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Ups and downs

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
SusieGriff

SusieGriff

Well-Known Member
Relationship to Diabetes
Type 1
I talked to a few of you last night re my Type 1, newly diagnosed last nov. I have ben given Humulin M3 to my dismay, and as I've found out it's not very flexible. I'm in the process of trying to get to see my consultant, and Ive never had a follow up appointment since leaving hospital. My BG readings are between 4.8 through to 15 on the odd occasion, mainly at night, I upped my insulin at tea time by 2 units to see if it would steady itself... hypos at 2am was the result. so I'm torn between lower reading though the day with hypo's at night, or high reading in the pm and no hypos?? what's the best senario? I would and am trying to get it steady throughout the day, or am I asking for a miracle?
I hate not being in charge, if you like, of my own BG levels. It freaks me out when it gets high, as I had really bad eyes before I was diagnosed, and I really don;t want to go back there again. or any other nasties I keep reading about.
 
Hi Susie.

It's been a long time since I was on the 2 a day regime.

Have you been given any dietary advice as to what's best for avoiding the post-meal spikes some foods can give you, etc ?

It may be that you can avoid the highs for now by modifying your food intake which will avoid the hypos in the night (never nice).

Rob
 
Bimodal insulin is difficult to cope with. I only had to use bimodal insulin for a few months after diagnosis. I was told about basal bolus by a Tasmanian pharmacist, after I'd been on holiday with one of her daughters, a friend of mine - so I asked my clinic, and and things have been much better since.

I clearly remember was the need to take insulin about 30mins before breakfats & evening meal and having to eat a bedtime snack eg a couple of oatcakes (which I found very inconvenient - I'll happily not eat between 6 or 7pm and 8am).

To be honest, the occasional reading of 15mmol/l is pretty good on bimodal regime, so I wouldn't try to adjust your dose, just push for a more flexible regime, although it will mean more injections, 1 or 2 basal eg Humalin I / Levemir / Lantus and 1 bolus eg Humalog, Novorapid, Actrapid etc with each meal, usually immediately before or even just after eating.
 
Hi Rob, No I wasn't given any advice about types of food, just generally keeping to a 'healthy' lifestyle and have carbs with each meal. I'm having to find out myself what causes spikes. it's slow going though.
 
Copepod said:
Bimodal insulin is difficult to cope with. I only had to use bimodal insulin for a few months after diagnosis. I was told about basal bolus by a Tasmanian pharmacist, after I'd been on holiday with one of her daughters, a friend of mine - so I asked my clinic, and and things have been much better since.

I clearly remember was the need to take insulin about 30mins before breakfats & evening meal and having to eat a bedtime snack eg a couple of oatcakes (which I found very inconvenient - I'll happily not eat between 6 or 7pm and 8am).

To be honest, the occasional reading of 15mmol/l is pretty good on bimodal regime, so I wouldn't try to adjust your dose, just push for a more flexible regime, although it will mean more injections, 1 or 2 basal eg Humalin I / Levemir / Lantus and 1 bolus eg Humalog, Novorapid, Actrapid etc with each meal, usually immediately before or even just after eating.
Click to expand...

I am trying to get a consulation with the specialist, I'm going to mention the alternative to them. I'm worried about in the summer, spending days out and not being able to eat at the right time, with humulin I have to eat at specific times or I hypo.
 
It's difficult to give direct advice but foods like wholegrain pasta and bread will normally digest very slowly and last several hours, whereas foods such as mashed potato and any pulverised starchy food will digest quickly. Apparently, liquids will tend to speed up digestion and then absorption of glucose. It's a fairly complex topic, as you'll appreciate ! 🙄

Have you discovered the times of your insulin peaks ?

Rob
 
Just to complicate it all further, the stomach empties a lot quicker at low BG levels than when BG is high. So your timings on food peaks will depend on your pre meal BG.

Very hot or cold food or liquid will also slow down stomach emptying. GLucose from food has to reach the small intestine (after the stomach) before it is absorbed into the bloodstream.

You can tell I've got a new book, can't you ! :D

Rob
 
nomorecakes said:
I am trying to get a consulation with the specialist, I'm going to mention the alternative to them. I'm worried about in the summer, spending days out and not being able to eat at the right time, with humulin I have to eat at specific times or I hypo.
Click to expand...

Susie, you shouldn't have to live with this if it is proving so difficult for you. You may be able to get an appointment with a DSN (Diabetes Specialist Nurse) more quickly than speaking to a Consultant, and she/he would be able to advise about insulin regimes. At the very least a DSN might be able to suggest altering your doses to improve your levels. I'm pretty shocked that you haven't had any follow up since diagnosis - I felt like I was hardly ever away from one or other member of the medical profession for several months!

I'd call the clinic on Monday and ask for a DSN appointment. 🙂
 
Just remembered a link that may be of interest, if you like to read lots of info.

http://www.leicestershirediabetes.org.uk/

It's especially good for the in-depth info but you may need to dig deeply to get to it.

Rob
 
Oh Rob!!! you're confusing me !!! lol It's all too much to take in... no one told me about all this stuff. I know my BG are always high later on in the evening, ok during the day.
I eat lots of rice dishes with stir-fry veg.day time, evening I only feel like beans on toast or something small, oaty brown roll/ham and salad. always have sf jelly after always!! I love it. but nothing else bad really.
 
