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Hi

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Lucy I feel I am piling weight on eating no carbs snacks like cheese, nuts and meats! Sickened myself of scrambled eggs and smoked salmon! I want to eat cakes and crisps. Miss the way I used to be able to eat.
 
Have you done the DAFNE course or the on line BERTIE course both of which people have found useful in helping to eat normally and adjusting insulin.
 
MichelleF78 said:
Lucy I feel I am piling weight on eating no carbs snacks like cheese, nuts and meats! Sickened myself of scrambled eggs and smoked salmon! I want to eat cakes and crisps. Miss the way I used to be able to eat.
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vegetables, fruits especially berries, lower calorie things like fridge raiders? cheetos are only like 6g carb a packet, popcorn can be low too, as are jelly pots. Or eat what you used to eat if you have a carbohydrate ratio use that to cover it, or stick to small portions so that snacks are say 10g carb which you might be able to get away with without insulin (you'd have to test to check)
 
Hi, I understand you are new to type 1 and it is all a lot to take in, but can I ask why are you waiting 5 hours to eat please? If you levels are consitently high it may well be basal that needs a look rather than bolus.
 
They are not consistently high I am on 14 Levemir morning and now to try 16 at night. I am waiting for my levels to reduce to a healthy range before I eat again. Is this not correct?
 
Right now I am sitting at 9 and I had my breakfast at 9. Should I increase Levemir in morning?
 
MichelleF78 said:
Right now I am sitting at 9 and I had my breakfast at 9. Should I increase Levemir in morning?
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When you say you had your breakfast at 9 do you mean 9am or that your levels were at 9 before breakfast?
 
Hi my breakfast was 9am as i always go high on waking so I’m trying to correct before I I eat. Right now I’m sitting about 8 and my target is . Thank you
 
Can you talk us through your morning routine with insulin, food and readings for this morning? Do you have Libre and if so, can you post a photo of this morning's graph?

Things like when you wake up, do you test and inject before you get out of bed or wait till you are up and washed and dressed?
Timing with insulin, both bolus and basal insulin, particularly Levemir, can make a big difference. Once you set foot out of bed, your liver may start pumping out glucose to give you energy for the day, so for me it really helps to get my basal and bolus insulin into me before my feet touch the ground. Obviously don't bolus your breakfast insulin if you are intending to eat out, but in the normal course of things, injecting it as early as possible has been really helpful for me. In fact I experimented with setting an alarm for an hour earlier to inject my morning Levemir to give it time to get going before I got up. That experiment lasted for a month or two before the novelty wore off 🙄 , but I always inject before I get out of bed. Even if I am not having any breakfast, I find that I still need 1.5-2 units of meal time insulin (Fiasp) to counteract the glucose released by my liver (Foot on the Floor Syndrome). You may be different, so you will need to experiment to see what works for you.

I am a grazer, so i is certainly possible to do this with a basal bolus regime and you don't need to leave 5 hours between meals, but in the early days of diagnosis when they are trying to figure out your basal needs and ratios and correction factors, it helps to stick to 3 meals a day, so there isn't anything happening between meals which will distort the results.

I think it is important to note that if you are waiting for your levels to come back down to your target of 7 before injecting your next bolus of NR and then eating your next meal, you may be misunderstanding. The target is the number you are aiming for in your calculations when you need a correction. You won't necessarily achieve the target because there are something like 42 factors which impact on BG levels and you don't have control over many of them, so what you are aiming for and what you achieve are often very different, but that shouldn't stop you from eating.

If you are within the 5 hours that NR is active then I would not advise you do another correction (even if you need to) , but there is no reason why you can't inject the insulin to balance your next meal and then eat it after your prebolus time or if you are very high, inject and wait for levels to come down to 7 before eating.

