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Alex.H

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Type 1
Hello everyone, after a recent struggle with accepting my diagnosis as a type 1 diabetic, I was advised by a psychologist to make contact with Diabetes UK and reach out to some people to finally start processing everything after 10 years of burying it.

I've always been a bit of a unique case, diagnosed in my late 20's whilst living abroad in Canada, no family history of type 1, hypersensitivity to insulin so my glucose levels are generally good but I suffer from a lot of hypos on a regular basis as a result. The main reason I am reaching out now though is a counsellor recently rooted out a problem which I've been fighting with for years and that is that I've never truly come to terms with being type 1. I do the things I should as a diabetic fairly well but I do them on autopilot rather than mentally acknowledge and accept them and understand that I have to let go of some of the goals and dreams I had before I was diagnosed. Rather than addressing it, I buried myself in my work right from the start, physically pushing my body to its limits in an attempt to show that I'm still as physically capable as I was before my diagnosis and keep my glucose levels as low as possible without the need for larger doses of insulin.

As it stands right now, I take 5-7 units of Novorapid and 16 units of Tresiba, that hasn't really changed over the 10yrs that I've been diabetic. If anything I should probably be taking even less but my sensitivity to insulin is a struggle. 1-2 units can be the difference between me dropping to below 3.0 or going above 10.0. It gets exhausting and I don't ever feel like my doctors understand the mental toll it's taken despite attempts to communicate it. They are great with the data side but it feels like they see my fairly tight control and assume everything is fine. I've never spoken to another type 1 diabetic since I moved back to the UK over 7yrs ago and my family try to understand but I can see that it leaves them confused, especially with my situation with hypos.

So here I am, ready to start accepting and coming to terms with it all finally and to speak with people who might have a better understanding of the mental side of dealing with diabetes other than from a textbook.
 
I'll just comment on some practical aspects (which may or may not be helpful).
Alex.H said:
As it stands right now, I take 5-7 units of Novorapid and 16 units of Tresiba, that hasn't really changed over the 10yrs that I've been diabetic. If anything I should probably be taking even less but my sensitivity to insulin is a struggle. 1-2 units can be the difference between me dropping to below 3.0 or going above 10.0.
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How interesting. An obvious thing to try (if you haven't already) is half units. (If your diabetes team haven't suggested that I've no idea what they're thinking.)

Have you talked with the dietician on the team, to make sure you're taking account of the behaviour of Novorapid: that it tends to take ~30 minutes upwards to start acting but then continues for ~4 hours or so (though perhaps less with small doses)? (But those can both vary a lot between individuals.)

It might also be worth talking about changing the Tresiba for Levemir (Levemir is twice daily, so you can have doses that are better suited to day and night). I've no idea whether that would help (it would need to be something your diabetes team could consider with you). I'm wondering if the longer acting Tresiba is confusing what's happening during the day with the Novorapid, but I'm just guessing (many people use longer acting insulins and get on fine with them).

Have they suggested a pump? Pumps can provide much more finely determined doses. And of course hybrid closed loops can automate some of this; if you had one to provide a consistent base, perhaps handling the extra doses for eating and so on would be less problematic.
 
Bruce Stephens said:
I'll just comment on some practical aspects (which may or may not be helpful).

How interesting. An obvious thing to try (if you haven't already) is half units. (If your diabetes team haven't suggested that I've no idea what they're thinking.)
Click to expand...
My team in the UK have never mentioned half units. I am aware of them but all of my pens only do full units so I assume one would need a pen that can do halves? Never used them so I'm not familiar with the practical side I'm afraid.
Bruce Stephens said:
Have you talked with the dietician on the team, to make sure you're taking account of the behaviour of Novorapid: that it tends to take ~30 minutes upwards to start acting but then continues for ~4 hours or so (though perhaps less with small doses)? (But those can both vary a lot between individuals.)
Click to expand...
I am aware of the delay with Novorapid and it has been suggested to take it 20mins prior to eating which I have tried but same results unfortunately. I can repeat the same thing, eating the exact same serving of a meal 2-3 days running and get different results each time. Generally 1 out of the 3 will result in a sudden hypo. It generally comes down to physical activity and what I have been doing the few days prior. Even just walking to the store 5mins away can put me into a hypo even when my levels are at 6.0 - 8.0 before leaving.
This is where the mental drain comes in, it is exhausting trying to be prepared for the lows as they can onset with very little warning. There isn't much pattern to them sadly so it's made combating it difficult.
Bruce Stephens said:
It might also be worth talking about changing the Tresiba for Levemir (Levemir is twice daily, so you can have doses that are better suited to day and night). I've no idea whether that would help (it would need to be something your diabetes team could consider with you). I'm wondering if the longer acting Tresiba is confusing what's happening during the day with the Novorapid, but I'm just guessing (many people use longer acting insulins and get on fine with them).
Click to expand...
Levemir is something both my team in Canada and here in the UK have avoided. I'm not really sure of the reasoning but the team I had in Canada went straight for Lantus (because my insurance fully covered any costs) and assured me at the time it was the best available long acting insulin. My UK team however blamed it for several severe hypos that lead to seizures so they swapped me to Tresiba as it has a smoother curve than Lantus.

