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Stane

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I am new since November, been doing ok but purely by not eating lots carbs and nothing bad… normaly around80% in range, but something is going wrong, last three days just can’t control the levels… is constantly high… last night i had salad, roasted weg and fish( two units for 30 g carb),this was 8 pm…. And i wike up to this, i did give myself unit more night insulin.. anyone with experience can put me in right direction please
 

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That isn’t horribly high @Stane so don’t panic. Eating too few carbs actually makes control harder not easier. You might find you get better results by increasing your carbs a bit. Too few carbs causes insulin resistance and can make you feel like you’re constantly fighting to push your blood sugar down.

So, my advice would be to eat some proper carbs, ie bread, potatoes, etc with your meals. It will take a little while to get things back to normal, but then you can do a basal test and look at your mealtime ratios.

It might also be that your honeymoon period is coming to an end and your own insulin production has reduced.
 
This happens to us all from time to time. It isn't desperately bad so don't worry too much about it but if it is a regular trend then obviously you will want to do something about it.
Which basal insulin do you use and when do you take it?
 
Inka said:
That isn’t horribly high @Stane so don’t panic. Eating too few carbs actually makes control harder not easier. You might find you get better results by increasing your carbs a bit. Too few carbs causes insulin resistance and can make you feel like you’re constantly fighting to push your blood sugar down.

So, my advice would be to eat some proper carbs, ie bread, potatoes, etc with your meals. It will take a little while to get things back to normal, but then you can do a basal test and look at your mealtime ratios.

It might also be that your honeymoon period is coming to an end and your own insulin production has reduced.
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Thank you for replying, it is very upsetting, i just dont get it, am hungry all the time anyway and now bg going high is going to make me even more picky what i eat.. one i do hope i do get it and get it sorted
 
rebrascora said:
This happens to us all from time to time. It isn't desperately bad so don't worry too much about it but if it is a regular trend then obviously you will want to do something about it.
Which basal insulin do you use and when do you take it?
Click to expand...
Hi,thank you for finding time to reply, i use lantus at night 6 units( last night i did 7),my gb was still high in the morning, and with food i take novorapid, been doing 15 carbs for one unit…. Looks like i need to do less….
Am just cross, am so desperate to put same weight on and feel full but with bg playing up is going to be challenging…
Can i ask? How many times you eat( fo insulin).
 
Stane said:
Thank you for replying, it is very upsetting, i just dont get it, am hungry all the time anyway and now bg going high is going to make me even more picky what i eat.. one i do hope i do get it and get it sorted
Click to expand...

Right, so you need to consider changing your diet. Reducing carbs doesn’t solve high blood sugar. It can cause insulin resistance and stubborn highs. Eating more carbs at each meal actually makes control easier. There’s nothing wrong with carbs for Type 1.
 
Stane said:
Can i ask? How many times you eat( fo insulin).
Click to expand...
I eat as few or as many times a day as I like. Sometimes I just have one meal and a couple of snacks, sometimes I have 2 meals a day, sometimes 3 meals a day and sometimes I just graze all day picking at things. I eat when I feel like it or I have time. I have only myself to please, so it doesn't matter what or when I eat. I have been known to have a midnight feast/supper if I was busy until late. The wonderful thing about a basal/bolus system is that it allows you to eat what and when you like.

There is absolutely no reason why you should go hungry, so you really need to cut yourself a bit more slack and start eating what you want. Type 1 diabetes is about balancing the food you want to eat with insulin and getting the timing right. It isn't about restricting your diet although I choose to follow a low carb way of eating for a number of other reasons, it certainly doesn't mean I ever go hungry. In fact since eating low carb and more fat, I am very rarely hungry which is why some days I can manage on just one or two meals a day.
 
Hi @Stane Sorrythat you are finding things so frustrating at present.

I find that if I eat very low carb meals I then need to start taking account of the protein, as in the absence of carbs my body will have to use that. Too much to think about so I rarely have less than 25g carbs at a meal. This makes it a lot easier to dose for the meal.

As you are in the early stages of T1 you are likely to still have some beta cells making insulin, but these will gradually reduce, and your honeymoon period will come to an end. You will then need more insulin, and need to adjust both basal and bolus insulin.

Having said that I think the issues you are experiencing are more likely/to be around your choice of restricting your carbs, and your body processing protein in place of this. Let us know how you get on with any changes that you choose to make.
 
rebrascora said:
I eat as few or as many times a day as I like. Sometimes I just have one meal and a couple of snacks, sometimes I have 2 meals a day, sometimes 3 meals a day and sometimes I just graze all day picking at things. I eat when I feel like it or I have time. I have only myself to please, so it doesn't matter what or when I eat. I have been known to have a midnight feast/supper if I was busy until late. The wonderful thing about a basal/bolus system is that it allows you to eat what and when you like.

