Annemarie

[Bruce Stephens]

What’s a carb counting course? I’ve never heard of it.

It's part of a new (well, new since I was diagnosed a few decades ago) structured education course for managing Type 1 diabetes. NICE strongly recommends that newly diagnosed patients be offered it between 6 and 12 months after diagnosis (if I remember correctly). The best known is DAFNE but different CCGs may have their own.

There's also https://mytype1diabetes.nhs.uk and https://www.bertieonline.org.uk

The basic idea is that you have basal insulin (the slow-acting kind) which should keep you more or less stable while you're not eating. And bolus insulin (the NovoRapid) that you take for food. And there's (personal to you) ratios to say how much bolus insulin to take depending on what you eat (1:10g might be one, where you take one unit for each 10g of carbohydrate in the food). Commonly the ratios are different across the day. And you also learn about varying when to take the bolus insulin (usually a little before you eat), and about how non-carbohydrates (fat, protein, alcohol) can change things, and how to go about handling exercise.

I guess some will now include information on how to use Libre effectively. (There are some really excellent videos if you haven't already seen them, both those offered by Abbott and ABCDiab https://www.youtube.com/playlist?list=PLTmzbYIu6mAmiwdzoAuZP8DkxcdfnPlrN )

An actual course is well worth doing (whether in person or online).

 

[Bruce Stephens]

Most of us have our Libre set at 4-10 and I think the DSN said that they are happy if we can keep in range for 65% of the time

The usual target is over 70%. (But of course it's the kind of thing that might well be different for individuals for good reasons, so the over 70% is a general default thing.)

As you say, without some education keeping in range is likely to be very challenging.

 

[rebrascora]

The usual target is over 70%. (But of course it's the kind of thing that might well be different for individuals for good reasons, so the over 70% is a general default thing.)

As you say, without some education keeping in range is likely to be very challenging.

Thanks for that clarification. I just remember being significantly higher than the percentage the DSN said and that she was delighted with what I was achieving even though I would have preferred it to be better. Need to take my own advice about striving for perfection being futile!

 

[Bruce Stephens]

I just remember being significantly higher than the percentage the DSN said and that she was delighted with what I was achieving even though I would have preferred it to be better.

I'm sure I've seen abstracts suggesting that there's definite benefit in larger percentages (so 80% has measurably better outcomes than 70%, etc.). So it's not a case of stopping if you're a bit over 70%.

Just that over 70% is really pretty good, all things considered, so it's a useful target. (Along with all the other bits, <5% lower than 4, <5% over 13.3, <20% 10-13.3. (I probably have some of those slightly wrong.))

 

[everydayupsanddowns]

Just that over 70% is really pretty good, all things considered, so it's a useful target. (Along with all the other bits, <5% lower than 4, <5% over 13.3, <20% 10-13.3. (I probably have some of those slightly wrong.))

I think different guidelines are offered for people at different stages of life (eg pregnancy or later life)

This thread links to the international consensus

Time In Range - useful for Libre / CGM wearers

I've been meaning to post this for ages, but kept forgetting! At the ADA this year the international consensus paper on TIR (time in range) was published by a panel of experts with a huge amount of knowledge and expertise in supporting people to use continuous data to help manage their...

forum.diabetes.org.uk

 

[everydayupsanddowns]

Welcome to the forum @Annemarie

So pleased you have joined us! Diabetes can be an isolating experience, and it is great to have others alongside who are facing the same challenges day to day.

Sorry that you are having a few teething troubles with the forum - you are doing just fine replying though - so keep at it.

There is a little ‘how to’ section to help with the forum software here:

How to use the Forum

HOW DO I REGISTER? HOW DO I START A THREAD? HOW DO I COMMENT ON ANOTHER THREAD? HOW DO I REPLY TO AN INDIVIDUAL COMMENT IN A THREAD? HOW DO I ‘LIKE’ A POST? HOW DO I ‘REPORT’ A POST? HOW DO I EDIT MY PROFILE? HOW DO I CHANGE THE CAPTION UNDER MY POSTS? HOW DO I SEND A PRIVATE MESSAGE TO...

forum.diabetes.org.uk

Hope you feel that you are beginning to get to grips with your diabetes after a bit of a torrid start, and that you are beginning to feel better in yourself.

I think most of us who use insulin to manage our diabetes will be familiar with the experience of administering the same doses for the same foods, and getting very different results.

This can partly be because there are more factors that affect blood glucose than just the balance of food/dose/activity, (some have suggested there may be 42 factors!)

But also it can simply be your insulin needs changing as the werks and months roll around.

Good luck, and keep asking questions 🙂

 

[everydayupsanddowns]

If you’d like the chance to chat, we are currently holding monthly virtual Zoom get togethers on the second Sunday of the month at 3pm

Zoom is a free video-call app/website that allows us to share a video phone call from our homes, and just chat through any particular challenges, truimphs or disasters we have been experiencing.

