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A thankyou :)

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Doddy said:
Thankyou for your "explanation" Northerner x

I am wondering if I will eventually go onto Carb counting, therefore injecting for what I eat. I am the opposite to you in that my meals are fairly different...depending on how fussy the children are being! If i knew I was going to be injecting according food, I think i would find it a lot easier and know what I am doing, whereas at the moment, I am still getting higher figures if I eat the wrong things. I know I am still titrating, but the fact that different food does different things to my numbers...surely it makes sense to carb count and inject accordingly. I guess my question is, can a T1.5 do this, or is this regime only suitable for T1's. Is my GP only finding the benchmark figures and will then go on to teach me carb counting.
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YES!! Abso-bloomin-lutely! I think all of us pancreas-pretenders have to accept the whole 'moving goalpost' thing as part and parcel of the deal with D. So many variables affect the outcomes that it is partly by applying theory and largely by applying the 'wisdom' of experience that I try to make things work day to day. Who, in all honesty, ever has two days exactly the same? When it comes down to trips up and down the stairs... how stressed or otherwise one might be feeling... how warm the weather is... weekday... weekend... being busy... being relaxed...

There are so many variables that like Northerner I tend to stick to fairly consistent breakfasts/lunches most days (carb counted, but usually within a 5-10 grams of each other and very often pretty much identical components). Evening meals tend to be more varied, but are often very similar carb load.

I would not wait to start gathering your data, writing things down, and guestimating (and/or weighing/calculating) the carb counts of meals you are having. Sure the doses that work this month might be different in six months time, but a rolling programme of food/doses 'in' and results 'out' and a little compare and contrast pattern spotting can really help you when it comes to wild 'stab in the dark' celebrations/unusual meals.
 
everydayupsanddowns said:
...I would not wait to start gathering your data, writing things down, and guestimating (and/or weighing/calculating) the carb counts of meals you are having. Sure the doses that work this month might be different in six months time, but a rolling programme of food/doses 'in' and results 'out' and a little compare and contrast pattern spotting can really help you when it comes to wild 'stab in the dark' celebrations/unusual meals.
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I do hope I didn't confuse you Doddy! Mike is right - you should start writing your food diary now, along with your before and after BG readings. List the carb content of each meal/snack separately - you may be surprised that, even thought the meals appear to be very varied, the carb content is actually quite similar. For those that are quite different in carb content you would make the adjustment up or down on the dose you need. You will be surprised how quickly you accumulate data and experience that will help inform all your dosing choices, and this is basically what I work off now. 🙂
 
Thanks Alan! Sorry if my post was confusing 😱
 
Your post was fine 😉

I shall start to keep a log more strictly now. I am guessing I shouldn't do the 1u-10g tho?? Should I just inject what the dr has told me too? I wonder whether I should just do the ratio thing and see what happens or would this be wrong of me.
 
Are you being totally managed by your GP and not a Diabetes Specialist? My GP is scarily ignorant about insulin in particular. Very good with checking feet etc, but hadn't got a clue about Lantus. Told my son to up his Lantus by 10-15 units in one hit - scary stuff. Specialists have told him NEVER to increase by 1 or 2 units at a time and give it several days to settle at the new level (and I believe sometimes the rule is no more than 10% increase, which would only then be 2-3 units max).

When my son was diagnosed, he was put on Lantus and Novorapid, initially on fixed doses. Within just days he/we were taught to carb count, and told to basically (within reason) eat what you normally would, just modifying drinks, diet rather than full sugar drinks, sweetener rather than sugar in tea/coffee etc, but otherwise carry on as you normally would. Carb count everything, and as people have said, start at the rate of 1u of Novorapid for every 10g carbs. Very very quickly we saw his levels come down really well. They watched it for a few days, if his morning (fasting) levels started to rise, or were generally a bit higher than they wanted, they bumped his Lantus up by 1u. They would give that a week or two to settle, and if it was still too high they would bump it up 1u again. It would tend to settle for a few weeks, then we had to start dropping the Lantus down again, probably honeymoon bit. Now, 18 months on, his Lantus has been tweaked up again. The Novorapid relates to carb intake though, so saw his levels pre-meal get better and better. It really does work well, if the ratio is right.

BUT, as I said, his GP told him to go from 25 to 35 or 40 units in one go once, fortunately my son didn't. It scares me to think what would have happened had he have done, because it only ever got ramped up to 28u.

Have you ever been seen by a specialist? Could you ask to see one, and a Diabetes Specialist Dietician? Ours was great - even gave us a free set of digital scales! (Mind you, I believe they were funded by the local Children with Diabetes Group).

Carb counting really does work though. Ask for guidance ASAP. It will transform things, it really will.
 
As far as I'm concerned you can go at this from either end...

When I was first diagnosed it was customary for Drs to give you both doses and carb counts for all your meals/snacks etc. So you would know what [fixed] injections amounts you were going to give, and also had a set number of grams of carbs to 'match'. Xg for breakfast... Yg for lunch... and so on.

After a while I sort of worked out a basic 'rule of thumb' to increase/reduce doses where meals were substantially larger (or smaller) than 'normal', but by and large meal sizes were pretty fixed. More recently I've followed the current vogue for dividing everything down to units per 10g carbs and/or expected BG change for 1u.

If you want to keep to your fixed doses that's fine, but keeping a record of your meal sizes (and keeping them consistent from day to day) will help enormously. If you find 40g of carbs at breakfast keeps meaning you are hypo late morning, try upping it to 50g. That sort of thing...

If your doses are fixed you need to be eating fixed 'sized' meals (in terms of grams of carbs). If you vary the amount of carbs you are eating meal by meal, you need to adjust the doses meal by meal.

M
 
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Doddy said:
Your post was fine 😉

I shall start to keep a log more strictly now. I am guessing I shouldn't do the 1u-10g tho?? Should I just inject what the dr has told me too? I wonder whether I should just do the ratio thing and see what happens or would this be wrong of me.
Click to expand...

I was in the same situation, started with having a fixed amount of NovoRapid with evening meal, I could see this wasn't doing what it should have been so started taking it before every meal, could see that 1u:10g wasn't having the desired effect so started experimenting with the dose and found what worked for me all without any consultation with my DSN. Brought her up to speed with what I'd done when I saw her last week and she was happy enough.

People on here are what gave me the confidence to "go for it" I was pretty nervous about playing with my meds on my own, but I had a good understanding of the risks and felt that I knew what I was doing.

I think ultimately you have to feel confident in your treatment and your administration of the treatment, if you're not 100% then work closely with your DSN and take baby steps.

Good luck with it 🙂
 
Your replies are amazing, and are giving me the confidence to do this.

I have only seen my GP, but she does seem pretty clued up on Diabetes. I know she is the GP at the surgery who has a particular interest in Diabetes, which is why i went to her in the first place. I think if i told her I wanted to carb count, she would be fine with it.

My meals are very rarely the same, and I would feel I was doing the right thing to go ahead and carb count and dose accordingly. It seems to work well for all of you..I just wasnt' sure if it would for me, but hearing all your comments, it has to be worth a go.

You are all amazing 🙂

Thankyou 🙂
 
I shall take a look, thankyou 🙂
 
I found it a HUGE relief for there to be some 'science' or should I say 'logic' to what I injected for what amount of carbs.
 
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