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Purls of Wisdom said:
The DSN has already expressed her frustration and annoyance with me for still needing support. My GP won't entertain anything which is remotely related to Insulin. Who do I have to turn to?
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Is that a DSN at your local GP surgery or a DSN associated with a diabetes clinic?
I find the DSN at my GP surgery struggles with Type 1 as she mostly sees people with type 2. I would not expect her to provide any guidance with respect to insulin. Typically, the DSN at a GP surgery is a general nurse with an interest in diabetes.
In comparison, the DSN at my diabetes clinic is fantastic and has specialist diabetes training. It is pretty much all she does. I think she knows more than the consultant.
 
Purls of Wisdom said:
The DSN has already expressed her frustration and annoyance with me for still needing support. My GP won't entertain anything which is remotely related to Insulin. Who do I have to turn to?
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From what I have gathered Novorapid starts to work 10-20 minutes after injecting and its effect should last between 3 and 5 hours but some people do say that it takes much longer to take effect if glucose level is already high but even if glucose level is not then for them it takes longer so they prebolus before eating but you would need to find what the time in advance you need to do that as it will be specific to you.
If glucose level is high when you are going to eat, then people would add a correction dose to their bolus.
Hopefully some Type 1 folk will be along to give you some suggestions.
Did you manage to find a way of posting a picture of your Libre graph as I'm sure that will help people see what might be going on.
 
helli said:
It sounds as if you got caught in the type 2 advice to minimise carbs. This is not necessary with Type 1.
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Finally, someone else has hit the nail on the head. I do wonder if I have to unlearn everything I have learnt till now and re learn.
helli said:
Some find it is easy to calculate their insulin dose when they eat less carbs. However, I have found this can add to more complexity because, with little carbs, our body will convert protein to sugar which can affect our blood sugars. Therefore, I had to calculate insulin for protein at different ratios.
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Oh no. Not another counting drill.
helli said:
I have chosen to eat the same diet as I did before I had diabetes. I am happy to eat bread, potatoes, rice, pasta (although the sauces can make this more challenging) and pizza. I do not eat all of these all the time - I can go for months between pizzas, for example.
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My staggering hypers stop me from eating all those mentioned above and more. I would only eat 3 oven chips and a slice of pizza once in a blue for the fear of carbs overdose.
helli said:
I eat a mainly vegetarian diet which is very varied. For example, this week my dinner has included pie and mash, coconut, peanut and aubergine curry, shakshuka, mixed roasted root vegetables with feta and tonight it will probably be beetroot and covolo nero risotto.
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With apologies in advance, I won't touch either pie or mash cos of plain flour and potatoes. Many times, I have thought about the idea of eating chicken or white meat or fish knowing diabetes is not going anywhere. It will still be here even when I am gone!
helli said:
I never get bored with my food but my blood sugars are "only" 85% in range. I am happy with this because my CGM allows me to keep a close eye on my levels and correct when necessary whilst not allowing diabetes to take over my life.
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85% is an excellent range to be in, ask me.
helli said:
Sorry, I didn't mean this to be all about me but I wanted to highlight
1. Type 1 diabetes does not need to limit your diet
2. You are more than a diabetic. Remember to look after all of your mind and body which may mean compromising a little on diabetes targets at times.
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The best sentiment I have heard till date! Thank you.
 
Inka said:
At midnight last night, it went beyond 18.0.
Woken up to 12.0mmol/L.

What was your blood sugar when you went to bed?
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i was at a prayer meet. Dinner was delayed. Libre2 read 12.8mmol/L at 8:45pm before eating. Indian food, impossible to carb count. To be on the safe side, I took 9u of NR. I was not expecting any hyper, a hypo more so.
Inka said:
What time do you take your evening Levemir?
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Around 10:00pm.
Inka said:
Do you know why you went high? Eg evening meal, illness, etc etc.
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Evening meal not cooked by myself.
Inka said:
What would your blood sugar normally be overnight?
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The last reading before bedtime for the week gone varied between 5.4 to 12.8. So inconsistent and confusing.
Inka said:
Are you sure your basal (Levemir) is at the right doses - have you done a basal test?
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rebrascora said:
If levels dropped from 18 to 12 overnight then it looks like evening Levemir is possibly a bit too high to me, but that there was perhaps a problem with the evening bolus.

@Purls of Wisdom What time did you eat and what was your meal and what were your levels before the meal?
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I ate much later than usual. 9:00pm I can say. It was home cooked mixed daal, curried spinach and paneer, chapatis and raita. No dessert or fizzy cola. Pre meal reading was 12.8 mmol/L.
rebrascora said:
Can you take a photo of your Libre graph and post it so that we can see what is happening?
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For the duration of a week? A fortnight? Or a month? Thanks.
 
