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Inka said:
@JoRicco The 4 units of Novorapid you’ve been told to take before breakfast will cover a certain amount of carbs. We don’t know how many yet because it’s an individual thing and you’ve only recently been diagnosed. If you eat too many carbs, the Novorapid won’t be enough to cover them and if you eat too few, then you’ll hypo. It’s all about balancing the two.

Your body needs carbs to rebuild itself and for daily living. The diet recommended for Type 1s is a normal diet, including a wide variety of carbs like cereal, bread, pasta, rice, potatoes, quinoa, etc etc. I’m a bit concerned that you asked why you felt hypo “when you’ve been good”. Type 1 is not about going on a diet or avoiding carbs. Be very careful to look at the diabetes type of people here talking about what they eat. Type 1 and Type 2 are very different conditions. Type 1 is ‘simply’ about taking over the job your pancreas used to do. It is not caused by poor diet - it’s an auto-immune condition. You don’t manage it by depriving yourself of carbs, but by managing your insulins correctly.

I hope you’ve recovered from your hypo ok. Far better to be a bit high than hypo, especially early in diagnosis when you’re getting used to things. Take it easy this afternoon x
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Hi, i'm not avoiding carbs, just fancied scramb;ed eggs this morning 🙂 .. lesson learnt. I do eat a fairly healthy diet anyway but do include pasta, brown bread and usually have shredded wheat for breakfast. when i say i've been good, i meant with taking my bloods and keytones 🙂 .. x
 
Lots of good advice above. As a rough guide a typical starting ratio of insulin to carbs is 1U to cover 10g. So the 4U Novorapid you took would cover 40g. This ratio varies between people depending on any insulin resistance (which can change throughout the day) and whether you are still producing any insulin.

Hopefully you will get more help from your DSN soon regarding how to adjust your insulin.
 
JoRicco said:
How do you go about snacking mid meals ? Check levels as you go ? x
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At this early stage, generally it is easier to have low carb snacks between meals which don't need any insulin. Up to 10g carbs would be OK. Cheese, nuts, boiled eggs, some of the nut bars like Nature Valley protein bars or Morrisons do a box of 4 sea salt and dark choc nut bars which are just 7.9 g carbs if I remember rightly, a digestive biscuit is about 10g. Half a slice of toast with peanut butter, a slice of meat or a chicken drumstick... Eventually, once you learn to carb count, you can have whatever you like between meals and just inject the correct amount of insulin for it, but at the moment it is best to keep things simple and especially with your levels being a bit lower than ideal for this early stage, unbolused snacks are probably a good thing.

Talking of snacks.... and the risk of overnight hypos....
Have you been given a level to aim for at bedtime? ie. If your BG is below 8 at bedtime, to have a snack to bring it up a bit? That would be a very sensible precaution. If you have been told to aim for above 10 instead of 8 that is probably safer still, but 8 is a reasonable suggestion.
What have your bedtime readings been like the last few days and what were your morning readings following them?
 
rebrascora said:
At this early stage, generally it is easier to have low carb snacks between meals which don't need any insulin. Up to 10g carbs would be OK. Cheese, nuts, boiled eggs, some of the nut bars like Nature Valley protein bars or Morrisons do a box of 4 sea salt and dark choc nut bars which are just 7.9 g carbs if I remember rightly, a digestive biscuit is about 10g. Half a slice of toast with peanut butter, a slice of meat or a chicken drumstick... Eventually, once you learn to carb count, you can have whatever you like between meals and just inject the correct amount of insulin for it, but at the moment it is best to keep things simple and especially with your levels being a bit lower than ideal for this early stage, unbolused snacks are probably a good thing.

Talking of snacks.... and the risk of overnight hypos....
Have you been given a level to aim for at bedtime? ie. If your BG is below 8 at bedtime, to have a snack to bring it up a bit? That would be a very sensible precaution. If you have been told to aim for above 10 instead of 8 that is probably safer still, but 8 is a reasonable suggestion.
What have your bedtime readings been like the last few days and what were your morning readings following them?
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18/01 bed time 8.8
19/01 6.3 morning , evening 6.8
20/01 5.1 morning, evening 10.8
21/01 5.9 morning.
Nurse seemed happy yesterday ?
x
 
OK, so the Tresiba seems to be doing a decent job of holding you fairly steady at the moment although it dropped you 4mmols overnight last night. Sometimes when you start taking insulin, it gives your remaining insulin producing beta cells a breather after they have been working flat out for a while and suddenly they revive a bit and then the injected insulin can become too much. It often happens that there is a period of downward adjustment of doses in the first few weeks or months even.