The long acting insulin is definitely the issue for my hypos, everyone is in agreement on that but it's such a fine line on how much 1 unit can alter my daily readings that we haven't really been able to find a definitive answer.
Bruce Stephens said:
Have they suggested a pump? Pumps can provide much more finely determined doses. And of course hybrid closed loops can automate some of this; if you had one to provide a consistent base, perhaps handling the extra doses for eating and so on would be less problematic.
Click to expand...
Both of my teams suggested using a pump but I don't feel it's an option for me, not at this time anyway. My mental situation is that I've not wanted to accept being diabetic and having something attached to me that is a constant reminder of that is just not the right thing for me at this time. It took them over a year and a half to get me to accept having a Libre sensor and while I did take to it immediately once we got passed that mental block, there are points where it has caused issues with getting caught on something causing it to be ripped out of my arm. When that happens I'm hesitant to trust having things attached to my body in that manner.
 
Alex.H said:
My team in the UK have never mentioned half units. I am aware of them but all of my pens only do full units so I assume one would need a pen that can do halves? Never used them so I'm not familiar with the practical side I'm afraid.
Click to expand...
It's simple enough. You need reusable pens and cartridges rather than disposable pens. (Needles are the same.)

For Novorapid and Tresiba you'd use Novopen Echo Plus pens. (They remember doses, so if you ever find yourself wondering if you've given a dose or what it was you can see.) They're heavier than the disposable ones but the cartridges take up much less space.
 
Satan’s little helper said:
Hello, welcome to the forum. Insulin needs vary. They are what they are for the indevidual. One thing I’ve learned, the minute you look at how other competitors are doing in the “race,” you lose focus on the finish line.

Best wishes.
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Thank you for the welcome, apologies if my opening post came across in a confusing manner, my insulin dosages are not so much an issue, I know my situation is fairly unique to me alone.

The main reason I came here is just to converse with other diabetics to help me to stop burying my condition to the back of my brain and actually come to terms with it.
 
Bruce Stephens said:
It's simple enough. You need reusable pens and cartridges rather than disposable pens. (Needles are the same.)

For Novorapid and Tresiba you'd use Novopen Echo Plus pens. (They remember doses, so if you ever find yourself wondering if you've given a dose or what it was you can see.) They're heavier than the disposable ones but the cartridges take up much less space.
Click to expand...
Interesting, I don't actually use a disposable pen for my Novorapid but I've had the same pen since the day I was diagnosed so it only does full units.

This certainly something for me to discuss with my team when I finally get an appointment with them. Thank you for the advice, that really could be something worth trying if my doctors agree.
 
Alex.H said:
Interesting, I don't actually use a disposable pen for my Novorapid but I've had the same pen since the day I was diagnosed so it only does full units.
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So it's an even easier switch. I guess you use the Novopen 6 (or 5), as I do. Curious they'd choose that one rather than the Echo variants. I guess they just didn't know about your insulin sensitivity when you started and didn't consider changing the pens? (The Echo Plus and Echo pens sometimes get called children's variants but I think that's just an error nowadays. If you want half units then you want the Echo variants, and if you want to be able to inject more than 30 units in one go you need the non-Echo ones.)
Alex.H said:
This certainly something for me to discuss with my team when I finally get an appointment with them. Thank you for the advice, that really could be something worth trying if my doctors agree.
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Yes, it feels to me worth talking about. It's also quite possible that it wouldn't help that much. After all, what do I know?
 
