Newbie

[RosieA]

Hi all
Brand new here. I was diagnosed with type 1 four weeks ago. I had a throat infection and then was hospitalised with diabetic keto acidosis. Just had my 41st birthday. It’s all A bit of a shock! Looking forward to meeting others on the same journey and leaning lots! Xx

 

[Tdm]

Hi all
Brand new here. I was diagnosed with type 1 four weeks ago. I had a throat infection and then was hospitalised with diabetic keto acidosis. Just had my 41st birthday. It’s all A bit of a shock! Looking forward to meeting others on the same journey and leaning lots! Xx

It is a shock at first, but it gets easier and takes up a lot less of your headspace and time. Do you have a libre/cgm? What insulins are you on? Any question?

 

[everydayupsanddowns]

Welcome to the forum @RosieA

Ah diabetes - the birthday gift that keeps on giving!

I was diagnosed a few days after my 21st, so know what it‘s like to unwrap that particularly awkward-shaped parcel 🙄

Yup! It’s a steep learning curve for sure - but T1D while still very annoying - is increasingly able to be kept in it’s place with the help of new insulins, sensors, apps, and gadgets. Still takes a lot of effort mind you, and is potentially extremely serious for both physical and mental health… but it is something you can learn to live well with, and doesn’t have to stop you doing things you enjoy.

These books are quite well regarded by forum members:

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!

Think Like a Pancreas by Gary Scheiner - A practical guide to managing diabetes with insulin

And this thread has some hints and tips people wished they had learned much earlier in their walk with diabetes

5 Top Tips for Better Diabetesing

Just found myself absently wondering what I would say to myself if I could go back in time ‘Bill and Ted’ style and offer newly-diagnosed-me some hints and tips for better diabetes management, and a better relationship with my diabetes from future-me. What 5 hints and tips I might offer myself...

forum.diabetes.org.uk

Good luck with it all! And keep asking questions 🙂

 

[RosieA]

It is a shock at first, but it gets easier and takes up a lot less of your headspace and time. Do you have a libre/cgm? What insulins are you on? Any question?

Hi! Yes I managed to get a freestyle libre 2 which has been really good. I’m on lantus 12 units and novo rapid. I’m still learning how much to take - haven’t really had any support from the hospital since discharge but I’ve been managing to mostly keep my bg ok with a healthy low carb diet except yesterday when I had too many sweet things and I guess not enough novo rapid….!

 

[rebrascora]

Hi and welcome. There are plenty of us late starters with Type 1 on the forum, so plenty of brains to pick and people who can relate to your situation and share their experience.
The early days are pretty overwhelming so hang in there and it does certainly get easier. Great that you have Libre but you do have to be aware of it's limitations.... things like compression lows if you lie on the sensor during the night. These are false lows and the recommendation is to always double check lows and highs with finger pricks ideally before taking any action, unless it is obvious you are hypo.
Have you had a hypo yet and are you aware of the rule of 15 for treating them? ie when BG is below 4, eat 15g of fast acting insulin like 4-5 Dextrose tablets or 3 jelly babies or a small carton of orange juice or a small can of full sugar cola.
Then wait 15 mins and retest with a finger prick......Another limitation of Libre is that it takes much longer to show you have recovered from a hypo that a finger prick test. If you are back above 4 at the 15 min stage some people find it helpful to have a snall slow release carb snack like a digestive biscuit, but personally that would send my levels into orbit so you have to figure out what works for you. If you are not above 4 when you test 15 mins later, then you have another 15g fast acting carbs and test again in another 15 mins..... until you are above 4.
It is helpful to know that you can absorb glucose through your mouth often more quickly than your stomach, so chewing well or swilling your juice around your mouth will often mean your levels come up quicker than a couple of chews and swalling your chosen treatment straight down.

Anyway, really pleased you have found the forum because I have learned most of what I know from the good people here and experimenting on myself to see what works best and as a result I now feel like I am the expert in my own individual diabetes and I know how it works and how to manage it better even than my nurse or consultant, although I do of course listen to their input and ask their advice but ultimately I live with my diabetes day by day and hour by hour and meal by meal, so it makes sense for me to understand it better than someone who I have a 10 min conversation with on the phone twice a year. Hopefully the forum can help you to develop that confidence in your own ability to manage it well, although it sounds like you are already off to a good start.

