Poor mental health

[CathyFP]

Initial hypo signs should be felt before getting to 3.5 when you have Type 1. My consultant says you should feel them in the low 4s. This sensitivity to those early signs is important because it alerts you you’re going too low. The nasty hypo signs - profuse sweating, clumsiness, faintness, etc etc - mean you’re already deep in a hypo. IMO, those are to be avoided.

@CathyFP Why did your nurse tell you to lower the alarm? Was it so you could feel a hypo or was it because they thought the alarms were contributing to your anxiety?

@Inka I think the nurse thought the alarms were making my anxiety worse - thinking about it now - lowering it seems a bit dangerous but she was implying it wasn’t really a hypo till it got to 3.5. Anyway having it at 5 seems much better thanks

 

[CathyFP]

Certainly try reducing your basal. That seems very sensible.

There’s no amount of carbs you have to eat. You’re supposed to eat your normal healthy diet and take the insulin you need to cover it. 120g carbs doesn’t seem very many. If you’re purposely limiting your carbs, that’s not going to help your ability to go for walks or your mental health. Basically, you just eat what you would have done before and take the appropriate insulin. Type 1 is nothing to do with diet, and everything to do with insulin.

So, cereal, toast, sandwiches, fruit, cereal bars, pasta, rice, potatoes, yoghurt, ice cream, an occasional dessert/piece of cake, just like you probably ate before. You don’t aim for a daily total. You just eat normally. You’re only counting the carbs in order to calculate your bolus insulin not to limit them @CathyFP

Thanks @Inka I do realise I don’t need to limit carbs and I do suspect I’m not eating enough at the moment . Being depressed kills my appetite and this may be contributing to my problems with going low frequently at the moment. Do you take insulin for every snack you eat?

 

[CathyFP]

Initial hypo signs should be felt before getting to 3.5 when you have Type 1. My consultant says you should feel them in the low 4s. This sensitivity to those early signs is important because it alerts you you’re going too low. The nasty hypo signs - profuse sweating, clumsiness, faintness, etc etc - mean you’re already deep in a hypo. IMO, those are to be avoided.

@CathyFP Why did your nurse tell you to lower the alarm? Was it so you could feel a hypo or was it because they thought the alarms were contributing to your anxiety?

What kind of initial hypo signs would be felt around 3.5?

 

[CathyFP]

My nurse also told me to lower my alarm when I mentioned it was going off a lot at night. It was very early days so I didn't question it at the time so not sure what the reasoning was behind it. The hospital had set it at 4.5 and she said lower it to 4.2 or 4. All that seemed to do was give me less time to react to the situation and over do the cola and jelly babies so its going off high an hour or two later.

I followed Roland's advice and set it much higher and can now have a much more gentle response of a biscuit or two. That along with reducing my basal has improved things. I am probably more in the 7-9 range though than the 6-7 but practice...

I'd also agree with maybe not being so hard on yourself on 'time in range'. I was getting 90-92% but there was so much micromanaging especially as type 3 seems over responsive sometimes. I'm now aiming for 80% and feeling much more relaxed. The consultant told me to aim for 70% and while I didn't agree with all he said I'd hope that's based on his many years of experience. Still not relaxed but less anxious than I was. Going without the tech seems a step too far but something to think about when I'm a bit more than 4 months in.

I also aim to eat normally as I have to try keep weight on after surgery but the insulin is easier to manage with lower amounts of carbs or at least I get it wrong more often on a 90g carb meal than a 40.

We can't give medical advice but I would say to Cathy try changing small things and if it doesn't work or you're uncomfortable change it back. Take a walk of 2-3 minutes and once you know how that feels take a longer walk. Just remember your jelly babies 🙂

Thanks for your advice @Standup . You sound very calm for someone that’s only ‘4 months in’ . I wish I knew how you manage that!

I definitely agree that getting insulin doses right seems easier on lower carb meals.

 

[Standup]

What kind of initial hypo signs would be felt around 3.5?

I get blurred vision, feel uncoordinated and have difficulty focusing mentally.

 

[Standup]

Thanks for your advice @Standup . You sound very calm for someone that’s only ‘4 months in’ . I wish I knew how you manage that!

