should i? shouldnt i?

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D_G

D_G

Well-Known Member
Relationship to Diabetes
Type 1
Ok heres the thing! Its been 3 weeks since my diagnosis and the doctor put me on the folowing MDI:

12 units Novarapid b4 brekfast
15 units Novarapid b4 lunch
15 units Novarapid b4 dinner
20 units Levemir about 10pm

So in these three weeks my levels have been all over the place, having highs and lows (mostly highs) so i asked the doc if i can learn to count carbs to level out my sugars by adjusting my insulin dosage to match the carbs i eat.......and he said no! :( app i should not be doing it for another year because of the honeymoon period or something.

But i am fed up of having these highs and lows and i know that if i carb count and adjust my insulin i will probably be able to control my levels?

So my question is do i carry on with the doctors orders or go against them and do what i think is right?? i dont know what to do incase i end up messing it up :confused::confused:

help anyone? x
 
There is the honeymoon period you will still be in, once you start inject insulin your body will suddenly start to produce some again.
How about you go back to your doctor and explain the levels and he might increase your doses.
When are you most high?
You could always try to eat less carbs, eg switch from white bread/pasta/rice to seeded bread or brown bread/rice/pasta, less potatoes etc etc and see if that helps x
 
You might also ask about doing a DAFNE (Dose Adjustment For Normal Eating) course. They work for many people.
 
Hi DG, is the doctor not at least adjusting your fixed doses? I was on similar doses to you when first diagnosed, but I was in regular contact with the DSN for the first few weeks, giving them my levels and them telling me whether to raise or lower my different meal doses. If it's clear that your doses are keeping you constantly high, they obviously need changing.

I can;t advise you to go against the advice of your medical team, but it might be useful for you to try carb counting and to determine what doses you think you might need. You could then take these figures to your doctor or DSN and it would give them some good information to advise you.

I can't see why you should wait a year to start carb counting - I started much sooner than that. I did have more hypos in those early days, but had good symptoms and readily available jelly babies. I think you need to be more assertive and tell them that you are not happy with your current high levels. Good luck!🙂
 
I think that you need to get your Dr or DSN to help you out with adjusting your doses. I can understand that they want to give you some time before you start a carb counting course, doesn't mean that you can't start before the course, plenty of people carb count who haven't been on courses, myself included.

You basal dose is less than half of your bolus doses, so that might indicate an inbalance. When do you tend to be high and low? is there any pattern to it? Because if there is then we could suggest which doses might need to be looked at.
 
I can't say go against your doc's advice but am flabberghasted that they haven't discussed carbs with you and/or adjusting your doses.

For a start the glaringly obvious problem, without even knowing what your levels are is that for some reason you have less insulin for breakfast than you do for lunch and tea. I reckon 90% of people absolutely need a lot more NR for breakfast than any other meal. This is because generally you are insulin resistent in the morning and insulin sensitive at tea time !

I do understand you may well be in honeymoon but there is no set time on this. To put a time of a year is bizarre. Some people only honeymoon for a month !! If you are constantly high, keep making appointments to see the doc, he will soon get sick of you and start doing something. I would do this, every few days. I know it may be a pain but they will start taking notice.

Good luck.
 
Thanks for all your replys!

I have an appointment with the doctor this friday so am going to discuss adjusting my insulin doses AGAIN and make him listen to me! I know i dont need as much insulin as he is telling me to have but im too scard to go agaist his orders!

For example today before my lunch i was 7.3 had my normal dose of 15 unit ate a chicken and cheese salad with a couple of crakers (i dont actualy eat alot of carbs for lunch) 2 hours later was feelin abit shakey so checked sugar 2.7!! so i know that i needed less insulin for that meal.

I tend to go high in the evenings after dinner as i am trying very hard not to snack (like i used to) but sometimes it just gets the better of me, this is why i want to carb count so if i do have a snack attack i can cover them with the insulin.

maybe i should try an xperiment at lunch tomoro and only inject according to how many carbs...so like two bits of bread = 20 carbs i worked out that 500 rule and i think my ratio is 1:8 so i can round that up and only inject 3 units of insulin?? is that how it works? but that is a loooong drop from my usual 15 units im too scared to do it!!
 
If you are running high later in the evening it may also be your levemir that is running out. A lot of people find it doesn't last the full 24 hours, so they split their dose into two injections - something else for your doctor to consider!🙂

Dropping from 15 to 3 does sound very drastic. If it was me I'd be more tempted to have the same meal and drop by just a fraction, say down to 12 or 13 units. As sofaraway said earlier, your ratioi of fast to slow is quite big i.e. you are taking a large proportion of your insulin as fast. Normally, the ratio is around 40% slow and 60% fast, so it may be that, if you increased your basal you would need less fast acting. Definitely some adjustments needed - don't leave without some answers! 🙂
 
I take 2 shots of levemir, one in the morning and one in the evening as i was going high in the evenings and since doing it im not high in the evening any more x
 
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