Type 1 diabetic

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The_Bowlii said:
Hi @Dave.j1984! And welcome to the forum. I was diagnosed just a couple of months ago as type 1 diabetic aged 56. My life turned on its head but this forum has been great as you’re not alone and EVERYONE has problems, challenges, successes and failures. I’d never been on a forum before either but it’s well worth it. Great to have you on board!
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Thank you and I hope you get more success with the doctor than I did
 
Hi
Good to see you back here. I'm sure it can't be easy when you are running your own business and trying to manage your diabetes and have "a life" but important to come back and touch base when you need to and there is usually someone here to chat to.

I hope the move to Tresiba goes well. Was this as a result of an appointment at the diabetes clinic? Are you getting more support? I will be interested to know which fast acting insulin they swap you to. It's not a good idea to change too much at once so I would give it a month or two before you change your fast acting. Tresiba is a much longer acting basal insulin with a much flatter profile of activity than Lantus. It works really well for some people. The key thing is to adjust your dose so that it gives you a fairly level overnight graph. You then may need to adjust your meal time ratios to make up any shortfall during the day with your meal time insulin.

How are things with your girlfriend? Hope the pregnancy is going well and that her brother is doing as well as can be expected in the circumstances.
 
rebrascora said:
Hi
Good to see you back here. I'm sure it can't be easy when you are running your own business and trying to manage your diabetes and have "a life" but important to come back and touch base when you need to and there is usually someone here to chat to.

I hope the move to Tresiba goes well. Was this as a result of an appointment at the diabetes clinic? Are you getting more support? I will be interested to know which fast acting insulin they swap you to. It's not a good idea to change too much at once so I would give it a month or two before you change your fast acting. Tresiba is a much longer acting basal insulin with a much flatter profile of activity than Lantus. It works really well for some people. The key thing is to adjust your dose so that it gives you a fairly level overnight graph. You then may need to adjust your meal time ratios to make up any shortfall during the day with your meal time insulin.

How are things with your girlfriend? Hope the pregnancy is going well and that her brother is doing as well as can be expected in the circumstances.
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Yeah the baby is fine and im gutted to say that her brother passed away a week ago which is very sad and she has been not talking to anyone and I am giving her the space and time she needs as this has been a very difficult time for her so I have assured her that im here when she is ready to talk
 
Oh goodness! I am so sorry! That is heartbreaking! I hope she has family for support but so sad that she is cutting you out when she needs support and cuddles the most.
 
rebrascora said:
Oh goodness! I am so sorry! That is heartbreaking! I hope she has family for support but so sad that she is cutting you out when she needs support and cuddles the most.
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I know it’s hard but I know that she deals with things by being alone and I do keep sending her messages to let her know that I am here for when she needs me
 
How are you managing with your diabetes? Do you feel like you are making some progress now? When do you start the Tresiba?
 
rebrascora said:
How are you managing with your diabetes? Do you feel like you are making some progress now? When do you start the Tresiba?
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I am already on the tresiba and that seems to be settling my levels but I’m still struggling with when I eat and when to do the fast acting so that it doesn’t spike so much and that’s why the specialist is changing the fast acting as she thinks that the new one will help with that
 
Good to hear the transition to Tresiba has gone smoothly and you feel it is a benefit. Did she tell you the name of the fast acting insulin? Just wondering if you would recognize it if I suggested possibly Fiasp or Lyumjev? I use Fiasp, but it wasn't a simple straightforward swap from NR for me and it took 2 x 3month trials going back to NR in between, to get it to work for me, as it can be quite quirky. I am happy with it now 3 years down the line but I have to be very proactive with corrections. And I still have to prebolus 30-45mins in advance of breakfast to prevent spiking depending upon my waking reading but just 10-15 mins before other meals. Hopefully it will work well for you but do shout up if you need some help with it as it can be tricky and frustrating at first.
PS Not at all suggesting that you will need to inject it 30-45 mins before breakfast. Start by injecting it just before you eat and then slowly extend the prebolus time by a few minutes each day until you find your perfect timing.
 
rebrascora said:
Good to hear the transition to Tresiba has gone smoothly and you feel it is a benefit. Did she tell you the name of the fast acting insulin? Just wondering if you would recognize it if I suggested possibly Fiasp or Lyumjev? I use Fiasp, but it wasn't a simple straightforward swap from NR for me and it took 2 x 3month trials going back to NR in between, to get it to work for me, as it can be quite quirky. I am happy with it now 3 years down the line but I have to be very proactive with corrections. And I still have to prebolus 30-45mins in advance of breakfast to prevent spiking depending upon my waking reading but just 10-15 mins before other meals. Hopefully it will work well for you but do shout up if you need some help with it as it can be tricky and frustrating at first.
PS Not at all suggesting that you will need to inject it 30-45 mins before breakfast. Start by injecting it just before you eat and then slowly extend the prebolus time by a few minutes each day until you find your perfect timing.
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Hey there sorry for not responding sooner I have been so busy with work and general life and I have now been given fiasp for my fast acting insulin I am going to start it in the morning and I have also been suffering with some sort of flu over the last few weeks which has caused me a lot of major high readings and now my ha1c has gone from 7% to 8.7% over the past couple of weeks but I have got some really good news for once in my life which is that me and my girlfriend are getting on so much better and we are both very happy to announce that we’re having a little baby girl so for once a bit of happy news hopefully you could give me any advice you can on fiasp as I am very nervous about this change in insulin hope you’re well and hope to hear from you soon
 
Hi. Great to hear that your relationship is getting back on track. So pleased for you both and your little girl to be!
Sorry to hear that you have been ill. I am just recovering from Covid. There is a lot of it going around and I needed a lot more insulin to keep my levels in check both for a few days before symptoms developed and then the first week of symptoms.