Do you understand what I mean about not going to bed with a BG level below 8. If your bedtime test gives you a reading of 6.8 like it did the 19th, I would encourage you to eat a digestive biscuit before you go to sleep to push that level up a bit more to keep you safe overnight. One digestive biscuit will probably increase your BG by about 3mmols, so you will go from 6.8 to about 9.8 and that means you are less likely to experience a hypo overnight. If you are 7.9 at bedtime, maybe just have half a digestive biscuit.

It may seem like I am being overly cautious and you have managed your first hypo really well, but nocturnal hypos can be harder to manage because you wake up sleepy and confused and sometimes peoples bodies don't wake them up until levels have dropped lower than they would feel it during the day, so it can be more challenging.
It is also important to check that your hypo treatment has worked 15 mins after eating or drinking the treatment, and if you haven't come back up above 4 in that time, have another 3 jelly babies or whatever and test again after another 15 mins.
You were lucky today and the first hypo treatment worked, but it doesn't always, so do remember to do the follow up check. Insulin can be a very powerful and even deadly medication so whilst I don't want you to be frightened of it, I do want you to be prepared and keep yourself safe. You body can very easily chuck some extra insulin out when you least expect it during this early period of diagnosis, so you can't be too careful.
 
rebrascora said:
OK, so the Tresiba seems to be doing a decent job of holding you fairly steady at the moment although it dropped you 4mmols overnight last night. Sometimes when you start taking insulin, it gives your remaining insulin producing beta cells a breather after they have been working flat out for a while and suddenly they revive a bit and then the injected insulin can become too much. It often happens that there is a period of downward adjustment of doses in the first few weeks or months even.

Do you understand what I mean about not going to bed with a BG level below 8. If your bedtime test gives you a reading of 6.8 like it did the 19th, I would encourage you to eat a digestive biscuit before you go to sleep to push that level up a bit more to keep you safe overnight. One digestive biscuit will probably increase your BG by about 3mmols, so you will go from 6.8 to about 9.8 and that means you are less likely to experience a hypo overnight. If you are 7.9 at bedtime, maybe just have half a digestive biscuit.

It may seem like I am being overly cautious and you have managed your first hypo really well, but nocturnal hypos can be harder to manage because you wake up sleepy and confused and sometimes peoples bodies don't wake them up until levels have dropped lower than they would feel it during the day, so it can be more challenging.
It is also important to check that your hypo treatment has worked 15 mins after eating or drinking the treatment, and if you haven't come back up above 4 in that time, have another 3 jelly babies or whatever and test again after another 15 mins.
You were lucky today and the first hypo treatment worked, but it doesn't always, so do remember to do the follow up check. Insulin can be a very powerful and even deadly medication so whilst I don't want you to be frightened of it, I do want you to be prepared and keep yourself safe. You body can very easily chuck some extra insulin out when you least expect it during this early period of diagnosis, so you can't be too careful.
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Right, got it Thankyou . I will make sure i'm above levels at night . <3 . Although my treatment was AMAZING Wednesday, and i know they have alot to do but i do wish it had been explained a little more BUT thankfully you guys are here !!!! xxx
 
I'm sorry to be soo needy today lol BUT i have a christening tomorrow 2pm . I will have lunch before i go but how do i go about the buffet and alcohol ? Just test regularly ? xx
 
Sometimes you just can't take it all in at one appointment and they know that, so they try to give you the essentials but it's complicated and even if they had told you more, you might not have been able to retain it all. I know a lot of what I was told at my first appointment went in one ear and out of the other because I was so shell shocked. The forum has been a life line for me to fill in the blanks and learn from others experiences here.
The key thing with diabetes management is that you are the one who lives with it day by day and meal by meal and night by night and the nurse isn't going to be there in the supermarket with you when you hypo or at 3am when you wake up confused and sweating and your heart pounding, so you have to become the expert in understanding how the insulin works and your body works and how best to balance it all, but most importantly, how to keep yourself safe.
 
@JoRicco - the nurse was happy and so should you have been - but that wasn't today, was it! Those results are pretty fantastic really considering you've only just been diagnosed, so indeed well done you.

There are only 3 types of food we eat - carbohydrates, protein and fat. You need to really get going asap learning which category the foods you generally eat, fall into. To begin with you need to concentrate on identifying the carbs, since those are what we absolutely need mealtime insulin to cover. (Some people do need some for protein but here am I, 50 years in advance of you - and I haven't yet. Solely carbs for me.)