Bruce Stephens said:
So it's an even easier switch. I guess you use the Novopen 6 (or 5), as I do. Curious they'd choose that one rather than the Echo variants. I guess they just didn't know about your insulin sensitivity when you started and didn't consider changing the pens? (The Echo Plus and Echo pens sometimes get called children's variants but I think that's just an error nowadays. If you want half units then you want the Echo variants, and if you want to be able to inject more than 30 units in one go you need the non-Echo ones.)
Click to expand...

I actually use a Novopen 4, I have a Novopen 5 which was given to me when the plastic housing broke on my 4 but in all honesty, I just swapped the housing from the 5 to my 4 since there wasn't any difference that I could see. It's silly but I've had my Novopen 4 since day one and when it came to throw it away, I couldn't bring myself to do it because it's been my pen for so long. I just swapped over the housing since the 5 looked identical in every way. I still have the Novopen 5 as well.

My sensitivity was definitely not known at the time. I went into a 10 month honeymoon phase where I worked my body so physically hard that I did not need any insulin during that period. It was only when I finally injured my back and got laid up for a year that I had to go back onto it. By then I was back in the UK and my team here haven't been anywhere near as engaged with me as my team in Canada were. The difference between private and NHS healthcare I guess?
Bruce Stephens said:
Yes, it feels to me worth talking about. It's also quite possible that it wouldn't help that much. After all, what do I know?
Click to expand...

Well, this is exactly why I wanted to talk to other diabetics finally, to get some insight of things I can bring back to my team with to see if it's worth trying. They certainly haven't had any new ideas for the last 2yrs so anything is worth suggesting right now.
 
I am with @Bruce Stephens all the way on the suggestions he has made, especially the half unit pens for both NovoRapid and Tresiba or Levemir if you end up changing. So many times I am torn between 2 units or 3 and splitting the difference can make all the difference.
I would be concerned that after 10 years the mechanism on your NovoPen 4 may be worn and not dispensing accurate doses, so it may be contributing to your difficulties. There was a lady on my DAFNE course who had a very old injector that she had had for 40 years and she trusted it because it had kept her alive for all those years but it turned out that it was no longer dispensing accurate doses and even though she took tiny doses and I mean just 2 or 3 units of Lantus she was hypoing regularly through the night and frequently needing paramedics but going high during the day. She ended up with a pump that could administer the tiny amounts of insulin she needed in minute amounts every few minutes which made a massive difference to her quality of life.

If you feel like exercise from a previous day is interfering with the next days results and it most can do that, then I too would recommend Levemir. I love my split dose Levemir for it's flexibility. One of my biggest problems is that I have a big disparity between daytime and nighttime basal needs (I need lots more during the day but hardly any at night and I suffer nocturnal hypos the night after I have done more exercise/activity than usual. With Levemir I can dial back my evening dose to account for that which helps a lot. With Tresiba each dose lasts up to 40 hours so each dose is overlapping the next dose to give you even coverage day and night but if your body needs a lot less at night or you want to change it to accommodate more exercise for a couple of days, you can't really do it. It is like stopping a super tanker. You need 3 days notice to slow it down or change course, whereas Levemir lasts about 16-18 hours so you can make changes with your next dose which will have almost immediate effect and you can adjust the timing so that you get the peak of activity when you need it most. Levemir is a good halfway house between injections and pumping as regards basal dosing because you can fine tune it more. Maybe your team elt that because you did not want to engage fully with your diabetes that an extra injection and decision on doses would be too much for you. But getting your basal insulin as close to fitting your body and lifestyle needs as possible, both in terms of the actual insulin profile and the dose, is key to getting more stability with your NR. Your basal insulin is like the foundation of a house. You need it to hold you steady (which is very different to providing a smooth, uniform level of insulin because our bodies rarely do uniform. They have ebbs and flows and circadian rhythms that need adjustment here and there to keep you on an even keel. Some people find Tresiba works for them but if you know how to adjust Levemir to get the best from it, you can tailor it to your body pretty well. Did I mention that I absolutely love my Levemir!! 🙄

As regards you burying your head in the sand, I am not sure I understand what you mean. Most people who do that, don't take their insulin and/or don't check their levels. It sounds to me like you do everything that you need to and more, keeping fit etc, but perhaps you haven't had the right support and tools to help you manage it well and perhaps you have a form of burnout because you are frustrated with it not playing ball, which is totally understandable. Whilst we all know that the diabetes is confusing and contradictory and the goal posts move regularly, which is intensely irritating, having the tools and knowledge to change your strategy when the posts move so that you can still play reasonably well with the newly positioned goal posts is the important thing. Learning from people here is what enabled me to navigate this frustration and I now treat my diabetes like a long running computer game thanks to this background knowledge and of course the wonderful help of Libre. Talking of which.... Do you have Libre or other CGM?

