Does it always have to be like this?

[becky_boo]

Hi guys hope everyone is ok?

I've been diagnosed for just over a month now. I am on set insulin units for my nova and lantus, which I have my nova with every meal.

The thing that is annoying me is that I was told I have to have my insulin and my meals at around the same time every day.
But then I am finding it difficult to have a social life.
Thursday I meet up with friends but I had to have my dinner at 6 and missed out on going for a meal with them all later on and was just sat in a pub eating on my own in a big group.
The sunday my boyfriends birthday we had to head out hrs earlier then we would normally because I have to eat at certain times.
Now today I am meeting up with another friend for lunch but we are not meeting till 2.30 (normally eat at 12) so now I am worried about going to low or hight because of this!

I mean I am still all new to this, is there away round all this? I dont want to have to keep cancelling things .

Thanks x

 

[Otenba]

If you can, get yourself on a DAFNE course because that'll help you get the flexibility and confidence you deserve. You can find your nearest DAFNE course here: http://www.dafne.uk.com/all-courses.html

As long as your background insulin (Lantus) dose(s) are correct, then you can eat when you want (keeping in mind what other factors affect your BG will determine what insulin you take each time you decide to eat - this is just diabetic life though). You can test if your Lantus is correct by eating a carb free meal at the time when you want to check it is okay.

Just out of interest, are you still 'honeymooning'? If yes, it's likely your doses will change as you leave the honeymooning period.

Take care.

 

[DeusXM]

It shouldn't be like this at all. The whole point of the Novorapid/Lantus regime is that you should be able to eat what you want, whenever you want. The rigid mealtimes advice comes from the days when people were only on two injections a day and has no place in modern diabetes treatment. Frankly, I think your care team has given you outright wrong advice.

A DAFNE course might be helpful but the essential point is as long as your BG stays fairly stable on Lantus when you don't eat, and you match your Novorapid intake to the carbs you eat, you don't need a special course to eat what you want when you want.

 

[margie]

This shouldn't go on for ever - call your DSN and explain your problem. You should be able to inject (with in reason) around your routine and reduce/ increase your fast acting depending on what you eat. Its possible that your team want you to get used to injecting before giving your flexibility. However, its causing you some distress and so a chat with someone who can tell when you can move to carb counting and self adjustment of doses sounds like it would be good for you.

 

[Otenba]

A DAFNE course might be helpful but the essential point is as long as your BG stays fairly stable on Lantus when you don't eat, and you match your Novorapid intake to the carbs you eat, you don't need a special course to eat what you want when you want.

This is true, however DAFNE covers much more than just carb counting basics - it sums up years of knowledge into a 5-day course. Definitely worth doing, especially with the ignorant advice you've been given so far. 🙂 No loss if you do it either - it's free to all on the NHS.

Whatever happens, I hope things work out okay in the end.
Take care.

 

[jalapino]

I really hope things get better for you x

 

[Doddy]

I am taking the same insulin as you, and I am on the same fixed doses.
This does give you the flexibility to eat when you want which is one reason i changed from mixed insulin.
Once you get your basal right, then its a lot easier to be flexible with meal times. Stick with it, you will get there. I have been on this for approx a month now i think, and find myself wanting to learn to carb count as I still have highs after some meals.

 

[RWJ]

Routine eating

Hi Becky
When I was first diagnosed over 5 years ago, I had the same concerns and ate on my own a lot!
However (if you are as lucky as me) over time I managed to get confidence to vary my insulin (Novorapid x3 and Levimir before bed) to suit having a "normal" working (my job means a variable lunch time) and social life. Always making sure, if I was having a later lunch or dinner, I had snacks available just in case I suddenly went low. ( I carry a small pack of oat cakes, a pack of dextrose tablets and a small can of normal coca cola).
I find as long as you eat and inject together the gaps between meals are fairly flexible. I'm sure, as we are all different, you will get many more opinions. The point is to find your own rules, experiment - but preferably with company (boyfriend etc) in case you miss any symptoms.
Good luck
Ron

 

[robofski]

The whole point of an MDI routine is that you should have the flexibility to eat when you want and to a certain extent, what you want! In fact if your on fixed doses of NR then when you eat shouldn't be a problem, it's what you eat that will be the issue, this is why learning to adjust your dose based on what you're eating becomes so important.

I too started on a fixed does of NR but it was pretty pointless as I don't eat the same thing every meal. I very quickly learnt the basics thanks to the folks on here and just started making the adjustments to my NR dose myself.

With a stable basal it's so much freedom, if I want to skip a meal, I can, if I want to eat at stupid o'clock I can, MDI really does make life semi normal!

Speak to your DSN about moving on down the road, you shouldn't have to live with these restrictions.

 

[Northerner]

Agree with all that others have said, would just add that one thing to be awareof if you have a shifting/flexible mealtime is that you may have some insulin still working from a previous injection when you come to inject again. Novorapid can stay active for up to 5 hours, although it does tail off towards the end, but you have to be aware of 'stacking' your insulin injections.

 

[DeusXM]

No loss if you do it either - it's free to all on the NHS.

Absolutely - if you've got the spare time, definitely go do it. I'm only sceptical about DAFNE as they always want me to do a five-day thing. When you've got a job, you don't really want to take off five days worth of sick leave or lose five days of holiday time.

 

[Pigeon]

Absolutely - if you've got the spare time, definitely go do it. I'm only sceptical about DAFNE as they always want me to do a five-day thing. When you've got a job, you don't really want to take off five days worth of sick leave or lose five days of holiday time.

