Questions questions questions!

[Purls of Wisdom]

This discussion has been separated away from an earlier thread about life expectancy here: https://forum.diabetes.org.uk/boards/threads/life-expectancy-with-diabetes.101190/

I relate with Jenny65. Googled the same in first couple of days after being diagnosed. Not the news I wanted to hear but I was OK with it. Everyone has to go one day; no one is here to stay forever.
I am trying my darnest best to do the right thing. But nothing seems to be working. It is so worrying and frustrating. At present my gripes are as follow

1) am I not understanding the basics and why?

2) what am I eating wrong for the BG LEVELS to spike up to >14mmol? Too many carbs? Not enough protiens? Fail to calculate carbs? Not getting the ratio right? I had set doses, 1:10 ratio and now 1:5 ratio for breakfast. Still spikes.

3) I prefer weetabix for breakfast. Right or wrong choice?

Seeded or brown bread 2 slices with cheese cucumber and tomato. Protien is missing, I know. A piece of fruit.

A cup of tea and little amount of unsalted roasted brown chickpeas, pumpkin seeds or plain peanuts.

For dinner, there is usually homemade lentils or a green veg curry with 2 wholemeal chapattis. A fruit. Handful of Almonds or 2 walnuts.

3 + months have passed and I seem none the wiser. I know it will take time but how long? I am losing the will to carry on.

I have completely given up on snacking, fizzy drinks, potatoes, rice and overeating. Seriously speaking, I can not think of what else to do. What to replace my carb heavy foods with. I must admit that I do get hungry at times, luckily I have the will power. Am I not exercising enough? Not drinking enough water?
I was never of athletic nature. Running a household with extended family of 9 members at the age of 23 wasn't easy. I had left my entire life, a loving family and friends behind in India. I found myself a term time job for my sanity and self respect. I had no energy left in my small frame of body. I did 8,000 steps a day and thought I was doing much better than many. Obviously not, I know now.

I am an eggetarian. I have never smoked or drank in my life. I loved to eat though. I supported a slightly sluggish life style due to age and laziness I hasten to add.

I have survived breast cancer in 2016 and have suffered from depression and anxiety, since 2003, due to immense mental pressure and my worrying nature. Initially I refused to take meds and being on and off a few times under medical supervision, I have come to the bitter realisation in 2017 that I have to take antidepressants for the rest of my days whether I like it or not. Was not easy for me to accept. And now this... ...

At times I lose hope, feel angry, helpless, frustrated and never hopeful. Do not see any reason for me to be upbeat hence no fear of dying I guess.

At this stage all I want for someone to tell me if I am eating more carbs than I should in an ideal world for diabetics. What to replace carbs with? Which protein rich foods? What can I eat when I feel super hungry in between meals? Replacing carbs with more proteins and fat - will this not eventually increase the cholesterol levels? Should I be taking slow carb snack before going to bed in order to avoid hypos during the night? Please no one tells me that I can eat anything since on insulin. It is crystal clear that I can't. Not yet anyway.

My head is constantly buzzing with these questions and more. I am aware that I can drive people mad with my endless questions, but that's just me. More I know and understand, better I feel within myself.

Is there anyone on this profound forum who has or feels the same ... I would love to hear from them. Any other advice or reprimand is welcome too.

Thank you all. Take Care. Stay healthy and safe!

 

[Inka]

@Purls of Wisdom If you look at your threads, you’ll see lots of helpful suggestions, many of them saying similar things. I suggest you try to condense the advice down to a brief list - that is, pick out the important things from all the responses. Write/type them out and then you’ll have something to refer to for ideas and reassurance.

If you find yourself coming back to the same worries again and again, even though you have the answers/suggestions on your list, you’ll know that that’s the anxiety trying to stress you out. You’re doing ok. xx

 

[Leadinglights]

@Purls of Wisdom If you look at your threads, you’ll see lots of helpful suggestions, many of them saying similar things. I suggest you try to condense the advice down to a brief list - that is, pick out the important things from all the responses. Write/type them out and then you’ll have something to refer to for ideas and reassurance.

If you find yourself coming back to the same worries again and again, even though you have the answers/suggestions on your list, you’ll know that that’s the anxiety trying to stress you out. You’re doing ok. xx

That is a really good suggestion for @Purls of Wisdom as it is sometimes quite hard to pick the bones from things when they are in different threads and it would help to focus the mind and formulate some questions for her DSN.

