newbie Type 1

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Like @helli I would inject for snacks, but at present you are in fixed doses, so it is more of a case of matching food to the injections you are on. Whey you see your nutritionist this week, and they start you on carb counting ask about snacking.

We were told at the start not to inject for snacks of 10 g or less but as I can inject I would rat(er cover all the carbs that I choose to eat, as I know that any I eat will increase my glucose levels. It is a lot easier on a pump but on injections, once you have your ratios to help you work out the doses you can make a decision depending on the size of your snack.

It has probably been mentioned already, but I know that I found having a half unit pen very useful. It meant that I could make finer adjustments to my doses, which was great as I started on very small doses. Well worth asking about this when you see the nutritionist. These are only available in the reusable pens, which are better for the environment and also when packing to go away the cartridges take up less space than a pack of pens. I also found it useful to have different coloured pens for the background insulin (Absalgar for you) and the quick acting bolus. I am not the only one to have got them muddled up, so the colours help avoid this (most of the time).
 
sharie said:
Thanks again everyone, a couple more questions how do you incorporate snack or are they a no no?

Good luck with the libre, it’s handy for keeping an eye on your sugars without having to prick yourself but as the others said double check with the machine when you get lower readings. Have you had a hypo yet? Feel free to message me any time.
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Thanks Sharon. No hypo yet as my sugars are still high but coming down slowly under guidance from the hospital. I’ve got a stash of jelly babies wherever I go just in case! Yep, I’ll keep in touch, I’m sure.
 
Jelly babies are good, but when you want the quickest possible acting rise, fruit juice or full sugar fizzy drinks do the job.
Jelly snakes are a good, and to my mind, tastier alternative to jbabys s and its easier to subdivide them. Ditto jelly beans, jelly belly ones are about a carb each.

Re snacking....you can either have now carb snacks (eg baby bel, cheese, hardboiled egg) or add the snack into your meal time carb count and have an hour or so afterwards, or treat then as an extra meal with its own injection of rapid acting insulin...i find this last way tends not to come with too much of a peak for some reason. But if you inject, say, after 8, you are opening yourself up to more chance of cgm alarms in the night. But sometimes, you just need a cheese and branson pickle sarny....

It may be best to get comfy with meals before you throw in the complication of snacking.
Like a science experiment, its best just to change one variable at a time. And those include how far in advance of eating you inject, where you inject, how much you inject, and whether its a workday (i have different ratios for non workdays, also, for some reason, breakfast-go figure!)
Which is why i laugh at the ideas your dr with give you a ratio. They will, but its just a starting point.
It took me a couple of months to get confident adjusting my insulin dose myself, but when i did my control improved dramatically.
But you have to learn the basics first....

If it starts feeling complicated or distressing, remember, t1 control is two things....eating, and injecting. And you can do both of those!

It does get easier
 
Tdm said:
Jelly babies are good, but when you want the quickest possible acting rise, fruit juice or full sugar fizzy drinks do the job.
Jelly snakes are a good, and to my mind, tastier alternative to jbabys s and its easier to subdivide them. Ditto jelly beans, jelly belly ones are about a carb each.
Click to expand...
Now veggie versions are available, the main downside to jelly sweets is that they melt.
Don’t leave them on a car as you may be greeted with a jelly lump next time you need them.

The other potential disadvantage is other people like them. It is important to train friends and family that they are your medical treatment, not a treat for anyone.

I use raspberry Lift GlucoTabs which I buy in bulk from eBay and decant into plastic tubes. No one else is tempted by them. In fact my partner has a bag of JBs next to his bike kit.

Tdm said:
t1 control is two things....eating, and injecting. And you can do both of those!
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Please take care of your mental health. It may be a small thing but I avoid considering diabetes control. It involves far far more than just eating and injecting as there are so more things which can affect our BG and many are definitely not within our control (stress, exercise, illness, …). As a result controlling your diabetes all the time is as likely as controlling a class of 5 year olds all the time. Diabetes (and 5 year olds) can be managed but control is unlikely.

It is difficult explaining type one management to newbies - on one hand, you don’t want to confuse the heck out of them with all the variations (e.g. some people may need different insulin to carb ratios at different times of the day) but, on the other hand, you don’t want to over-simplify things (e.g. bg is only affected by insulin and food).
It is a narrow line to tread.

