Little worried

[Louise38]

Hi there all, my son was newly diagnosed with type 1 a few days ago, he’s been taking 4 units fast acting before breakfast, lunch and tea and 8 units slow for 3 days now. At his consultation they said his sugar needed to come down slowly but as you can see it’s come down quickly should I be worried. I’ve attached pic of his diary. Thankyou

 

[Inka]

Hi @Louise38 You or your son would have to check with his team to find out what his individual targets are. They should give you a range eg 9-14 (just using that as an example, could be different numbers).

I don’t think his numbers are awfully low and I was expecting to see lower numbers when I clicked on your attachment, so I don’t think you should panic. However, for your own peace of mind I suggest giving his team a call and just establishing what numbers they’re looking for at this stage. That way you won’t be guessing or doubting yourself, you’ll know exactly what they’re wanting to see and that will provide reassurance for you both.

 

[stillgoing]

If I were you I would get into contact with your diabetic team and ask what they mean by quick! The before meal should be the lowest point so after his meal I would expect it to be a bit higher at the before bed.

As @Inka says a range eg 9-14 and how many days they want this held before aiming for the next range. My personal range is 5-9 but younger diabetics are normally recommended tighter and lower than this.

Let us know what the team recommend.

 

[Louise38]

Hi @Louise38 You or your son would have to check with his team to find out what his individual targets are. They should give you a range eg 9-14 (just using that as an example, could be different numbers).

I don’t think his numbers are awfully low and I was expecting to see lower numbers when I clicked on your attachment, so I don’t think you should panic. However, for your own peace of mind I suggest giving his team a call and just establishing what numbers they’re looking for at this stage. That way you won’t be guessing or doubting yourself, you’ll know exactly what they’re wanting to see and that will provide reassurance for you both.

Hi there and thankyou for your reply. Yes I will ring early tomorrow morning. Don’t actually think they gave us a target range but will ask thankyou

 

[stillgoing]

Have you started carb counting yet! It looks like they expect all three meals to be about the same value but looking at his results then perhaps last meal needs to be increased slightly. Best wishes

 

[Louise38]

If I were you I would get into contact with your diabetic team and ask what they mean by quick! The before meal should be the lowest point so after his meal I would expect it to be a bit higher at the before bed.

As @Inka says a range eg 9-14 and how many days they want this held before aiming for the next range. My personal range is 5-9 but younger diabetics are normally recommended tighter and lower than this.

Let us know what the team recommend.

Thankyou so much, yes we will contact them first thing in the morning and let you all know

 

[Louise38]

Have you started carb counting yet! It looks like they expect all three meals to be about the same value but looking at his results then perhaps last meal needs to be increased slightly. Best wishes

No we’ve been told to stick to the same dosage for a while just until we get used to doing it then look to carb count later. My son is 24 by the way and we’re just so confused at the moment still. Thankyou

 

[stillgoing]

At the moment they are trying to stabilise the condition so they should have told you what sort of things he should be eating. These things should all be of the same carb value. Later on they will try and work out how the insulin and carb react so that you can change the meals to have different amounts of carb and adjust the amount of insulin you take. You can then get back to a more general eating rather than a restricted menu. If your team have not recommended meals get them to do so when you phone them🙂

 

[Inka]

No we’ve been told to stick to the same dosage for a while just until we get used to doing it then look to carb count later. My son is 24 by the way and we’re just so confused at the moment still. Thankyou

The reason why your son was told not to reduce his numbers too quickly was that a sudden drop can potentially cause problems. This is why he was told to do it gradually - and that’s very important and very good advice.

He shouldn’t be aiming for normal numbers. His team will help him get his numbers down to the normal range carefully and gradually.

 

[Louise38]

At the moment they are trying to stabilise the condition so they should have told you what sort of things he should be eating. These things should all be of the same carb value. Later on they will try and work out how the insulin and carb react so that you can change the meals to have different amounts of carb and adjust the amount of insulin you take. You can then get back to a more general eating rather than a restricted menu. If your team have not recommended meals get them to do so when you phone them🙂

They didn’t ask us to keep to the same carb value as far as I can remember, but there was so much information coming at us I may have missed it. I shall check with them tomorrow. Thankyou again

 

[Louise38]

The reason why your son was told not to reduce his numbers too quickly was that a sudden drop can potentially cause problems. This is why he was told to do it gradually - and that’s very important and very good advice.