 

[Purls of Wisdom]

@Purls of Wisdom personally a high carb breakfast would not be a good start to the day, but if you can cope with grain based then it will do no harm to have cereal - but I found that it has more effect on me in the mornings so I have 1/4 of my daily carbs first thing and the rest in the evening - I only eat twice a day.
Some people find the opposite, and need to have fewer carbs later so as not to see a spike - that is why it is a good idea to check and test, and settle into a routine which is backed up by testing.
As you are taking insulin I can't advise choosing lower carb foods, the moderators don't like it, but you can use your results and hopefully have advice from your HCPs to make adjustments safely so as to see fewer high numbers.
I wrote down the carb content of foods I eat as a percentage, and also a typical portion size and the carbs in that, to help me to plan meals for a week at a time.

Great and thoughtful advice. How many carbs do you eat on average? What do you eat for carb free breakfast? I am new to the regime of eating breakfast. More over eating weetabix is an achievement as it is. Finding something low carb is hard.

Granted I am on insulin, how many carbs I must eat minimum in every meal in order to avoid spikes?

I do feel as I come across as a slow learner, trust me, I am not. It is just this ailment has knocked me for sixes. Wonder if there are other individuals who have felt the same where the simplest things do not make sense or add up.

 

[Purls of Wisdom]

As you are taking insulin I can't advise choosing lower carb foods, the moderators don't like it

Presumably because it could be extremely dangerous. Pretty good reason, I’d say.

Dear Inka, care to explain more? I know in order to use up the fast acting insulin, I need to eat carbs. I am not managing to strike the balance as yet. I calculate carbs. Inject thinking it is the right amount and then comes the dreaded sharp peak. Back to the same proverbial square as they say. A vicious circle indeed.

 

[Leadinglights]

Great and thoughtful advice. How many carbs do you eat on average? What do you eat for carb free breakfast? I am new to the regime of eating breakfast. More over eating weetabix is an achievement as it is. Finding something low carb is hard.

Granted I am on insulin, how many carbs I must eat minimum in every meal in order to avoid spikes?

I do feel as I come across as a slow learner, trust me, I am not. It is just this ailment has knocked me for sixes. Wonder if there are other individuals who have felt the same where the simplest things do not make sense or add up.

The way somebody who is purely dietary managed will approach how many carbs they eat at any one meal differently from somebody who is taking insulin and people taking insulin will do different things depending on what particular insulins they are taking and when. So the questions you ask it is not really possible to answer.
If you said I take 5 units on insulin and my insulin to carb ratio is 1 to 10 then somebody could say then you can/should eat 50g carb at that meal and that may or may not cause a increase in blood glucose more than you want so you might then think 'Is my carb to insulin ratio correct'
I'm afraid managing blood glucose is not an exact science but there is a good bit of trial and hopefully not to much error.

 

[Inka]

Dear Inka, care to explain more? I know in order to use up the fast acting insulin, I need to eat carbs. I am not managing to strike the balance as yet. I calculate carbs. Inject thinking it is the right amount and then comes the dreaded sharp peak. Back to the same proverbial square as they say. A vicious circle indeed.

Yes, Drummer has, presumably, been asked not to recommend low carb diets to people on insulin but still does it, just with the added little dig at the mods here. It is wrong.It is potentially very dangerous to suggest someone on insulin eat low carb because it’s possible they could have a severe hypo. By severe, I mean losing consciousness, having a seizure, or worse.

 

[Leadinglights]

Dear Inka, care to explain more? I know in order to use up the fast acting insulin, I need to eat carbs. I am not managing to strike the balance as yet. I calculate carbs. Inject thinking it is the right amount and then comes the dreaded sharp peak. Back to the same proverbial square as they say. A vicious circle indeed.

Although it is early days for you I think you need to be asking for some help from your diabetic nurse and ask to go on the education courses as it should give you a better understanding of the principals of managing the balance between insulin and carbohydrate intake. At the very least ask for a review of the insulin regime you are currently on.
From what you imply you are matching your carbs to the insulin rather than adjusting to insulin to match whatever carbs you want to eat.

 

[Purls of Wisdom]

@Purls of Wisdom If you look at your threads, you’ll see lots of helpful suggestions, many of them saying similar things. I suggest you try to condense the advice down to a brief list - that is, pick out the important things from all the responses. Write/type them out and then you’ll have something to refer to for ideas and reassurance.

If you find yourself coming back to the same worries again and again, even though you have the answers/suggestions on your list, you’ll know that that’s the anxiety trying to stress you out. You’re doing ok. xx

Everyone must ve known me now by the name of Mrs. Anxiety.

