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Thea FS

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Type 1
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Hi there
I’m reaching out here for help. I’m T1 and 50 years old. I live abroad and my command of the language here has made it super challenging to manage my diabetes as I don’t fully understand how to manage my insulin. Whilst the doctors are extremely helpful I wonder if anyone would help guide me a little bit with insulin use, particularly fast as I’m finding it hard to keep my levels stable. I was diagnosed 3 years ago, I’ve tried many times to understand what I’m supposed to be doing but find myself cutting out food groups (carbs) which is unmanageable longer term. Thanks in advance to anyone that fancies being a buddy of sorts!
 
Hi @Thea FS and welcome to the forum - sorry to hear you are finding things difficult - If you are type 1 taking insulin you don't need to worry about cutting out food groups, it's about balancubg the right doses of insulin to deal witth the food you are eating - what insulin(s) are you taking at the moment?
 
Welcome @Thea FS 🙂 Type 1s can eat a normal diet. We just have to make sure our insulin doses and timings are right. What insulins do you take?

The foundation of control is your basal/slow insulin. That’s supposed to keep your blood sugar steady and in range in the absence of food. It’s important to get that right first because if it’s wrong, it makes it harder to get your bolus/fast insulin right. For your bolus/fast insulin, you need to know your meal ratios - how many grams of carbs 1 unit of insulin covers. These are expressed like this: 1:12, ie 1 unit to every 12g carbs, or 1:10g, 1:8, 1:20, etc.

I recommend looking at Bertie here:


Also, there are a couple of books often recommended for Type 1s on this forum:

Think Like a Pancreas’ by Gary Scheiner.

And Type 1 Diabetes in Children Adolescents and Young People by Ragnar Hanas (ignore the title - great for adults too)

Think Like A Pancreas is American but I liked the chatty style and it contains some great information, as does the Ragnar Hanas book.
 
Thanks so much for replying! So I’m on tresiba and novorapid. I have played around with the tresiba dose previously but think maybe I need to increase it. I’m on 20units a day at the moment. Would it be worth splitting this over the day at all do you think?

I’ll find those books, thank you for the recommendation!
 
Tresiba is a very long acting insulin so I'm not sure splitting it would be recommended - you can test whether or not your daily dose is correct by doing a basal test - this link explains how to do it:

www.mysugr.com

How To Successfully Test Your Basal Rate

Are you looking for basal rate information and testing instructions? Perfect! You're in the right place!
www.mysugr.com www.mysugr.com

With the Novorapid, for some, including me, it was not so rapid so I had to take it quite a long time before eating to avoid big spikes in BG - if you are spiking too much after food, I'd consider trying taking it 5 mins earlier than usual - if it is still going too high and taking a while to come down, then consider your ratios as @Inka has mentioned earlier

Do you have a CGM (Libre/Dexcom etc.)?
 
Ok thanks that makes sense. I will try taking it earlier. I keep spiking then I take too much fast and have hypos. I need to get better at understanding carb quantities in foods… Yes I do have a freestyle monitor.
 
Carb counting is a vital tool - the Bertie course that you can do online that @Inka mentioned covers that in detail - I would also suggest the Carbs & Cals Book and/or app which contains pictures of foods and portion sizes so you can count the carbs quite accurately, and work out your Novorapid dose accordingly, and taking it earlier than usual (15 mins before eating instead of 10 mins) should hopefully help
 
Thea FS said:
Thanks so much for replying! So I’m on tresiba and novorapid. I have played around with the tresiba dose previously but think maybe I need to increase it. I’m on 20units a day at the moment. Would it be worth splitting this over the day at all do you think?

I’ll find those books, thank you for the recommendation!
Click to expand...

Tresiba is a very long-acting basal so you can’t really split it. You might find a different basal easier if you’re struggling to get the Tresiba right.

I dislike the Carbs and Cals book as I don’t think the pictures are particularly helpful. The best way to carb count is to use proper measures - ie a good quality set of digital scales, a tablespoon, a measuring jug, etc, depending on what you’re measuring. You’ll soon build up a knowledge of carb counts. Also, jot the total carbs per serving on your favourite recipes.
 
You say you live abroad so there is a version of the Carbs and Cals which is World Foods which may be more useful.
 
Welcome to the forum @Thea FS

Hopefully the links and resources you’ve been recommended will help you gain confidence getting your basal right, adjusting your insulin doses, and carb counting your meals.

They’ve helped lots of forum members before you🙂
 
Whereabouts do you actually live? - as all sorts of people on here know how to interpret the carbohydrate content of all sorts of foods which are more commonplace in other parts of the world, for various reasons.
 
Easy peasy then - carbs = glucides. Plenty of fresh food available to satisfy every taste!
 
Inka said:
Tresiba is a very long-acting basal so you can’t really split it. You might find a different basal easier if you’re struggling to get the Tresiba right.

I dislike the Carbs and Cals book as I don’t think the pictures are particularly helpful. The best way to carb count is to use proper measures - ie a good quality set of digital scales, a tablespoon, a measuring jug, etc, depending on what you’re measuring. You’ll soon build up a knowledge of carb counts. Also, jot the total carbs per serving on your favourite recipes.
Click to expand...
I do like the carbs and cals book, and I would recommend it, (it would be boring if we were all the same and all liked/disliked the same things) and they do also list the amount of carbs, portion size (weight in g's, etc) as well as other info. Its not just pictures with no other info.
I also like the pictures, as they are a good quick reference to actually see how big a portion should be, as its sometimes difficult to visualise what 100g of something is? But as I say, we are all different and theres nowt wrong with that. 😎
 
Perhaps it’s more useful if you’re Type 2 and not on insulin @pjgtech ? It can depend on an individuals needs and preferences, as well as lifestyle, of course.
 
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