Later life type 1

[Mumpie_olgran]

Hi all, proud new owner of a type 1 diagnosis which came atypically late apparently (mid 40s) although I now see from a few posts here that that's not that late compared to some!
I also had the fun of discovering what ketoacidosis means and spent a while with an IV hook up to get that straightened out. So lots to come to terms with in fairly short order!
To be fair I feel OK about it all, just a lot a lot a lot of questions brewing. What do hotels think about needles when on holiday, airlines too. I already eat pretty healthily but still need to get used to aligning jabs with meals and so on.
And most recently whether to worry about glucose readings that were all in the 6s and 7s throughout the last 24 hours, only to jump to 11 just before bed. Do I need to stick in more to deal with it or expect it to drop?
Just a lot of experience I don't yet have I suppose
Anyway, hi all and good to see that this is an active forum. Hope to hear a bit and maybe one day I'll be able to offer a bit of advice too

 

[Bruce Stephens]

What do hotels think about needles when on holiday, airlines too.

Your hotel surely won't have anything to do with them? I guess you might worry about people in the restaurant being bothered that you're injecting yourself at the table but honestly nobody will care or even notice.

You can buy smaller sharps containers (suitable for travel) for used needles and things. Airlines are familiar with the usual stuff that we need to carry. Take a letter from your GP or DSN saying you have type 1 diabetes just in case (most likely nobody will ever ask to see it but it's just as well to have it).

Travelling with diabetes

Travelling with diabetes means there are a few more things to think about before you set off. But living with diabetes shouldn't be a barrier to taking trips or holidays at home or abroad. Plan to take two to three times the amount of insulin or other diabetes medication and equipment you’d...

www.diabetes.org.uk

Do I need to stick in more to deal with it or expect it to drop?

For the moment I suggest not to worry about 11 just before bed.

 

[Tdm]

Well done on the 6 and 7s! At this stage having a highish bs before bed is not a bad thing, it will help ensure you don't have a nighttime hypos, though you will soon work out what dose you need to bring it down safely and reliable (says me who was chomping at glucose at 3am last night cos she rather over did it...)
Re blood sugars going up...was it a meal high in fats? That may have delayed the raising of the bs from your meal so they peaked after your insulin stopped working. Low gi meals may need you to inject straight before or, indeed, after the meal, or somexwith the meal and some more, say, an hour afterwards (split bolus). Some meals are just imposible to get right, bu then what works one day doesn't the next...
By the was way diagnosed early 50s and its overwhelming at first but you'll soon get the hang of it!

 

[SB2015]

Welcome to the forum from another late starter (53). As you have identified there is a lot to get your head round at the start but you have clearly made a good start and it will get easier.

Keep the questions coming and we will help as best we can.

 

[helli]

Welcome to the forum. When we get a Type 1 diagnosis, we have many questions. In fact, after nearly 20 years, I am still learning.
Why do hotels and airlines need to care about needles? I travel a lot on planes and stay in hotels. I feel no need to tell anyone about my diabetes and take my needles with me. I just carry a small bottle with me and decant it into a larger sharps bottle when I get home. It is not an official sharps container: just a small cosmetics bottle.
As for a rise before bed, with experience, you will learn when to dose. For me, it is about how much fast acting insulin I have active. Fast acting insulin lasts for about 4 hours.

 

[Mumpie_olgran]

Hey Bruce thanks for the quick reply, wasn't expecting that so soon
Sorry should have been more specific on the hotels point. I was thinking about getting rid of used sharps. Do you bring your own sharps box and then leave it with them to dispose of?

 

[Robin]

Welcome to the forum! You’re right, there are quite a few of us on here diagnosed in 'later life' I was 51.
When I’m on holiday, I just put my used needles in a little plastic pot, take them home with me, and empty them into my sharps bin when I get home. I was once on a flight where they announced that if anyone needed a sharps bin, they’d come round with one, but usually I just add them to my stash for taking home.

 

[Bruce Stephens]

Do you bring your own sharps box and then leave it with them to dispose of?

