A not new newbie

[Radders]

Thank you, I will contact the surgery in the morning and also start the basal testing process, the problem I have is that the advice it gives about things to do when basal testing, for example not being stressed I am going to struggle with because I am so stressed at the moment, so I am unsure whether it will be accurate or not?

Hi Sarah.

It will be accurate for times when you’re stressed, which is a start. The thing is to start somewhere and take things one at a time. My priority would be to work out if you can what caused the hypos at work and try to prevent those as they obviously distress you. Do you have any idea what might have caused them? Or any thoughts about something straightforward you could change?

 

[Sarah JW]

Hi Sarah.

It will be accurate for times when you’re stressed, which is a start. The thing is to start somewhere and take things one at a time. My priority would be to work out if you can what caused the hypos at work and try to prevent those as they obviously distress you. Do you have any idea what might have caused them? Or any thoughts about something straightforward you could change?

I think that some of the problem at work is because I am so busy I dont get chance to eat all my lunch and then went hypo because I had already jabbed for it, Iv tried jabbing afterwards, but that is worse because I forget and then am hi. I am ging to try and do a basal test starting tonight. I hate`the attention that hypos bring

 

[Northerner]

I think that some of the problem at work is because I am so busy I dont get chance to eat all my lunch and then went hypo because I had already jabbed for it, Iv tried jabbing afterwards, but that is worse because I forget and then am hi. I am ging to try and do a basal test starting tonight. I hate`the attention that hypos bring

Sarah, start putting your foot down. I've worked in very busy environments too, but when you have diabetes you must take time to think of yourself, inject and eat properly - the job can wait, your well-being is far too important! 🙂 Everyone is fully entitled to a proper lunch break, so make sure people know you intend to have yours and whatever it is can wait 🙂

 

[SB2015]

I think that some of the problem at work is because I am so busy I dont get chance to eat all my lunch and then went hypo because I had already jabbed for it, Iv tried jabbing afterwards, but that is worse because I forget and then am hi. I am ging to try and do a basal test starting tonight. I hate`the attention that hypos bring

Hi Sarah

I understand ‘not wanting to make a fuss’ but we can’t ignore things like eating to go along injections. Do you have a good line manager? Can you talk to them about this. Although that may seem very difficult it may make less of a fuss as if you can get time to eat lunch and inject. (I was amazed at the very unexpected level of support I got having missed a meeting due to having a hypo 1 week into a new job). The spike that you may get if you inject as you start eating may for now be less of a problem than a hypo if you split the injection and food. However busy your job is they need to allow you to take care of yourself. I wasn’t sure what help to ask for at the start as I was only a couple of months into it and had no idea how to manage what I was doing. We gradually worked out a way of working round potential problems.

As others have said, it is very unlikely that a practice nurse will know anywhere as much as you do about T1. Keep pressing for the referral to the specialist team. They are there to help us and very familiar with the difficulties that we all have at times with managing all that we have to do. They will no doubt be impressed with your wanting to get this sorted and will be able to help you.

 

[HOBIE]

Power to you Sarah JW. It is hard work at times being T1. Stress all ways makes me go low because your head is doing overtime. You are surviving 😉. Good luck

 

[Sarah JW]

I will try to speak with my line manager about it, they are aware and there is a big focus at the moment about staff well being and everyone making sure they have lunch, I think the problem is me, and the expectations I put on myself to make sure everything is completed and everyone is happy. It also has an impact on my evening meal as I stay late most days which then has an impact on my tea, I get hungry then snack and then dont jab for it and end up sky high. I dont want diabetes to stop me being good at my job, I hate everything about diabetes and the fact that it has so much control and power over my life. I hate going for check ups, I hate and have such bad memories of going to out pt clinics in the hospital as a child.
I tried the basal rate testing last night, but had to stop as was hypo at 2am, again over treated and sky high this morning. I used to be pretty good at not over treating a third of a bottle of lucozade was great, but the reduced sugar has now thrown me and Im not sure how much to have

 

[Radders]

The usual recommended hypo treatment is 15g carbs. It’s quite straightforward (when you’re not hypo!) to work out how much that is from the info on the label. Give a shout if you need help to do that. Alternatively I normally use Dextrosol tablets which are 3G carbs each, others swear by jelly babies. There’s a simple thing you can do straight away to help you take control: work out in advance exactly what you are going to do next time hypos strike. That way you don’t need to worry about it when you’re actually hypo.

 

[Sarah JW]

The usual recommended hypo treatment is 15g carbs. It’s quite straightforward (when you’re not hypo!) to work out how much that is from the info on the label. Give a shout if you need help to do that. Alternatively I normally use Dextrosol tablets which are 3G carbs each, others swear by jelly babies. There’s a simple thing you can do straight away to help you take control: work out in advance exactly what you are going to do next time hypos strike. That way you don’t need to worry about it when you’re actually hypo.