There is absolutely no reason why you should go hungry, so you really need to cut yourself a bit more slack and start eating what you want. Type 1 diabetes is about balancing the food you want to eat with insulin and getting the timing right. It isn't about restricting your diet although I choose to follow a low carb way of eating for a number of other reasons, it certainly doesn't mean I ever go hungry. In fact since eating low carb and more fat, I am very rarely hungry which is why some days I can manage on just one or two meals a day.
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Wow, 8 months in and i feel am at the beginning again, i have been eating 3 times so 3 injections plus night one and small carbs to keep in range.. i dont even know how would keep on track if was eating every 2-3 hours…. I find meals don’t peak gor2.30-3 hours… i have not had carbs since 4.30 and my levels are in range but high… i think need to read my books again and start from beginning.
Thank you so much for respond.
Stane
 
Books are for guidance and the advice the DSNs give you is guidance but nothing is set in stone and you have to learn to do what suits you and your body and your lifestyle and your response to food and insulin.
For instance, the general guidance is to inject NovoRapid 20 mins before meals. I needed to inject it over an hour before breakfast to stop my levels from spiking up to 15 every morning and then crashing back down to about 5 even with a low carb breakfast of yoghurt and berries. Many other people would hypo long before an hour was up, but this is what worked for me and the only way to find this out was to start carefully experimenting by increasing the prebolus time by a few more minutes each day. I only needed about 20-30 mns at other times of day, but in the morning I needed a long time to overcome FOTF. I am now using Fiasp instead of NR which is a bit quicker but I still need 30-45mins prebolus time at breakfast and longer if I wake up in double figures. A DSN would never tell you to wait so long, but this is what my body needs, so this is what I do to get good diabetes management. I don't let guidelines stand in my way.

You are also not supposed to stack corrections but sometimes that is the only way to get my levels down if they go high, particularly with Fiasp which is a bit of a wimp when levels are above 10. Again a DSN would try to discouage me from doing this, but it is what works for me and my body and my insulin.

A lot of my snacks are low carb snacks so I don't need insulin for say a pot of olives with feta cheese or a slice of ham with coleslaw. But if what I want to eat has more than 5g of carbs I just inject for it even if I injected some insulin half an hour earlier for something else that I ate. It is no different than going to a restaurant and having a starter and a main course.... you inject the amount of insulin for each course as you get it and this is not stacking insulin, it is just bolusing for what you eat. The only important thing is that you don't do a correction each time you inject overlapping insulin because there is active insulin from the first injection still working, when you inject the next lot and so you just inject however much you need for what you are going to eat next.
 
The absolute bog standard suggestion when people like me started with Novorapid was always to try 1u for every 10g of carbohydrate we ate and see if that was enough or too much or too little. The important word here is TRY. ie if not exactly spot on - change it up or down.
 
rebrascora said:
Books are for guidance and the advice the DSNs give you is guidance but nothing is set in stone and you have to learn to do what suits you and your body and your lifestyle and your response to food and insulin.
For instance, the general guidance is to inject NovoRapid 20 mins before meals. I needed to inject it over an hour before breakfast to stop my levels from spiking up to 15 every morning and then crashing back down to about 5 even with a low carb breakfast of yoghurt and berries. Many other people would hypo long before an hour was up, but this is what worked for me and the only way to find this out was to start carefully experimenting by increasing the prebolus time by a few more minutes each day. I only needed about 20-30 mns at other times of day, but in the morning I needed a long time to overcome FOTF. I am now using Fiasp instead of NR which is a bit quicker but I still need 30-45mins prebolus time at breakfast and longer if I wake up in double figures. A DSN would never tell you to wait so long, but this is what my body needs, so this is what I do to get good diabetes management. I don't let guidelines stand in my way.

You are also not supposed to stack corrections but sometimes that is the only way to get my levels down if they go high, particularly with Fiasp which is a bit of a wimp when levels are above 10. Again a DSN would try to discouage me from doing this, but it is what works for me and my body and my insulin.