It's not always 5 days solid. My course was in newcastle, called SNACCS (Specialist kNowledge About Carbohydrate Counting for Self-management!) and was 4 mornings, each a week apart. Work were fine about me having time off to do it, I was newly diagnosed and they knew it would help me in the long run so I didn't have to take annual leave or anything. I think it's always worth asking, if you have an understanding boss!

 

[trophywench]

DAFNE never is split it's always a whole week.

However, other courses (usually based around the BERTIE course) are delivered on day a week for X weeks, Cov & Warwicks CARBS 4 1 course is like that. Each week, you put into practice what you've learned so it's a gradual build up to far better BGs for everyone.

My company moaned like hell, I'd been there 9 years - why NOW? I said You've only had to wait 9 years for it, I've been waiting 35, get over it.

Seriously the best thing I've ever done for my diabetes. And very enjoyable anyway!

 

[becky_boo]

Hey thaanks guys i was just having one of them moments yesterday =)

I am or was going through the honeymoon period pretty badly but i am not having asa many hypos now and am running quite hight a lot now so hopefully that means the honeymoon is over!!! lol Seeing my team today so im sure i will find out then.

I really want to do the DAFNE course but my team said i am going to stay with them (at the hospital) for a few months then they will send me to the community people and they will assess me and then send me for the course.

Ive only been diagnosed for just over a month so still learning, but I am so grateful to have a place like this to get your input =D xxx

 

[PattiEvans]

I've never heard of anyone having to go to community assessors... but if you are ready and willing to learn there's a very good course you can do online, it's written by the same people (BERTIE) as the course Trophywench went on. See this link http://www.bdec-e-learning.com/welcome.asp?M=LOG293&Err=293&CID=C20041119145024-839850473
I taught myself from a previous version of that some years ago. It's a very good course. At the end of the day, it's your diabetes and you have to be 99% of your diabetic team - which is really nice actually, cos it enables you to work with the medics rather than having everything done "to" you.

 

[Otenba]

Absolutely - if you've got the spare time, definitely go do it. I'm only sceptical about DAFNE as they always want me to do a five-day thing. When you've got a job, you don't really want to take off five days worth of sick leave or lose five days of holiday time.

Heya. 🙂

I know what you mean. Unfortunately most of it isn't something you can do in one day. They have the 5 days to help with the learning process because most classes will have individuals from different walks of life and understanding of their condition.

I think I was quite lucky with my arrangement because I'm full time work too. I had to convince my employer that they'd get the benefit of me being even less likely to go off sick if I did it - stuff like that. HR did some background research to get an idea and they were happy to give me a few days special leave and I covered the rest with what remaining holiday I had. I did mine around the end of the financial year (April to May time) so I finished off last years holiday for it.

Discussion threads by DAFNE graduates if anyone's interested:
http://www.dafneonline.co.uk/forums/1/topics/255
http://dafneonline.co.uk/forums/1/topics/254

Hi there, been a graduate myself for over a year. In answer to your question, my employer has over 4000 employees and at first I was asked to take sick leave. When discussed further I found that I was actually entitled to attend the course under the DDA (Disability Act). Therefore did not cost me annual leave or my very good sickness record. Diabetics are covered under the disability act.
Regards
Sarah

(from page 2 here of first link)

I wonder if this is true? I doubt I can speak up about it now if it is. XD

 

[DeusXM]

Unfortunately most of it isn't something you can do in one day.

Very true. What DAFNE tries to teach is something that even the very best spend their whole lives learning. I still think though that there is a point where DAFNE becomes less useful. I've had diabetes for 14 years and have packed a LOT of weird foods, lifestyles and activities into that time. I know it sounds arrogant but I'm not convinced DAFNE can teach me anything I don't already know - if it was a morning thing I might do it, but I'm not inclined to miss a week's worth of work when probably 4 and a half days of it are already under my belt.

I had to convince my employer that they'd get the benefit of me being even less likely to go off sick if I did it - stuff like that. HR did some background research to get an idea and they were happy to give me a few days special leave and I covered the rest with what remaining holiday I had. I did mine around the end of the financial year (April to May time) so I finished off last years holiday for it.

See, I'm not convinced by that. In the last five years I've had two sick days, when I was hospitalised for pneumonia (this was in the Middle East in summer as well, hilarious!). I also don't really feel inclined to contribute my holiday time to this stuff - if I'm taking a week off, I'm using it to go somewhere fun. But yeah, DAFNE still does have value for the newly dxed and should be offered as standard to everyone on MDI within 3 months of diagnosis.

 

[KateF]

(from page 2 here of first link)

I wonder if this is true? I doubt I can speak up about it now if it is. XD

Hi Otenba, It is true that diabetes is a disability under the Equality Act (was Disability Discrimination Act) however what that means is that the employer must consider what reasonable adjustments it can make. It doesn't mean that all employees are entitled to paid time off for a dafne course. The employer in that person's case decided that they would provide the time, but I see no reason why other employers couldn't ask the person to take all or some as annual leave, as it is all about what is reasonable for that employer to do at that time.

 

[KateF]

To the original poster: My OH was originally put on 2x daily insulin and told to eat to that - so in theory a fixed carb amount and fairly fixed eating times. 4 months in to being on insulin (just the other week) he asked to go basal bolus and we are reading the guidelines from DUK on carb counting/dose adjustment and doing the online course from BDEC (no dafne or anything else offered in our area). As you learn more about managing your diabetes and are on the right routine you will be able to adapt to your lifestyle.

We too had problems going out and not being able to eat at the right time, hence saying that the routine the consultant went for was just no good for us as we want to have a life too. You will get to a better place as you tell the DSN you want to change and use the online education too.