He shouldn’t be aiming for normal numbers. His team will help him get his numbers down to the normal range carefully and gradually.

Yes they told us all of that but we’re just sticking to the dosage they told us and trying to eat a bit more healthy. That’s why I was worried it had come down significantly, thought it would be slower. Have a lot of questions for them tomorrow unfortunately

 

[Amity Island]

The reason why your son was told not to reduce his numbers too quickly was that a sudden drop can potentially cause problems. This is why he was told to do it gradually - and that’s very important and very good advice.

He shouldn’t be aiming for normal numbers. His team will help him get his numbers down to the normal range carefully and gradually.

Hi Inka,

Do you know if, when someone gets admitted for first time, do they start their basal on a preferred time of day, or is that left to later when things are more organised? Or do they just get the basal in asap?

Thanks

 

[Amity Island]

They didn’t ask us to keep to the same carb value as far as I can remember, but there was so much information coming at us I may have missed it. I shall check with them tomorrow. Thankyou again

Hi Louise38,

If your son is on a fixed amount of mealtime (aka bolus) insulin, then this will only cover for a fixed amount of carbs.

This makes it easier to start. So using myself as an example, 4units would allow about 40grams of carbs to be eaten in a meal. That's a ratio of 1unit of insulin to 10g of carb, which is often a starting point when diabetic and on insulin.

Worth mentioning now, is that diabetics ratios are all different and also often change from across the day starting from when they woke. Typically, many diabetics need more bolus insulin in the morning and this reduces with each meal across the day.

I use 2 units of insulin for every 10g carb when I wake, 1.5units for every 10g carb for lunch and tea 1unit for each 10g.

You'll learn all this over the next few weeks.

Keep coming back to the forum as much as you need.

 

[Louise38]

Hi Louise38,

If your son is on a fixed amount of mealtime (aka bolus) insulin, then this will only cover for a fixed amount of carbs.

This makes it easier to start. So using myself as an example, 4units would allow about 40grams of carbs to be eaten in a meal. That's a ratio of 1unit of insulin to 10g of carb, which is often a starting point when diabetic and on insulin.

Worth mentioning now, is that diabetics ratios are all different and also often change from across the day starting from when they woke. Typically, many diabetics need more bolus insulin in the morning and this reduces with each meal across the day.

I use 2 units of insulin for every 10g carb when I wake, 1.5units for every 10g carb for lunch and tea 1unit for each 10g.

You'll learn all this over the next few weeks.

Keep coming back to the forum as much as you need.

Thankyou for your reply. Yes that certainly sounds like what we should be doing so I’ll aim for 40grams of carbs per meal now. It’s just so much to take in but we’re getting more confident daily. I’ll be speaking to his team in the morning. Thankyou agsin

 

[Amity Island]

Thankyou for your reply. Yes that certainly sounds like what we should be doing so I’ll aim for 40grams of carbs per meal now. It’s just so much to take in but we’re getting more confident daily. I’ll be speaking to his team in the morning. Thankyou agsin

I know, it's a heck of a lot to take in and hard to see if you are a parent too trying to do their best to help.

I was the same age when I was diagnosed. Last year at uni. It was a shock! But I soon got the hang of it. It all depends on how resistant one is to change as to how well someone deals with it.

For me 4 units would "allow" me just 20g of carbs at breakfast, because I am 2units to 10g carb when I wake.

 

[Inka]

Hi Inka,

Do you know if, when someone gets admitted for first time, do they start their basal on a preferred time of day, or is that left to later when things are more organised? Or do they just get the basal in asap?

Thanks

I don’t know. I was diagnosed years ago. I had a sliding scale drip at first. Then moved onto mixed insulin, which included basal. I can’t remember exactly what time of day this was but I think it was the morning (I had two injections, morning and evening).