Thank you, I have always used lucozade and had it sorted as when I was younger would over treat so was quite proud of myself as an adult to train myself to a third of a bottle. I will have a look at what I can use, I cant stand dextrose tablets so will work out the jelly babies, or another sugary drink

 

[SB2015]

Thank you, I have always used lucozade and had it sorted as when I was younger would over treat so was quite proud of myself as an adult to train myself to a third of a bottle. I will have a look at what I can use, I cant stand dextrose tablets so will work out the jelly babies, or another sugary drink

It must be hard having had a regime that worked and now having to adapt it again. I think others have found the changes in the sugar content in drinks has been a hassle.

If your basal rate test left you hypo in the night that could mean that your background insulin is too high over night. Are you on a split background? Some have found switching to Levemir and then splitting that gives them more flexibility to make changes

One thing that helped me to avoid overtreating a hypo is that I have set a 15 min reminder to retest on my handset. I used to have it set at 10 min and too often I was not back in range, but that extra 5 min has helped and I do get back up in general.

 

[Radders]

It must be hard having had a regime that worked and now having to adapt it again. I think others have found the changes in the sugar content in drinks has been a hassle.

If your basal rate test left you hypo in the night that could mean that your background insulin is too high over night. Are you on a split background? Some have found switching to Levemir and then splitting that gives them more flexibility to make changes

One thing that helped me to avoid overtreating a hypo is that I have set a 15 min reminder to retest on my handset. I used to have it set at 10 min and too often I was not back in range, but that extra 5 min has helped and I do get back up in general.

I have to wait 20 minutes.

 

[Sarah JW]

It must be hard having had a regime that worked and now having to adapt it again. I think others have found the changes in the sugar content in drinks has been a hassle.

If your basal rate test left you hypo in the night that could mean that your background insulin is too high over night. Are you on a split background? Some have found switching to Levemir and then splitting that gives them more flexibility to make changes

One thing that helped me to avoid overtreating a hypo is that I have set a 15 min reminder to retest on my handset. I used to have it set at 10 min and too often I was not back in range, but that extra 5 min has helped and I do get back up in general.

Yes I am on split Levemir, I have done 2 basal rate tests over night now and am absolutely shattered, I have gone hypo in the night both times, so will look at reducing evening levemir.
It is the immediate panic when hypo, that is causing me to have far more than I need, so found that the lucozade wasnt making me feel better and so am eating half a packet of biscuits

 

[SB2015]

Yes I am on split Levemir, I have done 2 basal rate tests over night now and am absolutely shattered, I have gone hypo in the night both times, so will look at reducing evening levemir.
It is the immediate panic when hypo, that is causing me to have far more than I need, so found that the lucozade wasnt making me feel better and so am eating half a packet of biscuits

Well done for managing the overnight basal tests, especially as it is so exhausting having to wake to test regularly through the night. I hope that the night time reduction in Levemir sorts the night hypos out. I remember being told to get the nights sorted first as you can then start the day well and work on other things.

It is very hard not to panic when having a hypo, especially if you have had a bad experience with one. Certainly quick acting glucose should bring you back up more quickly than biscuits, but if that is not working you could ask for a prescription of hypostop which is simply liquid glucose. Sickly but effective. I was told that on a pump I no longer needed my biscuit after treating a hypo. I kind of missed that so sometimes just have one (with a bit of insuiln) anyway.

You are dinog the right things and just need to keep giong one step at a time.

 

[Sarah JW]

Well done for managing the overnight basal tests, especially as it is so exhausting having to wake to test regularly through the night. I hope that the night time reduction in Levemir sorts the night hypos out. I remember being told to get the nights sorted first as you can then start the day well and work on other things.

It is very hard not to panic when having a hypo, especially if you have had a bad experience with one. Certainly quick acting glucose should bring you back up more quickly than biscuits, but if that is not working you could ask for a prescription of hypostop which is simply liquid glucose. Sickly but effective. I was told that on a pump I no longer needed my biscuit after treating a hypo. I kind of missed that so sometimes just have one (with a bit of insuiln) anyway.

You are dinog the right things and just need to keep giong one step at a time.

Thank you so much everyone for the support, I really appreciate it. Last night was hypo free (I think) but woke up with BM of 27.3,so maybe was hypo, also had hypo this evening, Im not sure whether the weather maybe affecting me. Does this happen to anyone else?
I have not done my insulin for my tea this evening and am going to correct at bedtime because I was so scared of going hypo again

 

[SB2015]

Good morning Sarah.

Can you think of other reasons why you were high yesterday morning?
As you say it could be that you had a hypo and still need to drop your night time Levemir
Did you do your bolus injection the night before?
Was the meal you ate particularly large, did it have a lot of fat in it, was it a curry or pizza (notoriously difficult to manage)

With the evening meal and corrections, I have found it helpful to eat no later than 6:30 (where possible) to give my body time to process the food before I go to bed, and then I know that I can also correct if needed as I may we’ll have got my carbs out a bit. It is a bit restrictive but I have found it worth it.

