Six months into T1, SO fed up!!

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clarita84

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Relationship to Diabetes
Type 1
Hi all, bit of a long story here, but feel the background is important. I was diagnosed with T1D at the end of May - I'd lost loads of weight and ended up in hospital with DKA. On discharge I was put on fixed doses of insulin (Novorapid) for each meal, plus Lantus. I spoke to my nurse a week later, and she adjusted my doses, and I was unable to get in touch with her for another month. When we next spoke in July, she adjusted my doses again, and told me I'd been misdiagnosed and was actually T2 as I had no antibodies. I'd be able to come off insulin and could reverse the condition with diet and exercise. I questioned her about it - because I was severely underweight (my BMI was 15) and as far as I was aware, DKA isn't likely in T2. She was insistent that no, I was definitely T2. Having read up about antibodies not being present in 20-25% of people newly diagnosed T1, I called her back to check AGAIN and she said, no, you're definitely T2. So I was left feeling kind of confused - how could things have gone so wrong that a previously healthy and active thirty-something had developed T2, but also...oh great, I can reverse things...let's go low carb.

My physical and mental health started to go on a steep decline - because of the uncertainty and the worry about what had gone wrong in my body. I couldn't get in touch with the nurse - always busy or unavailable. I finally had a consultant appointment in August, and she was unaware that I'd been told I was T2, she said no, definitely T1. I hadn't been misdiagnosed, I'd been given dud info by the nurse. I was so upset that she'd toyed with my emotions like that.

Luckily, I have been able to change nurse, I saw her at the end of September and she is much better. I was told at that meeting that I would see the dietician at the start of December, to start carb counting so I had more flexibility with my eating. She said they like to wait six months with adult diagnoses to ensure the honeymoon period is over. Fine.

I have a history of disordered eating (and my team knows this). I am scared of being high (The irrational part of my mind sees being high as I've eaten too much.) I struggle with fixed doses because I feel very restricted with food. I am afraid to snack - sometimes I'll have a few nuts - I stick to very strict meal times, and eat more or less the same meals every day. I've not had the confidence to return to the gym, as I weight train and know this can make your sugars go high. I also have no idea how to adjust my insulin after exercise such as walking - which I know makes me much more insulin sensitive.

When I saw my nurse last week she told me I couldn't see the dietician in December ("it's messy" or something?!) so now, it might be January. I am just SO fed up with it all!!!!!! When I was diagnosed, the consultants tripped over themselves to tell me I'd live a normal life and yet here I am, six months later stuck on a rigid eating regime, and too scared to exercise properly because I don't know how to adjust my insulin to fit in with it.

I have been carb counting to the extent that I will take an extra unit if I want two pieces of toast instead of one with my soup, or if I want a banana instead of strawberries with my breakfast. But I don't have a clue what to do if I wanted say, a starter and main in a restaurant, or a particularly high fat meal that may take longer to digest.

A dietician won't solve my eating issues, and I don't need them to tell me how to carb count - my lifetime of eating issues means I know exactly what's in most food products - but I do need some advice on how to deal with possible high blood sugars after weight training, how correction doses should be accounted for when dosing for meals, how to adjust my doses if I've been out walking or doing cardio etc. And I was rather hoping I'd be able to have a cup of tea and a mince pie one afternoon over Christmas, but now that is out the flipping window. I'm just so sick of being fobbed off and given dud information!!
 
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{{{Hugs}}}
First thing to do, is work out what your insulin to carbohydrate ratio is - so the old way to do this, is to test your BG and if it's pretty good between 5.0 and 7.5 - then eat a pretty exact nice round number amount of carbs - eg a plain digestive biscuit at 10g - then test test test after eating it to keenly observe what happens to your BG. For most of us, we started off like this and noted that the 10g increased our BG between 2.5 and 3.0 on our meter. Then we need to discover how to get rid of that extra 2.5/3.0 - so the first thing to try is 1u of fast acting.

No way will being 2.5 more than you usually are kill you, nor will an extra 1u of fast acting, as long as the starting point of BG is pretty 'middle of the road' and not too near 4 or 10 !

Also - get going with https://www.bertieonline.org.uk/ and have a plod through that one module at a time, and learn properly all the pros and cons. You will find it makes 100% sense!
 
Definitely look at BERTIE @clarita84 You won’t need to restrict your eating once you get sorted with carb-counting. Don’t worry too much about seeing a dietician. With care and caution, this is something you can teach yourself.

Type 1s can eat a normal diet once they learn how to adjust their insulin. You’ve made a start by altering your dose for toast. What you need to do is total the carbs in your meals for more accuracy. Start with breakfast and gradually move on to other meals once you know what you’re doing. I found a notebook very, very handy. I jotted down meal details, noted the carbs, and noted what insulin dose worked for that meal.
 
And I was rather hoping I'd be able to have a cup of tea and a mince pie one afternoon over Christmas,
I'm fairly sure if you could see a dietician in time, they'd say go ahead.

You've got insulin and ways of measuring blood glucose. I know things are not where they ought to be, but you can survive a cup of tea and a mince pie, and it sounds like doing that would be significant to you.
 
Thank you all SO much for replying 🙂 I'll make a start on Bertie and have a go at working out my ratio...I know it's not the end of the world, not seeing the dietician, but when the goalposts keep moving it just felt like another WHY MEEEEE moment.
 
Hi. A few things. An antibody test is not enough to confirm T1 or not. You also need a C-Peptide test which measures your insulin level. I had to insist the surgery did that for me via the diabetes clinic and it showed I was just above the T1 level but a lot below being T2. Your diet does sound a bit erratic? Bananas are no-no for us as they are very high in sugar and even some T1s need to control carb intake as even high levels of injected insulin may not work very well (I'm one of those so keep the carbs under control). I always say beware Dieticians as many haven't a clue. If they say to have low-fat foods then seek other advice.
 
Bananas are NOT a no-no! They might be for you personally @DaveB as I believe you mentioned you might have some insulin resistance. The only thing I was told to avoid was Coke and similar unless I was treating a hypo.
 
Indeed don't make assumptions - way back when I went on my dafne course, two DSNs and the clinic dietician had all done the training together down at BDEC. The CCG were so bloody mean they'd only let them do it and pay for the course itself if they paid all their own expenses (travelling accommodation and food) Then they and the consultants had the secondary battle to allow ANYONE to have a pump. Roche won exclusivity because they agreed special terms. DAFNE itself was always considered far too expensive. Hence she was excellent! (No idea whatsoever what the current one is like)

Hence why all in all, I am so perennially cynical about NICE Guidelines and our CCG.
 
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