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Advice

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
I am sorry to hear you are so worried. Yes going onto insulin is scary, imo it’s being made much harder for you because and I am sorry to say this, your nurse. In my non medical opinion once she realised how sensitive you were just to the basal insulin, she imo should have reduced the units especially the evening one even more. Tbh if I was in your shoes I would reduce it.

The sooner you get to see/speak to a DSN the better. So when you next speak to thepractice nurse diabetes nurse (dn) tell her like it is for you , don’t hold back.

I have been reading here but not posting much as you are being given such good advise.

It’s easier for us as we have been on insulin for some time, we’ve learnt how to handle things and this may sound strange to you but we know far more about our own particular diabetes than our DNs( practice nurse) .
It will get easier honest ! But at the moment you are on a very steep learning curve and probably suffering from information overload as well as being so worried.
Though you may not think so right now ,you are actually handling things very well !
 
I agree with Lin - you are being really logical in the way you are approaching things and trying to work out how something happened and what you can do instead to try and avoid the same scenario happening again.

Scary - Oh yes, to begin with it's frightening. Soon you'll venture to change something all by yourself - and be allowed to gloat about your expert advice to yourself!
 
I am really sorry if my posts have caused you undue anxiety but I really felt that you didn't fully appreciate the difference between daytime and night time hypos and were not fully understanding how powerful insulin is. I understand that it is difficult for your health care professionals to guestimate that first starting dose but it was obvious to all of us that the night time one particularly was too high and dangerous. This should be a time when you are learning to build confidence with your insulin but it is a very powerful and potentially lethal medicine and the dose is quite critical, particularly for someone like yourself who is underweight and very insulin sensitive.
It may be that being able to see what is happening to you written down and ask questions of you is making it easier for us to interpret what is going on better than a telephone conversation with the nurse. As others have said, she will be used to dealing with Type 2 diabetics who are insulin resistant and often take much larger doses..... sometimes as much as 50 or even 100 units at a go, so you can see how 5 units may seem like a very small amount to her and not of concern, whereas a diabetic specialist nurse who deals mostly with Type 1 diabetics would, I am sure, have spotted the need for more of a reduction. I don't blame your DN who I am sure is doing her best and may be getting guidance from a DSN but when information is relayed via a third party, some can get lost or misunderstood. I am sure she is lovely and most likely good at her job but she is being asked to deal with something which is above her level of training.... possibly due to the Covid situation.

As regards my night time hypo, I have had rather too many recently and whilst I am used to them now and thankfully they are not bad ones and I have confidence that I can cope with them, I have to be aware that that confidence can easily lead to complacency which is a very real danger for us. I am trying different strategies to prevent them but it is difficult to fix and sometimes a pump is the only answer, because my basal needs don't match with the profile of basal insulins available at the moment. I would not have been experienced enough to cope with one in the first few days of starting on insulin and it would have made me terrified to go to sleep if I had.

Your evening strategy sounds like it was a good one and I hope you had a safe night and you are feeling a little less anxious today. Please let us know how you got on when you have time.
 
Your very large snack should have kept things ok @LittleSunflower and I hope you had a good night. But you shouldn’t need to be eating mega bedtime snacks to ward off the effects of too much nighttime Levemir. A smaller dose would be more sensible. I’m sure you can see the logic in that. You’re doing really well and have a very good understanding of what’s going on, I think, so don’t underestimate what you’re doing. You’re doing well - genuinely 🙂
 
Good morning all, thank you for your words of encouragement and support. Needless to say there have been more tears but it’s not surprising with everything that’s going on. I suppose it’s better than keeping it bottled up.
@rebrascora please don’t be sorry, I would much rather know all of what you’ve told me than to be oblivious, for something to happen and for me not to know how to treat or what was going on. So thank you.

I am still very anxious this morning and didn’t have the best nights sleep which has caused some sort of trapped nerve headache in the back of my neck and lower head. It’s pulsating as if it’s been tense for so long (of which it has for the last few days due to all of the information). Took a paracetamol in hope that helps.

BUT back to my diabetes, I managed to finally pluck up the courage to test my BG levels myself twice already and take my 5 units of Insulin without any help.
I tested around 4-5am and was 6.6. I tested again at 8:30am and was 5.8 (the same as yesterday morning). I had my normal breakfast of two slices of wholemeal marmite toast and as I said, took the 5 units of Levemir shortly after. Feeling quite peckish now so maybe a light snack before lunch. Hope you are all keeping well yourselves today X
 
Sorry to hear you have a tense neck and stress headache but totally understandable in the circumstances and it is important to treat pain with appropriate medication because pain and inflammation also impact BG levels, so you did the right thing talking paracetamol.

