Hi I have just been diagnosed with type 1 diabetes, I am keeping a diary of the food i am eating as asked by the dietician. I've found i eat a lot of carbs and I have been taking the background insulin (20) with the QA insulin (4) and my bloods throughout the day continually seem the be around 20-21. Am I taking to little? the dietician did talk about carb counting but because of COVID-19 did not go much past the pictures book of carbs and I am not really sure about this. Any advice for a new diabetic about snacks I could eat throughout the day and if you think I need to ask if i can take more QA insulin.
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Diagnosed yesterday
- Thread starter James B
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rebrascora
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Hi and welcome.
It is a bit overwhelming at first, to get that diagnosis and have to start injecting insulin and testing etc so don't be in a rush to make dramatic changes all at once. The DSNs (Diabetic Specialist Nurse) will almost certainly have started you on a lower level of basal (background) insulin than you will eventually need with the intention of slowly increasing it to bring your levels down slowly. This is important because sudden and dramatic changes can cause damage to the nerves and blood vessels (particularly in the eyes) as well as make you feel unwell. It is a common phrase on this forum that Diabetes is a marathon, not a sprint and it is better to keep making small changes than go for broke.
If you are eating a lot of carbs then you could start very slowly reducing your portion sizes but you need to be careful as it is possible to go too far the other way and end up hypo, which is worse than being too high..... have you been told to carry hypo treatment with you at all times just in case (dextrose tablets/jelly babies/full sugar coke/orange juice etc) ?
If you want a low carb treat/snack that doesn't involve an insulin injection then a boiled egg with mayonnaise or a high meat content sausage, or a chicken leg/thigh or a few nuts, or olives if you like them or a chunk of your favourite cheese all work well. I rather like a square of very dark (70%+ cocoa) chocolate with a spoonful of peanut butter.... but then I am probably just a bit weird.🙄
I am sure the nurse will be in touch in the next few days to see how you are getting on and suggest changes to your insulin regime which will probably include increasing your background insulin. It is important to get that one right before you start messing with the quick acting insulin otherwise you can end up chasing your tail.
Carb counting will enable you to learn how to adjust your quick acting insulin to cover the food you choose to eat but it takes time to learn and you are at the very early stages when they will still be trying to figure out your carb to insulin ratios, so for the moment it is probably more helpful to just eat normally and give your team info on your food and readings so that they can work out what adjustments need to be made in the days and weeks ahead to bring your levels down slowly.
The Carbs and Cals book provides a pictorial guide to assessing carb content of food/meals. I obtained a copy from the dietician. This may be what you were referring too. I choose to eat low carb so it was not particularly helpful to me but many diabetics consider it their "bible".... I believe their is a Carbs and Cals app which enables you to check carb content when you are eating out etc without having to lug the book around with you.
You really just need to give yourself time to get used to injecting and keeping a food diary and monitoring your levels and your team will figure out what adjustments need to be made until you gain more experience. It is important to drink plenty of water when your levels are that high to help flush the surplus glucose out of your system. If you have not heard from your team/DSN by the end of Monday or Tues, then give the helpline a ring and discuss your readings with them.
Good luck and keep us posted with your progress. I am 14 months down the line from you and still learning. They don't normally give you a course until you have at least a month or two of experience post diagnosis and with things the way they are at the moment, it will no doubt take longer, but it will all happen in time and by then they will have got your basal and bolus insulin doses much closer to what they need to be and it will be more a question of you learning to fine tune things.
It is a bit overwhelming at first, to get that diagnosis and have to start injecting insulin and testing etc so don't be in a rush to make dramatic changes all at once. The DSNs (Diabetic Specialist Nurse) will almost certainly have started you on a lower level of basal (background) insulin than you will eventually need with the intention of slowly increasing it to bring your levels down slowly. This is important because sudden and dramatic changes can cause damage to the nerves and blood vessels (particularly in the eyes) as well as make you feel unwell. It is a common phrase on this forum that Diabetes is a marathon, not a sprint and it is better to keep making small changes than go for broke.
If you are eating a lot of carbs then you could start very slowly reducing your portion sizes but you need to be careful as it is possible to go too far the other way and end up hypo, which is worse than being too high..... have you been told to carry hypo treatment with you at all times just in case (dextrose tablets/jelly babies/full sugar coke/orange juice etc) ?
