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Finally had my first nurse appointment - some questions though

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stackingcups

stackingcups

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Hi, after a month or so of waiting I finally got to see the diabetes nurse at my GP surgery today and got started on insulin - 10 units for now.

Nothing about food was mentioned yet - I don't know if thats because we didn't have time, or if being type 3c complicates things?

I'm trying to reduce carbs, but wondering if there is an amount per day I should be aiming for? NHS seems to suggest half my calories should come from carbs and I should be having some with every meal, but I know the advice on here from you guys differs.

Also, how long should I expect to see the insulin making a difference?

Thanks
 
What insulin have you been given @stackingcups ? The differing diet advice you see around the forum is often because of the difference between Type 1 and Type 2s, and whether the person is on insulin or not.

How high was your blood sugar before you were given insulin? You’ll need some carbs with your insulin and you should have hypo treatments available in case you go low.
 
Hi, I got given lantus. My HbA1c was 74 I think. My morning readings are around 11-12 on average.
 
Ok, Lantus is a basal/background insulin. I suspect your dose might be increased gradually. It’s normal to start on less than they think you’ll need and then increase it gradually. So, to answer your question, it will take a little time to get the right amount for you.

What’s your blood sugar like 2hrs after meals? Did they mention the possibility of a mealtime insulin too?
 
Yesterday I went from 9 before lunch (felt shakey and c**p) to 15.6 two hours after.

No mention of meal times yet, but I have a telephone appointment with a DSN next month, and today's nurse said they may do some tweaking.
 
Hi. NHS diet advice is usually best ignored although you are a T3c so some aspects might be relevant. In general, favour fats and proteins rather than carbs in the food mix
 
stackingcups said:
Yesterday I went from 9 before lunch (felt shakey and c**p) to 15.6 two hours after.

No mention of meal times yet, but I have a telephone appointment with a DSN next month, and today's nurse said they may do some tweaking.
Click to expand...

Feeling shaky and c**p at 9 will probably be what’s called a false hypo where your body has got used to running high so dropping into a more normal range feels ‘wrong’ to it. This will gradually reduce.

@DaveB I thought 3cs could eat similarly to Type 1s. I’ve seen nothing that says they have to concentrate on fat and protein.
 
I think as a type 3c too much fat isn’t a good idea as we have trouble with our digestion. Otherwise I eat the same as a type 1 as I have the insulin to cover it, but if you’re only on a basal insulin that will be trickier, they started me on a mixed insulin ( Humulin I) which did reduce my HbA1c initially but I still had a restricted diet as I didn’t have any fast acting to cover my meals. I did eventually get them to prescribe fast acting too, then the hospital changed the mixed to Levemir which has been so much better. See how it goes but I feel a basal/ bolus regime is probably better suited to you in the long run. Elaine.
 
Hi @stackingcups, to come back to original question. I'm a humble T2 not on insulin but from my reading of many posts and threads on the forum I think you are in for a period during which you and your diabetes nurse are going to work out what is best for you. This will mean adjusting insulin doses to balance out what you are eating. As far as I can see, from what insulin dependent members say, that can only be done by trial and error. The saving grace is that most seem to report that they feel much better once on insulin and things improve further when they have optimised their insulin intake.

The general dietary advice from the NHS is just that, general advice for those without any complications. It needs to be read bearing that in mind. Personally I would set it aside whilst trying to get your regime sorted out, especially, as @eggyg (our resident 3c guru), points out you may need to take into account other digestive issues that come with 3c.

Keep posting and asking questions. The responses, particularly from those with 3c experience, will help you work your way through the maze.
 
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