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Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
Confused.com
- Thread starter Kimbers
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Windy
Well-Known Member
- Relationship to Diabetes
- Type 2
Is it your son who has diabetes @Kimbers ? Was he recently diagnosed and do you know what type of diabetes it is?
If you're overwhelmed, do you have someone who can help with your son to give you a break (a relative/friend that you trust and he'd be happy with), or contact one of the autism charities or a social worker at your local authority autism team that you can discuss if you can have a carer's break or some support to let you top your batteries up again? It's a thankless task being a carer and you need to keep yourself well for both you and your son.
Sarah
If you're overwhelmed, do you have someone who can help with your son to give you a break (a relative/friend that you trust and he'd be happy with), or contact one of the autism charities or a social worker at your local authority autism team that you can discuss if you can have a carer's break or some support to let you top your batteries up again? It's a thankless task being a carer and you need to keep yourself well for both you and your son.
Sarah
Docb
Moderator
- Relationship to Diabetes
- Type 2
Hi @Kimbers and welcome to the forum. Can you tell us a little more? We have members who care for others with diabetes on the forum whose experiences you can draw on to try and get some sort of control.
PS.... I have deleted your other thread to make sure all replies get posted in this one thread.
PS.... I have deleted your other thread to make sure all replies get posted in this one thread.
He has been on a mix insulin since being diagnosed and now they say we need to change. This means carb counting to work out insulin told the consultant would write to gp to get prescription, to work out dose, we were told to one unit per 10 carbs and that is it. No education on carb counting at all
Leadinglights
Well-Known Member
- Relationship to Diabetes
- Type 2
- Pronouns
- She/Her
To what extent does your son manage his condition or do you do everything for him.
Hopefully the new regime will give more stable blood glucose levels, do you know what they have suggested for insulins. There are courses for carb counting one of which is on-line BERTIE I think it is called.
Hopefully the new regime will give more stable blood glucose levels, do you know what they have suggested for insulins. There are courses for carb counting one of which is on-line BERTIE I think it is called.
Bruce Stephens
Well-Known Member
- Relationship to Diabetes
- Type 1
I manage it for him. He is on Mixtard 30 during the day as usual as daytime readings ate fine but he goes high in the night so Novo Rapid and Lavimere during the night.I just feel a bit overwhelmed with it as we have been offered no education on counting carbs - just sent away with 'most people have 10 units per night plus 1 unit per 10 carbs before evening meal.
I cook most meals from scratch - where do I begin. Stew for example - I weighed out each ingredient before cooking and then read somewhere that you should count carbs in cooked food not raw. Where is best to find carb values? I've read up on Lavimere and it states it lasts 24 hours. Will it affect his daytime insulin? Hes Berlin used to having snacks to regulate mixtatd 30 and now I guess the snacks have to be calculated and insulin given to counteract them. Ive read that since people have 1-10 ratio, some 3 - 10.
So many questions - just dont want to go in blind without some sort of idea or guidance as to what I'm supposed to be doing.
Leadinglights
Well-Known Member
- Relationship to Diabetes
- Type 2
- Pronouns
- She/Her
Hopefully some of the Type 1 folk will be along to answer some of your worries. But before changing onto a new regime you should be sure and confident in being able to do it and make sure you have a contact number for any emergency issues that might arise.
What was their reason for needing to change?
What was their reason for needing to change?
Lily123
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
Do you mean Levemir?
He has been going high during the night. One diabetes nurse said its Dawn Phenomenon another said insulin is running out
Yes I dont feel confident at all. I'm not going to do anything until I have spoken to someone at the hospital. He has been going high during the night. One diabetes nurse said its Dawn Phenomenon another said insulin is running out
Kaylz
Well-Known Member
- Relationship to Diabetes
- Type 1
Don't panic, carb counting isn't all that difficult, I'm 5 years in and I've never been on a carb counting course, I'm self taught and started less than a month after my diagnosis, have I read correct that they are wanting your son to stay on his mixed insulin as well? I'd query that as it doesn't seem right at all xx
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
Welcome to the forum @Kimbers
Whilst your son is on mixed insulin, in order to keep levels consistent (ish) he would need to be eating fixed amounts of carbs at set times to match the injections. As others have said that is very inflexible and makes it difficult over night. Switching to separate insulin’s should make it easier to settle things overnight.
