Hi, my name is Kate and have been type 1 for 24 years. I’ve just had surgery for a frozen shoulder and signed off work for 6 weeks to recover from my surgery and to really concentrate on my diabetes as I’m having a hard time at the moment with stresses of work keeping them under control. So looking to you all for some support during this time and going forward.
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- Thread starter Katieg
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Matt Cycle
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- Type 1
Hi Kate and welcome to the forum. 🙂 How do you manage your diabetes - pens or pump? Do you use the Libre?
Schrodinger
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- Type 1
Hi welcome to the forum from another long term T1.
rebrascora
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Hi Katie and welcome
Since you have been diagnosed such a long time, you might benefit from a DAFNE (Dose Adjustment For Normal Eating) course. Not sure if they were on the go 24 years ago but might help you to get back on track if you are struggling. Ask your DN to refer you. I am really looking forward to mine next month. It might also be helpful to start testing more regularly if you have eased back on that as many people do when they have been diabetic for a while. I also find it helps to eat a low carb diet and use the minimal amount of bolus insulin to cover the carbs I do eat. That way there is less risk of going too high or too low. Increasing your level of exercise will also help with both stress and your diabetes. It doesn't have to be anything overly strenuous, just a brisk walk each day. If you are off work for 6 weeks, this might be an ideal opportunity to instigate a new "healthy you" programme.
Good luck and if we can help you with any specific questions, just ask away. There are lots of knowledgeable, experienced and motivational people here on the forum, who are friendly and keen to help. It really is a great place for support and advice.... or even just a rant on those days when even your best efforts are thwarted, because we all understand how frustrating it can be sometimes.
Since you have been diagnosed such a long time, you might benefit from a DAFNE (Dose Adjustment For Normal Eating) course. Not sure if they were on the go 24 years ago but might help you to get back on track if you are struggling. Ask your DN to refer you. I am really looking forward to mine next month. It might also be helpful to start testing more regularly if you have eased back on that as many people do when they have been diabetic for a while. I also find it helps to eat a low carb diet and use the minimal amount of bolus insulin to cover the carbs I do eat. That way there is less risk of going too high or too low. Increasing your level of exercise will also help with both stress and your diabetes. It doesn't have to be anything overly strenuous, just a brisk walk each day. If you are off work for 6 weeks, this might be an ideal opportunity to instigate a new "healthy you" programme.
Good luck and if we can help you with any specific questions, just ask away. There are lots of knowledgeable, experienced and motivational people here on the forum, who are friendly and keen to help. It really is a great place for support and advice.... or even just a rant on those days when even your best efforts are thwarted, because we all understand how frustrating it can be sometimes.
Flower
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- Relationship to Diabetes
- Type 1
Hello Kate and welcome, glad you've joined us 🙂
Sorry you are having a tough time with your control. Have you done a basal test lately to see if your long acting insulin is doing its thing? I know the thought of basal testing is hard to take but it is the basis for bolus and ratios so is a good place to start.
Did your consultant give you a plan of action to help you try and improve things?
Let us know how things are going and what is or isn't working for you. 🙂
Sorry you are having a tough time with your control. Have you done a basal test lately to see if your long acting insulin is doing its thing? I know the thought of basal testing is hard to take but it is the basis for bolus and ratios so is a good place to start.
Did your consultant give you a plan of action to help you try and improve things?
Let us know how things are going and what is or isn't working for you. 🙂
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SB2015
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- Relationship to Diabetes
- Type 1
Hi @Katieg and welcome to the forum.
Some of the things that I used when on injections to improve my management were
Switching to Levemir as my background which I was then able to split morning and evening.
Doing this gave me the flexibility to make changes during the day without altering the basal insulin over night.
Basal rate testing to get the insulin doses correct
Timing of my Bolus Injections.
Many people o here reported how they reduced their post meal spikes by pre blousing for meals where they were able to. I do this for all meals at home, but don’t chance it when I am eating out. I had to find how far ahead of a meal to inject (and this changes during the day) by trial and improvement, and this has definitely helped.
Limiting to my carbs to an agreed target.
I found that the Bolus insulin did not work as well when I had bigger amounts of carbs at a meal. We now stick to a target of 30g of carbs at each meal (but it is only a target). Others work to their own amounts. I had been taught that so long as I injected the Bolus that goes with the amount of carbs I ate. It had not occurred to me that the spikes I was getting were depending on the size of meals.
These are tips I have picked up from others on here, and they have helped me. It might be worth trying in eif them for yourself and see if it helps.
Some of the things that I used when on injections to improve my management were
Switching to Levemir as my background which I was then able to split morning and evening.
Doing this gave me the flexibility to make changes during the day without altering the basal insulin over night.
Basal rate testing to get the insulin doses correct
Timing of my Bolus Injections.