I have to say, those are great readings!! I am actually quite jealous! You are managing things really well with your snacks but as @Inka says, if you don't want to continue to eat a lot at bedtime, reducing that Levemir by another unit would be the thing to do. I know you are slim and I believe could perhaps do with putting on some weight from other thigs you have said, so if you are happy continuing with the bedtime eating and the current 4 units then it shouldn't be a problem, but if it feels like it is an effort to eat so much just to keep you from dropping too low through the night (which is what we call "eating to your insulin") then a further dose reduction at night would be sensible with only a small snack.

Hope you have a good day and look forward to a progress report later if you have time.

It is often the case that you are quite hungry once you start on insulin because your body has been struggling to utilize the energy from the food you have been eating without enough insulin and so you have been living off your body stores, but with insulin now, the body wants to replace those body stores and needs more food to do that, so your brain tells you you need to eat more ie you are hungry. It is all a very clever system, especially when it works right. You will learn to have a huge appreciation for just how clever the pancreas is (or was in our case as diabetics) once you learn all about how many things affect your BG levels and how it balanced everything once you learn to (try to) do it all manually by injecting insulin. I say "try to" because we never get it right all the time. Some people's levels are easier to balance than others and it is highly individual but no one gets it right all the time and striving for perfection is the way of madness. All you can do is your best and limit the risks and try to figure out what went wrong when things go awry so that you can improve next time but there are plenty of occasions when you just never figure out why it didn't go to plan and you just have to shrug and move on.
 
How are you today @rebrascora?
I would be in even more of a state without yours and everyone else’s input this past week. I am very appreciative of everything you’ve told me.
My lunch time reading was 9.7 (as I had a banana for snack which most likely boosted my sugars up). I fell asleep for a good few hours and woke up with a 5.2 before dinner - definitely began to feel sick and shaky so had a chocolate digestive and a small cup of milk before dinner too.
I am going to stick with the 4 units this evening as I will also have the same large snack again. Like you mentioned, I do need to gain the weight and feel better knowing I’ve had something and not changed the dose again so soon. If that needs to be done, I’m sure it will be but as of right now, it feels better to have the snack and stick with those 4 units.
Having struggled with an eating disorder for the most part of my life, I cannot believe how well I am coping with the amount of food I am eating. 3 meals and 3 snacks a day thus far, with that hunger feeling along the way too and no ill feeling towards it as I know I have to eat otherwise it will be dangerous for me, having started on the insulin. Don’t get me wrong, I definitely have those rough moments (such as last night when I wrote that post about not being able to cope) but those of you on here, have reassured me that I am not alone in this and that insulin is to help me feel better.
Tuesday/Wednesday felt like the end of my little world, no idea how I was supposed to test my BG levels or inject myself.. 3 days later I am able to do this. Thank you for believing and supporting me through this journey 🙂
 
So pleased you are coming to terms with the practicalities of testing and injecting a little bit. It will eventually become almost second nature. We all know what a huge shock it is, so we understand how you are feeling. You really are coping brilliantly in the circumstance, so be proud of yourself and what you are achieving. I think you are wise to stick with your evening dose and snack regime again tonight because diabetes really likes consistency (it is my big failing 🙄 ) and it will help to build your confidence, which is a huge factor in itself.
Hope your neck/headache has eased and you have a better night's sleep.

As regards my day, so kind of you to ask, but unfortunately I managed to pull a calf muscle whilst out running this morning so had to hobble home and that put paid to me digging up a water pipe to replace a water trough for my horses or much else I had planned for this afternoon, but I pottered on in the kitchen making some duck carrot and orange soup with a leftover carcass and I'm having that for dinner now and I had a lovely long chat on the phone with my best mate who has just returned from Australia, so the day has improved as it has gone on! 🙂
 
Yes, I thought it would be best to stick with the 4 with the consistency element too. I will probably set an alarm to test in the middle of the night just to be on the safe side again although like @Inka said, the large snack should help take me through the night (of which it did last).

The headache has moved to the other side now but I do believe it’s just from me clenching my jaw with anxiety for the past few days. I didn’t realise I was so tense until I thought about relaxing, everything started to ache. Another paracetamol and some more rest should do the trick, I hope.

Sorry to hear you pulled a muscle :( It definitely sounds like you’ve had a good day apart from that little set back this morning. I hope you’re taking it easy whilst having that delicious sounding, homemade soup this evening. The perfect type of meal to warm you up too in this chilly weather.
 