If you’d like to find out more check this thread:

Virtual Meetup - second Sunday of the month

We have had a couple of successful virtual meetups over the summer, and there seems to be appetite for more opportunities to gather ‘virtually’ for a bit of a chat and catchup via video ‘Zoom‘ meeting. So I am suggesting we start to hold these regularly on the second Sunday of the month for a...

forum.diabetes.org.uk

And add your name so I can send you the Zoom meeting details / invitation 🙂

 

[KARNAK]

Hello @Annemarie welcome to the forum.

You nicked my crown I was 156 at diagnosis and aged 63 at the time.😎
Your doing well so keep it up, my HbA1c was down to 48 after 3 months
and is now at 32 mainly with the help of the forum, in my area Torbay the
carb to Insulin course is called TIFA ( Torbay Insulin and Food Adjustment)
course. This proved to be an excellent addition to my big D (Diabetes)
journey, I am in constant touch with my DSN and Dietician and my surgery
is second to none.

The Carbs & Calorie Counter book is excellent and will help in keeping
your BGL`s under control, this is available from DUK shop and Amazon.

I think you have enough to be going on with for now so welcome aboard
and ask any question at anytime, take care.

 

[Annemarie]

Hello @Annemarie welcome to the forum.

You nicked my crown I was 156 at diagnosis and aged 63 at the time.😎
Your doing well so keep it up, my HbA1c was down to 48 after 3 months
and is now at 32 mainly with the help of the forum, in my area Torbay the
carb to Insulin course is called TIFA ( Torbay Insulin and Food Adjustment)
course. This proved to be an excellent addition to my big D (Diabetes)
journey, I am in constant touch with my DSN and Dietician and my surgery
is second to none.

The Carbs & Calorie Counter book is excellent and will help in keeping
your BGL`s under control, this is available from DUK shop and Amazon.

I think you have enough to be going on with for now so welcome aboard
and ask any question at anytime, take care.

Thank you, I must find out about the carbs course as it’s never been mentioned before, I was diagnosed at 68 although the hospital (Stoke Mandeville) Dr said I should have been diagnosed at least 12 years before

 

[trophywench]

If you look at your hospital website, and search 'Services A-Z' under D and then click on Diabetes, scroll down until you see the list where you will find 'InSight' - that's the name of your local course - so ring (or email) a DSN there and ask what's happening ! Some hospitals are doing them by 'Zoom'.

 

[Annemarie]

A carb counting course is a course which teaches you how to count or assess the amount of carbohydrate you are eating and adjust your insulin doses to cope with that amount of carbs.
All the carbohydrates we eat get broken down into glucose by our digestive system and absorbed into the blood stream. Insulin helps that glucose to enter the cells in the muscles and organs where it is used for energy or stored. The body of a non diabetic person knows exactly how much insulin to produce to counteract the carbohydrates we eat and keep our BG steady and in range. As diabetics we need to manually adjust the amount of insulin we need and there are something like 42 factors which have an impact on our BG levels, so it is not just about the food we eat, but stress, infection, the weather, hormones, different seasons.... loads of stuff, so it is incredibly difficult (probably impossible) to manually achieve the balance all the time.... it really makes you appreciate what a clever organ the pancreas is when it no longer works properly and you are trying to do it's job for it, so please do not feel guilty about not getting it right all the time..... because non of us do....Learning and accepting that perfection is impossible when it comes to BG levels is one of the most important lessons with diabetes. We can only do our best and considering that you haven't had a carb counting course, you are doing really well to keep in a narrow range of 4-8 at all. Most of us have our Libre set at 4-10 and I think the DSN said that they are happy if we can keep in range for 65% of the time, but don't worry if you are not achieving that yet because you really need more education to help you achieve that.

Thank you @rebrascora that is very informative. I didn’t know about it but after Googling my hospital I see that such a course is run and by my diabetic nurse! I haven’t seen or heard from her this year but I’ll be ringing her on Monday

 

[Annemarie]

If you look at your hospital website, and search 'Services A-Z' under D and then click on Diabetes, scroll down until you see the list where you will find 'InSight' - that's the name of your local course - so ring (or email) a DSN there and ask what's happening ! Some hospitals are doing them by 'Zoom'.

I sent a message to another member to say I followed this advice, yes my hospital does courses and they are run by my diabetic nurse!! I haven’t spoken with her this year but I’ll be ringing her on Monday

 

[Bloden]

Thank you, I must find out about the carbs course as it’s never been mentioned before, I was diagnosed at 68 although the hospital (Stoke Mandeville) Dr said I should have been diagnosed at least 12 years before

Hi Annemarie and welcome. 🙂 Have a look at www.bertieonline.org.uk for carb counting, etc. I’ve been diabetic for 12 years but was sent this link by a new DSN for a bit of a refresher. I found it very useful. There’s also a book / app called Carbs and Cals - if you eat a typical U.K. diet and lots of takeaways, it’s also useful for carb counting. Good luck!

 

[Bloden]

Beat me to it @Bruce Stephens!