I would also recommend an intensive education course like DAFNE (Dose Adjustment For Normal Eating). It is so much more than just a carb counting course and teaches you how to adjust your insulin for exercise and alcohol and illness etc and how to spot when your basal doses need changing. Probably one of the best features of the course is that you get to spend time with other Type 1s in person talking about the challenges and issues you each face and learn to problem solve for each other. You can learn so much from others..... as this forum is a testament to. DAFNE is a week long course or some places run it one day a week for several weeks. Your clinic should be able to refer you onto it as it is run by the NHS or perhaps contracted out these days. Next to this forum it is where I learned the most about diabetes and not just the theory or practicalities but also how people approach it mentally. We are all differetn and there is no one right way. Our diabetes is unique to us and we live with it day by day and night by night and meal by meal and trip to the shops or whatever, so we have to learn to be the expert on our diabetes. You can do that with the help of this forum and some careful experimentation on yourself.
 
rebrascora said:
I would be concerned that after 10 years the mechanism on your NovoPen 4 may be worn and not dispensing accurate doses, so it may be contributing to your difficulties. There was a lady on my DAFNE course who had a very old injector that she had had for 40 years and she trusted it because it had kept her alive for all those years but it turned out that it was no longer dispensing accurate doses and even though she took tiny doses and I mean just 2 or 3 units of Lantus she was hypoing regularly through the night and frequently needing paramedics but going high during the day. She ended up with a pump that could administer the tiny amounts of insulin she needed in minute amounts every few minutes which made a massive difference to her quality of life.
Click to expand...
This is interesting and the kind of thing that none of my doctors have ever mentioned to me.
rebrascora said:
If you feel like exercise from a previous day is interfering with the next days results and it most can do that, then I too would recommend Levemir. I love my split dose Levemir for it's flexibility. One of my biggest problems is that I have a big disparity between daytime and nighttime basal needs (I need lots more during the day but hardly any at night and I suffer nocturnal hypos the night after I have done more exercise/activity than usual. With Levemir I can dial back my evening dose to account for that which helps a lot. With Tresiba each dose lasts up to 40 hours so each dose is overlapping the next dose to give you even coverage day and night but if your body needs a lot less at night or you want to change it to accommodate more exercise for a couple of days, you can't really do it. It is like stopping a super tanker. You need 3 days notice to slow it down or change course, whereas Levemir lasts about 16-18 hours so you can make changes with your next dose which will have almost immediate effect and you can adjust the timing so that you get the peak of activity when you need it most. Levemir is a good halfway house between injections and pumping as regards basal dosing because you can fine tune it more. Maybe your team elt that because you did not want to engage fully with your diabetes that an extra injection and decision on doses would be too much for you. But getting your basal insulin as close to fitting your body and lifestyle needs as possible, both in terms of the actual insulin profile and the dose, is key to getting more stability with your NR. Your basal insulin is like the foundation of a house. You need it to hold you steady (which is very different to providing a smooth, uniform level of insulin because our bodies rarely do uniform. They have ebbs and flows and circadian rhythms that need adjustment here and there to keep you on an even keel. Some people find Tresiba works for them but if you know how to adjust Levemir to get the best from it, you can tailor it to your body pretty well. Did I mention that I absolutely love my Levemir!! 🙄
Click to expand...
My team pushed Tresiba on me despite my resistance to changing it. I was on Lantus and it worked well for me for the most part but they felt its curve didn't work well with how physical activity affected my glucose so drastically. After my first seizure, they took that opportunity to put me onto to Tresiba. I think I will be asking them about this when I next get an appointment because Tresiba did not improve anything. I had multiple seizures after swapping to it because they didn't tell me about it staying in my system for so long. With Lantus I used a sliding scale when I knew I was going to be particularly active the next day. No one told me at the time it would take several days for changes to take effect with Tresiba.
rebrascora said:
As regards you burying your head in the sand, I am not sure I understand what you mean. Most people who do that, don't take their insulin and/or don't check their levels. It sounds to me like you do everything that you need to and more, keeping fit etc, but perhaps you haven't had the right support and tools to help you manage it well and perhaps you have a form of burnout because you are frustrated with it not playing ball, which is totally understandable. Whilst we all know that the diabetes is confusing and contradictory and the goal posts move regularly, which is intensely irritating, having the tools and knowledge to change your strategy when the posts move so that you can still play reasonably well with the newly positioned goal posts is the important thing. Learning from people here is what enabled me to navigate this frustration and I now treat my diabetes like a long running computer game thanks to this background knowledge and of course the wonderful help of Libre. Talking of which.... Do you have Libre or other CGM?
Click to expand...
This is what confuses a lot of people I speak to I think, because I do actually do all of the things I'm supposed to and maintain great control (except lows) they don't see me as having any issues. I've spoken to the clinic psychologist in the past because I did get to a point where I was so burned out and frustrated with the lack of support that I stopped checking my glucose for quite some time. I still took my insulin but did it blind which was extremely dangerous I know but I was at a point where I did not care anymore. I wanted to feel like a normal, healthy person again who could just do things on impulse with my friends and not have to plan everything around a potential hypo.

