Caught unguarded

[Jacen017]

Does that mean pricking my finger 4 times more?

Does that mean I ve to prick my finger 4 times more daily?

If you want to see what sort of impact the food you are eating is having on you then yes, you would need to test before and 2 hours after.

You can always start just testing one meal and see how you get on. It's never going to be a one size fits all situation, you need to find what works for you.

As you are using Novorapid 3 times a day I'm assuming that you are using it with each meal? I believe you would either need to be adjusting your food to match the carbs covered by a set dose or adjusting your dose to match the carbs you are eating.

For example, I inject 1 Unit of Novorapid for every 10g of carbs I'm going to be eating but that ratio is different for different people. Try to speak with your DSN about carb counting.

 

[Purls of Wisdom]

Does that mean pricking my finger 4 times more?

Hi Purls Of Wisdom,

I don't have much advice on the types of food to eat as I'm currently matching my insulin to my meals and managing to have a normal diet without to much difficulty but I totally remember that panic and constant hunger!

As others suggest, the best thing is to test your blood glucose levels before a meal and then again 2 hours after the first bite to see what sort of impact that meal has had on you and you can start to get an idea of what you can tolerate. If I remember correctly you're looking for a rise of no more than 2-3 mmol. (Someone please correct me if I'm giving the wrong advice)

What I can help you with is the Needle Phobia that you mentioned. I also suffer from Needle Phobia and that for me was the worst part of being diagnosed with diabetes.

It was taking me almost 2 hours to prick my finger or inject at first and then as soon as I had managed to do it I had to start trying again so I could get the blood to test again after 2 hours! I had several times where I would faint with the needle in my stomach😳🙄.

What I found helped me in the end was to take the needle out of the lancing device and prick myself manually - it's more painful but gives me a feeling of control that I couldn't get using the device as intended.

For injections - I found that bouncing the needle gently on the stomach whilst taking deep breaths would cause it to just slip in almost accidentally.

I've also now purchased a device called TickleFlex which is absolutely brilliant, you slip it over the tip of your insulin pen and it hides the needle. It has little rubber arms that tickle the skin and distract so you don't feel the needle going in and at the same time it gathers the skin up onto the needle. It fits fine over my Novorapid pen but does not fit on my Toujeo pen properly.

I hope you're doing ok, it does all start to get better even though it feels like it never will at the start.

Does that mean I ve to prick my finger 4 times more daily?

Some of that will depend on which type of diabetes you end up having, and whether you continue to use mealtime and background insulins (also known as basal:bolus or multiple daily injections).

For T1 and LADA/T1.5 there are online or in-person courses like DAFNE or Bertie (other local variants exist) which teach you about the interactions between insulin, carbs, alcohol, exercise, stress, temperature, illness and a host of other variables. And how to understand, interpret and use your BG meter results to help inform your decisions, doses and choices.

Essentially it’s an ongoing process of adjusting your background (basal) dose so that it just holds your BG levels steady when you don’t eat, then adjusting your insulin:carbohydrate ratio so that by calculating or estimating the amount of total carbohydrate in any meal or snack you can get an insulin dose that should match.

It sounds a lot more complex written down as a summary that it is in practice, and soon enough you’ll be able to guesstimate the carbs in any plate of food from 50 yards.

Good luck, and let us know how things go 🙂

Sounds impossible task to comprehend at present. Where are those courses available from?

 

[trophywench]

If you have Type 1 diabetes, the hospital clinic will arrange this for you. If you don't have Type 1, you won't be offered such a course, but in any case it isn't rocket science, just a bit of maths involved is all and we can assist you if you ask.

Testing your BG via a fingerprick shouldn't actually hurt. Try reading this

Painless Pricks

Managing blood glucose levels for type 2 diabetes. Learning how to achieve long term control by testing and diet.

loraldiabetes.blogspot.com

 

[everydayupsanddowns]

Does that mean I ve to prick my finger 4 times more daily?

Clinical trial data shows that more frequent BG monitoring is associated with better outcomes. Typically it is found to be helpful to check your levels before each meal (to help adjust your dose) and before bed (for safety). There may be additional times where it’s helpful to check, eg if you think you might be experiencing hypoglycaemia or for the legal DVLA driving requirements.

If you find fingerstick monitoring difficult because of your needle phobia you may be able to access isCGM (Libre) or rtCGM (eg Dexcom) where blood samples are needed far less frequently.

A lot of this will become clearer when your exact diagnosis is confirmed, so try not to get stressed about it in the mean time.

 

[Leadinglights]

I'm not sure testing before you eat and after 2 hours is appropriate if you are injecting insulin as the body is going to be responding differently than a Type 2 with diet management where they do want to be finding out the effect of meals.
Hopefully some Type 1 or folk taking insulin can clarify.

 

[rayray119]

I'm not sure testing before you eat and after 2 hours is appropriate if you are injecting insulin as the body is going to be responding differently than a Type 2 with diet management where they do want to be finding out the effect of meals.
Hopefully some Type 1 or folk taking insulin can clarify.

But you might get an idea on how you're timings are and wether it might be a good idea to eat somthing. That's why j do it.

 

[rayray119]

I have recently been diagnosed. Type unconfirmed. It came as a shock to say the least. I did not know anything about it. Partly cos of needle phobia. Learning bit by bit but not enough. Being very hard on myself when it comes to meal times and more so too much information on the net and little support. Too early I have been told. I am acutely stuck with what to eat, how much a day and in week. I need urgent guidance before I starve myself to nothing. Please help.
Thanking you in advance.

