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I don't really know what to think about my blood sugars since I changed the Lantus. Saturday night, I lowered it from 34 units to 33 to stop the drastic/constant lows that I was having. It's been three nights of that and I just can't see the outcome yet.

Sunday was okay. I woke up higher than I went to bed but I'd also eaten a snack without any bolus to cover. I ran in the 190 to 250 range through the day which was frustrating but I wasn't eating the best.

Monday, I woke up at 239 which was 20 points lower than I went to bed at (with no correction that night). I stayed in range for most of the day except for a spike to 287 and a slow decline that bounced from 199 to 237. The 287 was my fault as I missed a bolus for a low carb snack in the afternoon thinking that I was dropping low (I had the feeling but not the numbers to back it up).

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I'm currently recovering from a fairly unexpected blood sugar of 49. It's the lowest I've been all week despite battling a multitude of lows. It really doesn't feel good. Especially after I've just finished an intense Jillian Michaels' workout (30 Day Shred) and just had to guzzle Coke and snacks.

Even before starting the Symlin on Tuesday evening, I was having lows at two odd times of the day. Morning and early evening after work. I'd wake up lower than I'd like, spike through the morning and afternoon and drop low almost immediately after leaving work. Symlin has only complicated this issue.

Today was the worst low of them all. After watching the Dexcom sit above 200 all day long, I had a salad with waffle fries for dinner. I bolused for the 204 prior to the meal on top of the fries and chicken. Then I decided to drink a Coke. 10 units of Humalog. An accurate bolus.

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Because of my recent tummy troubles, I've decided to put off the Metformin start for at least another week. So instead of starting Metformin today, I've decided to get back into the groove of the need for insulin. Instead of purposefully skipping Lantus doses and fudging my boluses, I'm going to get into the routine of doing these things right.

My current Lantus doses are split at midnight (16 units) and noon (18 units). However, I've had a lot of trouble remembering them or getting them on time lately without a schedule. So I think I need to try a one dose Lantus shot for awhile. I've done it before and it just doesn't give me as tight of control as I like, but it's better than no insulin at all.

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When I have checkups with my endo I typically don't have questions. Usually it's more or less an in-and-out-how-are-your-blood-sugars type appointment.

But things are chaning in the world of health insurance and I have tons of questions for my apointment next week. (Which is a follow up from barely two months ago when bloodwork showed that my thyroid had decided to take a vacation. We increased my thyroid meds; bloodwork this Wednesday; actual appointment next week.) I have received three letters in the last month or so from my insurance company telling me that the Novolog I use is now going to be a Tier 3 prescription (i.e, the highest co-pay) and that the number of test strips I can get will now be limited.

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The problem that I have with Lantus is that one dose just doesn't cut it for me. It claims a 24 hour lifespan, but honestly...it's probably more like 20 hours on a good day. Which means that my blood sugars start spiking towards the end of that injection.

That's exactly why I split my doses however many years ago. It worked, dropping my A1c like a lead balloon. And now that my schedule nearly forced me into either the insane asylum or a once-per-day dose, I'm struggling to find an appropriate time for my Lantus injection.

An evening shot wasn't working because I was having to take such a bulk of insulin that I was dropping way below my safety point by morning. And now I've switched to an early afternoon injection, but I'm afraid that looks like it's bombing as well.

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Tuesday night, I switched my Lantus over to a once-per-day shot instead of the split doses I'd been using previously. I started with 22 units of Lantus at 8pm. I knew I'd see some highs, but I didn't want to risk an unexpected night low after making the first switch.

And I did see some elevation. I ran mostly in the 180-290 range all through Wednesday, which wasn't as high as I was expecting really. I made sure to consider food in the highs, along with the usual post-breakfast spike. And I was confident that a few more units of Lantus might do the trick (or at least get me closer).

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As I looked at my averages last night in preparation for my Friday endo check-up, I couldn't help but complain to myself that there is no pattern. Every day is different, often drastically so. I can't find any constant area. There aren't variables causing these random shifts, at least not to the naked eye.

First, there's my morning blood sugars. Sometimes I wake up low even after a bedtime snack with no bolus. And sometimes I wake up in the 200 or 300 range with no apparent cause. Because of my history of seizures and severe lows, I lean towards the lows though. At this point in my life, I'd rather wake up 300 occasionally instead of trying to raise my insulin to counteract those highs.

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Right now, I'm staring at my logbook trying to decide what changes I need to make and what else I want to try with all this. This past week has been a bit rocky so my averages are all over the place. Mostly, they're high. At least higher than I want them to be. So while I'm staring at my book, I'm trying to piece together this last week and figure out what is going on with these numbers.

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Exercise can be a really tricky thing when you're diabetic. Whether you're starting a new routine or just changing up an old one, it's tough to manage blood sugars alongside cardio and resistance training. The ups and downs add an extra edge to the difficulty of staying in shape.

Last week, I decided to try some new exercise classes which sent my blood sugars into a tailspin. Luckily, I was able to lower my insulin and fend off the lows...but I wasn't able to achieve the balance that I crave. This week I'm still working hard to get back into shape (and lose some more weight)...but mostly I'm trying to find that medium ground between the highs and lows of exercise.

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It's the end of my logging week again, so I'm sitting down to examine the logbook that I hold so dearly close to my diabetes management's heart. The time that I set apart for this goes something like this. First, I update the logbook with my most recent numbers, Lantus doses, and any important comments including new prescriptions, strange food choices, or exercise. Next, I tally daily averages as well as averages for time of day. After that, I analyze those averages compared to the last weeks averages and look for any resounding patterns that might need changing.

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