Fiasp tends to work a bit quicker than NR but not massively so. For me the big advantage is that it is pretty well finished working in about 3 hours instead of 5 with NR (you may be different, so don't assume that). The down side is that once your levels get above 10 it sometimes seems like you are injecting water and I found I had to be much more confident with using my insulin both in terms of proactively trying to keep levels below 10 as much as possible, but also that I needed a lot more insulin when I did go above 10 in terms of both ratios and corrections. I often have to stack corrections to bring my levels down once they get stuck above 10 which is totally frowned upon and is potentially dangerous to do, although with most people having Libre or other CGMs now, you can keep a closer eye on your levels after doing it, to mitigate the risk. I found this was better and safer for me than injecting one really large correction at one go (sometimes called rage bolusing, because you get frustrated and dial up a dose you know is too big because levels are not shifting with your normal dose).
Fiasp also seems to work much quicker when levels are low in the 4s and 5s and I can sometimes get away with injecting and eating straight away in that situation without needing to prebolus but if levels are above 8, it is pretty slow and above 10, I can easily be waiting 2 hours for it to start bringing me down.
I expected it to be a straight swap with NR but just a bit faster, but the reality was not as straightforward and I had to find new strategies to make it work for me. Generally, my levels were stubbornly high more and I had to learn to be a bit more generous with it.
You may find it works great for you, without any quirks, so don't be frightened of trying it, but if you come across any problems give me a shout here and I will see if I can make sense of it.
 
rebrascora said:
Hi. Great to hear that your relationship is getting back on track. So pleased for you both and your little girl to be!
Sorry to hear that you have been ill. I am just recovering from Covid. There is a lot of it going around and I needed a lot more insulin to keep my levels in check both for a few days before symptoms developed and then the first week of symptoms.

Fiasp tends to work a bit quicker than NR but not massively so. For me the big advantage is that it is pretty well finished working in about 3 hours instead of 5 with NR (you may be different, so don't assume that). The down side is that once your levels get above 10 it sometimes seems like you are injecting water and I found I had to be much more confident with using my insulin both in terms of proactively trying to keep levels below 10 as much as possible, but also that I needed a lot more insulin when I did go above 10 in terms of both ratios and corrections. I often have to stack corrections to bring my levels down once they get stuck above 10 which is totally frowned upon and is potentially dangerous to do, although with most people having Libre or other CGMs now, you can keep a closer eye on your levels after doing it, to mitigate the risk. I found this was better and safer for me than injecting one really large correction at one go (sometimes called rage bolusing, because you get frustrated and dial up a dose you know is too big because levels are not shifting with your normal dose).
Fiasp also seems to work much quicker when levels are low in the 4s and 5s and I can sometimes get away with injecting and eating straight away in that situation without needing to prebolus but if levels are above 8, it is pretty slow and above 10, I can easily be waiting 2 hours for it to start bringing me down.
I expected it to be a straight swap with NR but just a bit faster, but the reality was not as straightforward and I had to find new strategies to make it work for me. Generally, my levels were stubbornly high more and I had to learn to be a bit more generous with it.
You may find it works great for you, without any quirks, so don't be frightened of trying it, but if you come across any problems give me a shout here and I will see if I can make sense of it.
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Thank you for your reply and I was advised by my dietitian to do the same ratio as I did with the nova rapid which is 1 unit for every 15 grams of carbs and to do it ten minutes before I eat so I will try that in the morning with my breakfast and then go from there I will let you know tomorrow how I get on
 
Take care with the timing of your pre-bolusing.
I find Fiasp is very sensitive to my starting BG. If my BG is less than 5, it will work instantly - quicker than it takes to digest my food - and I will hypo. Therefore, I have to bolus AFTER eating and definitely not 10 minutes before.
As @rebrascora mentions when my BG has higher than 10, it takes much longer to work - it can take an hour to see movement on my CGM graph.

You may be different but in your position, I would keep an eye on BG, pre-bolusing time and Fiasp speed. Then adjust accordingly.

The good thing is, as you have been advised, the strength, hence I:c ratio, is the same as NovoRapid.
 
Thank you for the advise i will take any advise i am given as i had to ask the dietitian for the information on how I should use the new insulin as I was basically just sent the prescription for it and not advised or told anything about how to start using the insulin as in basically just there is a new insulin for you and off you go I really am getting to the stage of giving up on the support I haven’t had from the start as it’s not much better now
 
It is frustrating that we aren't informed stuff from health care proffesionals, but its fairly common...i just finished a DAPHNE course were they were moving people from novorapid to fiasp (not me) and they said none of the stuff about fiasp that i know people have found from this board. I'd have chipped in but it would have been frowned upon.
But that is why this forum is so great.
I'm glad things are going well for you and your growing family!
 
@Tdm I think the problem is that the insulin provider does not share this information and it is only through living with it that we learn. Plus everyone is different which means the effect is different people.
Very few endos or DSNs live with diabetes themselves. Instead they have to deal with many many people with many many different needs, lifestyles and reactions to diet, insulin, exercise. At best, they can provide guidelines and things to look for.
That is why this forum is great - it is almost entirely people who live with diabetes 24 hours a day, 7 days a week, 52 weeks of the year. We are not better than diabetes health care providers. We come to it from a different perspective.
This is why I rarely criticise healthcare providers. They have an incredibly difficult job to do, often on a low salary, working long hours.
 
Hi @Dave.j1984!
I hope that the FIASP is working better for you. Sorting out timings is a continuous project that may well change bit by bit, as do our ratios. Just keep a watch on things and keep asking questions on here. As @helli says there is plenty of experience to tap into.
 
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