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This will be my frist summer coming up, things are already heating up, so dose anyone have any tips for managing T1 in warmer weather?

Sara Grice

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Type 1.5 LADA
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I know heat can effect BG levels and I want to be prepared, my levels have been slipping higher recently, and it's getting on my nerves. Its not enough that my nurse was concerned, and not enough to consider bolusing, but I am considering maybe upping my long acting a bit if it dosen't improve by next week.

I have a hunch this is weather related, but even if its not i want to be prepared for the summer, wat can I do to keep things managed as things get hotter.
Also as a related side note, If I need to bollus a high..how do I work out how much to give?
 
If you need to give bolus insulin to correct a high @Sara Grice you need to know your Correction Factor - ie how much 1 unit of bolus insulin will drop you. My CF varies from day to evening. Your team might be able to give you advice. You could email them with that question maybe?
 
If you need to give bolus insulin to correct a high @Sara Grice you need to know your Correction Factor - ie how much 1 unit of bolus insulin will drop you. My CF varies from day to evening. Your team might be able to give you advice. You could email them with that question maybe?
That's a good idea I will next week
 
What happens for many of us is that we need a little less basal insulin in the summer compared to the winter, BUT because you are likely still in the honeymoon period, you may not see this just yet as your basal needs may be increasing as your remaining beta cells die off.
The other thing to consider is, are you a person who enjoys hot weather or do you find it uncomfortable. If the former, then you may find you need less insulin and if it stresses your body and makes you feel uncomfortable, then you may need more insulin.

As with everything diabetes related, it depends on the individual.

As regards correction factors and doing a correction when your levels are higher than you would like, it was suggested to be that I start with the approach that 1unit of insulin might drop me 3mmols, so if I was on 11mmols before my next meal, a 1unit correction could take me down to about 8mmols or 1.5units would take me down 4.5mmols (3+1.5) to bring me down to about 6.5mmols. I would then add that calculated correction to my meal bolus, so if I was having 40g carbs and I had a meal ratio of 1:10 then I would bolus 4u for the food plus a 1.5u correction so I would dial up 5.5 units and hopefully, if that correction factor was right my levels would be about 6.5mmols when that insulin had finished working (usually about 4-5 hours later..... assuming my basal insulin dose was keeping me steady. If your basal dose is not keeping you steady then you really can't draw any useful conclusions from the result you get, so doing some basal testing is usually the starting point before you start trying to work out correction factors or adjusting meal ratios.

I am giving an example of what was suggested to me for correction factor starting at 1u drops you 3mmols. If you are very sensitive to insulin then 1u might drop you as much as 6mmols. I believe if you use a 1:10 ratio for meals then a 1:3 correction factor is usually somewhere near, but again it can vary with time of day (morning usually being when people need more) and BG levels and can change over time as everything tends to do occasionally with diabetes.

You should not calculate and inject a correction in between meals unless it is more than 4-5 hours after your previous bolus because you will still have active insulin working. So for example, if your levels spike up to 15 two hours after breakfast, DO NOT be tempted to do a correction then because the insulin that you injected for breakfast will still be working and could well bring you down into range by lunchtime and if you were to add extra insulin on top, that could cause you to hypo. However if by lunchtime you are still sitting at 11 or 12mmols then you would add a correction provided that it is 4-5 hours since your last injection.

Once you get more experienced, this advice becomes more flexible and I certainly correct between meals sometimes but until you learn how your body responds then you are best following the guidelines to only correct just before your next meal and add it to your meal bolus.

Have you been offered a DAFNE (Dose Adjustment For Normal Eating) course? If not, then ask about this as it will give you the opportunity to ask lots of questions like this and learn when to adjust your basal doses etc. Mine was a week long course but some places do it as 1 day a week over several weeks. There are usually only 6-8 people on each course, sometimes less, and there is a DSN and diabetes specialist dietician who take the course, so you have the opportunity for lots of questions and can discuss any problems the next morning, when you go through your previous day's results and see what you can learn from them. You also learn how to problem solve for other people as usually people have different issues with their diabetes management. That stands you in good stead for when your diabetes changes and you start experiencing different problems. You also get to spend lots of time with other Type 1s and that in itself can be one of the highlights of the course.
 
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While some of us find the weather can affect our BG (some of us need more insulin and others need less), this is not the only thing.
As you were diagnosed less than a year ago, I wonder whether your increased BG maybe due to more beta cells dying off so your body is producing less insulin.
In my case, this happened over 8 years - every so often I would need to increase my insulin dose until, after 8 years, my dose became stable(ish).

Learning how to adjust your dose and having the confidence to do so comes over time. We learn to recognise patterns and tweak the dose accordingly.
 
