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NEW TO GROUP

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
J

Jan M

New Member
Relationship to Diabetes
Type 2
Was diagnosed in may this year with type 2 and over active thyroid and been in hospital twice due to ketones and hypo's just recently im now told im type 1
Im struggling to control my levels there always to high GP not much help
Any info on altering my insulin dose to help control these levels im currently on
12mg Levemir at ninight long acting
12mg Levemir in morning
10mg Nova rapid 3 times a day with food
Im struggling so much with this at mo
PLEASE HELP
 
A warm welcome to our forum Jan M. Sorry to hear you're struggling hun but dont despair as other T1's will be along shortly to give you advice.
You take care now.
WL
 
Last edited:
Welcome to the forum Jan.
Having been misdiagnosed won't help with your management.
Are you under the hospital? Or the GP?
I believe standard procedure is to be a bit conservative on the insulin doses. They are then adjusted depending on your BG levels. The person you're seeing should advice on this.
There are plenty of insulin users, including mis diagnosed, on here who'll be able to give more info.
 
Ralph-YK said:
Welcome to the forum Jan.
Having been misdiagnosed won't help with your management.
Are you under the hospital? Or the GP?
I believe standard procedure is to be a bit conservative on the insulin doses. They are then adjusted depending on your BG levels. The person you're seeing should advice on this.
There are plenty of insulin users, including mis diagnosed, on here who'll be able to give more info.
Click to expand...

Hi Thank you for your reply and advise
 
Jan M said:
Was diagnosed in may this year with type 2 and over active thyroid and been in hospital twice due to ketones and hypo's just recently im now told im type 1
Im struggling to control my levels there always to high GP not much help
Click to expand...

GP's not likely to be able to help you that much, but they can (and really should) refer you to a specialist who can. Probably at your local hospital (though at my GP surgery the diabetic specialist nurses visit once a month now). (My GP happens to specialise in diabetes so she is more helpful than average, but even so she'd be the first to suggest that I talk to the local diabetes team if needed.)

As a general principle, increasing insulin doses decreases blood glucose, but you note being in hospital a couple of times with hypos, so you really really need to see someone qualified who can give suitable guidance.
 
Hello @Jan M and welcome 🙂

Were you put you on insulin by the hospital or gp and did they give you any follow up appointment or contact phone no./email? If not, I would get in touch tomorrow with my gp and ask for an urgent referal to the diabetes team at the hospital. Starting insulin is a big change and the initial doses of insulin recommended before meal and night time are a conservative best guess to tide you over until you can be advised how to alter your insulin yourself. Meanwhile keep glucose tablets/jelly babies to hand in case your blood sugar starts to fall too low.

There are education courses that show you how to count the number of carbs in foods/meals, work out your insulin to carbohydrate ratio and learn how to balance your insulin needs with the food eaten. It makes life much more flexible and teaches you to correct highs as well.Once you have been seen by a diabetes team ask for a referral to a course.

Insulin does work with the right amount at the right time but it doesn't just happen and you need support and advice to start to tweak your doses. Ask for help asap and hopefully your levels will start to improve .
 
Last edited:
Jan M said:
Was diagnosed in may this year with type 2 and over active thyroid and been in hospital twice due to ketones and hypo's just recently im now told im type 1
Im struggling to control my levels there always to high GP not much help
Any info on altering my insulin dose to help control these levels im currently on
12mg Levemir at ninight long acting
12mg Levemir in morning
10mg Nova rapid 3 times a day with food
Im struggling so much with this at mo
PLEASE HELP
Click to expand...
Hi Jan, most useful thing is to be with the diabetes specialist at local hospital, it's not really that helpful to be with a g.p at diagnosis, it will more than likely be beyond their ability. This forum is an amazing source of info, some really helpful people on it so you are in a good place to start learning. One of the most important things for anybody on insulin is to get their basal insulin dose correct. This is your benchmark to set out your meal Time insulin from. Ideally, for example if you missed a meal, if your basal is correct, blood sugar should be level all the way through that missed meal period (provided no excercise is done to lower it or in some circumstances raise it). It's tricky at the beginning of starting insulin, it's a balance of getting both basal (24hr background) dose just right, then finding out how much to take at meal times with the bolus (short acting insulin). BTW. Bolus doses can vary depending on time of day. I could take more insulin for the same meal in the morning than I would for the same meal at night.
 
Hello @Jan M and welcome to the forum 🙂

Sorry to hear you're struggling and that your GP isn't much help. As others have said, GPs tend not to know much about type 1, so you need to get a referral to a hospital diabetes team. The person you really want to see is a hospital diabetes specialist nurse (DSN) as they will be very knowledgeable about living with diabetes on a day-to-day basis, and be able to help you find the insulin doses which are right for you (we all need different doses, and our needs will vary from meal to meal and sometimes from week to week, so learning how to adjust them for yourself is really important).
 
Hello @Jan M

Sorry to hear about your diagnosis, and then reclassification to T1. Hopefully you can get some proper support and advice from the hospital clinic, and have some 1-to-1 sessions to help you get to grips with things.

