u/Brief-Letterhead1175

I've been limiting my hiking trips to less than 2 weeks at a time because after the first few days my liver is releasing glucose and making it impossible to eat and not run sky high. After a while I get tired of eating nothing but tuna packets and so I go home, gain some weight, and eventually return to the trail.

Limiting my time on trail is taking too long to complete the long trails on my bucket list. I'm now faced with a situation where I'm running out of healthy time where I will be able to continue my endeavors, so I need to be able to stay on trail for months at a time if I am to finish the bucket list trails.

Any thru-hiker T1s or other ultra athletes out there who have successfully dealt with this? Any advice would be greatly appreciated, as I've been dealing with this for years and need to step up my mileage ASAP without starving to death in the process. Thanks!

I've been struggling with control for the last year or so. At this point I've tried all the usual things like metformin, switching between mdi and pump, changing insulins, etc to no avail. I cannot increase exercise anymore because there are only 24 hours in a day. I've always been strict on the diet. GLP1s would likely help but are counterindicated due to a comorbidity.

In theory, the action of SGLT2s is what seems most likely to help me. I've tried explaining this to my endo but he acts like I'm crazy.

Any advice on how to approach my endo to get him to prescribe? Thanks!

I have unpredictable spikes in insulin resistance if I don't get a very specific amount and quality of exercise, so I do that. I also am fairly strict about avoiding complex carbs and certain foods, like pizza and sushi. I try to limit carb intake as a whole to about 100 or less per day because thats how I get good control.

I also happen to do a sport that requires I have adequate fat reserves to offset very limited calorie intake for several weeks at a time, meaning that I do consume massive amounts of the types of foods that don't affect my BS when I need to.

Apparently, because I do focus heavily on food consumption, this looks like an eating disorder. How is trying, and achieving, good glucose control and still managing to live life doing what I want safely an eating disorder?

Anyone else accused of having an eating disorder because T1 doesn't let us just eat whatever we want without consequences?

Long story, with a simple question. I'm curious about some issues I am having on MDI and how they relate to the long acting insulins. To rule out some things, I want to go back to using my very old but functional Medtronic 722.

When I mentioned considering a pump, my endo just tried to push the iLet on me, which after many great responses to my questions about it on here, isn't for me.

So, I really just want cartridges (MMT332A) and infusion sets (MMT 397) and humalog to go back to my old pump for a bit and sort out some things. My endo will not give me a prescription for these, as he wants me to get a new pump.

Anyone know if there is a way to get the supplies without a prescription or with an online prescription. I don't really care if I have to pay out of pocket, but don't want to have to do repeat visits for endos all to say no.

I'm being pushed to get a pump, specifically the Beta Bionics Ilet. I am confused as to why, based on their own literature, anyone in good control would add another layer of frustration to their treatment.

The literature touts A1Cs achieved around 7.4 and TIR around 67%. This would be significantly worse control than I currently have, so I'm at a loss as to the why.

I am also tremendously concerned about the potential for massive overcorrection. I almost always have readings that are artificially high by 100 to 200 mg/dl for the first day or so of a new sensor, so this sounds insanely dangerous to let the pump dose for extreme hyperglycemia for 2 days straight when I am.actually in range.

Nobody from Beta Bionics can answer my questions and my endo dismisses my concerns.

What am I missing here? Thanks!

Over the past year my A1C has crept up from a consistent 6.0, with my last A1C at 7.0. My cgm data verifies that this is an actual decline in control and not just A1C variability. In response, I have gradually reduced carb intake and increased exercise but control continues to decline and I have reached a point where I cannot eat less or exercise more without risking other serious problems. Glp1s are counterindicated due to existing complications and metformin has not helped. I cannot use a pump anymore due to scar tissue from decades of pumps and shots so I'm on MDI, which has worked well for a long time.

Any outside the box thoughts or suggestions, or do I just accept this is okish control and the reality of living with this disease for many decades?

I have recently seen some research that shows encouraging results with SGLT2 use for T1s for whom GLP1s are counterindicated. It appears the main issue is the potential for DKA, but I cannot find any info on how much of a risk this really presents.

Here's why I ask, and why I'm hoping someone can shed some light, in a nutshell. I'm well controlled (6ish A1C and 85-90% TIR) but the insane amount of exercise it takes to keep the insulin resistance at bay is becoming unsustainable. It appears many T1s in this scenario are given GLP1s and that works well, but isn't an option for me due to retinal scarring and the increased risk of detachment using GLP1s. I've never had DKA or any ketone issues in 40+years, so I'm definitely not one of those at high risk for DKA, so I'm hoping I found a workaround cheat code.

Any experience or thoughts are greatly appreciated.

Sorry for the long story, but this was by far the worst I've ever experienced and hopefully someone can provide some insight. This morning I woke up at 120mg/dl. I'm certain this was a fairly accurate reading as it had been riding there all night. Took 30 units of Toujeo as always (on MDI). Go outside to feed animals as I always do, as this bit of activity avoids feet-on-the floor syndrome. This all takes 15 minutes. Start feeling bad, dexcom says 100. Come inside to verify and I'm 27. Dexcom now alarms low. Freak out and eat 120 grams of glucose jelly beans bc I know this is something really, really bad. Check in 5 minutes and I'm 23. Inhale basquimi, check in a minute and still 30. Luckily daughter is home so she brings me 2 sodas. Still conscious, so chug them and check in a minute. Apparently go unconscious, so daughter uses injectable glucagon. Wake up in what she says is 5 minutes. Check and I'm 45. Continue eating candy and another soda. 15 minutes later and I'm up to 57. Keep checking for about an hour and eventually hit 70. Several hours later I peak at 110, so its now controlled.

So, well over 200 carbs and two different administration's of glucagon and I get back to normal without overshooting, so the treatment was perfect but absolutely terrifying. WTF happened?! The only thing I can think is that I injected directly into a blood vessel and all that insulin kicked in immediately. I am 100% certain that I didn't accidentally take too much or the wrong insulin because I physically sign out my insulin every day on a chart before and after taking it, bc I'm OCD.

Any thoughts?