BG before insulin is 16.5 this evening. Much higher than I thought it would be
 
What did you eat for your evening meal @LittleSunflower Did you retest just to make sure? Your blood sugar seems to go high later in the day. Novorapid will help with that.
 
Inka said:
What did you eat for your evening meal @LittleSunflower Did you retest just to make sure? Your blood sugar seems to go high later in the day. Novorapid will help with that.
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Retest when?
I had Southern fried chicken breast x2 with a small amount of mash potato for dinner. I tested a ketostix too but that’s come back to the 0.05 traces colour.
It definitely seems like I will need to introduce the Novorapid to help with meal levels.
 
If I get an ‘unusual’result - ie not what I was expecting -I wash my hands and retest immediately just to make sure I didn’t have anything on my hands that messed the result up.

It could just be the carbs in your meal that made you higher. Mashed potato can be quite deceptive in that a small serving has a fair few carbs. Nothing that Novorapid won’t sort when you get it 🙂
 
Inka said:
If I get an ‘unusual’result - ie not what I was expecting -I wash my hands and retest immediately just to make sure I didn’t have anything on my hands that messed the result up.

It could just be the carbs in your meal that made you higher. Mashed potato can be quite deceptive in that a small serving has a fair few carbs. Nothing that Novorapid won’t sort when you get it 🙂
Click to expand...
I didn’t realise I could do that. I only went based off of the first reading. I had the usual 4 units of insulin shortly after.
Do you think it will be ok if I have the two digestives and milk like usual and set an alarm to test in the night then? I don’t think I need the large snack if my levels are high based off of that 16.
 
It’s up to you. You could reduce your snack a tiny bit but I’d be cautious. You might just want to eat your normal snack and see what happens. If you do choose to reduce it, I’d go with a small amount eg 1 and 1/2 digestives instead of 2 (that removes around 5gcarbs). Still have the milk with it.
 
Afternoon all, hope you’re having a nice relaxing Sunday.
My level this morning was 5.2 so I still dropped a major amount during the night, even with the 1 and a half digestive with milk snack before bed.

I have a question in relation to food, is there a guide of how many grams of carbs and how much sugar I should be eating in a day? Is this based off of current weight/height/bmi - will my nurse take me through this soon?
I’ve been keeping an eye on how many carbs I eat daily and trying to stay away from the sugary things but not entirely sure how this works or what’s right for me yet as I definitely don’t want to be restricting or losing anymore weight if I can help it. Any advice?
 
No - the recommended diet for Type 1s is the same healthy diet recommended for everyone. The only thing you need to avoid is sugary drinks - except if you’re having a hypo or about to exercise, etc.

Just eat your normal diet and, once you have the Novorapid, calculate that according to your carbs. There’s no need to stick to any limit (within reason, obviously). I rarely bother to work out my total daily carbs. All I care about is calculating the right insulin for each meal and snack. I’m slim and have excellent diabetic control.

Again, if I was in your situation I’d reduce the evening Levemir. You have enough data now to show it’s too much.
 
Ok thank you. In regards to snacks type foods, is it best I stay away from crisps/biscuits due to them not being that healthy anyway? Or is this still allowed in moderation along side the healthy, balanced diet?

With the night time insulin
If it was you, would you reduce to 3 units, instead of the usual 4?
Would it not be best for me to stick with the 4 units (for consistency) and keep the snack, maybe even add the sandwich for a longer last carb intake and speak with my nurse tomorrow about insulin doses?

My levels today have been
Before breakfast 5.2
Before Lunch 7.3
Before Dinner 9.2
 
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Well, yes in theory in a perfect world no-one would eat them, but I eat crisps sometimes (had some yesterday), and biscuits too on occasion. The crisps I just fancy, but the biscuits I have as convenient snacks (eg a plain digestive is a convenient 10g carbs) or top-up carbs. So perhaps just be aware of which you choose, and don’t over-indulge (same as anyone else).

If it was me, yes, I’d drop the evening Lev to 3 units. I’d still have the same size snack for the first couple of nights at least until I was confident about what was happening. I’d also test during the night. You might well find you need less than 3 units, but 3 would be a sensible thing to try if I was in your situation.
 
It could well be that the night time dose of Levemir is insufficient to last you until before dinner. OTOH you absolutely shouldn't have to stuff your face to avoid hypos at bedtime either.

I'd drop it to 3u too, but you've really got to persuade Nursie to get you Novorapid and two half unit pens (one for each insulin) NOW.

If she resists - honestly ring 111. I quite seriously fear this could so easily escalate to ringing 999 cos you have no choice.
 
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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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