Many people o here reported how they reduced their post meal spikes by pre blousing for meals where they were able to. I do this for all meals at home, but don’t chance it when I am eating out. I had to find how far ahead of a meal to inject (and this changes during the day) by trial and improvement, and this has definitely helped.
Limiting to my carbs to an agreed target.
I found that the Bolus insulin did not work as well when I had bigger amounts of carbs at a meal. We now stick to a target of 30g of carbs at each meal (but it is only a target). Others work to their own amounts. I had been taught that so long as I injected the Bolus that goes with the amount of carbs I ate. It had not occurred to me that the spikes I was getting were depending on the size of meals.
These are tips I have picked up from others on here, and they have helped me. It might be worth trying in eif them for yourself and see if it helps.
Hi, what is Basel testing? I have to admit I have been on insulin for 24 years and some of the terminology being used on here is over my head, I really haven’t got a clue! So sorry but think I might be really out of touch with diabetes at present, and it is very concerning! You guys are so supportive and thank you so much for taking the time for your advice and support x
stephknits
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- Relationship to Diabetes
- Type 1
Hi Katieg and welcome to the forum. Testing your basal is about finding out whether you are taking the right amount of background insulin for you. Normally people pick a time of day to do -say the morning and then don't eat any breakfast and check what happens to their blood sugars without any bolus (fast acting) insulin on board. Theoretically your background should stay reasonably stable. Lantus can be difficult as it takes a couple of days for any changes you make to take effect. As said before, Levemir gives you a bit more flexibility as you can split it and thus take different amounts for day and night.
Matt Cycle
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- Type 1
Hi Kate. Don't worry they're silly names!! but basal and bolus are another name for your long and short acting insulins. The basal (Lantus in your case) deals with the glucose trickled out by your liver that keeps your organs functioning. Your bolus insulin (NovoRapid) deals with any carbs that you eat. Basal testing is a way of making sure your Lantus dose is correct.
https://forum.diabetes.org.uk/boards/threads/basal-testing-made-easy.19060/
There are a number of basal insulins on the market and if you find that Lantus doesn't suit after basal testing you could try one of the others e.g. Levemir that may be more flexible for what you need. Once you're sure your basal dose(s) is correct you can then start tinkering with your NovoRapid if needed.
Do you carb count? i.e. match your NovoRapid doses to the carbs you're eating? The starting point is normally 1 unit NovoRapid to 10g carbs.
SB2015
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- Relationship to Diabetes
- Type 1
Hi Katie
Sorry to have used such a mass of terminology. I do remember the sense that everyone on here knew so much when I first came in, but everyone was very patient and helpful.
Just take one step at a time to get things under control. I was advised to sort the background insulin first (your Lantus). If the link @Matt Cycle has given you about testing your background/basal insulin is correct, is in any way confusing just come back and ask. No one minds. Also do get back in touch with your DSN. As you have decided to get things sorted they should be very keen to help you along with that, as we are.
Things have changed so much just in the last few years so it is great that you have found the forum as people on here have their finger on the pulse and help the rest of us.
Bruce Stephens
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Judging by the website, it started some time after 2000 (first thoughts seem to have been 1997, and I think first publication was 2002). Now that DAFNE (or other structured evidence-supported education) is strongly recommended by NICE to people (like me) whose diabetes predates such things as well as to newly diagnosed people, I agree that's a good thing to ask about. (Apart from anything else there's a good chance there'll be a waiting list so asking early and often makes sense. If your area's anything like mine, they don't (or didn't) usually offer their course except to newly diagnosed patients. I think that NICE recommendation is fairly new.)
Failing that, there's https://www.bertieonline.org.uk which might be useful even if you are offered an in-person course.
Thanks again everyone for you replies. I did a course about 5 years ago at my diabetes clinic which was very similar to DAFNE, and couldn’t believe the changes in the world of diabetes since I was diagnosed in 1996! After the course I did feel really informed and began to make changes working out my ratio’s etc...however in the last couple of years my job has changed and I’m under so much stress and pressure. I love my job as I have been doing it for 22 years, but I need to make some big changes and start to be more selfish and take time for me and my health. I have printed some tracking sheets off and going to start today with working out my ratio’s and I’m also going to call my DSN to arrange an appointment to get some help, but need some facts and figures before I go for the appointment.
SB2015
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- Relationship to Diabetes
- Type 1
Glad to hear that you are going to find some time for yourself in amongst the stress of your job.
Gathering some data about your pre-meal and post meal levels alongside your carbs is a great idea and will help the DSN help you to sort out ratios etc. Let us know how you get on, and keep in touch.
Bruce Stephens
Well-Known Member
- Relationship to Diabetes
- Type 1
Yes, collecting some numbers should help them suggest things to try. As you know, it's entirely possible that stress (together with the frozen shoulder and surgery) will mess things up, likely meaning you'll need a bit more insulin. And as others have suggested, maybe splitting the basal dose (with Levemir) would be useful.
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