Munjeeta
Well-Known Member
- Relationship to Diabetes
- Type 1
Here you are Rossi!!
Today was probably the most usefulk and practical of the days so far. All the background stuff covered, we were able to get more into the nitty gritty of things. We began as usual by dissecting our levels. Mine were quite interesting as I went to a ballet class on Tues evening, so seeing the effects of the exercise on the rate of absorption of my insulin was great.
THe first session was on hypoglycaemia. Practical, useful advice. Also, the science bit... A hypo reading for a diabetic is a reading below 4 mmol/l. Your body responds to this by producing adrenalin which gives us the hot, shaky, sweaty symptoms. The adrenalin makes your liver produce glucose to bring you bg level back up. The confusion/ weakness/ disorientation/ balshiness/ slowing down some of us experience is a result of the brain being starved of glucose. All very interesting, and I can't believe I'd never been told this before! The DAFNE guidelines say to treat hypos differnetly depending on the time till the next meal: <1 hr, just 10-15g rapid acting sugary carbs like OJ/lucozade/glucose tabs. 1-2 hrs till next meal 10-15g rapid acting stuff then 10g of starchy carbs. >2 hrs till next meal 10-15g rapid acting followed by 20g starchy carbs. This formula seems to work. I have teetered on the verge of being low for the last 24 hours (all these DAFNE adjustments 😛) and have not bounced back once - highest reading in the last 24 hrs is 7.7 😱)
Most important messages were: do NOT correct the bg bounceback from a hypo (something I was likely to do...) and when hypo drink fruit juice as your rapid acting carb. This works for me like a dream, although I was sceptical that it would.
Then we discussed driving and alcohol briefly. Main rules for driving are to test before you drive, if your ng is less than 5 have a snack. If you hypo when driving pull over, take keys out of ignition and sit in passenger seat, treat then wait 45 mins before driving again - this is how long it takes your brain to recover fully - scary stuff. Also found out, scarily, that if hypo warning signs are lost and 3rd part intervention is required to get you out of a hypo you automatically lose your license for a minimum of 6 months. Eek.
Alcohol... Interesting! The science bit: when we drink, our livers metabolise the alcohol which is toxic to our bodies. Because it is so busy doing this it doesn't have time to produce glucose whihc inevitably leads to our sugar levels dipping after drinking. So, main advice is to always have a snack (I asked about kebabs! Apparently perfectly suitable 😛) and do not cover with any insulin. Better to correct a higher reading in the morning than risk a hypo. I'm useless with alcohol and units etc etc so was shocked to find out that the big glass of red wine I'm so partial to is 3 units! A small glass is 2 units. But drinking Bloody Marys is apparently a GOOD thing because the tomato juice has carbs in (about 10g per drink) so keeps bg levels up without being too high, and means only a small snack is needed after. Yay!
After lunch was the bit on illness 0 really useful, and partners etc were invited along to this bit (as well as the hypo bit). Illness for a diabetic is defined as major or minor depending on the presence of ketones. Main thing was that when ill always look at sick day rules given to you but to:
Always test for ketones and react according to sick day rules.
Ensure contact numbers (GP, DSN) are handy and ring for advice sooner rather than later.
Drink lots of sugar free fluids.
Eat if poss but if not, sip sugary fluids
Do not stop taking insulin, again - look to sick day rules for advice on dosages.
When ill, the body is under stress so it produces other hormones which inhibit insulin, leading to rising bg levels, so we do need more insulin when ill. There are guidelines that say to use 10% or 20% of your daily insulin dose to keep bg levels down (again, look to sick day rules) and advice is to use total daily dose from the previous day to work this out.
Right. Las bit! The afternoon was all about eating helthily. The idea of DAFNE is to let youeat whatever you want: as little or as much of whatever food you want, but they are very careful to remind you that everyone should be aiming for a healthy diet, hehe... This was all quite generic, looking at the 5 main food groups and discussing each one. Basically in a nutshell:
Protein - eat lean meat
Fats, oils and sugars - smallest proportion of food intake should be made up from this group. monounsaturated fats are best, hydrogenated and saturated fats should be avoided.
CHO - wholegrain
Fruit and veg - 5 a day
Dairy - aim for low fat.
The eating out bit was interesting. We all had to bring in our ideal menu and we talked each one throuhg, about how to estimate CHO value etc. The mian points that came out of it were:
If you have taken too much insulin prior to eating then compensate by ordering a fruit juice ot keep bg from dropping.
If meal is particularly heavy on root veg or pulses round insulin dose up to counteract carbs, even though slowly abosorbed.
Look at supermarket brands of similar meals/ portion sizes to get an idea of CHO values.
If a particularly favoured meal, experiment! Repeat meal and remove a different componant each time to guage its effect on your bg glucose (e.g. differnet types of rice, chutney, etc)
If the meal is high in fat inject after as fat slows down the absorption of carbs and round insulin down.