 

[RosieA]

Hi and welcome. There are plenty of us late starters with Type 1 on the forum, so plenty of brains to pick and people who can relate to your situation and share their experience.
The early days are pretty overwhelming so hang in there and it does certainly get easier. Great that you have Libre but you do have to be aware of it's limitations.... things like compression lows if you lie on the sensor during the night. These are false lows and the recommendation is to always double check lows and highs with finger pricks ideally before taking any action, unless it is obvious you are hypo.
Have you had a hypo yet and are you aware of the rule of 15 for treating them? ie when BG is below 4, eat 15g of fast acting insulin like 4-5 Dextrose tablets or 3 jelly babies or a small carton of orange juice or a small can of full sugar cola.
Then wait 15 mins and retest with a finger prick......Another limitation of Libre is that it takes much longer to show you have recovered from a hypo that a finger prick test. If you are back above 4 at the 15 min stage some people find it helpful to have a snall slow release carb snack like a digestive biscuit, but personally that would send my levels into orbit so you have to figure out what works for you. If you are not above 4 when you test 15 mins later, then you have another 15g fast acting carbs and test again in another 15 mins..... until you are above 4.
It is helpful to know that you can absorb glucose through your mouth often more quickly than your stomach, so chewing well or swilling your juice around your mouth will often mean your levels come up quicker than a couple of chews and swalling your chosen treatment straight down.

Anyway, really pleased you have found the forum because I have learned most of what I know from the good people here and experimenting on myself to see what works best and as a result I now feel like I am the expert in my own individual diabetes and I know how it works and how to manage it better even than my nurse or consultant, although I do of course listen to their input and ask their advice but ultimately I live with my diabetes day by day and hour by hour and meal by meal, so it makes sense for me to understand it better than someone who I have a 10 min conversation with on the phone twice a year. Hopefully the forum can help you to develop that confidence in your own ability to manage it well, although it sounds like you are already off to a good start.

Thank you this is so helpful! Picking up little things from this forum has made a difference already. I’ve had a few hypos- mainly when going for a walk but so far have managed to catch them quickly. Still all over the place with the insulin doses - I haven’t had much support but am seeing Consultant in July so hoping I will be able to verify what I’ve read!

 

[Mumpie_olgran]

Hi sorry about the diagnosis, but not at all sorry you've found the forum. I'm still relatively new T1 from Jan and this place is a gold mine
Keep asking questions, you'll find people are very generous with responses
Good luck!

 

[helli]

Welcome to the forum @RosieA
Great advice above.
I'll just add a couple
- don't get dragged into "diabetes management" ideas that are targeted for type 2. A healthy diet for someone with Type 1 is the same as someone without diabetes. If you want to eat low carb, that's fine but it is not necessary. I found it harder to work out insulin doses with low carb because in the absence of carbs, our body breaks down protein into glucose. It does this at different rates for different types of protein so timing and insulin to protein ratios will vary.
Some people with Type 1 do follow this approach to keep their insulin dose low (lower doses mean smaller mistakes) but there is no such thing as too much insulin. Insulin is not harmful
- ask questions. There is a lot to learn. Twenty years in and I am still learning.
- look after all of you. Do not try to control your diabetes - there are too many things that can affect our blood glucose that we will fail. And don't make changes just for diabetes than will negatively affect your mental health. If you enjoy cakes, don't avoid them (unless you need to lose weight), just learn to dose your insulin. This will take time (back to asking questions and learning).

 

[Tdm]

I went low carb at first. It wss helpful but ultimately i found i could get same result with normal carbs.
Good you have a cgm, will keep you safe whilst you work things out. I am also on novorapid. For me it lasts around 5 hrs and is most active in the first 3 hours...you may find it easiest at first to excercise outside the first 3 hrs. I find i need to inject 15- 25 min before eating and i go for a 20 min walk when my levels start to rise to keep peaks down but that may not work for you-everyone is different. It sometimes gives a little drop justoutside the 5 hours, the little devil! Otherwise its fairly predictable.

What carb insulin ratio area you working to At the moment? My ratio is different for differnt times of day, and i need more insulin when its a work day than at weekend.

Whilst you are learning you may find it easiest to stick to the some of the same meals until you have worked out how they go. I keep to the same muselli that i know doesn't spike my blood sugars. Think like a pancreas is a good book though you can skip a lot of the maths ...i found trial end error the best way to figure out how much insulin you need. We are all our own scientists experimenting on ourselves

And, most importantly, its your diabestes so you work out your own insulin doses. At first i was rather dependent, but my control improved so much when to took control and read 'think like a pancreas'. Some great advice on here too! But, as already said, just make sure you don't get confused and follow advice intended for t2

 

[RosieA]

I went low carb at first. It wss helpful but ultimately i found i could get same result with normal carbs.
Good you have a cgm, will keep you safe whilst you work things out. I am also on novorapid. For me it lasts around 5 hrs and is most active in the first 3 hours...you may find it easiest at first to excercise outside the first 3 hrs. I find i need to inject 15- 25 min before eating and i go for a 20 min walk when my levels start to rise to keep peaks down but that may not work for you-everyone is different. It sometimes gives a little drop justoutside the 5 hours, the little devil! Otherwise its fairly predictable.

What carb insulin ratio area you working to At the moment? My ratio is different for differnt times of day, and i need more insulin when its a work day than at weekend.

