Help pls

[Ladyk]

Hi All,
Quite simply: I’m struggling! Diagnosed two years ago as by product of another condition - am Type 1. I have no confidence, frightened that my sugar levels go too high / too low etc. How do I get over this? Everyone says just count your carbs, but I just don’t know where to begin. It’s all too much. Have others / do others feel like this?

 

[Inka]

Hi @Ladyk 🙂 What insulins do you take and when? Are you on fixed doses for your meals? If you can explain a little more, you’ll get more tailored suggestions. Carb counting isn’t too hard so don’t worry about that. Tell us where you are now diabetes-wise and do ask any questions you want. Nothing is ‘silly’.

 

[Ladyk]

Welcome @Ladyk 🙂 What insulins do you take and when? Are you on fixed doses for your meals? If you can explain a little more, you’ll get more tailored suggestions. Carb counting isn’t too hard so don’t worry about that. Tell us where you are now diabetes-wise and do ask any questions you want. Nothing is ‘silly’.

I’m on Levimer &Nova Rapid. From what I can gather am on pathetic doses: 2.5 base and then just between 2 & 4 at meal times. It’s all so daunting: I’m finding that because (generally speaking) everyone knows the dangers of hypos etc, I’m scared.

 

[Inka]

It is scary. Hypos scare me too, even years after diagnosis. All you can do is test lots and do your best to minimise them and catch any lows early so you can treat them before you drop too much. Carb counting will help minimise them too.

Yes, your doses are small, but that’s ok. I started off on 1 unit of basal then went up to 2 units. There’s an online course that might help you with carb counting. I guess you know the basic principle? Count the carbs in the meal you’re about to eat, then calculate the correct insulin dose using your insulin to carb ratio. As an example someone might have a ratio of 1:20g carbs -1 unit of insulin for every 20g carbs. So, for a meal containing 40g carbs, they’d have 2 units of insulin.

Here is the online course, but please do continue to ask questions here 🙂

https://www.bertieonline.org.uk/

.

 

[Ladyk]

It is scary. Hypos scare me too, even years after diagnosis. All you can do is test lots and do your best to minimise them and catch any lows early so you can treat them before you drop too much. Carb counting will help minimise them too.

Yes, your doses are small, but that’s ok. I started off on 1 unit of basal then went up to 2 units. There’s an online course that might help you with carb counting. I guess you know the basic principle? Count the carbs in the meal you’re about to eat, then calculate the correct insulin dose using your insulin to carb ratio. As an example someone might have a ratio of 1:20g carbs -1 unit of insulin for every 20g carbs. So, for a meal containing 40g carbs, they’d have 2 units of insulin.

Here is the online course, but please do continue to ask questions here 🙂

https://www.bertieonline.org.uk/

.

I haven’t actually had any real “carb counting lessons”. As said diagnosed as by product of another condition so focus (me & by medics) was on that one. Literally all I have been told by (obviously no-one on forum as just joined) people is carb count. That is it. I’m frightened to go to sleep etc etc etc.Libre goes off if I sleep on it.

 

[Lucyr]

I haven’t actually had any real “carb counting lessons”. As said diagnosed as by product of another condition so focus (me & by medics) was on that one. Literally all I have been told by (obviously no-one on forum as just joined) people is carb count. That is it. I’m frightened to go to sleep etc etc etc.Libre goes off if I sleep on it.

It doesn’t look like you’ve just joined as you posted similar questions a year ago. How have you been getting on since then with the suggestions you were given last year?

 

[trophywench]

Flower - we were all equally scared to begin with, so though you won't believe me - it does mean, you know what? You are NORMAL !

In 1972 everything I picked up was telling me I'd be lucky to stay alive with all my bits and pieces, inner and outer, intact, long enough to collect my pension.

Funny, if that means I am lucky, how I've never won the pools or the lottery or a penny piece on my premium bonds - yet here I still am with working eyes, working kidneys, complete complement of limbs, no neuropathy, no ulceration and drawing my pension for over 10 years by now.

It's unrealistic to think you will ever avoid 100% of hypos - but know something else? they neither usually kill you or even render you incapable - especially now we have things like the Abbott Freestyle Libre that we can regularly scan in a few seconds and spot the downward arrows to treat any that occur before our blood glucose gets anywhere near the danger zone. Do you know about these? do you have one? - have you asked for one?

The idea is for us all to find out enough about or own diabetes so that after we have had a hypo and treated it so no longer hypo - we try and work out why the heck that happened? - and obviously to then try to avoid that same situation happening again. Well ALL try to help you on here if you can't fathom it out alone if you tell us the story - because you are definitely NOT alone any more!

 

[Inka]

If you find fixed doses easier, you can stick with those and just have the same amount of carbs for each meal each day. It doesn’t matter as long as you pay attention to the relationship between the insulin and carbs.

If the Libre is stressing you, then you could set an alarm to wake and finger-prick test at 1-2am or so. That way you can top up with food if needed and reassure yourself all’s ok. I find that despite having to wake, I sleep better after testing. You can also make sure you don’t have your evening meal too late. What time do you have your Levemir?

 

[Ladyk]

It is scary. Hypos scare me too, even years after diagnosis. All you can do is test lots and do your best to minimise them and catch any lows early so you can treat them before you drop too much. Carb counting will help minimise them too.