If you want a low carb treat/snack that doesn't involve an insulin injection then a boiled egg with mayonnaise or a high meat content sausage, or a chicken leg/thigh or a few nuts, or olives if you like them or a chunk of your favourite cheese all work well. I rather like a square of very dark (70%+ cocoa) chocolate with a spoonful of peanut butter.... but then I am probably just a bit weird.🙄
I am sure the nurse will be in touch in the next few days to see how you are getting on and suggest changes to your insulin regime which will probably include increasing your background insulin. It is important to get that one right before you start messing with the quick acting insulin otherwise you can end up chasing your tail.
Carb counting will enable you to learn how to adjust your quick acting insulin to cover the food you choose to eat but it takes time to learn and you are at the very early stages when they will still be trying to figure out your carb to insulin ratios, so for the moment it is probably more helpful to just eat normally and give your team info on your food and readings so that they can work out what adjustments need to be made in the days and weeks ahead to bring your levels down slowly.
The Carbs and Cals book provides a pictorial guide to assessing carb content of food/meals. I obtained a copy from the dietician. This may be what you were referring too. I choose to eat low carb so it was not particularly helpful to me but many diabetics consider it their "bible".... I believe their is a Carbs and Cals app which enables you to check carb content when you are eating out etc without having to lug the book around with you.
You really just need to give yourself time to get used to injecting and keeping a food diary and monitoring your levels and your team will figure out what adjustments need to be made until you gain more experience. It is important to drink plenty of water when your levels are that high to help flush the surplus glucose out of your system. If you have not heard from your team/DSN by the end of Monday or Tues, then give the helpline a ring and discuss your readings with them.
Good luck and keep us posted with your progress. I am 14 months down the line from you and still learning. They don't normally give you a course until you have at least a month or two of experience post diagnosis and with things the way they are at the moment, it will no doubt take longer, but it will all happen in time and by then they will have got your basal and bolus insulin doses much closer to what they need to be and it will be more a question of you learning to fine tune things.
SB2015
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Welcome to the forum @James B .
I have read through @rebrascora ’s comprehensive post. I would reiterate that there is a lot to learn very quickly, and the DSN will work with you to gradually sort out appropriate doses. Keep in contact with them and keep the records that they have suggested as it will help them to work with you to make decisions about any changes to doses.
Carb counting will become a major par of your effective management, and the carbs and cal Book is a good reference. The labels on packets of dry goods, and other things often include all the information you need along with a set of weighing scales.
Your levels are high at present but be patient as the DSN will work with you to bring them down into range. You will need more insulin but let them work with the information you collect and you will getbthere.
Having said all that this is a manageable condition. It has the habit of misbehaving at intervals but it needn’t stop you doing anything, it just takes a bit of planning.
We are VERY happy to answer any questions that you have and nothing is considered silly. Just ask.
I have read through @rebrascora ’s comprehensive post. I would reiterate that there is a lot to learn very quickly, and the DSN will work with you to gradually sort out appropriate doses. Keep in contact with them and keep the records that they have suggested as it will help them to work with you to make decisions about any changes to doses.
Carb counting will become a major par of your effective management, and the carbs and cal Book is a good reference. The labels on packets of dry goods, and other things often include all the information you need along with a set of weighing scales.
Your levels are high at present but be patient as the DSN will work with you to bring them down into range. You will need more insulin but let them work with the information you collect and you will getbthere.
Having said all that this is a manageable condition. It has the habit of misbehaving at intervals but it needn’t stop you doing anything, it just takes a bit of planning.
We are VERY happy to answer any questions that you have and nothing is considered silly. Just ask.
Thank you so much for both reply, I love how you are both so caring! I really appreciate you both answering me! I have been to Morrisons and picked up some full fat coke to stash in case i ever get low, at the moment I'm feeling super tired and drain, but can't sleep. Is this normal with high sugars? I am also having frequent headaches. There is a lot to learn, I was at the clinic for 2 hours learning the basics, how much more is there to learn? Thanks again guys I really appreciate it.