Just to encourage you I too had an extreme fear of needles before being diagnosed to put I got really worked up before getting any vaccines or blood tests done and need to close my eyes while these being done so when they told me i would need to be injecting myself several times a day I was freaked out. Now I've been injecting myself seal times a day for about 7 months I no longer have this fear and it even feels normal at points

 

[Purls of Wisdom]

Hi Purls Of Wisdom,

I don't have much advice on the types of food to eat as I'm currently matching my insulin to my meals and managing to have a normal diet without to much difficulty but I totally remember that panic and constant hunger!

As others suggest, the best thing is to test your blood glucose levels before a meal and then again 2 hours after the first bite to see what sort of impact that meal has had on you and you can start to get an idea of what you can tolerate. If I remember correctly you're looking for a rise of no more than 2-3 mmol. (Someone please correct me if I'm giving the wrong advice)

What I can help you with is the Needle Phobia that you mentioned. I also suffer from Needle Phobia and that for me was the worst part of being diagnosed with diabetes.

It was taking me almost 2 hours to prick my finger or inject at first and then as soon as I had managed to do it I had to start trying again so I could get the blood to test again after 2 hours! I had several times where I would faint with the needle in my stomach😳🙄.

What I found helped me in the end was to take the needle out of the lancing device and prick myself manually - it's more painful but gives me a feeling of control that I couldn't get using the device as intended.

For injections - I found that bouncing the needle gently on the stomach whilst taking deep breaths would cause it to just slip in almost accidentally.

I've also now purchased a device called TickleFlex which is absolutely brilliant, you slip it over the tip of your insulin pen and it hides the needle. It has little rubber arms that tickle the skin and distract so you don't feel the needle going in and at the same time it gathers the skin up onto the needle. It fits fine over my Novorapid pen but does not fit on my Toujeo pen properly.

I hope you're doing ok, it does all start to get better even though it feels like it never will at the start.

I took your kind advice and tested BG before and 2 hours after the meals. What a carry on. Before lunch I tested 10.7 and 2 hours later, it jumped to 14.3. Pre dinner reading was 8.5 and 2 hours later it was 14.9. Surprised, shocked and horrified, I am more baffled.

 

[Leadinglights]

I took your kind advice and tested BG before and 2 hours after the meals. What a carry on. Before lunch I tested 10.7 and 2 hours later, it jumped to 14.3. Pre dinner reading was 8.5 and 2 hours later it was 14.9. Surprised, shocked and horrified, I am more baffled.

IF that was something that somebody got who is Type 2 but not taking insulin then most definitely the meal was too carb heavy but for somebody taking insulin then it is more likely that the insulin dose is not enough to cope with the amount of carbs or the timing of the dose need adjusting. But I suspect you are not yet in a position to be changing things with out advice either from your DSN or some of the very helpful people here who are familiar with insulin regimes and what to expect.

 

[trophywench]

Well if you are Type 1 - that's perfectly fine. Target for us is 'back to normal before next meal' which you are, in fact you were below ! If Type 2 - not utterly fantastic but by no means a complete disaster.

Please - press for proper identification of which type of diabetes you have!

 

[Ditto]

Hello and welcome. 🙂

 

[helli]

If you want to see what sort of impact the food you are eating is having on you then yes, you would need to test before and 2 hours after.

This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.

 

[trophywench]

This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.

YES!!!!!

 

[Jacen017]

This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.

Thanks for correcting me 🙂

I got into the habit of doing it early days and just never stopped.

 

[Irisaria]

This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.

This is interesting! Does that mean ignore any spikes during the 4 hours so long as the BG reading drops to the 'correct' level after 4 hours or so?

 

[helli]

This is interesting! Does that mean ignore any spikes during the 4 hours so long as the BG reading drops to the 'correct' level after 4 hours or so?

I would not change the dose if my levels returned after 4 hours.
I am lucky to have a CGM so I can see when the spikes occur and have adjusted the pre-bolus time so the peak of the insulin potency closer matches the peak of carb digestion.

But if your levels return to "normal" after. 4 hours, your dose is correct.
And, in my opinion, short spikes should not be a concern. Remember, people without diabetes can see spikes up to 10mmol/l

 

[leonS]

With what is a high level of ketones with a high BG you are almost certain to be type 1. T2s can not produce ketones except under very specific conditions such as a serious prolonged infection. Even with this ketones are rare in T2.

There is no treatment for T1 other than insulin. Insulin must be injected several times each day. NICE say that a T1 should do a finger prick blood test AT LEAST four times a day.

I would accept the offer of insulin and press to have your treatment under the care of a specialist clinic. They can help wjth setting up initial values for your treatment - a skill that few GPs have.

 

[Irisaria]

I would not change the dose if my levels returned after 4 hours.
I am lucky to have a CGM so I can see when the spikes occur and have adjusted the pre-bolus time so the peak of the insulin potency closer matches the peak of carb digestion.

But if your levels return to "normal" after. 4 hours, your dose is correct.
And, in my opinion, short spikes should not be a concern. Remember, people without diabetes can see spikes up to 10mmol/l

Thank you, that makes a lot of sense!

 

[trophywench]

It's being far too high and staying high for hours on end, frequently, to worry about.

Occasional excursions, even into the stratosphere, are OK as long as you enjoyed whatever caused it!

 

[rayray119]

This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.

I wouldn't say it's completely misleading while not in my case anyway. I actually do find those in-between checks helpful to provide certain identify certain things. But everyone's different.