In the meantime, you might find some of the links and suggestions in the ‘useful links’ thread helpful - https://forum.diabetes.org.uk/boards/threads/useful-links-for-people-new-to-diabetes.10406/

in particular many members have found Ragnar Hanas’s book a very helpful and clear overview of type 1 diabetes https://www.amazon.co.uk/Type-Diabetes-Children-Young-Adults/dp/1859595669

Additionally you might find the online diabetes management course from Bournemouth NHS trust BERTIE gives you some practical and invaluable pointers to dose adjustment - http://www.bertieonline.org.uk/

but really, there’s no substitute for speaking to your healthcare team face to face.
 
Bruce Stephens said:
GP's not likely to be able to help you that much, but they can (and really should) refer you to a specialist who can. Probably at your local hospital (though at my GP surgery the diabetic specialist nurses visit once a month now). (My GP happens to specialise in diabetes so she is more helpful than average, but even so she'd be the first to suggest that I talk to the local diabetes team if needed.)

As a general principle, increasing insulin doses decreases blood glucose, but you note being in hospital a couple of times with hypos, so you really really need to see someone qualified who can give suitable guidance.
Click to expand...
Hi Bruce thank you for reply and support much appreciated
 
Flower said:
Hello @Jan M and welcome 🙂

Were you put you on insulin by the hospital or gp and did they give you any follow up appointment or contact phone no./email? If not, I would get in touch tomorrow with my gp and ask for an urgent referal to the diabetes team at the hospital. Starting insulin is a big change and the initial doses of insulin recommended before meal and night time are a conservative best guess to tide you over until you can be advised how to alter your insulin yourself. Meanwhile keep glucose tablets/jelly babies to hand in case your blood sugar starts to fall too low.

There are education courses that show you how to count the number of carbs in foods/meals, work out your insulin to carbohydrate ratio and learn how to balance your insulin needs with the food eaten. It makes life much more flexible and teaches you to correct highs as well.Once y
Flower said:
Hello @Jan M and welcome 🙂

Were you put you on insulin by the hospital or gp and did they give you any follow up appointment or contact phone no./email? If not, I would get in touch tomorrow with my gp and ask for an urgent referal to the diabetes team at the hospital. Starting insulin is a big change and the initial doses of insulin recommended before meal and night time are a conservative best guess to tide you over until you can be advised how to alter your insulin yourself. Meanwhile keep glucose tablets/jelly babies to hand in case your blood sugar starts to fall too low.

There are education courses that show you how to count the number of carbs in foods/meals, work out your insulin to carbohydrate ratio and learn how to balance your insulin needs with the food eaten. It makes life much more flexible and teaches you to correct highs as well.Once you have been seen by a diabetes team ask for a referral to a course.

Insulin does work with the right amount at the right time but it doesn't just happen and you need support and advice to start to tweak your doses. Ask for help asap and hopefully your levels will start to improve .
Click to expand...

ou have been seen by a diabetes team ask for a referral to a course.

Insulin does work with the right amount at the right time but it doesn't just happen and you need support and advice to start to tweak your doses. Ask for help asap and hopefully your levels

Hi Flower thank you for your reply and support much appreciated
Jan
Click to expand...
 
everydayupsanddowns said:
Hello @Jan M

Sorry to hear about your diagnosis, and then reclassification to T1. Hopefully you can get some proper support and advice from the hospital clinic, and have some 1-to-1 sessions to help you get to grips with things.

In the meantime, you might find some of the links and suggestions in the ‘useful links’ thread helpful - https://forum.diabetes.org.uk/boards/threads/useful-links-for-people-new-to-diabetes.10406/

in particular many members have found Ragnar Hanas’s book a very helpful and clear overview of type 1 diabetes https://www.amazon.co.uk/Type-Diabetes-Children-Young-Adults/dp/1859595669

Additionally you might find the online diabetes management course from Bournemouth NHS trust BERTIE gives you some practical and invaluable pointers to dose adjustment - http://www.bertieonline.org.uk/

but really, there’s no substitute for speaking to your healthcare team face to face.
Click to expand...

Hi thank you for your reply and support much appreciated ill have a look at those web sites
Jan
 
TheClockworkDodo said:
Hello @Jan M and welcome to the forum 🙂

Sorry to hear you're struggling and that your GP isn't much help. As others have said, GPs tend not to know much about type 1, so you need to get a referral to a hospital diabetes team. The person you really want to see is a hospital diabetes specialist nurse (DSN) as they will be very knowledgeable about living with diabetes on a day-to-day basis, and be able to help you find the insulin doses which are right for you (we all need different doses, and our needs will vary from meal to meal and sometimes from week to week, so learning how to adjust them for yourself is really important).
Click to expand...

Hi Juliet thank you for your reply and support much appreciated
Jan
 
Amity Island said:
Hi Jan, most useful thing is to be with the diabetes specialist at local hospital, it's not really that helpful to be with a g.p at diagnosis, it will more than likely be beyond their ability. This forum is an amazing source of info, some really helpful people on it so you are in a good place to start learning. One of the most important things for anybody on insulin is to get their basal insulin dose correct. This is your benchmark to set out your meal Time insulin from. Ideally, for example if you missed a meal, if your basal is correct, blood sugar should be level all the way through that missed meal period (provided no excercise is done to lower it or in some circumstances raise it). It's tricky at the beginning of starting insulin, it's a balance of getting both basal (24hr background) dose just right, then finding out how much to take at meal times with the bolus (short acting insulin). BTW. Bolus doses can vary depending on time of day. I could take more insulin for the same meal in the morning than I would for the same meal at night.
Click to expand...

Hi thank you for your reply and support much appreciated
Jan
 
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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
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