What happens for many of us is that we need a little less basal insulin in the summer compared to the winter, BUT because you are likely still in the honeymoon period, you may not see this just yet as your basal needs may be increasing as your remaining beta cells die off.
The other thing to consider is, are you a person who enjoys hot weather or do you find it uncomfortable. If the former, then you may find you need less insulin and if it stresses your body and makes you feel uncomfortable, then you may need more insulin.

As with everything diabetes related, it depends on the individual.

As regards correction factors and doing a correction when your levels are higher than you would like, it was suggested to be that I start with the approach that 1unit of insulin might drop me 3mmols, so if I was on 11mmols before my next meal, a 1unit correction could take me down to about 8mmols or 1.5units would take me down to 4.5mmols (3+1.5) to bring me down to about 6.5mmols. I would then add that calculated correction to my meal bolus, so if I was having 40g carbs and I had a meal ratio of 1:10 then I would bolus 4u for the food plus a 1.5u correction so I would dial up 5.5 units and hopefully, if that correction factor was right my levels would be about 6.5mmols when that insulin had finished working (usually about 4-5 hours later..... assuming my basal insulin dose was keeping me steady. If your basal dose is not keeping you steady then you really can't draw any useful conclusions from the result you get, so doing some basal testing is usually the starting point before you start trying to work out correction factors or adjusting meal ratios.

I am giving an example of what was suggested to me for correction factor starting at 1u drops you 3mmols. If you are very sensitive to insulin then 1u might drop you as much as 6mmols. I believe if you use a 1:10 ratio for meals then a 1:3 correction factor is usually somewhere near, but again it can vary with time of day (morning usually being when people need more) and BG levels and can change over time as everything tends to do occasionally with diabetes.

You should not calculate and inject a correction in between meals unless it is more than 4-5 hours after your previous bolus because you will still have active insulin working. So for example, if your levels spike up to 15 two hours after breakfast, DO NOT be tempted to do a correction then because the insulin that you injected for breakfast will still be working and could well bring you down into range by lunchtime and if you were to add extra insulin on top, that could cause you to hypo. However if by lunchtime you are still sitting at 11 or 12mmols then you would add a correction provided that it is 4-5 hours since your last injection.

Once you get more experienced, this advice becomes more flexible and I certainly correct between meals sometimes but until you learn how your body responds then you are best following the guidelines to only correct just before your next meal and add it to your meal bolus.

Have you been offered a DAFNE (Dose Adjustment For Normal Eating) course? If not, then ask about this as it will give you the opportunity to ask lots of questions like this and learn when to adjust your basal doses etc. Mine was a week long course but some places do it as 1 day a week over several weeks. There are usually only 6-8 people on each course, sometimes less, and there is a DSN and diabetes specialist dietician who scope take the course, so you have the opportunity for lots of questions and can discuss any problems the next morning, when you go through your previous day's results and see what you can learn from them. You also learn how to problem solve for other people as usually people have different issues with their diabetes management. That stands you in good stead for when your diabetes changes and you start experiencing different problems. You also get to spend lots of time with other Type 1s and that in itself can be one of the highlights of the course.
I asked about a DAFNE course but in my area they don’t do it, only offer a one day “carb counting course”, in October so 2 years after my diagnosis.
I’m not sure how much this is going to help as it’s scope seems limited.
 
I asked about a DAFNE course but in my area they don’t do it, only offer a one day “carb counting course”, in October so 2 years after my diagnosis.
I’m not sure how much this is going to help as it’s scope seems limited.
That is a real shame! Some areas offer their own version of DAFNE but I would expect they would have mentioned that if they do it. There is the online BERT1E course that you can do which is a DAFNE equivalent, but sadly not quite the same as an in person course with other Type 1s.

I did a one day carb counting course after a month or so on insulin and there was another newly diagnosed Type 1 guy on that and it was good to compare notes with him. The same diabetes specialist dietician took that day course who also did our DAFNE course, so it might be worth doing that if you haven't already, but after 2 years you may feel you are sufficiently competent with carb counting. DAFNE is so much more than just that and teaches you how to manage your insulin in all sorts of everyday situations like exercise and illness and partying with alcohol and things to consider to keep yourself safe as well as how and when to adjust your basal and how to problem solve when things go awry as they occasionally do with diabetes.
 
Good Shout @rebrascora - the BERTIE Course can be found here


Definitely worth a look 🙂
At this point I'd usually mention https://www.mytype1diabetes.nhs.uk/

That service is closing at the end of the month, though, so if you like its courses then get on and complete them! After that, your login will be usable on MyWay Diabetes. (I've no idea what that is. Looks like it might be a Type 2 thing?)

(I've nothing against BERTIE. Maybe that one freely available service is sufficient.)
 
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