I assumed most people had the insulin drip up to start, along with saline, etc for dehydration, then the injections were introduced when the emergency situation had passed and when rough doses had been calculated.

 

[Louise38]

I know, it's a heck of a lot to take in and hard to see if you are a parent too trying to do their best to help.

I was the same age when I was diagnosed. Last year at uni. It was a shock! But I soon got the hang of it. It all depends on how resistant one is to change as to how well someone deals with it.

For me 4 units would "allow" me just 20g of carbs at breakfast, because I am 2units to 10g carb when I wake.

Yea your right it’s hard for my son but I think it’s nearly as bad for me because I just want to do everything in my power to help and I’m scared in case I do something wrong. Wow you were at Uni, how did you cope? It’s just so much to take right now but we will definitely get the hang of it also.
The whole carb counting thing scares me too. But guess we will feel better tomorrow after spending to his team

 

[Inka]

Yea your right it’s hard for my son but I think it’s nearly as bad for me because I just want to do everything in my power to help and I’m scared in case I do something wrong. Wow you were at Uni, how did you cope? It’s just so much to take right now but we will definitely get the hang of it also.
The whole carb counting thing scares me too. But guess we will feel better tomorrow after spending to his team

Don’t be scared by the carb counting. It’s not as hard as it might sound, and, when your son is ready for it, carb counting will provide more flexibility and make life more normal as far as food is concerned. You’ll also find that you don’t need to sit there frantically counting each meal because he’ll be eating similar meals and so you’ll know the carb total for that meal without having to count it up.

Of course you want to help your son - and you are 🙂 You’re looking for knowledge, being careful, and giving him the support he needs. You’re doing all the right things. Sharing his diabetes helps share some of the pressure on him.

 

[everydayupsanddowns]

Thankyou for your reply. Yes that certainly sounds like what we should be doing so I’ll aim for 40grams of carbs per meal now. It’s just so much to take in but we’re getting more confident daily. I’ll be speaking to his team in the morning. Thankyou agsin

Do be aware that if you’ve not been advised to limit carbs and if his clinic are keen for his numbers to come down gradually, then aiming for a restricted carb count to ‘match’ insulin based on a value suggested on an internet forum may actually cause more problems than it solves, and may drive down his numbers too fast. There’s lots we don’t know on the forum about your son’s case, and if his team have aimed for a very gentle insulin start for any reason (eg they suspect he may still be producing some of hos own insulin as part of the honeymoon phase), then adopting 1:10 may not give enough ‘carb cover’ and could drive his numbers down sooner.

@Amity Island is only giving his own experience as a person who is no longer newly diagnosed, so it may be completely inappropriate to use those suggested ratios at the moment. Best to check with your team really 🙂

Getting those numbers down gently is the key. And don’t worry about asking his clinic lots of questions - that’s what they are there for! Getting an idea of the range that they would like him to aim for would be very helpful and reassure you that things are going along the right lines.

 

[Louise38]

Do be aware that if you’ve not been advised to limit carbs and if his clinic are keen for his numbers to come down gradually, then aiming for a restricted carb count to ‘match’ insulin based on a value suggested on an internet forum may actually cause more problems than it solves, and may drive down his numbers too fast. There’s lots we don’t know on the forum about your son’s case, and if his team have aimed for a very gentle insulin start for any reason (eg they suspect he may still be producing some of hos own insulin as part of the honeymoon phase), then adopting 1:10 may not give enough ‘carb cover’ and could drive his numbers down sooner.

@Amity Island is only giving his own experience as a person who is no longer newly diagnosed, so it may be completely inappropriate to use those suggested ratios at the moment. Best to check with your team really 🙂

Getting those numbers down gently is the key. And don’t worry about asking his clinic lots of questions - that’s what they are there for! Getting an idea of the range that they would like him to aim for would be very helpful and reassure you that things are going along the right lines.

Yes I wasn’t going to do the 40g carb without speaking to his team first, just waiting for them to ring back this morning. I know the forums are about people’s personal experiences but I would always speak to the professionals first . You’ve all been so amazing and the advice has certainly been a great help, I shall post what they tell us. Thankyou so much x