Yes, your doses are small, but that’s ok. I started off on 1 unit of basal then went up to 2 units. There’s an online course that might help you with carb counting. I guess you know the basic principle? Count the carbs in the meal you’re about to eat, then calculate the correct insulin dose using your insulin to carb ratio. As an example someone might have a ratio of 1:20g carbs -1 unit of insulin for every 20g carbs. So, for a meal containing 40g carbs, they’d have 2 units of insulin.

Here is the online course, but please do continue to ask questions here 🙂

https://www.bertieonline.org.uk/

.

Thank

Flower - we were all equally scared to begin with, so though you won't believe me - it does mean, you know what? You are NORMAL !

In 1972 everything I picked up was telling me I'd be lucky to stay alive with all my bits and pieces, inner and outer, intact, long enough to collect my pension.

Funny, if that means I am lucky, how I've never won the pools or the lottery or a penny piece on my premium bonds - yet here I still am with working eyes, working kidneys, complete complement of limbs, no neuropathy, no ulceration and drawing my pension for over 10 years by now.

It's unrealistic to think you will ever avoid 100% of hypos - but know something else? they neither usually kill you or even render you incapable - especially now we have things like the Abbott Freestyle Libre that we can regularly scan in a few seconds and spot the downward arrows to treat any that occur before our blood glucose gets anywhere near the danger zone. Do you know about these? do you have one? - have you asked for one?

The idea is for us all to find out enough about or own diabetes so that after we have had a hypo and treated it so no longer hypo - we try and work out why the heck that happened? - and obviously to then try to avoid that same situation happening again. Well ALL try to help you on here if you can't fathom it out alone if you tell us the story - because you are definitely NOT alone any more!

Thank you for all your kind words of support - means a lot. This may stupid, but I know the concept of carb ratio but my body has been is so up the spout with other conditions, the “teaching / learning of” carb counting hasn’t properly been pursued. I mean, how do you know / learn your carb ratio: some carbs affect me, some don’t. My other medical conditions have been the focus up until now - been the love of the NHS research focus! I’ve got the Libre, and managed to get on prescription. (Love your comment re “lucky” and not winning the pools - my sense of humour. Have had to adopt that approach with everything else.)

 

[Inka]

@Ladyk It is hard when you have other conditions too. It must be so frustrating for you. The first thing to stress is that Type 1 itself is a variable condition. So many things affect it. You’re not aiming for perfection because that’s impossible.

The first step is making sure your Levemir is right (right dose, right times). That’s the foundation of your ‘diabetes house’. Have you ever done a basal test? Once your Lev is sorted, you can then move on to your meals and slowly start to begin working out your carb ratios. They might be different for breakfast,lunch and evening meal. That’s normal.

 

[trophywench]

Would be useful to know if you inject the Levemir once, or twice a day.

 

[Ladyk]

@Ladyk It is hard when you have other conditions too. It must be so frustrating for you. The first thing to stress is that Type 1 itself is a variable condition. So many things affect it. You’re not aiming for perfection because that’s impossible.

The first step is making sure your Levemir is right (right dose, right times). That’s the foundation of your ‘diabetes house’. Have you ever done a basal test? Once your Lev is sorted, you can then move on to your meals and slowly start to begin working out your carb ratios. They might be different for breakfast,lunch and evening meal. That’s normal.

This is the thing: all of what you speak about hasn’t happened. To summarise: I was diagnosed with diabetes days before I was discharged from a rehab unit. From there, i “feel” only “generalised” support has been offered. Ignore hubbie in that bit because can’t fault him.) I have to say this with a caveat because everyone’s (including medical) focus was on my other conditions. Being honest I probably have to include myself in that aswell
because recovery was very hard.

 

[Inka]

A basal test (testing the amount of basal you’re taking is correct) is something that people usually do themselves. We did have a good link about it but I’m not sure if it’s still available @everydayupsanddowns @trophywench ?

Once you’re relatively sure your basal is ok, then you move onto the meals. Type 1 is something where we have to be our own experts to a large extent. I know that sounds worrying or scary, but it does gradually become more like second nature and you do get the hang of it.

We can’t give specific dosage advice but if you wanted to post a day’s blood sugar and meals (times and insulin amount), you might get some helpful suggestions.

I also recommend getting a book about Type 1. Start with something basic so you’re not overwhelmed. It’s reassuring to have something at hand.

 

[everydayupsanddowns]

A basal test (testing the amount of basal you’re taking is correct) is something that people usually do themselves. We did have a good link about it but I’m not sure if it’s still available @everydayupsanddowns ?

Yes it’s in the ‘Useful links’ Type 1 section at the top of the Newbies board:

Useful links for people new to diabetes

These links provide useful information, particularly to those newly-diagnosed. You can also browse the Recommended Books and Links sections for further information :) Contents: Type 1 Section Insulin Pumps Section Type 2 Section General Help and Information Section Complications and screening...

forum.diabetes.org.uk

Basal testing is a bit if a faff @Ladyk , but it was a real lightbulb moment for me when I discovered it, and I am constantly astounded at the comparatively huge effect of a relatively modest tweak to my basal dose in terms of smoothing out my levels and getting meal and correction doses to work as they should!

 

[Ladyk]

Would be useful to know if you inject the Levemir once, or twice a day.

Inject once a day in the morning.

 

[Inka]

Inject once a day in the morning.

Levemir is generally a twice a day insulin. Especially with very low doses, it runs out well before the stated time. Just something to bear in mind.

 

[trophywench]

It may be a very small dose - but if it ain't injected at the right time(s) for your body, it's no help. Now you have the Libre (instead of finger pricking) basal testing is so much easier - spend a few days slightly juggling mealtimes and get a full 24hr basal test done and dusted.