With all that you are dealing with, it certainly sounds like you would benefit from getting a referral to the specialist Diabetes team at your hospital. The only T1s that I am aware of who happily rely on the services of their GP surgery are ones that are very balanced. I would never want to be without the support of the DSN and Consultant. I know that they are there to help and that when I am getting in a muddle they will respond to emails or I can phone them. I would encourage you to get a referral. I know it may be difficult to find time for this but I think that it could help you to get things back on track.

You are already taking steps to sort out your levels. Stick to the two Levemir injections, adjusting them as necessary, and always inject for any food you eat. Then gradually work on each of your different ratios for injections, just as you have started to do. A DSN could help by looking at your results with you. They do not judge, they are there to help you sort things out.

 

[Sarah JW]

Good morning Sarah.

Can you think of other reasons why you were high yesterday morning?
As you say it could be that you had a hypo and still need to drop your night time Levemir
Did you do your bolus injection the night before?
Was the meal you ate particularly large, did it have a lot of fat in it, was it a curry or pizza (notoriously difficult to manage)

With the evening meal and corrections, I have found it helpful to eat no later than 6:30 (where possible) to give my body time to process the food before I go to bed, and then I know that I can also correct if needed as I may we’ll have got my carbs out a bit. It is a bit restrictive but I have found it worth it.

With all that you are dealing with, it certainly sounds like you would benefit from getting a referral to the specialist Diabetes team at your hospital. The only T1s that I am aware of who happily rely on the services of their GP surgery are ones that are very balanced. I would never want to be without the support of the DSN and Consultant. I know that they are there to help and that when I am getting in a muddle they will respond to emails or I can phone them. I would encourage you to get a referral. I know it may be difficult to find time for this but I think that it could help you to get things back on track.

You are already taking steps to sort out your levels. Stick to the two Levemir injections, adjusting them as necessary, and always inject for any food you eat. Then gradually work on each of your different ratios for injections, just as you have started to do. A DSN could help by looking at your results with you. They do not judge, they are there to help you sort things out.

Thank you so much for the advice, I have been on to the gp nurse asking for referral over to DSN
I find it really hard not to eat late because by the time I have finished work and sorted my grandma who has dementia, I rarely get home before 8pm

 

[SB2015]

Ideal meal times are not always practical, so we have to make the best fit we can for the Diabetes to work with our lives. Just tackle things step and by step.

If you can’t ge the Pratice nurse to give you a referral can you go back to your GP. I am sure you would benefit from some specialist advice, and the Practiec will struggle to help you alter ratios etc.

 

[Sarah JW]

The practice nurse is getting annoyed with me, I have contacted her several times to check whether she referred me. I know she hasnt because I ahve spoken to the SDN and they havnt received a referral, I have now given up, the nurse just keeps trying to get me to change my machine when she knows full well I dont want to. I phoned and requested a gp call back on fri, so I am hoping that they get back to me monday. My friend has suggested I just go in and see the gp, but I am so fed up of wasting my life with all these apointments I just want to be normal

 

[SB2015]

It may be that the referral would have to be done by the GP, rather than the nurse, so it is good that you are arranging for a call back. Are you able to book appointments online? As a back up you could book an appointment with the GP, so that if they have not phoned you back there is that in place.

The only T1s that should be managed by the GP surgery are those that are stable and self managing, but they should always be able to refer back to the specialists. The nurse getting annoyed is not your problem, although I know it must be irritating and tiring, and just adds to the stress. Once you are in the hands of the specialists they will be able to support you appropriately. Stick at this phase as in the long run once you have the help to get things should get easier.

 

[Ruby/London]

Hi
I have posted a little while ago, I am not new to diabetes having been diagnosed in 1980, however I am relatively new to this site. I am really struggling at the moment with a variety of things in my life and a bit worried about disclosing all of which to one of these sites. My diabetes is all over the place, HBA1C the highest it has been for a while and I feel out of control with it. I feel scared of going back to see practice nurse or even the diabetes nurses as I feel that I should know what I am doing. I have such a busy life both at work and at home and just feel so helpless at the moment to make changes, then feeling guilty about not making changes. I just do not know what to do, I feel so empty

Personally, I'd ditch the guilt, take a deep breath and make an appointment. I think it is important that your support team know how much you are struggling and would want to support you. It might also be useful to ask for a referral for some counselling, talking therapies can be a great help and it sounds like you might also be struggling with exhaustion/depression, which wouldn't be at all surprising from what you have described.

Sending you a virtual hug - sounds like you need one. Don't worry about sorting it all out - a step at a time...

Good luck, Sarah and it would be good to hear how you are getting on - even if you don't feel ready to make changes.

Update...
Glad to hear you have taken the plunge and contacted the practice but sorry to hear that the practice nurse is not being helpful. Persevere . Personally, I'd make an appointment to see the GP to discuss your options and see if he can hurry this referral along. It might also be worth asking if there is any help for carers, even a coffee with a local carers group can make a difference. You need a support network, online and offline, by the sounds of it.

 

[HOBIE]

Please look after yourself & your grandma. Have you thought about a Pump ? I am self-employed & never know if I am up ladders or scaffold. I put a temp basal on when it suits. Good luck 😉