Bruce Stephens
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- Type 1
Oh there's lots more! And yes, feeling tired and drained, and finding sleep difficult are all normal things to feel. On the positive side, once you do have a reasonably normal blood sugar level you should feel more normal generally.
rebrascora
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James, we totally understand how you feel because we have been there ourselves and I certainly have the wonderful members of this forum to thank for my current state of health, knowledge and sanity, so I am just paying it forward to you.
The headaches are likely due to dehydration. Drink as much water or low carb drinks as you can to help keep you hydrated as your kidneys are likely working overtime, trying to get rid of all that glucose in your blood.... you are likely weeing more frequently as a consequence.... both day and night which interrupts sleep but the high BG will also have your brain buzzing.... it is kind of on a sugar high all the time. This will settle down when your levels drop lower. The fatigue/lethargy is also due to your high glucose levels and will improve/disappear when you get into normal range.
I don't want to overwhelm you any more than you already are but there are people with 50+ years experience of living with diabetes who are still learning, so don't expect to have the hang of it in a few hours or days or weeks even. I have been on here almost every day for the past year learning more. The great news is that there is currently a lot of progress with tech which enables people to manage their diabetes much more effectively than 20 or 30 years ago and new stuff is being developed all the time, so whilst there is a lot to learn, there is also a lot of equipment available to help us and the diabetes shouldn't stop you doing anything you really want to in life, providing you put a bit of effort into managing it.
As regards hypo treatment, ideally you want things that you can easily carry around in a pocket or handbag. I appreciate that with social distancing a bottle of coke is fine to have at home but keeping a few jelly babies or dextrose tablets in a ziplock bag in your pocket it often more convenient. It is also wise to keep some in your bedside cabinet in case you hypo through the night because you do not want to be floundering around in the dark trying to find some (especially if you live in a house with stairs) when your brain is fogged by low blood glucose.... that is how accidents happen. Many of us have stashes of hypo treatment in most rooms in the house as well as a drawer at work and perhaps in a sports bag that you take to the gym and us ladies, in most of our handbags.... you just never know when you will need them.
Hopefully, your diabetic team will bring your levels down very slowly and it will be a long time before you experience a hypo, but that can lead you into a false sense of security sometimes and very occasional hypos can be much more scary than having them more frequently. I remember that I had 2 in a week about a month after I started on insulin and I was worried sick. Now I sometimes have 2 in a day and don't bat an eyelid. It is all part of the learning curve and everyone is different. Having the forum to seek advice and bounce ideas/concerns off people who understand, really helps to make sense of it.
Sorry for writing War and Peace..... I'm not very good at condensing things! 😉
The headaches are likely due to dehydration. Drink as much water or low carb drinks as you can to help keep you hydrated as your kidneys are likely working overtime, trying to get rid of all that glucose in your blood.... you are likely weeing more frequently as a consequence.... both day and night which interrupts sleep but the high BG will also have your brain buzzing.... it is kind of on a sugar high all the time. This will settle down when your levels drop lower. The fatigue/lethargy is also due to your high glucose levels and will improve/disappear when you get into normal range.
I don't want to overwhelm you any more than you already are but there are people with 50+ years experience of living with diabetes who are still learning, so don't expect to have the hang of it in a few hours or days or weeks even. I have been on here almost every day for the past year learning more. The great news is that there is currently a lot of progress with tech which enables people to manage their diabetes much more effectively than 20 or 30 years ago and new stuff is being developed all the time, so whilst there is a lot to learn, there is also a lot of equipment available to help us and the diabetes shouldn't stop you doing anything you really want to in life, providing you put a bit of effort into managing it.
As regards hypo treatment, ideally you want things that you can easily carry around in a pocket or handbag. I appreciate that with social distancing a bottle of coke is fine to have at home but keeping a few jelly babies or dextrose tablets in a ziplock bag in your pocket it often more convenient. It is also wise to keep some in your bedside cabinet in case you hypo through the night because you do not want to be floundering around in the dark trying to find some (especially if you live in a house with stairs) when your brain is fogged by low blood glucose.... that is how accidents happen. Many of us have stashes of hypo treatment in most rooms in the house as well as a drawer at work and perhaps in a sports bag that you take to the gym and us ladies, in most of our handbags.... you just never know when you will need them.