Anyway - you did yourself a double whammy this morning - not only did you inject Novorapid that you didn't need - you also compounded that error by taking considerable exercise - cos that's what walking round a supermarket becomes for anyone who doesn't deliberately exercise most days - I worked in an office and although there was some walking to/from buses or trains, the lunchtime shopping in the middle of Birmingham and the once a week supermarket shop, I really didn't move myself that much. Just the supermarket trek is enough to send some folk who did get their insulin right - hypo! - or at least, lower their BG.
 
JoRicco said:
How do you go about snacking mid meals ? Check levels as you go ? x
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Simple answer = yes. But you are in muddy water at present, so there isn't really a simple answer!

Because your clinic have put you on fixed NovaRapid (= bolus or quicker acting insulin) there is a presumption that you will just have 3 main meals and minimal snacks. If you just snack on very low, or no carb, foods then in principle you shouldn't need to check levels as you go and your snacks shouldn't affect your BG. Snack examples could be olives, cheese, meats, eggs, boiled or scrambled, fish (tuna is perfect), salads and there are many more options; but no toast (although the ultra- low carb bread would probably be OK) or breaded fish, check paté packaging and indeed any other pre-packed foods.

Your 4 units of bolus before each meal, as already said, presumes a typical meal of 40 gm carbs. But for most of us, life isn't like that! I personally like a big breakfast, a snack-like lunch and a main evening meal. I carb count and adjust my insulin doses accordingly. I was kept on fixed doses for about 7 months and realised my BG was extremely erratic, on what is often described as a rollercoaster of low to high and back again; so I taught myself to carb count and "rebelled". But this was during lockdown so I had only e-mail contact with my diabetes clinic.

Moving forward, I fully agree with the earlier remarks of well done so far. Since you currently are on fixed doses and don't seem to be provided yet with the Libre 2 Continuous Glucose Monitor (CGM) sensor, finger prick testing is your only way of monitoring and there is a realistic limit to how frequently you can do that. I spent my 1st year without Libre 2 and was fp testing over 10x daily; my GP felt that was excessive, didn't want to write the renewal prescription for these and (behind my back) sought confirmation of this from my Diabetes Specialist Nurse (DSN); then unilaterally reduced my test strip allowance to 4x daily. I courteously, but robustly, contested that and both my GP and DSN backed down. I reckoned I needed to routinely test 5x daily PLUS every time I'd gone hypo - twice for each hypo, to confirm I was actually hypo and then to confirm that recovery was happening; I would go hypo 2 or more x daily! No-one had explained the basic need to match my meals to the insulin I was taking. PLUS every time I needed to drive - to satisfy DVLA rules. So 10+ times daily fp was sometimes definitely not enough.

Anyway, you are getting great advice from others. I would suggest you courteously, but very robustly, get your GP to prescribe Libre 2 - which under the revised rules from spring 2022 a GP can (and should) do - without the previous requirement for this to be recommended by a Specialist clinic. CGM does mean more "learning" and doesn't mean zero fp. But the benefit to you and your BG management is amazing, as well as the reduced mental stress of not knowing what is going on. It is all very confusing and complicated right now and I found it pretty frightening at times - until I gained a much better understanding of all the many inter-related things. My work background had a "mantra" that Knowledge Dispels Fear, which it certainly did for me and my slightly unusual form of Diabetes.
 
Don't worry about asking lots of questions. We are happy to help you as much as we can.

Go very steady on the alcohol as it does have an impact on BG and can cause you to hypo. If you will be driving yourself I would suggest you give it a miss altogether to be safe. If you are going to be a passenger, then know that it can drop your levels so eating a little of the buffet should mitigate that risk. Unfortunately buffets are usually quite high carb and notoriously difficult to calculate and inevitably there is a temptation to put stuff on your plate and then go back and pick at more and you lose track. What time are you likely to be eating? You might be best having brunch rather than breakfast and lunch and then the buffet, if it is going to be mid afternoon, so that you are not injecting and eating too close together. If you intend to do brunch and then eat a reasonable amount of the buffet then inject for it. If you are going to have lunch and then just eat a small token of the buffet with a drink in order to be polite and partake then you might get away with a couple of party sausage rolls and a glass of fizz without any insulin. best to have a plan in advance of how you are going to tackle it and try to stick to the plan, but if you get there intending to just have a nibble and not bolus (inject insulin) for it but it is all far too tempting and your plan changes, then yes you will need insulin.
 