Purls of Wisdom said:
Finally, someone else has hit the nail on the head. I do wonder if I have to unlearn everything I have learnt till now and re learn.
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Definitely, because you have been fed nonsense for even type 2's.
But you are getting the right advice now, so it's all upwards from now on hopefully.
 
How do you take in information best? I'm a book person and quite independant so 'think like a pancreas' and my libre worked for me . If you are a person person perhaps a in-person course like Daphne may work? If you are a visual person, perhaps find a reliable you tubing diabetic who talks about diabetes?

I'm thinking you may benefit from something structured that you can take at your own pace.
 
Tdm said:
How do you take in information best? I'm a book person and quite independant so 'think like a pancreas' and my libre worked for me . If you are a person person perhaps a in-person course like Daphne may work? If you are a visual person, perhaps find a reliable you tubing diabetic who talks about diabetes?

I'm thinking you may benefit from something structured that you can take at your own pace.
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I think I am a persons' person, more so now a days. I will only settle once all my questions and counter questions are answered with a believable explanations.

I usually follow Type 1 talks on YouTube. He has gone on some weird diet. Carbs free I think, which has made me lose my interest.

Is Daphne not for T2DM sufferers? Or you meant DAFNE?
 
travellor said:
Definitely, because you have been fed nonsense for even type 2's.
But you are getting the right advice now, so it's all upwards from now on hopefully.
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I couldn't be more thankful to everyone for investing their time and efforts in me. I woke up feeling upbeat and calm this morning. What a difference it had make.
 
Purls of Wisdom said:
Is Daphne not for T2DM sufferers? Or you meant DAFNE?
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Yes DAFNE is for T1s “Dose Adjustment For Normal Eating”.

The T2 course is Desmond. (Diabetes Education and Self Management for Ongoing and Newly Diagnosed).
 
helli said:
Is that a DSN at your local GP surgery or a DSN associated with a diabetes clinic?
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The one who is associated with the Grey Clinic. I expected better and sympathetic support. Not my fault that they are short staffed, over worked and pushed for time.
helli said:
I find the DSN at my GP surgery struggles with Type 1 as she mostly sees people with type 2. I would not expect her to provide any guidance with respect to insulin. Typically, the DSN at a GP surgery is a general nurse with an interest in diabetes.
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I am lucky to have a great surgery. Couldn't have asked for a better team.
helli said:
In comparison, the DSN at my diabetes clinic is fantastic and has specialist diabetes training. It is pretty much all she does. I think she knows more than the consultant.
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On the contrary, the DSN seems to think that one month long support should be sufficient. What about the professionalism and ability to differentiate among patients and treat them accordingly?
 
helli said:
That is very likely to be because you are not taking enough insulin.
You need more education on how to calculate your insulin dose.
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My insulin to carbs ratio has not been reviewed for long time and I dare not ask.
 
Has your diagnosis been confirmed by c-peptide and GAD antibody tests or have they just assumed you are Type 1 because the regime you were following when your diagnosis was Type 2 was not working.
I am failing to understand why they don't think that now you are Type1 you don't need a review of your insulin ratios and dose and more help with adjustments and also to be offered the DAFNE course. You could of course do the BERTIE on line course people have suggested and do your own research on the actions and profile of the insulins you are taking.
 
Purls of Wisdom said:
My insulin to carbs ratio has not been reviewed for long time and I dare not ask.
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Once you’ve done some basal testing, and are sure that’s at the right dosage, then you could look at your meal ratios yourself and see if they need tweaking.

I know you had that hyper overnight as you describe, but the good thing is you’ve worked out what caused it. That sounds trivial, but it’s not. That understanding will help you moving forward 🙂
 
Purls of Wisdom said:
My insulin to carbs ratio has not been reviewed for long time and I dare not ask.
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If you do not get this right, you will continue to experience high levels.
As @Inka has suggested, you need to get your basal level correct. This is your foundation. Once you have a stable foundation, you can build upon it with your bolus with insulin to carb ratio and correction dose.
As I mentioned earlier, I get my diabetes to work around my life. This is possible. I was diagnosed nearly 20 years ago. I still live a very full, active and varied life and have no complications due to my diabetes.
Limiting your diet seems to be making you miserable so you need to find a way to eat more of what you enjoy by learning how to use your insulin.
lt is not easy but, for me, it has definitely been worth it.
 
Leadinglights said:
Has your diagnosis been confirmed by c-peptide and GAD antibody tests or have they just assumed you are Type 1 because the regime you were following when your diagnosis was Type 2 was not working.
I am failing to understand why they don't think that now you are Type1 you don't need a review of your insulin ratios and dose and more help with adjustments and also to be offered the DAFNE course. You could of course do the BERTIE on line course people have suggested and do your own research on the actions and profile of the insulins you are taking.
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The Consultant explained that it is too early for c- peptide test. The results will not be 100% accurate.
 
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