Novorapid fixed dose - questions!

[pawprint91]

You don't sound critical of them at all but I can read an element of frustration in your posts that I can relate to as I was in a similar situation. I think being a regular member of this forum enables you to progress so much more quickly because you gain a lot of extra knowledge that other newly diagnosed people just don't have... I found this on my DAFNE course too.... but I imagine it is hard for DSNs to recognize that level of knowledge in someone newly diagnosed when the majority of people they deal with will have no understanding. My comment about them being stretched was more really justification in response to @DaveB's comment about you not officially carb counting and dose adjusting yet. I think you are easily ready for that but I am guessing they don't have the time. Fixed doses are a stop gap solution and I imagine since the pandemic more people will be on fixed doses for longer simply because they haven't got the time to educate people.
I am pleased you took the remainder of my post for the compliment it was intended to be.

I didn't take any of your post as a criticism of me, so don't worry (the dangers of the internet and not being able to convey meaning so well all of the time ) -but up until my foundation course this week and being granted a bit more freedom, I was feeling frustrated with my team and was aware of sounding so on here, when I already know the NHS is super stretched - and like you say, since the pandemic, probably far worse! Just out of curiosity, at what point do you think I'll know when my body is ready for carb counting - when the fixed doses I've worked out currently just aren't doing their job anymore?

 

[Inka]

@pawprint91 Many (most?) Type 1s are taught basic carb-counting at diagnosis. It’s not hard and actually makes life easier 🙂 Fixed doses are in themselves a kind of carb counting - just the opposite way round in that you match your carbs to your insulin rather than your insulin to your carbs. You’ll pick it up in no time, I’m sure, because you seem very switched on and focussed🙂

 

[Finn]

Just out of curiosity, at what point do you think I'll know when my body is ready for carb counting - when the fixed doses I've worked out currently just aren't doing their job anymore?

I'm sure this varies person to person (and I live outside the UK, so my experience may vary), but I was taught to carb count 3 months after diagnosis.

Before I learned to carb count, I was trying to eat carb-consistent meals (so being aware of the carbs I was eating and what sort of things were carb-heavy, but not counting the carbs) and making adjustments to my fixed doses as I saw fit (but just general fixed dose increases and decreases, not changing my doses meal to meal).

 

[nonethewiser]

I didn't take any of your post as a criticism of me, so don't worry (the dangers of the internet and not being able to convey meaning so well all of the time ) -but up until my foundation course this week and being granted a bit more freedom, I was feeling frustrated with my team and was aware of sounding so on here, when I already know the NHS is super stretched - and like you say, since the pandemic, probably far worse! Just out of curiosity, at what point do you think I'll know when my body is ready for carb counting - when the fixed doses I've worked out currently just aren't doing their job anymore?

Current regime isn't working so time for change, carb counting is easy, after while you get good at eyeballing food to know value then take appropriate amount of insulin.

Like all things in life its not perfect but is better than fixed doses believe me.

 

[SB2015]

Switching from fixed doses Makes life so much more flexible. It is not that complicated and the sooner you start the quicker you will learn the carbs in the foods you commonly eat. I was started on this within a couple of weeks after diagnosis. I did the DAFNE course over a year after diagnosis but was already using my ratios to work out doses. It enabled me to eat what I wanted to when I wanted to.
I would say it is time for you to start, especially as what you are doing at present isn’t working for you.

 

[pawprint91]

Thank you to everybody for your helpful replies! I'm not sure I've made myself very clear - I think fixed doses is working for me currently, but I have been taught how to and do, to an extent carb count, in order to work out whether to increase or decrease my fixed dose, as I said in an earlier post. For example, I had a chinese the other night that had 75g of carb - when it's time to carb count I have been encouraged to start with the ratio 1 unit of insulin to 10g of carbs. I had 4 units of insulin for that meal (taking into account I would be walking the dog etc after too). I then stayed in range (well, under 10) for the evening with no crazy spikes. But if I'd had 7 units of insulin as I would be if I were carb counting, I would have been hypo, I am sure - this is what makes me think fixed doses are working for me currently. Sorry if it's me who has misunderstood things here with anybody's responses!

 

[Bruce Stephens]

I had 4 units of insulin for that meal (taking into account I would be walking the dog etc after too).

Which is a sensible decision. Carb counting doesn't mean you always just inject what you need for a meal ignoring the rest of what you're doing. Reducing a dose to account for a walk later is very much in the spirit of adjusting doses (as you'll find if and when you get on a course, or go through BERTIE online, or whatever).

 

[pawprint91]

Which is a sensible decision. Carb counting doesn't mean you always just inject what you need for a meal ignoring the rest of what you're doing. Reducing a dose to account for a walk later is very much in the spirit of adjusting doses (as you'll find if and when you get on a course, or go through BERTIE online, or whatever).

We had a foundation course at the hospital pre-DAFNE (which could be up to a year after diagnosis, apparently) and this was touched on. I guess everything is trial and error even when you're out of the honeymoon phase until you find what exactly works for you personally, right?

 

[Bruce Stephens]

We had a foundation course at the hospital pre-DAFNE (which could be up to a year after diagnosis, apparently) and this was touched on. I guess everything is trial and error even when you're out of the honeymoon phase until you find what exactly works for you personally, right?

Yes. Having ratios (even though they can vary) gives a good starting point (and gives freedom so that we can confidently eat whatever food we want, when we want), but there's always a certain amount of judgement involved and sometimes our judgement turns out not quite right.