No, I take mine home with me. For the needles I use a clipper thing to clip the main pointy bit off (and the rest is fairly well protected by the plastic so I just discard it in the regular waste). If I change a Libre sensor I just bring back the extra stuff (the applicator and the old sensor).

https://www.amazon.co.uk/BD-SAFE-CLIP-NEEDLE-CLIPPER-1/dp/B007GX4US2

 

[Leadinglights]

Even getting rid of sharps bins at home can be fraught as different areas have a variety of policies. You can be given one easily enough but then find it can be hard to dispose of.

 

[Mumpie_olgran]

Well done on the 6 and 7s! At this stage having a highish bs before bed is not a bad thing, it will help ensure you don't have a nighttime hypos, though you will soon work out what dose you need to bring it down safely and reliable (says me who was chomping at glucose at 3am last night cos she rather over did it...)
Re blood sugars going up...was it a meal high in fats? That may have delayed the raising of the bs from your meal so they peaked after your insulin stopped working. Low gi meals may need you to inject straight before or, indeed, after the meal, or somexwith the meal and some more, say, an hour afterwards (split bolus). Some meals are just imposible to get right, bu then what works one day doesn't the next...
By the was way diagnosed early 50s and its overwhelming at first but you'll soon get the hang of it!

Pretty low GI really. Chicken and broccoli although I did have a slice of wholemeal toast with cheese and then some raspberries afterwards. Now that I write that down it doesn't sound too surprising a result? All prior meals have been pretty close to carb free. This is all just so new....
I guess the bit I'm really not used to is whether Bs should come down if its own accord and by how much

BTW wow on all the speedy responses. This place is a great comfort already, thanks all

 

[Leadinglights]

Perhaps you would like to say what insulins you are on and what advice you have been given about the carbs to have for your doses.
If you are having 'carb free' meals and injecting insulin do make sure you have hypo treatments and your testing kit to hand if needed.

 

[Mumpie_olgran]

Thank you. Not that much advice given yet really as I'm due a follow up with the nurses next week. They've got me on 16 units Largin and 4 units per meal of novorapid and I'm keeping a log of food and BS readings which I imagine I will then work through once I have better amount of data

 

[Bruce Stephens]

I guess the bit I'm really not used to is whether Bs should come down if its own accord and by how much

It might. Your pancreas might still be producing some insulin, or your dose of Glargine (Lantus) might be slightly too high, or the stress of the day might be enough. Or, come to think of it, the Novorapid dose might still be (just) active and drop you further. (Many of us find that after a day of a bit more physical activity than usual, we need to reduce the insulin that evening a little.)

It's safer to be a little higher than too low, especially to begin with. Presumably you don't have a CGM yet? (Something like Libre 2 can ring an alarm as you go low, so makes risking a correction dose at 11 a bit less dangerous. I'm pretty sure your DSN will still strongly recommend against doing it, and I think they'll be right.)

 

[rebrascora]

Hi and welcome from me too. Another late starter here at 56yrs old (4 years ago now)

If you are injecting fixed doses of NovoRapid with your meals then you need to eat normal balanced meals not low carb, otherwise you risk having hypos. Type 1 diabetes is about eating your normal diet and learning to balance the insulin you inject to what you want to eat, not about adjusting your diet. I follow a low carb way of eating through choice but I know enough to adjust my doses accordingly. The 4 units of NR with each meal is usually aimed at dealing with about 40g carbs to start with as they tend to start with a 1:10 ratio unless they think you will be very insulin sensitive and then adjust it as needed after that. If you don't eat enough carbs to release glucose to match it, that insulin will still remove that glucose from your blood stream and potentially drop your levels dangerously low.
The Glargine (usually referred to as Lantus) will probably bring your levels down a bit overnight so don't worry about that 11 for now, it is still miles better than the levels you had when you were DKA I am sure.

 

[Lucyr]

So long as you don’t leave needles lying around hotels, they won’t think anything, or even be aware that you’re using them. Just take your used needles home with you.

 

[Mumpie_olgran]

It might. Your pancreas might still be producing some insulin, or your dose of Glargine (Lantus) might be slightly too high, or the stress of the day might be enough. Or, come to think of it, the Novorapid dose might still be (just) active and drop you further. (Many of us find that after a day of a bit more physical activity than usual, we need to reduce the insulin that evening a little.)