Hopefully, your diabetic team will bring your levels down very slowly and it will be a long time before you experience a hypo, but that can lead you into a false sense of security sometimes and very occasional hypos can be much more scary than having them more frequently. I remember that I had 2 in a week about a month after I started on insulin and I was worried sick. Now I sometimes have 2 in a day and don't bat an eyelid. It is all part of the learning curve and everyone is different. Having the forum to seek advice and bounce ideas/concerns off people who understand, really helps to make sense of it.
Sorry for writing War and Peace..... I'm not very good at condensing things! 😉
D
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Hi James,
Glad you have found the forum so quickly, can see you have already had a wealth of helpful responses and no doubt there will be more to come. I don't want to add anything to what’s been said, but just to reiterate do ask absolutely anything if you’re left wondering, nothing is a silly question. The more you ask the more you’ll learn, but there is a lot to take on board so don’t feel you need to rush. Hope you start to feel better very soon.
Glad you have found the forum so quickly, can see you have already had a wealth of helpful responses and no doubt there will be more to come. I don't want to add anything to what’s been said, but just to reiterate do ask absolutely anything if you’re left wondering, nothing is a silly question. The more you ask the more you’ll learn, but there is a lot to take on board so don’t feel you need to rush. Hope you start to feel better very soon.
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Welcome to the forum @James B
Shat a difficult time to get a diagnosis! With everything so upside down and all over the place.
Glad you’ve found the forum, and a little additional extra support along the way.
Hopefully you will be able to contact your DSN for advice on and potential strategies for dose adjustment and corrections in the interim, while you wait for more detailed education.
In the meantime, if you’d like to do some preparatory reading, Diabetes UK has some introductory carb counting information here:
www.diabetes.org.uk
And there’s a well regarded and very helpful online e-learning course from Bournemouth diabetes centre here:
www.bertieonline.org.uk
Good luck with it all, and keep asking questions! Your inquisitive approach is going to pay dividends in your self management without a doubt.
Shat a difficult time to get a diagnosis! With everything so upside down and all over the place.
Glad you’ve found the forum, and a little additional extra support along the way.
Hopefully you will be able to contact your DSN for advice on and potential strategies for dose adjustment and corrections in the interim, while you wait for more detailed education.
In the meantime, if you’d like to do some preparatory reading, Diabetes UK has some introductory carb counting information here:
The nuts and bolts of carb counting
When you live with type 1 diabetes, carb counting is a great way of managing your blood sugar or glucose levels. It can give you more freedom and flexibility in what you eat when you're preparing meals at home, grabbing food on the go or eating out. Carb counting does take some time and effort...
And there’s a well regarded and very helpful online e-learning course from Bournemouth diabetes centre here:
Bertie Diabetes
www.bertieonline.org.uk
Good luck with it all, and keep asking questions! Your inquisitive approach is going to pay dividends in your self management without a doubt.
rebrascora
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Hi James
I've only just logged in to the forum and seen your post. How are you feeling now? If you gave yourself 20 units of Novorapid (QA insulin) instead of Background insulin I hope you have been drinking that coke you bought and quite a bit more carbs in whatever form you have available to mop it up. Fingers crossed you were mistaken and it was the background insulin you used, otherwise I imagine you have probably experienced your first hypo by now.
I would give yourself maybe 15 units of the background insulin now rather than the full 20 units, if you really did make that error (you will have been dropping low all morning if you did and probably feeling pretty rough) and check your BG regularly throughout the rest of the day.
I hope you are OK. It is an easy mistake to make and you are certainly not the first person to do it. Please let us know how you are as soon as you can.
I've only just logged in to the forum and seen your post. How are you feeling now? If you gave yourself 20 units of Novorapid (QA insulin) instead of Background insulin I hope you have been drinking that coke you bought and quite a bit more carbs in whatever form you have available to mop it up. Fingers crossed you were mistaken and it was the background insulin you used, otherwise I imagine you have probably experienced your first hypo by now.
I would give yourself maybe 15 units of the background insulin now rather than the full 20 units, if you really did make that error (you will have been dropping low all morning if you did and probably feeling pretty rough) and check your BG regularly throughout the rest of the day.