Carb counting can seem complicated to start with, but your head soon finds space for those bits If info about foods you use regularly, and for others there are scales to weigh things. We sometimes work from the basic ingredients using mr Google if necessary,other times we use the packets. We don’t often eat pre-prepared meals but look at some packaging to get an eye for carbs in meals out. The nurses will have given you a starting ratio, I think you mentioned 1 unit for 10g of carbs, and then that can be changed gradually to match what your son needs. This takes a bit of time and some of us find we need different ratios for different times of the day.
Do keep in touch and keep the questions coming.
Whilst your son is on mixed insulin, in order to keep levels consistent (ish) he would need to be eating fixed amounts of carbs at set times to match the injections. As others have said that is very inflexible and makes it difficult over night. Switching to separate insulin’s should make it easier to settle things overnight.
Carb counting can seem complicated to start with, but your head soon finds space for those bits If info about foods you use regularly, and for others there are scales to weigh things. We sometimes work from the basic ingredients using mr Google if necessary,other times we use the packets. We don’t often eat pre-prepared meals but look at some packaging to get an eye for carbs in meals out. The nurses will have given you a starting ratio, I think you mentioned 1 unit for 10g of carbs, and then that can be changed gradually to match what your son needs. This takes a bit of time and some of us find we need different ratios for different times of the day.
Do keep in touch and keep the questions coming.
Docb
Moderator
- Relationship to Diabetes
- Type 2
Can I offer a thought which, as usual, will be about the numbers. The term "carb counting" is used a lot but if you think about it, you are actually only estimating carbs.
Accurate measurement of carbohydrate is extremely difficult and anything you look up will not be a precise figure but an estimate of what it might be made by somebody who probably knows what they are doing. If you make up a meal with different components, each with an estimated carb content, then the errors will tend to balance themselves out and to some extent will compensate for the imprecision in the base numbers. So trust good estimates and a good estimate is one which works in your circumstances. It might mean a bit of work in the early days keeping records to find out what estimates work for you but as time goes on you will be able to rely on your instincts.
When it comes to getting it right, let me offer you an analogy. Think of archery, you have a bow, some arrows and a target. An expert will give you the principles of loading the bow and loosing the arrow and if you follow their directions you might think you will hit a bulls eye straight off. It will be luck if you do. Chances are you might miss the target completely to start with but with a bit of practice you will begin to hit the target more often and in no time at all you will begin to hit the target more often than not. That is good enough, you don't have to be the best archer in the world. As long as you don't have to spend hours searching the countryside for your arrows, you will be doing OK.
So what I suggest is that you learn the principles and then embark on administering your son's mixed insulin regime. Keep in mind that until you have some experience your efforts might be a bit hit and miss. Don't be concerned if it is, it's a necessary step in the process. Above all keep in mind you are aiming for a target range and not some magic perfect score. As time goes on the chances are you will find your self hitting the target with boring regularity.
Accurate measurement of carbohydrate is extremely difficult and anything you look up will not be a precise figure but an estimate of what it might be made by somebody who probably knows what they are doing. If you make up a meal with different components, each with an estimated carb content, then the errors will tend to balance themselves out and to some extent will compensate for the imprecision in the base numbers. So trust good estimates and a good estimate is one which works in your circumstances. It might mean a bit of work in the early days keeping records to find out what estimates work for you but as time goes on you will be able to rely on your instincts.
When it comes to getting it right, let me offer you an analogy. Think of archery, you have a bow, some arrows and a target. An expert will give you the principles of loading the bow and loosing the arrow and if you follow their directions you might think you will hit a bulls eye straight off. It will be luck if you do. Chances are you might miss the target completely to start with but with a bit of practice you will begin to hit the target more often and in no time at all you will begin to hit the target more often than not. That is good enough, you don't have to be the best archer in the world. As long as you don't have to spend hours searching the countryside for your arrows, you will be doing OK.
So what I suggest is that you learn the principles and then embark on administering your son's mixed insulin regime. Keep in mind that until you have some experience your efforts might be a bit hit and miss. Don't be concerned if it is, it's a necessary step in the process. Above all keep in mind you are aiming for a target range and not some magic perfect score. As time goes on the chances are you will find your self hitting the target with boring regularity.