Good luck with getting more help from your diabetes team. The changeover should be pretty quick. It will make summer (and the rest of your life) easier and more fun 🙂 At the same time, ask about carb(ohydrate) counting - some areas have week long DAFNE (Dose Adjustment For Normal Eating) courses, but at the very least, ask a diabetes specialist nurse or dietician to go through the basics with you.

Just wanted to mention a potential source of confusion - there are several insulins called Humalin; Humalin I is long acting; Humalin M3 is a bimodal; there are also Humalin N and Humalin R, plus other mixes. It's really important to always use the full name and state dose and units, whenever describing your medication to any medics (and anyone else eg on this board). There are enough problems with medics mis-writing / mis-reading prescription charts.
 
Sorry for bombarding you ! :D

It may be advantageous for you to have a browse through some of the older threads about food and try and pick up on what does what. I've learnt a lot in the past few months that I had never heard of in the previous 30 years.

Sadly, very little of that info is available beyond this forum or others like it. If you can stick to seedy bread (wholegrain preferably) you'll find your BG may stay a bit lower through the evening. Baked beans may well send BG up quite high quite quickly. As you said, experimentation is needed.

Do you have plenty of test strips on prescription ?

Rob
 
Oh No!! I was told beans, any type are good for you they have a LOW gi rating... now I just don't know what to eat. :( sigh..
and yes, Rob, I have quite a lot of test strips to be getting on with, my surgery are really good at letting me have lots!
 
Don't worry - baked beans only raise blood glucose because their sauce is full of sugar. You're right, beans themselves are all low GI.
 
It's a minefield to say the least !

Best thing is to stick to what you know for now and try to get onto MDI (basal/bolus) asap.

I'm guessing you've been given set amounts of carbs to aim for at each meal to match the insulin profile.

Rob
 
Copepod said:
Don't worry - baked beans only raise blood glucose because their sauce is full of sugar. You're right, beans themselves are all low GI.
Click to expand...

OF COURSE !!! forgot about the sauce!!! 🙄

Thanks
 
Robster65 said:
It's a minefield to say the least !

Best thing is to stick to what you know for now and try to get onto MDI (basal/bolus) asap.

I'm guessing you've been given set amounts of carbs to aim for at each meal to match the insulin profile.

Rob
Click to expand...

Well, set amounts? nope! just eat carbs, i.e. pasta, bread, potato, rice with each meal! left me hanging somewhat! If you wern't as sharp with all the questions as I am (sorry) whatever would happen ????
 
Hey Susie

No wonder you are confused and no idea what is going on. Can I ask how old you are? You don't have to tell me.

I only know of children who are put on twice daily mixed insulins because appparently it is easier for the schools !!!!!

To put it into perspective if you had been diagnosed in Europe you would be on a pump or MDI (multiple daily injections) from the word go. They don't use twice daily any more.

We use it here because of money and very lazy old school medical teams.

If your team haven't seen you again or are happy to keep you on twice daily, my first suggestion is change your hospital to a much better up and coming or already established good practice hospital. If you tell us where you are then someone may be able to help with a suggestion.

For me and many others the sign of a good hospital these days is if they offer insulin pumps. It is irrelevant whether you want one or not but it means they are generally up to date with their care and so will help you with food and carb counting etc rather than the little rubbish you have been told.

You are entitled to change hospitals, your GP can do this for you. If you google Patient Choice you will see how and why you can change. It is easy.

I think you are great for finding a forum to help, lots of people don't and they accept what they are being told so lots of brownie points I think for you.

There are loads of us here to help you. Why don't you take a look at the food part and read some stuff. Take a note of whether people are 1 or 2 as the help and advice where food is related does differ sometimes. People with type 2 sometimes don't eat carbs or have low carbs. People with type 1 who carb count are fine to eat any carbs.

I hope you can get this sorted out but remember you are only newly diagnosed and this will take some time to get your head around ok, so no beating yourself up about it all.

🙂🙂
 
As I understand it, with a mixed insulin, you have a % of long acting and the remainder short acting.

The short acting should cover your meals, as my bolus does.
The long acting should work between meals to cover the glucose which your liver trickles into your bloodstream to keep your brain, organs, etc alive when fasting.

If you are having to adjust your doses to cover your variable meals, then you will also be adjusting your long acting which, I would imagine, should be pretty much fixed to match your liver's glucose output.

In other words, you are either forced to risk high BG by not raising your insulin dose to cover your meals or hypos if you raise your dose, which is raising your long acting during the night.

I hope I've got this correct.

When I was on mixes, I had to eat set amounts of carbs at set time. Hence the introduction of MDI which revolutionised control.

ROb
 
Hi Adrienne

I was diagnosed last year Nov, at the ripe old age of 61!!! weird I know, but it happens I'm told. I'm (according to me) am only 25! in my head!! I feel I'm not 'old' at all, and am on the ball with all of this stuff. I know what doctors are like, as I used to be a medical receptionist. but only now I see the other side as it were, I am begining to realise what all those poor people were going through. I feel for you and your poor little one. I'm just lucky I suppose that I had most of my life in good health.
When you're newly diagnosed you take what health care professionals tell you as gospel, but I don't like what they've given me, it's taken me 3 months to realise there must be another way, and food wise.... what on earth?? my whole life now revolves around food!! why don't they give you a book or something telling you ideal food groups etc... I got a visit once with a dietician, that was it. becuase I come accross as intelligent they think I can cope and dismiss me.
 
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