After a couple of sessions with the psychologist we came to the root of my problem was the lack of support from my team. They agreed to help and improve communication and asked me to go onto the Libre system to give them a better picture of what was happening, which I did. Sadly they never held up their end of things and as soon as they had me on the Libre, communication stopped again. They haven't utilised the data despite me opting to share it directly which has just lead to further frustration and burn out from feeling like I'm fighting all of this completely on my own.


rebrascora said:
I would also recommend an intensive education course like DAFNE (Dose Adjustment For Normal Eating). It is so much more than just a carb counting course and teaches you how to adjust your insulin for exercise and alcohol and illness etc and how to spot when your basal doses need changing. Probably one of the best features of the course is that you get to spend time with other Type 1s in person talking about the challenges and issues you each face and learn to problem solve for each other. You can learn so much from others..... as this forum is a testament to. DAFNE is a week long course or some places run it one day a week for several weeks. Your clinic should be able to refer you onto it as it is run by the NHS or perhaps contracted out these days. Next to this forum it is where I learned the most about diabetes and not just the theory or practicalities but also how people approach it mentally. We are all differetn and there is no one right way. Our diabetes is unique to us and we live with it day by day and night by night and meal by meal and trip to the shops or whatever, so we have to learn to be the expert on our diabetes. You can do that with the help of this forum and some careful experimentation on yourself.
Click to expand...
This sounds incredibly useful and something I would definitely be interested in. When I was diagnosed in Canada, they immediately had me attend a full day course which covered a lot of advanced (by UK standards) techniques and I absorbed every bit of information they gave me. I'm familiar with things like the effect of fibre and how to factor it into my carb counting and using foods containing certain types of fats to help keep my levels up when consuming alcohol and the effects of alcohol on my glycogen production etc. However, when it comes to mentally coping and avoiding burnout, none of the courses or specialists I have spoken with have covered this. It is what I need now more than ever so any courses that cover that side of things would be a huge benefit.
 
I’m T2 and not taking insulin so can’t suggest anything on that score but I do think this forum is a truly remarkable place for mental support.
Conversations here often go way beyond diabetes and they’re something I find invaluable. So welcome, pull up a chair, have a look around the place and join in any conversation thread you fancy.
 
ColinUK said:
I’m T2 and not taking insulin so can’t suggest anything on that score but I do think this forum is a truly remarkable place for mental support.
Conversations here often go way beyond diabetes and they’re something I find invaluable. So welcome, pull up a chair, have a look around the place and join in any conversation thread you fancy.
Click to expand...
Thank you for the welcome Colin! I've already got some great information just from looking around on the forum and from the people who have responded to my post so I'm looking forward to join in some of the discussions going forward.
 
Welcome to the forum @Alex.H

Glad you’ve already found some of the posts and replies you've read helpful. I completely agree with @ColinUK - I find the forum a very helpful source of support, encouragement, sympathy, ideas and tips, and most of all a sense of being less alone in the daily grind and frustrations of life with diabetes in all its various flavours.