It's safer to be a little higher than too low, especially to begin with. Presumably you don't have a CGM yet? (Something like Libre 2 can ring an alarm as you go low, so makes risking a correction dose at 11 a bit less dangerous. I'm pretty sure your DSN will still strongly recommend against doing it, and I think they'll be right.)

Bs came down to 7.3 pre breakfast this morning so feels like the right approach last night
And no CGM yet. I'm literally fresh out of hospital so expect to get stuck into all that this coming week
Have you had any downsides to the CGM? I'm an information junkie so that side appeals. Presumably I pay for it but that's OK with me
And have people here done many comparisons on which CGM?

 

[Inka]

Thank you. Not that much advice given yet really as I'm due a follow up with the nurses next week. They've got me on 16 units Largin and 4 units per meal of novorapid and I'm keeping a log of food and BS readings which I imagine I will then work through once I have better amount of data

The recommended diet for Type 1s is just a normal diet. It’s very usual to be started on less insulin than you need. This is partly for safety, but also because it’s better to bring the blood sugar down gradually as a sudden drop can potentially cause damage to your eyes. So, ideally, you should be a bit higher than 6 or 8 at this stage. The idea is your eat a normal diet and then your insulin is adjusted to cover it, just like your own pancreas would do if your immune system hadn’t attacked it 🙂

Here are a couple of books about Type 1 that are popular here:

Think Like a Pancreas’ by Gary Scheiner.

And Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas (ignore the title - it’s great for adults too).

There’s a lot to learn early on so take things slowly and carefully. It’s a huge change to daily life, so be kind to yourself. Ask anything you want here - no question is too trivial or ‘silly’.

You don’t pay for the Libre 2, which is a Flash GM rather than a CGM, but there are various options if you do want to pay. However, the Libre 2 is generally very good.

 

[Mumpie_olgran]

Oh right, I didn't realise that at all. They sent me home with some leaflets on type 1 including dietary recommendations so I've basically dropped free sugars and nearly all carbs.
You reckon I should keep eating normally (incl lasagne, fish pie, chicken Kiev types) even if they show high outcomes on Bs? Then agree adjustments with the nurses when I see them next week?
Pretty sure I've just repeated your post back to you but having in my own words will help this beginner!

 

[Mumpie_olgran]

Oh right, I didn't realise that at all. They sent me home with some leaflets on type 1 including dietary recommendations so I've basically dropped free sugars and nearly all carbs.
You reckon I should keep eating normally (incl lasagne, fish pie, chicken Kiev types) even if they show high outcomes on Bs? Then agree adjustments with the nurses when I see them next week?
Pretty sure I've just repeated your post back to you but having in my own words will help this beginner!

PS thanks have ordered the books!

 

[everydayupsanddowns]

Thank you. Not that much advice given yet really as I'm due a follow up with the nurses next week. They've got me on 16 units Largin and 4 units per meal of novorapid and I'm keeping a log of food and BS readings which I imagine I will then work through once I have better amount of data

Welcome to the forum @Toooldfortype1

Sorry you’ve had to join our little club!

Yes it has been more than 30 years since ‘juvenile diabetes’ was renamed Type 1, to recognise that it can occur at any age, and yet many non-specialists still seem to hold onto the notion that type 1 mostly occurs in childhood - when in fact 50% of cases are diagnosed in adults!

Sounds like you are doing really well so far. Just to mention that there’s no particular need to limit or reduce your carbohydrate intake when you live with T1 (unless you would like to do that for other reasons). As long as you balance your carbohydrate with the insulin doses you are taking, you can each as much or as little carbohydrate at you choose at any meal.

So for me I have a habitual baseline of moderate carb meals and their doses that I generally stick to (because personally I find this easier) but meals can vary from next-to-no carb to 120g-150g in a single meal 🙂

Just keep on gathering the data and see how you are responding to different meals and you’ll most likely find a sort of ‘benchmark’ amount that suits your 4u doses at different mealtimes (which may be different as insulin sensitivity can be different at breakfast, lunch amd evening meal). Then you can aim to hit your ‘count’ with some degree of confidence that the insulin usually has enough juice to balance those carbs 🙂

Good luck, and keep asking questions 🙂