 

[Purls of Wisdom]

Although it is early days for you I think you need to be asking for some help from your diabetic nurse and ask to go on the education courses as it should give you a better understanding of the principals of managing the balance between insulin and carbohydrate intake. At the very least ask for a review of the insulin regime you are currently on.
From what you imply you are matching your carbs to the insulin rather than adjusting to insulin to match whatever carbs you want to eat.

This is exactly what the confusion is. I roughly calculate my carbs and then take insulin. I try not to deviate from my previous doses cos I should only be increasing or decreasing by 1 unit at a time. Keeping it same for 3 days to see their true effect.

 

[Purls of Wisdom]

From what you imply you are matching your carbs to the insulin rather than adjusting to insulin to match whatever carbs you want to eat.

I have not reached that goal post as yet.

 

[Leadinglights]

This is exactly what the confusion is. I roughly calculate my carbs and then take insulin. I try not to deviate from my previous doses cos I should only be increasing or decreasing by 1 unit at a time. Keeping it same for 3 days to see their true effect.

You may need to be a bit more accurate in your carb calculation as it may not need very much over or under estimation to make you insulin dose too much or too little and could account for your erratic levels.

 

[gll]

@Purls of Wisdom
okay lets rewind.
are you on 5u 10u 10u fixed doses fast acting (mealtime) insulin or do you take 1u for every 5g carbs with brekkie and 1u for every 10g carbs for the other meals?
the two are completely different ways of handling it x

Just trying to get a clearer picture of what your regime is.

What are you adjusting every 3 days? long acting (once a day) or fast acting (mealtime) insulins?

(edit - want to throw in some hugs, seriously, my heart goes out to you x)

 

[Purls of Wisdom]

Yes, Drummer has, presumably, been asked not to recommend low carb diets to people on insulin but still does it, just with the added little dig at the mods here. It is wrong.It is potentially very dangerous to suggest someone on insulin eat low carb because it’s possible they could have a severe hypo. By severe, I mean losing consciousness, having a seizure, or worse.

Would you say that 2 weetabix are too many carbs for someone who takes 6 units of Novorapid? I know it spikes me up. 1 weetabix is not going to fill me up till lunch time. Furthermore, would going for a walk or being on my feet after eating not help in keeping the spikes down?

 

[Purls of Wisdom]

You may need to be a bit more accurate in your carb calculation as it may not need very much over or under estimation to make you insulin dose too much or too little and could account for your erratic levels.

You have hit the nail on the head. Any tips?

 

[Leadinglights]

Would you say that 2 weetabix are too many carbs for someone who takes 6 units of Novorapid? I know it spikes me up. 1 weetabix is not going to fill me up till lunch time. Furthermore, would going for a walk or being on my feet after eating not help in keeping the spikes down?

How many carbs are there in the two Weetabix and the milk you have with it and what is your carb to insulin ratio.

 

[Purls of Wisdom]

@Purls of Wisdom
okay lets rewind.
are you on 5u 10u 10u fixed doses fast acting (mealtime) insulin or do you take 1u for every 5g carbs with brekkie and 1u for every 10g carbs for the other meals?
the two are completely different ways of handling it x

Just trying to get a clearer picture of what your regime is.

What are you adjusting every 3 days? long acting (once a day) or fast acting (mealtime) insulins?

(edit - want to throw in some hugs, seriously, my heart goes out to you x)

I take 1u for 5g of carbs for breakfast and 1u for 10g of carbs for meal times. 14u of Levemir in the morning and 13 at night time.

 

[Inka]

Would you say that 2 weetabix are too many carbs for someone who takes 6 units of Novorapid? I know it spikes me up. 1 weetabix is not going to fill me up till lunch time. Furthermore, would going for a walk or being on my feet after eating not help in keeping the spikes down?

I think you have two problems. I think you forget things or don’t fully understand sometimes? I also think you sometimes explain unclearly. For example, a few posts back you said your breakfast ratio was 1:5g but now you’re saying you are on fixed doses?

To reduce the spike you need to take the right amount of insulin at the right time. That’s presuming your basal insulin is correct.

 

[Leadinglights]

You have hit the nail on the head. Any tips?

Look on the packets, look at shop websites, get the book or app Carbs and Cals or similar so you know the carbs per 100g or everything you are going to have and weight everything or measure your milk. Invest in a calculator.

 

[Inka]

How many carbs are there in the two Weetabix and the milk you have with it and what is your carb to insulin ratio.

Do you take insulin?