Phew. Hope that's helpful!
Today was probably the most usefulk and practical of the days so far. All the background stuff covered, we were able to get more into the nitty gritty of things. We began as usual by dissecting our levels. Mine were quite interesting as I went to a ballet class on Tues evening, so seeing the effects of the exercise on the rate of absorption of my insulin was great.
THe first session was on hypoglycaemia. Practical, useful advice. Also, the science bit... A hypo reading for a diabetic is a reading below 4 mmol/l. Your body responds to this by producing adrenalin which gives us the hot, shaky, sweaty symptoms. The adrenalin makes your liver produce glucose to bring you bg level back up. The confusion/ weakness/ disorientation/ balshiness/ slowing down some of us experience is a result of the brain being starved of glucose. All very interesting, and I can't believe I'd never been told this before! The DAFNE guidelines say to treat hypos differnetly depending on the time till the next meal: <1 hr, just 10-15g rapid acting sugary carbs like OJ/lucozade/glucose tabs. 1-2 hrs till next meal 10-15g rapid acting stuff then 10g of starchy carbs. >2 hrs till next meal 10-15g rapid acting followed by 20g starchy carbs. This formula seems to work. I have teetered on the verge of being low for the last 24 hours (all these DAFNE adjustments 😛) and have not bounced back once - highest reading in the last 24 hrs is 7.7 😱)
Most important messages were: do NOT correct the bg bounceback from a hypo (something I was likely to do...) and when hypo drink fruit juice as your rapid acting carb. This works for me like a dream, although I was sceptical that it would.
Then we discussed driving and alcohol briefly. Main rules for driving are to test before you drive, if your ng is less than 5 have a snack. If you hypo when driving pull over, take keys out of ignition and sit in passenger seat, treat then wait 45 mins before driving again - this is how long it takes your brain to recover fully - scary stuff. Also found out, scarily, that if hypo warning signs are lost and 3rd part intervention is required to get you out of a hypo you automatically lose your license for a minimum of 6 months. Eek.
Alcohol... Interesting! The science bit: when we drink, our livers metabolise the alcohol which is toxic to our bodies. Because it is so busy doing this it doesn't have time to produce glucose whihc inevitably leads to our sugar levels dipping after drinking. So, main advice is to always have a snack (I asked about kebabs! Apparently perfectly suitable 😛) and do not cover with any insulin. Better to correct a higher reading in the morning than risk a hypo. I'm useless with alcohol and units etc etc so was shocked to find out that the big glass of red wine I'm so partial to is 3 units! A small glass is 2 units. But drinking Bloody Marys is apparently a GOOD thing because the tomato juice has carbs in (about 10g per drink) so keeps bg levels up without being too high, and means only a small snack is needed after. Yay!
After lunch was the bit on illness 0 really useful, and partners etc were invited along to this bit (as well as the hypo bit). Illness for a diabetic is defined as major or minor depending on the presence of ketones. Main thing was that when ill always look at sick day rules given to you but to:
Always test for ketones and react according to sick day rules.
Ensure contact numbers (GP, DSN) are handy and ring for advice sooner rather than later.
Drink lots of sugar free fluids.
Eat if poss but if not, sip sugary fluids
Do not stop taking insulin, again - look to sick day rules for advice on dosages.
When ill, the body is under stress so it produces other hormones which inhibit insulin, leading to rising bg levels, so we do need more insulin when ill. There are guidelines that say to use 10% or 20% of your daily insulin dose to keep bg levels down (again, look to sick day rules) and advice is to use total daily dose from the previous day to work this out.
Right. Las bit! The afternoon was all about eating helthily. The idea of DAFNE is to let youeat whatever you want: as little or as much of whatever food you want, but they are very careful to remind you that everyone should be aiming for a healthy diet, hehe... This was all quite generic, looking at the 5 main food groups and discussing each one. Basically in a nutshell:
Protein - eat lean meat
Fats, oils and sugars - smallest proportion of food intake should be made up from this group. monounsaturated fats are best, hydrogenated and saturated fats should be avoided.
CHO - wholegrain
Fruit and veg - 5 a day
Dairy - aim for low fat.
The eating out bit was interesting. We all had to bring in our ideal menu and we talked each one throuhg, about how to estimate CHO value etc. The mian points that came out of it were:
If you have taken too much insulin prior to eating then compensate by ordering a fruit juice ot keep bg from dropping.
If meal is particularly heavy on root veg or pulses round insulin dose up to counteract carbs, even though slowly abosorbed.
Look at supermarket brands of similar meals/ portion sizes to get an idea of CHO values.
If a particularly favoured meal, experiment! Repeat meal and remove a different componant each time to guage its effect on your bg glucose (e.g. differnet types of rice, chutney, etc)
If the meal is high in fat inject after as fat slows down the absorption of carbs and round insulin down.
Phew. Hope that's helpful!
