New type 1 diabetic looking for information and advice

[georgie29]

Hi guys,

I was diagnosed type 1 diabetic a few weeks ago now and am just starting to get my head around everything and have lots of questions about my experience and how its differs to everyone else's. Here's a quick summary of my diagnosis:

I was admitted to hospital on the 19th March after I went to an out of ours GP appointment with a two week history of thirst and increased urination. My BM's were 22.9 and there were lots of ketones and high glucose in my urine so I was admitted to hospital. They tested my electrolytes and found that my potassium was really low so I was put on IV potassium and insulin with dextrose. My hba1c was 117 but my BM's have been quite well controlled following that initial treatment so hopefully it will be much better next time.

I was able to go home the next day but have since had barely any energy and my sugars drop like a stone as soon as I start to exercise. I was running 5k 3 times a week every week since christmas (including the week I was diagnosed) and now can barely walk a few hundred metres without my sugars dropping from 11/12 to 4. Everyone keeps saying it should get better but it doesn't seem to be at all, has anyone else struggled massively to get back to exercise after a DKA?

I was wondering also if there is anyone who has also struggled with low potassium ( I am on supplements intermittently at the moment and as soon as I stop taking them it drops within a few days). I have had lots of tests but everything is coming back fine so my doctors have no idea of the cause and this has never been an issue in the past before I was diagnosed.

Finally (sorry I know this is massive), I'm having problems injecting myself. When I first came out of hospital I was able to do it fine without any issues, but when my potassium was low my hands were shaking and I had numerous injections which scratched the skin, were extremely painful or just didn't work properly at all and since then I've been unable to will myself to do them. I'm fine with other people injecting me but I get really anxious when doing it myself, anyone have any tips or tricks? I know its something I'm just going to have to get used to but it seems like its become a bit of a mental block now.

Thank you and I hope you are all doing well!

 

[Rothers1969]

well hi
you've come to the right place, you have to do it yourself!!! no other way around that im afraid, i know its hard it is but your always gonna need your insulin and sometimes people wont be there.
this is a massive change to your life. you've had a lot of information thrown at you, hospital! doctors! and now its you and your insulin pen. you can do this where are you injecting ? if you don't mind me asking and what size needle do you have.

it feels very medical at the moment but believe me you wont think twice about it. i was very scared at first couldn't do it i cried. its not easy and find a nice squishy bit to do it in.
as for your running that's just going to need some adjustment talk to your team but there's nothing you cant do with your diabetes that you couldn't do before. it just needs managing and you WILL learn to do it we all do. it could be your trying to run literally before you can walk exercise can send your sugars plummeting.
you will get this it a process and its not easy but there is so much help and support here for you. find all the information you can but know when to take a break too. once you feel in control of it and not it you things will get easier xx good luck xx
tracey

 

[Bruce Stephens]

but when my potassium was low my hands were shaking and I had numerous injections which scratched the skin, were extremely painful or just didn't work properly at all and since then I've been unable to will myself to do them.

I'd guess once you get better control over the shaking (so resolve the low potassium problem, I guess) that'll help a lot. But likely at the moment you're in a bit of a spiral of not being able to inject yourself that well which leads to being nervous the next time which leads to not being able to do it well.

I think just keep working with your healthcare team and (if you can) get help from other people in giving your injections while it's hard for you.

 

[helli]

Welcome @georgie29

Diabetes seems like a huge thing to deal with but I will say it is NOT a massive change to your life. Once you get over the initial bumps, there should be nothing you cannot do. Ideally, a little bit of planning is useful but that does not mean you cannot go for an ad hoc meal (when the restaurants open) or rush out at the last minute if you are running late.

Exercise can be a challenge, especially as it affects our blood sugars differently depending upon the type of exercise, the intensity, how fit we are and, probably, the socks we are wearing on the day. If you are finding your blood sugars drop, there are few tricks which may help
- make sure you have no bolus insulin on board as exercise is making your body more efficient at using insulin. You don't mention what insulin you are taking but most people take a slow acting once or twice a day and a fast acting one whenever they eat. The fast acting insulins typically remain active for about 4 hours. So I avoid exercising 4 hours after eating.
- have a snack of about 10 to 15g slow carbs before you head out
- add a small amount of juice or squash to your water that you drink whilst running. This means you will be topping up the carbs as you use them.

I agree with the other comments that there is no way around injections. Some people have found things like numbing the area of your injections with an ice cube helps. I don't know whether you look when others inject you (I can do it to myself but hate watching someone else jab me) but if you look away, perhaps forcing yourself to watch will also build your confidence.

 

[rebrascora]

Hi and welcome from me too.