A lot of my snacks are low carb snacks so I don't need insulin for say a pot of olives with feta cheese or a slice of ham with coleslaw. But if what I want to eat has more than 5g of carbs I just inject for it even if I injected some insulin half an hour earlier for something else that I ate. It is no different than going to a restaurant and having a starter and a main course.... you inject the amount of insulin for each course as you get it and this is not stacking insulin, it is just bolusing for what you eat. The only important thing is that you don't do a correction each time you inject overlapping insulin because there is active insulin from the first injection still working, when you inject the next lot and so you just inject however much you need for what you are going to eat next.
Click to expand...
Hi, i have read this few times,
I have been eating 3 times with no carb snacks in between, i have been doing ok but something is up, i eat give insulin three hours later is out of range and going up… a i do then give bit insulin to get it down… i have not read anywhere details in correction and had no training as such.
I do get it that type1 is challenging, and thst changes and with time you get it, is just every time i think i get it things change.
Anyway , thank you so much for trying to explain and finding time to reply, hopefully i will figure it out,
Stane
 
Stane said:
Hi, i have read this few times,
I have been eating 3 times with no carb snacks in between, i have been doing ok but something is up, i eat give insulin three hours later is out of range and going up… a i do then give bit insulin to get it down… i have not read anywhere details in correction and had no training as such.
I do get it that type1 is challenging, and thst changes and with time you get it, is just every time i think i get it things change.
Anyway , thank you so much for trying to explain and finding time to reply, hopefully i will figure it out,
Stane
Click to expand...

If you’re not eating enough carbs at your meal, this is often what happens: your blood sugar will rise a few hours later. If you eat carbs with your meal (I think Think Like A Pancreas author Gary Scheiner suggests 30g minimum) then you shouldn’t get that delayed rise.
 
Inka said:
If you’re not eating enough carbs at your meal, this is often what happens: your blood sugar will rise a few hours later. If you eat carbs with your meal (I think Think Like A Pancreas author Gary Scheiner suggests 30g minimum) then you shouldn’t get that delayed rise.
Click to expand...
You are so knowledgeable, may i ask how long have you had diabetes?
One more silly question, on libre… i know we are meant to be 4-10 to be in range…
What about spikes as long in range? And is it possible to have really nice smooth line??
 
I’ve had Type 1 more than 30 years @Stane One big thing I’ve learnt is that perfection is impossible. The Time in Range is just a guide. No-one is expecting you to be 100% in range all the time. Also, even people without diabetes don’t get straight lines. Blood sugar naturally goes up and down through the day in people without diabetes. That includes spikes after meals.

70% or above Time in Range is considered excellent control. It sounds like you’re doing very well.
 
Stane said:
You are so knowledgeable, may i ask how long have you had diabetes?
One more silly question, on libre… i know we are meant to be 4-10 to be in range…
What about spikes as long in range? And is it possible to have really nice smooth line??
Click to expand...
Flat lines not possible, really. I end to have flatter lines with low carb, but even 'normal' people have 'spikes'. Low carb has its own downsides, including insulin resistance.
Walking after eating can flatten spikes, as can prebolusing
 
@Stane speak with your DSN about corrections.

I find that my background amounts are only set in stone for a week or so and then change due to my menstrual cycle, I am 18 years in and me and my team only worked this out thanks to the libre (I suspected it all along) being able to see the data helped me.

There’s that lost somewhere of 40+ things which impact diabetes. But it includes everything from the weather to the amount of exercise you have been doing recently and also even just emotions.

You will always need to adapt and there is no such thing as perfect. As others have said if you can be over 70% most of the time that’s considered great control. I work to time in range over 3 months as my guide. And also allow myself leeway sometimes for event I know about, such as illness.

You are doing great and I don’t think I’ve had many weeks where I am not learning something new about my body and diabetes.

Keep it up, and we are here to help
 
PhoebeC said:
@Stane speak with your DSN about corrections.

I find that my background amounts are only set in stone for a week or so and then change due to my menstrual cycle, I am 18 years in and me and my team only worked this out thanks to the libre (I suspected it all along) being able to see the data helped me.

There’s that lost somewhere of 40+ things which impact diabetes. But it includes everything from the weather to the amount of exercise you have been doing recently and also even just emotions.

You will always need to adapt and there is no such thing as perfect. As others have said if you can be over 70% most of the time that’s considered great control. I work to time in range over 3 months as my guide. And also allow myself leeway sometimes for event I know about, such as illness.

You are doing great and I don’t think I’ve had many weeks where I am not learning something new about my body and diabetes.

Keep it up, and we are here to help
Click to expand...
Thank you, so much to take on.. i have decided to eat more as did not before now i know not to be hungry and put weight on i must!
 
Stane said:
What about spikes as long in range? And is it possible to have really nice smooth line??
Click to expand...

Chasing flat lines is a fast route to frustration and burnout I think.

But…

When I first had access to a continuous sensor (Libre 1) I was able to see what had been going on ‘between the dots’ and that showed me that sometimes while my dose worked out eventually, there was a sharp rise soon after eating, that came down later.

What helped me was giving my insulin a little earlier. Then waiting a few minutes to give my insulin a bit of a headstart.

I found it really helped at breakfast and a shorter wait at lunch, but if I tried it in the evening I ended up hypo. Plus the ‘right’ wait time varies throughout the year - so it’s a strategy that needs careful and cautious handling!
 
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