No 1 - alcohol reduces blood glucose so please DO be careful. As an idea, large thin sliced bread is 15g carb per slice so one 'round' of sandwich will be 30g but normally cut into 4 triangles for buffets hence each piece is 7.5g. A 3inch diameter batch is 25 - 30g carb. You're unlikely to eat the equiv of a whole bag of crisps, but I daresay there will be stuff like sausage rolls, quiche, pizza etc so the pastry and pizza base are carbs. But you're drinking alcohol so that will help counteract some of the carbs.

Fondant on (or in - sometimes layers of sponge cake are glued together with fondant too, yuk) cake is almost 100% sugar - so about 99.9% carbs - in comparison the cake itself will be very small!
 
trophywench said:
No 1 - alcohol reduces blood glucose so please DO be careful. As an idea, large thin sliced bread is 15g carb per slice so one 'round' of sandwich will be 30g but normally cut into 4 triangles for buffets hence each piece is 7.5g. A 3inch diameter batch is 25 - 30g carb. You're unlikely to eat the equiv of a whole bag of crisps, but I daresay there will be stuff like sausage rolls, quiche, pizza etc so the pastry and pizza base are carbs. But you're drinking alcohol so that will help counteract some of the carbs.

Fondant on (or in - sometimes layers of sponge cake are glued together with fondant too, yuk) cake is almost 100% sugar - so about 99.9% carbs - in comparison the cake itself will be very small!
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I don't really like cake 🙂 ... I'm resisting my ferrero roche's .
 
JoRicco said:
Good afternoon all. my pre breakfast reading was 5.9, had 2 scarmbled eggs with abit of cheese in at apr 9am. Went food shopping at 11 and by 11.30 ( at the checkout) i went all shakey , sweaty and a bit weak, had 3 jelly babies, came home and tested and i'm 8.0 ??? why did i feel like that when i've been good ? I'm not even in my first week yet LOL. started insulin wednesday .TIA
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What was your blood sugar at the till when you felt weak and shakey? Always carry your meter and always test when you feel like that.

Hopefully you weren’t driving home and someone else drove you?
 
I don't mind cake but just cannot bear anything mega sweet. However some people say they enjoy drinking Coca Cola which is a mystery to me.

I could resist the FRs too - UNTIL I ate one ........

Ah, but then of course should I be hypo .... ! (neither chocolate nor (most) cake are good hypo treatments because of the fat in em, which slows the carbs down too much)
 
Lucyr said:
What was your blood sugar at the till when you felt weak and shakey? Always carry your meter and always test when you feel like that.

Hopefully you weren’t driving home and someone else drove you?
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No i wasn't driving, my friend was . I did have my meter but didn't check it there and then ( felt pressured as was at the check out . Idiot , i know ) I was only 5 mins from home so took it as soon as i got in. I know.. another lesson learnt x
 
JoRicco said:
I'm sorry to be soo needy today lol BUT i have a christening tomorrow 2pm . I will have lunch before i go but how do i go about the buffet and alcohol ? Just test regularly ? xx
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Fully agree about alcohol control; in principle alcohol and insulin don't work well together.

I've been to several buffets in the last 3 years and found each time I can get an almost carb free meal from the buffet: cheese, cold meats, salads, even mayonnaise based things like slaws, or eggs in mayo; so it might not be the problem you anticipate. Slightly more difficult for a hot buffet. I have no embarrassment about asking ahead what the buffet will be and take no-carb or ultra-low carb snacks with me - as a contingency. I also have no embarrassment about going, on arrival at the venue, to personally see what the buffet is going to be; preparation is for me a great thing - reduces the elements of unwanted surprise. I have a 'man-bag' with my insulin, fp and meter, my hypo responses and my potential contingency snacks. It's all surprisingly easy, with just a little forward planning; in time this sort of thing will become totally normal to you.

Enjoy tomorrow.
 
Proud to be erratic said:
Fully agree about alcohol control; in principle alcohol and insulin don't work well together.

I've been to several buffets in the last 3 years and found each time I can get an almost carb free meal from the buffet: cheese, cold meats, salads, even mayonnaise based things like slaws, or eggs in mayo; so it might not be the problem you anticipate. Slightly more difficult for a hot buffet. I have no embarrassment about asking ahead what the buffet will be and take no-carb or ultra-low carb snacks with me - as a contingency. I also have no embarrassment about going, on arrival at the venue, to personally see what the buffet is going to be; preparation is for me a great thing - reduces the elements of unwanted surprise. I have a 'man-bag' with my insulin, fp and meter, my hypo responses and my potential contingency snacks. It's all surprisingly easy, with just a little forward planning; in time this sort of thing will become totally normal to you.

Enjoy tomorrow.
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Thankyou x
 
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