I think most of us on this forum continue to learn more about our diabetes regardless whether we were diagnosed 4 months ago or 40 years ago. For me, the important thing has been finding ways to live my life with diabetes rather than because of diabetes. Snacking is important to me so telling me to avoid it until I have got the different ratios at different times of day would have never been a good idea. I am as likely to give up snacking as to give up exercise.
Bearing our differences in mind, I try to caveat advice with “in your shoes, I would …” or “in my experience, I find …” and try to avoid telling people not to do something because I don’t know how important it is to them.

Sorry, I had not intended a lecture and definitely want to applaud the way you have learnt so much about how to manage your diabetes with your life.
 
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Tdm said:
Jelly babies are good, but when you want the quickest possible acting rise, fruit juice or full sugar fizzy drinks do the job.
Jelly snakes are a good, and to my mind, tastier alternative to jbabys s and its easier to subdivide them. Ditto jelly beans, jelly belly ones are about a carb each.

Re snacking....you can either have now carb snacks (eg baby bel, cheese, hardboiled egg) or add the snack into your meal time carb count and have an hour or so afterwards, or treat then as an extra meal with its own injection of rapid acting insulin...i find this last way tends not to come with too much of a peak for some reason. But if you inject, say, after 8, you are opening yourself up to more chance of cgm alarms in the night. But sometimes, you just need a cheese and branson pickle sarny....

It may be best to get comfy with meals before you throw in the complication of snacking.
Like a science experiment, its best just to change one variable at a time. And those include how far in advance of eating you inject, where you inject, how much you inject, and whether its a workday (i have different ratios for non workdays, also, for some reason, breakfast-go figure!)
Which is why i laugh at the ideas your dr with give you a ratio. They will, but its just a starting point.
It took me a couple of months to get confident adjusting my insulin dose myself, but when i did my control improved dramatically.
But you have to learn the basics first....

If it starts feeling complicated or distressing, remember, t1 control is two things....eating, and injecting. And you can do both of those!

It does get easier
Click to expand...
Thank you.
 
Ok guys another question is what if you don’t fancy your dinner does skipping it effect your sugar levels, I’m guessing this is variable too?
 
sharie said:
Ok guys another question is what if you don’t fancy your dinner does skipping it effect your sugar levels, I’m guessing this is variable too?
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You can skip a meal anytime you like as long as you don't inject mealtime (bolus) insulin before it. If you have injected and then don't feel like eating, you will need to eat or drink some carbs to counteract that insulin.
 
If you've not injected for it, and your basal profile is correct (and flat for the meal in question), then skipping meals should be fine, your BG should remain stable.

The caveat re basal profile being flat is that normally one tries to get a flat BG overnight, which can sometimes mean there's a bit too much or too little at other times of the day. This would result in a drop or rise, respectively, in the absence of food and additional bolus. You shouldn't get much of a change though if you get any, in which case have a snack on the order of 10g of carbs or a unit or two of insulin, to keep it flat.

Edited for clarity - I was only suggesting eating something if your basal dose at the meal time would make you run low if you didn't eat; I'd also need some bolus for 10g, though tbh I'd have troubles only having a 10g snack so would definitely need some bolus!
 
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sharie said:
Ok guys another question is what if you don’t fancy your dinner does skipping it effect your sugar levels, I’m guessing this is variable too?
Click to expand...

Hello, from personal experience. I quite often skip meals. (Then eat later for practical reasons.) the “10g snack” mentioned earlier, can throw me up by 3or 4mmol? I would need to inject an appropriate amount of insulin to accommodate the “snack.” (Unless through activity, my basal is dropping me.)

It’s not going to hurt if you don’t feel hungry. Just keep an eye on how you react?
 
Good morning @sharie

As others have said missing meals or eating at different times is not a problem in the regime you are on. Just don’t do a meal time bolus (Novorapid) if you don’t have a meal.

At this stage your team will be bringing your levels down gradually with your fixed doses, and will work with you, looking at the information from your sensor, to tweak your basal and bolus doses, and then enable you to do this yourself.

As @helli has eloquently said, and I like her analogy of a class of 5 year olds, they will help you to learn how to adjust things to suit your life, and with our diabetes we just do the best that we can. It will never be perfect.
 
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