Whilst you are learning you may find it easiest to stick to the some of the same meals until you have worked out how they go. I keep to the same muselli that i know doesn't spike my blood sugars. Think like a pancreas is a good book though you can skip a lot of the maths ...i found trial end error the best way to figure out how much insulin you need. We are all our own scientists experimenting on ourselves

And, most importantly, its your diabestes so you work out your own insulin doses. At first i was rather dependent, but my control improved so much when to took control and read 'think like a pancreas'. Some great advice on here too! But, as already said, just make sure you don't get confused and follow advice intended for t2

I’m trying to work out my carb to insulin ratio but haven’t been very successful so far but I’ve bought Think Like a Pancreas and that has been really helpful so maybe I will learn a bit more about it through that! Is it the Dafne course that teaches that?
will all carbs create a spike even with insulin? But the returning to normal after 2 hrs is the important thing? Sorry for the basic questions!- I haven’t had any real advice since being in hospital!
Many thanks

 

[RosieA]

Welcome to the forum @RosieA
Great advice above.
I'll just add a couple
- don't get dragged into "diabetes management" ideas that are targeted for type 2. A healthy diet for someone with Type 1 is the same as someone without diabetes. If you want to eat low carb, that's fine but it is not necessary. I found it harder to work out insulin doses with low carb because in the absence of carbs, our body breaks down protein into glucose. It does this at different rates for different types of protein so timing and insulin to protein ratios will vary.
Some people with Type 1 do follow this approach to keep their insulin dose low (lower doses mean smaller mistakes) but there is no such thing as too much insulin. Insulin is not harmful
- ask questions. There is a lot to learn. Twenty years in and I am still learning.
- look after all of you. Do not try to control your diabetes - there are too many things that can affect our blood glucose that we will fail. And don't make changes just for diabetes than will negatively affect your mental health. If you enjoy cakes, don't avoid them (unless you need to lose weight), just learn to dose your insulin. This will take time (back to asking questions and learning).

Thanks that’s helpful - I haven’t worked out my carb to insulin ration yet so I’ve found low carb easier to manage the blood sugar but I think it’s prob not sustainable for me long term and that’s interesting re the protein and glucose. Many thanks for the advice

 

[Tdm]

Occasionally i don't get a spike...but its vary rare. Even non diabetics spike.
Dunno if they goes into ratios on daphne as been waiting for it since diagnosis - a year and counting! If i were you, i wouldn't wait before doing what you can to get on top of your levels.

One way of getting your ratio is to have a meal. Say 50 carbs. Have your insulin...say 5 units. Potter around. Take extra carbs if you go low. After 5-6 hours see where you are. If pretty much at the same bs level, then add up all the carbs in meal and thosr taken after, divide by insulin, and voila!
So, if you had 50 carbs tea, then total of 10 glucose to top up, to deal with 6 units of rapid acting insulin, your ratio would be 1 to 10.
Next time you have a meal AT THE SAME TIME of day, and the same broad condition (eg working, weekday etc) then use this ratio. Keep adjusting til it seems to work, and you do not need to top up with carbs.
But 1st it may be best to concentrate on getting basal (long acting) insulin right. To put it simply, look what happens overnight. If you stay levelish, then your basal is right. Also means you stand more chance of a good night sleep! Once basal is right then you can look at fine tuning your bolus (quick acting insulin). Though it may be hard to see at first as you will be all peaks and troughs and no flatlands.
See 24 hr graphs. First was me after about 4 months after diagnosis, all over the shop, 2nd today (with the grey bit being 5 to 10)

I think a insulin to carb ratio of 1 to 10 is the usual place to start. My ratios vary week to week and go from 1 to 8 midday when working to around 1 to 22 at weekend breakfast. Have they not told ypu what ratio to start at?

I did low carb at first but found it hard to keep the weight on, plus eventually i became more insulin resistance, plus i like bread and potatos. I now consider my low carb like training wheels on a bike- but still do low carb when i want less drama.
I did do 'no carb' dinners eg mushrrom omeletes, with no insulin, but found the sugars crept up slowly unless i was particularly active.
I think the 2 hrs thing is more a t2 thing. I have pretty good control, but i can't say i usually get back to 'normal' within 2 hours...and as most rapid insulins work long after that, you will prob end up going low if you try. In range is generally considered 4 to 10 - if you do it 70 to 80% of the time you are doing well, but for now, just do what you can!
Feel free to post charts on here so we can tell you what to do (we like that lol!)

 

[everydayupsanddowns]

Yes @RosieA - DAFNE will help you understand your ratios, correction factors, and give a framework for dose timing, and management of things like alcohol, exercise, illness and all the rest.

There’s a free online course BERTIE which covers similar topics if that would be helpful in the meantime @Tdm

www.bertieonline.org.uk