Returning type 1

[angel2020]

Hello
I’m struggling to keep my blood sugar levels and wondering if any one can give me any advice

 

[Inka]

Hi @angel2020 🙂

What insulins do you take? Are you carb counting? What are your blood sugar numbers?

Is there any particular time of day/night you’re having trouble?

 

[Kaylz]

Are you rotating sites regularly? Have you tried changing to fresh insulin? Are you feeling unwell or anything?
xx

 

[angel2020]

I take nova rapid flex through the day and lantus at night. Im not carb counting. Sometimes it’s though the day and sometimes it can be at night. It fluxuwates my levels

 

[angel2020]

Are you rotating sites regularly? Have you tried changing to fresh insulin? Are you feeling unwell or anything?
xx

 

[Kaylz]

I take nova rapid flex through the day and lantus at night. Im not carb counting. Sometimes it’s though the day and sometimes it can be at night. It fluxuwates my levels

Have you checked your lantus dose is correct by performing a basal test, also what are you eating? and how many units do you take at meal times of novorapid, as a Type 1 you ideally need to learn to carb count and adjust your doses yourself based on carbohydrate intake and BG at the time etc xx

 

[angel2020]

I dont know what you mean by site changes. No I have been on nova rapid and lantus for 14 years. I’m feeling well.

 

[Kaylz]

I dont know what you mean by site changes. No I have been on nova rapid and lantus for 14 years. I’m feeling well.

Using a different area for each injection so you aren't causing scar tissue to build up in areas and cause absorption problems, I meant changing the pen or the cartridge to a fresh one from the fridge incase yours have been compromised in some way, have you tested your ketones? xx

 

[angel2020]

I eat mostly healthy and it all de on what bloods are before eating

 

[angel2020]

Yes I use different areas areas all the time

 

[rebrascora]

Hi

Where do you inject your insulin? These are the injection sites and sometimes they get a bit irritated or damaged and the insulin doesn't absorb as well or gets trapped in scar tissue caused by too many injections into the same location and then it can sometimes release hours or days later when you don't expect it to.
For instance I inject NovoRapid into my stomach and inject in a circle around my belly button and I inject my long acting insulin into my bum and alternate left cheek and right cheek, but I have used my thighs before which I find take a little longer for the insulin to be effective.

 

[Kaylz]

I eat mostly healthy and it all de on what bloods are before eating

Its not what you eat its how many carbs you have in the meal, you need the insulin dose to match the carbohydrate content of your meals and should establish an insulin to carb ratio, I'm surprised you've not been taught this after being diabetic so long, I self taught less than a month into my diagnosis as it makes things by far more manageable xx

 

[Bruce Stephens]

I'm surprised you've not been taught this after being diabetic so long,

The current standard way to do it wasn't always what was taught (since nobody knew about it and you really need modern insulins to make it work). I wasn't taught this when I was diagnosed (back in the last millennium, either).

So for anyone that doesn't know about this (and can make the time to participate in a suitable course, whatever that involves now), make a fuss and try and get on one. (The main one is DAFNE. See also https://www.bertieonline.org.uk and https://mytype1diabetes.nhs.uk which contain similar kinds of guidance.)

 

[angel2020]

haven’t tested ketones

 

[Kaylz]

@Bruce Stephens I wasn't taught, I taught myself to give myself the best chance at managing my condition, research isn't difficult to do and thats exactly the route I took xx

 

[everydayupsanddowns]

The current standard way to do it wasn't always what was taught (since nobody knew about it and you really need modern insulins to make it work). I wasn't taught this when I was diagnosed (back in the last millennium, either).

It wasn’t taught exactly (in terms of ratios)... but the basics of matching carbs to dose in the form of ‘exchanges’ or ‘lines’ was certainly taught pretty much 30 years ago. Because that when I was taught it.

A few years later a DSN told me “Oh we don’t teach that any more” and at the time I wondered what they had replaced it with.... only to find out a decade later that in many cases the replacement was nothing much.

I think they just thought people couldnt be bothered with it 🙄

When I was first diagnosed I knew that my evening meal needed to be 60g of whichever carbs I fancied, and that the dose was x

Looking back I am very glad to have had the introduction I did!

 

[Bruce Stephens]

It wasn’t taught exactly (in terms of ratios)... but the basics of matching carbs to dose in the form of ‘exchanges’ or ‘lines’ was certainly taught pretty much 30 years ago. Because that when I was taught it.

Oh yes, absolutely. But it wasn't quite as systematic as it is now. (In my experience.) It was normal to vary meals a bit, but not (in my experience anyway) recommended to vary them a lot, whereas it's expected that you be able to do that now (to skip lunch one day, for example). Maybe after the newer insulins came out the training was changed, but I'm pretty sure with the likes of insulatard and actrapid (and whatever came before them) such things wouldn't work well.

 

[everydayupsanddowns]

Yes protaphane and insulatard were far peakier than analogues.

Though I gather that the first DAFNE cohort were on those earlier basals and achieved results which have been quite hard to match!

 

[trophywench]

Well the thing is, my hospital didn't actually start offering carb counting and dose adjustment formal training until well after shedloads of other hospitals and area, and I undertook the course in 2008 so well after numerous other individuals and areas and hence, struggling to fathom out why it seems to have completely passed you by @angel2020. I'd been T1 for over 30 years at that point - nearer 40 - and it changed my understanding 100% for the better.

I urge every T1 to investigate such courses in their area - but for heaven's sake do the Online version if you can't access a 'live' one. Thus you are able to gain excellent control of your BG for the majority of the rest of your life.

 

[everydayupsanddowns]

Weirdly it was Cov and Warks in your neck of the woods where I had my helpful introduction to pancreas impersonation @trophywench!