I hope you get on well with a half unit pen, and that doses and meals that you are managing so carefully begin to behave more reliably if there have been any dose-delivery glitches with your older pen. I think the recommendation is to change them every 5 years or so?

It might also be interesting for you to consider insulin pump therapy in the context of your unpredictable hypos, which are affecting your quality of life. That is basically the first criteria for getting an insulin pump, as the data around hypos is very positive for pumps.

In your situation it seems particularly useful, because rather than having to commit to whole or half units, you can give boluses very accurately down to 1/10th of a unit or less.

Additionally you can temporarily reduce or suspend your basal insulin profile (which is actually minute doses of rapid insulin through the 24 hours) where you know you have activity coming up. I’m another who can drop into a hypo from just a gentle walk to the shops if I have insulin on board - so a combination of basal suspends and a jelly baby here or there help me head off those potential lows without rebounding into the stratosphere!
 
Alex.H said:
Hello everyone, after a recent struggle with accepting my diagnosis as a type 1 diabetic, I was advised by a psychologist to make contact with Diabetes UK and reach out to some people to finally start processing everything after 10 years of burying it.

I've always been a bit of a unique case, diagnosed in my late 20's whilst living abroad in Canada, no family history of type 1, hypersensitivity to insulin so my glucose levels are generally good but I suffer from a lot of hypos on a regular basis as a result. The main reason I am reaching out now though is a counsellor recently rooted out a problem which I've been fighting with for years and that is that I've never truly come to terms with being type 1. I do the things I should as a diabetic fairly well but I do them on autopilot rather than mentally acknowledge and accept them and understand that I have to let go of some of the goals and dreams I had before I was diagnosed. Rather than addressing it, I buried myself in my work right from the start, physically pushing my body to its limits in an attempt to show that I'm still as physically capable as I was before my diagnosis and keep my glucose levels as low as possible without the need for larger doses of insulin.

As it stands right now, I take 5-7 units of Novorapid and 16 units of Tresiba, that hasn't really changed over the 10yrs that I've been diabetic. If anything I should probably be taking even less but my sensitivity to insulin is a struggle. 1-2 units can be the difference between me dropping to below 3.0 or going above 10.0. It gets exhausting and I don't ever feel like my doctors understand the mental toll it's taken despite attempts to communicate it. They are great with the data side but it feels like they see my fairly tight control and assume everything is fine. I've never spoken to another type 1 diabetic since I moved back to the UK over 7yrs ago and my family try to understand but I can see that it leaves them confused, especially with my situation with hypos.

So here I am, ready to start accepting and coming to terms with it all finally and to speak with people who might have a better understanding of the mental side of dealing with diabetes other than from a textbook.
Click to expand...
Hi @Alex.H and welcome to the forum. I smiled when I saw your post because I could have written it! I was only diagnosed in August this year with type 1 diabetes at the age of 56. No history in the family, driven at work, push myself in all things sport and then BOOM, type 1 diabetes. I’m still coming to terms with it and have been referred for counselling too. My biggest concern was being able to do everything as before and I really struggled with a sense of weakness and fallibility and also the sense of unfairness. I also see the low insulin doses and time in range as a challenge to be the best and it’s very wearing.

Having said all that, there are some great people on here who have really helped. I’m just in from 45 miles on the bike having understood from several people how to fuel properly, plan and prepare. Essentially, I’m a good way back now to where I was before but still cursed with perfectionism! 🙂

Like you, one unit either way and even the order in which I eat food can be the difference between being high all night or chewing jelly babies to stave off a hypo. You’re far from being alone in this.

Anyway, welcome and I hope this all helps.
 
everydayupsanddowns said:
Welcome to the forum @Alex.H

Glad you’ve already found some of the posts and replies you've read helpful. I completely agree with @ColinUK - I find the forum a very helpful source of support, encouragement, sympathy, ideas and tips, and most of all a sense of being less alone in the daily grind and frustrations of life with diabetes in all its various flavours.

I hope you get on well with a half unit pen, and that doses and meals that you are managing so carefully begin to behave more reliably if there have been any dose-delivery glitches with your older pen. I think the recommendation is to change them every 5 years or so?

