of Humalog for carbs, and 1:50 for corrective.

unfortunately, she doens’t have a real endo (although her regular doc is kickass), so we’re trying to fine-tune this for her…

16

[quote]cycobushmaster wrote:
just out of curiosity, what are the doses of those of you that are diabetic?

my wife takes about 14 IU’s of Lantus at night, and then 1:25 of Humalog for carbs, and 1:50 for corrective.

unfortunately, she doens’t have a real endo (although her regular doc is kickass), so we’re trying to fine-tune this for her…[/quote]

I’m on a pump now but I used to take 10 units Lantus in the morning and at night, taking it all at once caused me to many low BGs, and 1:10 Novoloag for carbs with a 1:30 correction.
I spent years with out insurance trying to do it myself and I did manage for a time but eventually it was more then I could handle. I was lucky to get a good job that had insurance.

17

I do 20-24 lantus at night before bed pending how much I ate that evening/night. It’s a bit risky to take right then because of overnight hypo chances but if I cut back further I get major dawn effects in the morning. With 24 lantus I still get a dawn effect but it is usually delayed or not as powerful (ie, I go up to the low 200s slow instead of high 300s fast). Most nights I am just fine… occasionally not. I wake up every night anyways though to use the bathroom and always check my BS then too no matter what. I didn’t used to but now it is a (pain in the ass) habit.

As for fast-acting stuff I do 1:15-20 I guess… I’m not too strict with it really as long as you take it and then don’t go doing a bunch of stuff away from the home where the food is, it is not much of a worry if I under/over shoot by a unit or two.

I find the hardest calculation is to take fast-acting before you are going to eat and when you are already high (BS >200). I always end up needing a lot more than what I think. Part of it has to do with your liver and getting it to turn off glucose production (which you are already doing when you are low, and eating just exasperates it) from what I can tell… something that has not been studied very well.

Also I am 5’11" - 175, about all muscle which is relevant. Being lean versus not lean changes things a lot.

18

I personally couldn’t date someone so irresponsible. She literally has a death wish with an A1C level this high. Diet is a only one half of the equation. An equally important (if not more important) half of the equation is managing her insulin dosages as to ensure optimal blood sugars throughout the day/night (i.e. 80 to 180 range ideal).

I’m sorry. Without even knowing a darn thing about her she must have some serious mental/emotional issues to allow an A1C level this high. A death wish literally. I would be angry with someone like this constantly and would not allow myself to care about them since they obviously don’t care much about themselves. She’s basically undergoing a slow form of suicide and should be checked into the hospital (against her will if necessary). This is so bad that some other adult should be responsible for all of her decision-making (a la Britney Spears style) since she is incapable of doing it herself.

19

[quote]icecold wrote:
Do not give up hope, but some people just get a very aggresive type of type I diabetes. Very often those affected seem fairly normal in their 20s but are disabled by the time they are 40. It is sad. Not trying to scare you away, but you should know what you are in for should you marry her.

[/quote]

No one has a “more aggressive” from of Type 1 diabetes than another. You either have Type 1 diabetes or you don’t. If you properly manage your Type 1 diabetes and keep blood sugars in check during your life you can live to a ripe old age complication free.

I would not marry this person because she apparently is extremely irresponsible and apparently has a death wish.

20

[quote]cycobushmaster wrote:
wow…lots of good advice here!

my wife is a type 1 diabetic, and has had periods of good control, and lately had shitty blood sugar control (A1C at 13). she has gastroparesis, which is nerve damage to her stomach, most likely due to poor control prior to us meeting. this is very hard on her, because her stomach empties about 10 times slower than normal, which resuslts in her throwing up a lot, and making it unpredictable what her blood sugar will be, etc.

however, my wife, and i’m sure many other diabetics are like this, try to do “normal” things, which means they’re not managing their diabetes.

fortunately, my wife has taken up yoga, and is trying to eat better, which i’m trying to encourage. one of the things that we’re doing, is focusing on preparing more meals together, and making it more of a ritual for us. it helps that i’m in the process of getting myself back in shape right now. however, they are times when we both get irriated with each other, since it looks like i’m harping on her for eveything, and i think she’s not trying as hard as she should be…

this will be tough for you, since she’s “just” your girlfriend. she will most likey be resistant to you telling her how to manage her health, so you need to be rather delicate about this. i’d suggest picking up some basic daibetes books out there, and helping educating her about diet and exercise.

there are several supplements that my wife has found success with (that i got her on, and NO doctor suggested)…

alpha lipoic acid/chromium picolinate: helps her insulin sensitivity (she probably needs 1/3 of the insulin she did before)
acetly l carnitine: helps with diabetic neuopathy
benfotiamine: helps prevent glycation
b-complex/vict c, etc: makes up gaps in nutrition

i’d also suggest omega-3’s, since they would reduce inflamation

from what i’ve seen, the biggest thing that helps is consistency…eating the same thign at the same time, checking blood sugars consistenly, exercising at the same time…managing diabetes is like a job, where you don’t get a day off.[/quote]

I’d just like to say here that exercise, eating balanced meals, etc are all great things to do but the MOST important thing a Type 1 diabetic can do is to keep his/her blood sugar levels in check by checking it often and using insulin responsibly. If you don’t properly balance blood sugar with insulin none of the other stuff matters in the long run…This wasn’t necessarily directed at you but to all others on this board that may have misinformation about this disease.