There are basically two sources of blood glucose
- our livers drip glucose into our blood stream all through the day and night.
- the food we eat.
The purpose of the Levemir is to deal with the blood glucose from our livers. For simplicity, this is assumed to be stable although there may be some difference between day and night. So, typically, we have a fixed dose of this. Some people only take one dose a day but most have two Levemir injections - one at night and one in the morning. This is because it does not last 24 hours for most of us and it gives us the flexibility to have different doses for day and night.
NovoRapid is used to work with the glucose from the carbs we eat (our bodies break down all carbs to glucose). This is why we need an insulin to carb ratio. The ratio varies from person to person but 1 unit of NovoRapid to 10g carbs is typically where we start.
Carb calculation becomes second nature pretty quickly. Like other, I cook from scratch and have got used to eyeballing a meal to carb estimate based on experience of weighing and calculating similar meals. The same for snacks (although, for me, these are more likely to be packeted so the carbs are written down).
NovoRapid can also be used for corrections. For most people, it lasts about 4 hours. If my levels are high 4 hours after eating (or when injecting for my next meal), I calculate a correction dose based on my Insulin Sensitive Ratio (how many mmol/l does my level reduce by with 1 unit of NovoRapid?).
Your diabetes team should give you starting points for
- Levemir dose. Morning and night
- insulin to carb ratio
- insulin sensitivity ratio
They should also give you guidance on how to adjust these as we are different and our doses can change over time. For example, when we are ill or stressed our liver drips more so need more Levemir.
At first, this may all seem very intimidating but many of us have got by without training courses once we understand the basics.
And the forum is here to help you.
- our livers drip glucose into our blood stream all through the day and night.
- the food we eat.
The purpose of the Levemir is to deal with the blood glucose from our livers. For simplicity, this is assumed to be stable although there may be some difference between day and night. So, typically, we have a fixed dose of this. Some people only take one dose a day but most have two Levemir injections - one at night and one in the morning. This is because it does not last 24 hours for most of us and it gives us the flexibility to have different doses for day and night.
NovoRapid is used to work with the glucose from the carbs we eat (our bodies break down all carbs to glucose). This is why we need an insulin to carb ratio. The ratio varies from person to person but 1 unit of NovoRapid to 10g carbs is typically where we start.
Carb calculation becomes second nature pretty quickly. Like other, I cook from scratch and have got used to eyeballing a meal to carb estimate based on experience of weighing and calculating similar meals. The same for snacks (although, for me, these are more likely to be packeted so the carbs are written down).
NovoRapid can also be used for corrections. For most people, it lasts about 4 hours. If my levels are high 4 hours after eating (or when injecting for my next meal), I calculate a correction dose based on my Insulin Sensitive Ratio (how many mmol/l does my level reduce by with 1 unit of NovoRapid?).
Your diabetes team should give you starting points for
- Levemir dose. Morning and night
- insulin to carb ratio
- insulin sensitivity ratio
They should also give you guidance on how to adjust these as we are different and our doses can change over time. For example, when we are ill or stressed our liver drips more so need more Levemir.
At first, this may all seem very intimidating but many of us have got by without training courses once we understand the basics.
And the forum is here to help you.
Thank you for your reply. Can you advise of a good website or app to learn from?
They want him to stay on mixed for the day and carb count at night.
Lily123
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
That Is very unusual for your son’s diabetes nurse to want him on both mixed insulin and carb count. Could this be until you feel confident in helping your son to carb count that the diabetes nurse will take him off mixed insulin?
Kaylz
Well-Known Member
- Relationship to Diabetes
- Type 1
Personally I don't think that's the way to go about it, having a separate basal and bolus insulin on top of a mixed insulin could cause a lot of problems as he will still have mixed insulin in his system and adding 2 different insulins on top could cause a lot of hypo's etc, usually it's one routine or the other not both so I'd personally bring this up with whoever provide his care and I certainly have never heard of anyone using 3 different types of insulin at once
Sorry I never used apps or websites, just nutrition information for the products I was using which can be found on the packets or supermarket websites but I see Bruce has posted the link to the BERTIE website further up the post which you may find useful xx
Leadinglights
Well-Known Member
- Relationship to Diabetes
- Type 2
- Pronouns
- She/Her
I think you need more clarity about that from your team as from what others are saying it makes no sense.
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