Sorry to hear you are struggling with a few things. I think as regards the running you need to give yourself a month or two and work on building up your walking by setting yourself small targets which you can build on. I also wonder if the potassium deficiency is impacting your fitness.
As regards having difficulty injecting yourself and your hands not being steady, I wonder if the Tickle-Flex device might be helpful. I believe it was developed to help children and older people who have less coordination but can of course be used by anyone and might be helpful to hold the needle steady for you and give you confidence. If you do a search, I believe there is a promotional video explaining how it works, which might help you figure out if it is worth a try for you.

 

[Kaylz]

The iport might help with injecting, I'm not sure the criteria for getting them funded but worth asking, it's a device you stick on and keep on for up to 3 days and you do your injections into it xx

 

[georgie29]

well hi
you've come to the right place, you have to do it yourself!!! no other way around that im afraid, i know its hard it is but your always gonna need your insulin and sometimes people wont be there.
this is a massive change to your life. you've had a lot of information thrown at you, hospital! doctors! and now its you and your insulin pen. you can do this where are you injecting ? if you don't mind me asking and what size needle do you have.

it feels very medical at the moment but believe me you wont think twice about it. i was very scared at first couldn't do it i cried. its not easy and find a nice squishy bit to do it in.
as for your running that's just going to need some adjustment talk to your team but there's nothing you cant do with your diabetes that you couldn't do before. it just needs managing and you WILL learn to do it we all do. it could be your trying to run literally before you can walk exercise can send your sugars plummeting.
you will get this it a process and its not easy but there is so much help and support here for you. find all the information you can but know when to take a break too. once you feel in control of it and not it you things will get easier xx good luck xx
tracey

Thank you, I just want to get back to my normal self but feel a million miles away from that right now. Hopefully I'll get there in time.

 

[georgie29]

Welcome @georgie29

Diabetes seems like a huge thing to deal with but I will say it is NOT a massive change to your life. Once you get over the initial bumps, there should be nothing you cannot do. Ideally, a little bit of planning is useful but that does not mean you cannot go for an ad hoc meal (when the restaurants open) or rush out at the last minute if you are running late.

Exercise can be a challenge, especially as it affects our blood sugars differently depending upon the type of exercise, the intensity, how fit we are and, probably, the socks we are wearing on the day. If you are finding your blood sugars drop, there are few tricks which may help
- make sure you have no bolus insulin on board as exercise is making your body more efficient at using insulin. You don't mention what insulin you are taking but most people take a slow acting once or twice a day and a fast acting one whenever they eat. The fast acting insulins typically remain active for about 4 hours. So I avoid exercising 4 hours after eating.
- have a snack of about 10 to 15g slow carbs before you head out
- add a small amount of juice or squash to your water that you drink whilst running. This means you will be topping up the carbs as you use them.

I agree with the other comments that there is no way around injections. Some people have found things like numbing the area of your injections with an ice cube helps. I don't know whether you look when others inject you (I can do it to myself but hate watching someone else jab me) but if you look away, perhaps forcing yourself to watch will also build your confidence.

Yes I'm on 8 units of tresiba each morning then 4 units of novorapid with each meal. Thats a really good tip though to avoid exercise whilst the bolus is working, I'll definitely try that. Also hadnt thought of putting a small amount of juice in with water to keep my sugars topped up. Thanks so much 🙂

 

[georgie29]

The iport might help with injecting, I'm not sure the criteria for getting them funded but worth asking, it's a device you stick on and keep on for up to 3 days and you do your injections into it xx

Thank you I'll look into this x

 

[SB2015]

Welcome to the forum @georgie29 . Sorry to hear about your diagnosis and the issues that you are having at present. It is early days and there is a lot to get your head round.It really does get easier, but it takes a bit of getting used to.

With regard to doing your own injections, you will need to be able to do this, s there will be times when you need to do this and there is no one available to help you. It is a vicious cycle, as the more tense your u are the more difficulty there is. You have already had some suggestions about strategies, perhaps start by setting yourself the task of doing one of your injections each day, which ever you feel appropriate. I think I would probably go for the first one of the day so it is then out of the way.

With exercise it takes some time to sort out your correct doses of insulin, and you are only a few weeks in. Give yourself time to settle down and work with your team to make adjustments to your doses. Talk to your ur team about this, and if you can give them examples of what has happened that will help them and you to find what adjustments are needed. The cause of your dropping a lot when you exercise will depend when this is in relation to your meals. If you have eaten recently the insulin will still be active, and become more active if you are exercising. So you might need a reduction I your dose at the meal before. I find the diluted juice a useful strategy which I sip as I go, and it keeps things level. You also need to talk to your team about adjustments after you exercise. It depends on the intensity but many find that they need less insulin for a while after.

It is still very early in your journey through all this. It is difficult to be patient but you will be able to do all that you want to in time, but it might take a bit of time to get the doses sorted and work out what adjustments you will need.

Keep the questions coming. If you are happy to do tell us which insulins you are using as we can tailor our responses with that knowledge.