It might also be interesting for you to consider insulin pump therapy in the context of your unpredictable hypos, which are affecting your quality of life. That is basically the first criteria for getting an insulin pump, as the data around hypos is very positive for pumps.

In your situation it seems particularly useful, because rather than having to commit to whole or half units, you can give boluses very accurately down to 1/10th of a unit or less.

Additionally you can temporarily reduce or suspend your basal insulin profile (which is actually minute doses of rapid insulin through the 24 hours) where you know you have activity coming up. I’m another who can drop into a hypo from just a gentle walk to the shops if I have insulin on board - so a combination of basal suspends and a jelly baby here or there help me head off those potential lows without rebounding into the stratosphere!
Click to expand...
Thank you for the warm welcome!

Certainly half units is something I'm going to discuss with my team next week along with seeking out some further educational courses, as well as an appointment, hopefully, been waiting 10 months.
While I have suffered a significant burn out recently, re-engaging with other diabetics and some courses would really help I think. It provides that distraction but in a way that I am still engaged with my condition rather than burying it. Sitting around lost in my own thoughts has given me some time to actually process what has happened but now I'm ready to get back on the horse and start trying to find some solutions.
 
The_Bowlii said:
Hi @Alex.H and welcome to the forum. I smiled when I saw your post because I could have written it! I was only diagnosed in August this year with type 1 diabetes at the age of 56. No history in the family, driven at work, push myself in all things sport and then BOOM, type 1 diabetes. I’m still coming to terms with it and have been referred for counselling too. My biggest concern was being able to do everything as before and I really struggled with a sense of weakness and fallibility and also the sense of unfairness. I also see the low insulin doses and time in range as a challenge to be the best and it’s very wearing.

Having said all that, there are some great people on here who have really helped. I’m just in from 45 miles on the bike having understood from several people how to fuel properly, plan and prepare. Essentially, I’m a good way back now to where I was before but still cursed with perfectionism! 🙂

Like you, one unit either way and even the order in which I eat food can be the difference between being high all night or chewing jelly babies to stave off a hypo. You’re far from being alone in this.

Anyway, welcome and I hope this all helps.
Click to expand...
I can't tell you how much it means to know that there are other people experiencing the same thing with their diabetes and have found ways to make it work.

You have actually touched on a point that I have been discussing with my counsellor recently and one of the roots of my burn out and disengagement. The concern that I will not be able to achieve things that I had set out to do before my diagnosis. This was a huge blow for me realising that I couldn't just make a snap decision to climb a mountain that was in front of me suddenly. It's apart of who I was, acting on impulse, albeit some times a bit of a silly mistake. Coming to terms with the fact that I couldn't even attempt to do that anymore without careful prep and planning, it really made me question who I would become after my diagnosis.
This is where engaging here will be a big help. I can see that people like yourself have found ways to carry on living an active lifestyle whilst also dealing with lows.

Did you go on any courses to help with management of diabetes whilst exercising etc? It is certainly an area where my knowledge is still very spotty so it is one area I would really like to gain some insight.

Well done on the 45mile ride by the way! Even before being diagnosed that would have been quite punishing for me.
 
The excercise was the difficult bit for me, but eventually i worked it out.
So much of what you say was my feelings at first...being vulnerable, not being able to do things, but i think i'm gradually getting there. I totally felt the same about having things attached to me, but now i don't really notice my cgm (at the back of the arm you don't even see it) and was dead against the idea of pump... now i wouldn't say no, mainly for easier unhealthy snacking (probably best i haven't got one...)

Now, to be honest, and i know this could upset some, but i quite...well, not like having diabetes, but i kinda like the challenge...at the end of the day, its going to be with me for life, and its best to do what you can to come to terms with it...easier said than done but sounds like you are now taking positive steps.
 
Alex.H said:
Thank you for the welcome, apologies if my opening post came across in a confusing manner, my insulin dosages are not so much an issue, I know my situation is fairly unique to me alone.

The main reason I came here is just to converse with other diabetics to help me to stop burying my condition to the back of my brain and actually come to terms with it.
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Hello, and I apologise if my response missed your point.
I understand the drive to exel with the non diabetics. Ironically. My brief post yesterday was a quick hello to a fellow type one, just before I go out & prove my own “worth” in society.

You need an “ear” we can hear. 🙂

Reading back through other contributions. Now you are wall to wall with great advice!

Best wishes.
 
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