Type of Diabetes and Basal bolus insulin.

[ausasha]

Hi everyone.

I have 3 questions:

1. Has anyone here been diagnosed with Diabetes? My type is unknown as it is rare. But I don't have type 1, 2 or Mature Onset of Diabetes in Youth (MODY). I am having further investigations, as my the medications such as Gliclazide, Metformin, NovaMix and Humalog does not work. Thus, having a hard time in the first year of diagnosis.

2. Is anyone using the Basil bolus insulin? I am starting today and feel nervous as I will be going from extremely high levels to low levels, and I feel terrified of having a hypo. I am just wondering if anyone found it quick and effective.

3. I haven't seen or have a recent appointment, but, as I am changing to insulin I was told that I will be taught how to count carbohydrates. Can anyone tell me how that works?

Any advice will help!

Thanks so much all.

Ausasha

 

[becky.ford93]

Hi there sounds like you're in a bit of a confusing situation! With regards to basal bolus, don't panic. It will feel strange having your levels come down after being high for a long period, so don't be concerned if you find yourself feeling a bit weak/shaky (hypo type symptoms) before you get anywhere near 4mmol. Just test as often as you feel necessary, at least before every meal and before bed, plus any time that you start to feel the hypo symptoms your diabetic team will advise you of. With regards to carb counting - you'll be taught all you need to know. There are loads of great resources our there, personally I find the carbs and cals app particularly useful. Essentially you need to calculate how much total carbohydrate is in the meals you eat (NOT just sugar) and calculate the number of bolus units you need from that. Try not to feel overwhelmed, its a lot to learn but I promise you'll get there!

 

[azure]

Hi ausasha,

I'll tag @daisy1 who will provide some info for you later.

To answer your questions, yes the vast majority of people here have diabetes. Others are parents, partners or friends of people with diabetes.

Basal bolus is a very common insulin regime for people who need to take insulin and usually works well.

Carb counting isn't hard to learn. It's necessary so that you can adjust your insulin according to the food you eat. This gives you more flexibility.

I understand why you worry about hypos. If you test your blood sugar frequently that will help to avoid them. Always keep a hypo treatment with you eg glucose tablets or a sweet drink eg regular Coke.

 

[daisy1]

@ausasha

Hello and welcome to the forum Here, as mentioned above, is the information we give to new members. It contains a lot of information about carbs which I hope will be useful. Ask as many questions as you like and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[Daibell]

Hi. Many of us are on Basal/Bolus and it's good you are changing over from mixed. DNs usually start you on a Basal level based on weight (I was 10 units for 63KG and the Bolus on 1 unit to 10gm carbs at meal time). You can tweak from there. If you're worried about hypos you can always agree with the DN to start the Basal units slightly lower and the Bolus ratio with slightly less insulin.

 

[ausasha]

Thanks for the advice! I've seen the dietician and she has said that what I eat is generally pretty healthy and that I should increase my carbs. Hopefully, it will work in a few more weeks!