Three weeks in — having lows — feeling sad and scared

[Wendal]

Plus taking a more appropriate level of bolus should enable you to eat more of what you want and that will help you live a more normal life and help motivate you. moving forward.
Of course it is important whilst you are learning to keep your diet as constant as possible in order to learn how your body reacts.

 

[Inka]

Yes, the 50/50 basal bolus thing is just a rough starting point. I’ve had Type 1 30 years and I’ve never had that ratio. To my mind, you should consider doing a basal test first as that’s the foundation you’re building on. You can then look at your boluses. The 2 unit thing seems daft to me as it just limits your food. Also, you ^can^ eat snacks, you just need to be aware of your previous insulin and that it will still be working. I’d experiment with easily countable snacks to start with. You might find, for example, you need slightly less insulin for a particular snack than your ratio suggests because you have part of your previous bolus still working. It’s all a question of careful experimentation.

An important thing to say is that perfection is impossible. It’s not a case of learning everything then having perfect sugars. People who’ve had Type 1 for decades still get unexpected highs and lows. It’s just what it is. We’re trying to play the part of a pancreas and it’s not at all easy. It’s always a work in progress - and yes, it can be very frustrating.

 

[Proud to be erratic]

Have you been able to make any progress with getting a CGM, @ jasmine? Unquestionably CGM can not just give a better insight minute by minute about what your BG is doing, but it can allow you to be more confident in experimenting with insulin doses. It's extremely useful in seeing when basal adjustments are helping; you can look back at previous day's graphs and see the evidence of change and effect.

 

[everydayupsanddowns]

But I remember the endo telling me basal should be about 50% of my total insulin, and right now that puts me at 14 units basal and about 5 units bolus total a day, which seems.... wrong.

I think there’s a range to that. Somewhere between 60:40 and 40:60 isn’t uncommon. Not everyone splits exactly 50:50 (thinking logically it would depend entirely on what you were eating during the day!) but having your doses very ‘out of proportiion’ can be a sign that things aren’t right.

Also being told not to take more than 2 units bolus at a time is just sort of limiting the amount of food I can eat really, especially when she also said I shouldn't take more than one bolus injection every four hours -- doesn't really give me any time to snack? I don't know, I feel like what I'm being told to do is wrong but I don't know how to fix it...

That feels like a “let’s get you through this tricky bit” suggestion really. Something easy to follow, that should help you while you are in the honeymoon phase, where your pancreas might still be occasionally sputtering out its own insulin, but slightly unpredictably. It’s hoping to avoid the post-meal hypos, but then you are running high so are perhaps over-adjusting your basal? There’s a systematic way of checking whether your basal insulin is doing it’s job properly, which is a bit of a faff, but might be worth doing.

It all seems very unpredictable. I've been working off around a 1:25 carb ratio, and when I check 2 hours later, sometimes I'm in range, sometimes I've shot up and am high, and sometimes I've dropped down to 4. I feel like I'm banging my head against a wall.

These sorts of frustrations are part and parcel of managing T1 I’m afraid. Diabetes Maths is much more art than science, and there are more than 40 things that might affect your blood glucose levels, so it’s nothing like as simple as food+insulin=perfect results. There are ways of reducing some of the variables, and keeping basal and ratios tweaked as the seasons change which can really help. It will get easier in time. You’ll discover your own basic doses, hacks, and workarounds which help to keep you in range as much of the time as you can, but as many T1s here can tell you, perfection isn’t possible,

I usually go to bed high (because since she dropped my bolus, I'm obviously not taking enough for dinner) and drop a couple points in the night, but still wake up high.

It’s not uncommon for people to be started on slightly conservative doses to try to reduce the risk of hypos. Particularly if their flagging beta cells seem to be wading in from time to time. The early year or two (three?) can be a bit unpredictable. Some find that their last remaining beta cells help to smooth off the corners of doses, while for others it’s a bit more of a nightmare, never quite knowing whether some home-grown insulin might be thrown into the mix. I think @mashedupmatt can sympathise with you there if that’s what’s happening for you?

 

[jasmine]

Thank you all soooo much for the advice and support, it's honestly made me feel so much better I have an appointment next week with my GP so will push on getting a CGM. I'm glad to know it's normal to feel like this, will try to relax into the chaos a bit more if I can xxx

 

[mashedupmatt]

I think @mashedupmatt can sympathise with you there if that’s what’s happening for you?

Indeed - I certainly can - getting the ratios and basal right are very difficult in the first couple of years (for me!) - you think you've got it sussed and then the Diabetes Fairy starts playing games - In terms of basal to bolus ratios they differ hugely from person to person - I'm still on a very low basal but my bolus needs have increased dramatically - unfortunately there is no exact science - but you are doing brilliantly and keep up the great work @jasmine

 

[SB2015]

Well done @jasmine . You are doing brilliantly. Glad to read that you recognise the chaos that happens at the start. There are so many things to juggle, and you have your remaining Beta cells playing silly b…era at times and just wanting to confuse things. Try to be patient. You have a mind set that is going to set you in good stead for the T1 road ahead and as you have already found there is plenty of support available on here. Keep asking questions and keep see if you can get a sensor prescribed by your GP. It can be so much help to see what is happening.