 

[SB2015]

Oops, I took to long to type.

With the insulins you are on there will be plenty of flexibility. They have given you fixed doses as a starting point from which they will work with your u to find what ratios you need. Talk to your team about carb counting if you have not yet done so. Basically the more carbs you eat the more insulin you need, but it takes time to work out the suitable ratio for you. With the fixed doses to start with, if you log the carbs you are eating, the BG before and after and an exercise you are diong when, they will gradually help you to work things out.

 

[georgie29]

Welcome to the forum @georgie29 . Sorry to hear about your diagnosis and the issues that you are having at present. It is early days and there is a lot to get your head round.It really does get easier, but it takes a bit of getting used to.

With regard to doing your own injections, you will need to be able to do this, s there will be times when you need to do this and there is no one available to help you. It is a vicious cycle, as the more tense your u are the more difficulty there is. You have already had some suggestions about strategies, perhaps start by setting yourself the task of doing one of your injections each day, which ever you feel appropriate. I think I would probably go for the first one of the day so it is then out of the way.

With exercise it takes some time to sort out your correct doses of insulin, and you are only a few weeks in. Give yourself time to settle down and work with your team to make adjustments to your doses. Talk to your ur team about this, and if you can give them examples of what has happened that will help them and you to find what adjustments are needed. The cause of your dropping a lot when you exercise will depend when this is in relation to your meals. If you have eaten recently the insulin will still be active, and become more active if you are exercising. So you might need a reduction I your dose at the meal before. I find the diluted juice a useful strategy which I sip as I go, and it keeps things level. You also need to talk to your team about adjustments after you exercise. It depends on the intensity but many find that they need less insulin for a while after.

It is still very early in your journey through all this. It is difficult to be patient but you will be able to do all that you want to in time, but it might take a bit of time to get the doses sorted and work out what adjustments you will need.

Keep the questions coming. If you are happy to do tell us which insulins you are using as we can tailor our responses with that knowledge.

Thank you so much for taking the time to write this. I have actually managed to do my first injection in weeks today so I'm hoping that I can continue doing the majority of them at least from now on.

I wasnt aware of the longer term effects of exercise and do seem to get more hypos after so I will mention that to my diabetes nurse, thank you. I'm using tresiba in the morning (8 units) and novorapid (4 units) with each meal at the moment 🙂

 

[SB2015]

Well done Georgie. Take it step by step.

 

[trophywench]

The after effects of strenuous exercise on the body including the BG can and frequently do last for up to 48 hours. Sounds to me like you haven't discussed your exercise with your medical team, or they with you, very much.

Would they even be aware of your exercise habits?

Another question - what if any dietary discussions were there, before they sent you home?

 

[SB2015]

Thank you so much for taking the time to write this. I have actually managed to do my first injection in weeks today so I'm hoping that I can continue doing the majority of them at least from now on

Hi Georgie

Just another thought this morning. What length of needles are you using. I starter on 8mm which hurt. I went down to 4mm length which hardly ever hurt. So much better. There are also different manufacturers, some better than others. Let us know what you are using. There may be better options to ask for.

 

[SB2015]

Hi Georgie

I have just been sent this link from @Odette DUK to an event focusing on managing Exercise with T1. I will post it in the exercise strand too, but thought it might be of interest to you. In this early stage after your diagnosis it may help you to hear from others that successfully manage their exercise. As we have said you will need to be patient as you will need a bit of time with your team to get your insulin doses settled, but I thought it was worth mentioning.

We know sport, exercise, and type 1 can be difficult to navigate. There’s a lot to think about – from the amount of insulin you’ve got on board, to the kind of exercise you’re going to do, and what you last had to eat.
Join us at our ‘Managing type 1, sport and exercise’ Q&A panel session on Thursday, 29 April from 7pm on Zoom. You’ll hear from our panel of experts who’ll answer your questions about taking part in sport and exercise. The panellists include an Associate Professor of Diabetes, a Diabetes Specialist Nurse, a dietitian, and a former GB gymnast living with type 1.
Find out more and sign up for free here: https://eu.eventscloud.com/esurvey/sport

 

[trophywench]

Hee Hee - just copied the link to tell @georgie29 about it ! 🙂

 

[everydayupsanddowns]

Welcome to the forum @georgie29 and really well done on restarting your insulin injections - that really will help make things easier in the long run 🙂

Sorry you have had a bit of a rough time over your first few weeks. Well done on cracking on with the exercise though - very impressive! Hope that Q&A session is helpful.

There are some other online resources for managing T1 and exercise such as Extod.

Home

Home

www.extod.org

You might also find these books help to fill in some of the blanks while you are waiting for some availability of appointments with your clinic

Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas - considered to be the 'bible' for children and young people on insulin regimes. Don't be misled by the title - this book is relevant to people of all ages!

Or Think Like a Pancreas’ by Gary Scheiner