I definitely agree that getting insulin doses right seems easier on lower carb meals.

Well as I wasn't expecting to be here at this point that's a bonus. I'm also still signed off work so I can take things at my pace and not worry about having to fit in 'normal' life. Fitting work in will be interesting.

It does feel over whelming and sometimes I think I'm not sure I can do this for the next six months, twenty years or however long it might be but then I have a good day and decide maybe its not so bad. Its also been about small steps. Walking around the garden, walking to the end of the lane, going to a friends for tea, getting dropped off in town for 30 mins on my own. I don't worry about going high for these adventures so its a case of smart phone and glucose tablets and off I go. The trip to town didn't go so well in terms of the exercise as I 'fell' rapidly to 4.5 but some glucose tablets, a sit down and then an excuse to buy some rolos meant it was manageable. I was also expecting a low at that point based on experience from before so that helps keep things calm.

As well as physical activities I've also been trying different amounts of insulin and different timings based on what I'm eating. That's much harder but I know if I'm going to do some light gardening or walk up to a friends stables to see the horses I'll need less insulin than normal because I'm active - calling it exercise might be stretching it a bit.

 

[CathyFP]

Thanks @Standup . Well I’m so pleased that you are here.

Yes I have found learning to manage T1 while doing a very busy job extremely hard. I’m now signed off sick for a while so can focus on things a bit more easily.

 

[Inka]

Thanks @Inka I do realise I don’t need to limit carbs and I do suspect I’m not eating enough at the moment . Being depressed kills my appetite and this may be contributing to my problems with going low frequently at the moment. Do you take insulin for every snack you eat?

It depends @CathyFP If I’m having a snack to raise my blood sugar a little or having a snack before exercise, gardening, shopping, etc, I don’t bolus for it. However, if I’m sitting down working or watching TV and fancy a snack I bolus for it (unless it’s only a few carbs, eg 8g or whatever). I might take the full bolus or if I know my blood sugar would be going down before my next meal, I reduce my bolus slightly.

You’ll learn from experience - and experimenting 🙂

 

[Inka]

What kind of initial hypo signs would be felt around 3.5?

3.5 is hypo. Ideally you’d be feeling some initial signs before getting to that level. My initial signs start in the low 4s. They are subtle - a feeling of weakness, slight anxiety, etc. My consultant said that feeling the start of hypo signs in the low 4s is ideal, so it’s what I always aim for (by making sure I don’t drift too low).

My hypo signs are weakness, shakiness, sweating and/or feeling hot, feeling suddenly irritable and/or tearful for no reason, tingling lips, hunger, brain slowness, clumsiness, visual changes, and more that I’ve probably forgotten. When I was first diagnosed, the ones I noticed first were visual changes and brain slowness as they’re quite different and obvious.

 

[Jasmin2000]

3.5 is hypo. Ideally you’d be feeling some initial signs before getting to that level. My initial signs start in the low 4s. They are subtle - a feeling of weakness, slight anxiety, etc. My consultant said that feeling the start of hypo signs in the low 4s is ideal, so it’s what I always aim for (by making sure I don’t drift too low).

My hypo signs are weakness, shakiness, sweating and/or feeling hot, feeling suddenly irritable and/or tearful for no reason, tingling lips, hunger, brain slowness, clumsiness, visual changes, and more that I’ve probably forgotten. When I was first diagnosed, the ones I noticed first were visual changes and brain slowness as they’re quite different and obvious.

Thanks @Inka - weakness and anxiety is exactly what I feel too at 3.5 but I was never able to express it. My eyesight and concentration suffers at 3.0-3.3 but I'm still able to get my carbs in an orderly manner. I've also been at 2.1 without needing help but the adrenalin is painfully prickly.

 

[Leadinglights]

Some people seem to get signs that are observable by somebody else but they are unaware of themselves, a colleague who I never saw monitor his blood glucose would get twitching which progressed to pronounced jerky movement and then to barely being able to sit on a chair without falling off. A quiet word at the early stage to put some sugar in his coffee usually did the trick. I wish I knew then what I know now.