I hope you are OK. It is an easy mistake to make and you are certainly not the first person to do it. Please let us know how you are as soon as you can.
Hi Barbara, I think I am okay now I rang my mum who told me to drink the coke and have some toast with peanut butter on which I did and my Bloods Sugar is currently 16.1, feeling a bit tired and dizzy but I think I will be okay! definitely will pay more attention in future!
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Argh James!
Sorry you’ve had this experience.
You aren’t the first on the forum to have done this, and you certainly won’t be the last!
What to do next depends on how sure you are that you mixed them up.
If you are not sure, I would just ’firefight’ BGs through the day, and check much more often.
If you know for certain that you definitely took your basal dose as quick-acting, then your rapid acting ‘extra’ (if that’s what you did) will last for 4-6 hours from when you took it, so if you’ve not taken your regular basal dose you will begin to run short of insulin (after having been temporarily over-supplied!)
If you are sure you’ve not had any basal today, I t would be worth considering a smaller dose perhaps half or three-quarters what you would normally take to see you through the evening and overnight.
For the future, I would recommend you ask your DSN for a Novopen ‘Echo’ or similar reusable insulin pen (rather than disposables) as these have a screen/memory that will tell you when your last dose was, so you can always check back if you can’t remember!
Just keep checking more frequently for the next 24 hours, and expect the unexpected!
Sorry you’ve had this experience.
You aren’t the first on the forum to have done this, and you certainly won’t be the last!
What to do next depends on how sure you are that you mixed them up.
If you are not sure, I would just ’firefight’ BGs through the day, and check much more often.
If you know for certain that you definitely took your basal dose as quick-acting, then your rapid acting ‘extra’ (if that’s what you did) will last for 4-6 hours from when you took it, so if you’ve not taken your regular basal dose you will begin to run short of insulin (after having been temporarily over-supplied!)
If you are sure you’ve not had any basal today, I t would be worth considering a smaller dose perhaps half or three-quarters what you would normally take to see you through the evening and overnight.
For the future, I would recommend you ask your DSN for a Novopen ‘Echo’ or similar reusable insulin pen (rather than disposables) as these have a screen/memory that will tell you when your last dose was, so you can always check back if you can’t remember!
Just keep checking more frequently for the next 24 hours, and expect the unexpected!
rebrascora
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So pleased you are OK and your Mam was able to give you the advice you needed.
Mike has covered in his post above what I was trying to convey regarding your background insulin.
I had a moment last night when I took my bedtime reading and decided that I needed a correction of QA as well as my evening basal insulin. I injected the insulin and logged the reading and my two doses of insulin on my phone app but then couldn't be sure if I had given myself the basal (background) insulin or just the QA. The more I thought about it, I was convinced that I hadn't, so I jabbed myself again..... thankfully I was right.... but it is really easy to get confused if you don't fully concentrate. I have a Novopen Echo for my QA which is really useful for being able to check how much I last had and when but just normal disposable ones for my Levemir, so I wasn't able to check that.
Mike has covered in his post above what I was trying to convey regarding your background insulin.
I had a moment last night when I took my bedtime reading and decided that I needed a correction of QA as well as my evening basal insulin. I injected the insulin and logged the reading and my two doses of insulin on my phone app but then couldn't be sure if I had given myself the basal (background) insulin or just the QA. The more I thought about it, I was convinced that I hadn't, so I jabbed myself again..... thankfully I was right.... but it is really easy to get confused if you don't fully concentrate. I have a Novopen Echo for my QA which is really useful for being able to check how much I last had and when but just normal disposable ones for my Levemir, so I wasn't able to check that.
trophywench
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Keep your 'in use' long acting pen somewhere different to your quick acting pen. If you take your long acting in the morning, why not keep it somewhere you'll see it reliably each morning? What else do you do first thing? My other halves have shaved and used electric razors, so could eg bung the pen wherever they've kept the razor whilst not in use, or perhaps in their sock or underpants drawer. Top drawer of bedside table, wherever you keep your comb.
Dunno - where DO blokes keep such things?
Dunno - where DO blokes keep such things?
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