Hope that makes sense. If it doesn't, please ask and I will hopefully explain it better. In theory. You could have breakfast at 9am and then have a 20g carb snack at 11am and just inject however much insulin you need for 20g carbs and then have lunch at 1pm and inject however much you needed for lunch. However you would not calculate a correction for your levels being high at 11pm before the snack or 1pm before lunch because the NR you injected in between is still active. This is the same regardless of which insulin you use although for me Fiasp is usually finished working after about 3 hours. As I said, in the early days, you need to try to keep things simple so that your nurse can see what is going on more clearly.

As for DAFNE being hard work, I didn't find it so and really enjoyed it, but I had learned a lot from this forum before I went so I was probably more clued up than most. Whilst I don't "eat normally" as the course title suggests, it still provided me with some very useful knowledge and frameworks, which I can fall back on if/when my diabetes goes wonky, but mostly, it gave me confidence particularly with adjusting my Levemir doses, which has made a very significant difference to my diabetes management.
 
You can eat cakes and biccys etc, between meals if you make them low carb/keto...though it will be coconut flour or almond flour they need to be made of, and sweetners
 
You've had a really helpful response from the excellent @rebrascora above, so I'll try to add to this a little bit

Firstly many of us on here who are T1 have come to it later in life. I was in my early 40s when I was diagnosed. It's a huge upset and a lot to get used to, it sucks actually and that needs saying! but it gets better as you get to grips with it. Diabetes or any long term condition is a marathon and you can wear yourself out trying to control it, but ultimately we do the best we can on any one day, take the wins, and accept some days will be a bit rubbish. Finding a way to manage things that works for you is, in my humble, the way forward with this.

1) if you do not already have a CGM, I suggest you get a free 14 day trial one from Libre in the meantime, but it should be available to you as a T1. As you'll see from other threads the key to libre/cgm in general is using it well as tool to see what your blood sugar is doing in between finger pricks/meals etc. This can give us a lot of information which helps make plans

2) You do not have to low carb. Some members enjoy this way of eating and find this useful, but it is not necessary if it does not work for you. Personally I find coconut flour to be the devils work, and would much rather have a piece of deliciously carb-laden cake from the bakery and bolus for it. Once things have settled a bit more and you are confident with your insulin, you can pretty much eat as you would have before T1. The carbs and cals book/app is useful in the beginning for carb counting (actually i no longer need my copy of the book, if you would like it, dm me your address and I will send it to you), but eventually you will get your eye in and be able to accurately guesstimate the carbs in anything on sight.

3) Hopefully fiasp helps you - I can see you've had good advice on the other thread. We can't advise on dosing, but keeping good records of timings and amounts of insulin, reviewing and looking for patterns/having a chat with your DSN should help. Insulin resistance is often highest in the morning due to something called 'dawn phenomenon' or 'foot on the floor' when the liver helpfully dumps glucose into the bloodstream and this can make breakfast more challenging to bolus for. From everything you've said you are doing really well, just be gentle with yourself as you are learning.
 
I think you can have the best of both worlds- carby meals and perhaps a bit of cake, bolused for, and low carb treats for snacking.
Coconut flour can be the work of the devil , but it can also be v tasty in the right recipe. But even i draw the line at lupin flour or ground pork scratchings as a flour. Ew!
 
Hi @MichelleF78

You mention that you go high as soon as you get up. This is quite common. You don’t need to wait until the correction for that is sorted if you want an earlier breakfast. Once you are carb counting, and know how to do corrections for higher or lower levels, you can add in the adjustment to your breakfast dose. It is quite common for us to need more insulin in the morning than later in the day. That could then give you a bigger gap between your breakfast and lunch if that is what you want. Eventually you will be able to eat whatever you want when you want and just match the insulin you inject to what you need.

Great that you have the option to change to FIASP. This has worked well for some and they have been able to reduce their pre-bolusing. Another faster acting insulin is Lyumjev, so that could be another option if FIASP doesn’t suit you.

It could be helpful if you have a look at the Bertie course on carb counting. I know it is frustrating in these early stages after diagnosis, but just take things a step at a time.
 
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