High blood glucose levels

[PeterBeggs]

Hi @PeterBeggs and welcome to the forums.

I am a little confused .

I'm sorry for asking more questions but can you please clarify the following
1) how long have you been on insulin
2) are you definitely diagnosed T1 or are you a T2 on insulin. (Some people believe that T2s on insulin are T1). And there are other types of diabetes than T1 and T2 (eg MODY ).


To be honest, if you are a straight forward T1, I would expect you to be able to eat a normalish diet, including carbs, but having insulin to balance out those carbs.

Modern treatments for T1s (ignoring pumps for now) tend to consists of a two insulins - a basal that handles your insulin needs when you don't eat (eg at night) and a bolus fast acting insulin that you take when you eat, to balance out your food. You shouldn't be left hungry.

But I don't know whether your medical team want you to lose weight and whether they are just increasing your insulin dose slowly, or how much, if any, insulin you are still producing yourself.

Although many older people who become T1 develop the condition slowly, usually a 25 year old gets T1 quite fast, so their insulin production goes down quite quickly and they need to have their insulin dose adjusted accordingly. How often are you talking to your diabetic team?

Once more, welcome.

I have been on insulin about 1 month now and I am definitely a type 1 but I only use 1 insulin it's already mixed for me it's the 70/30 and as for having conversations with my diabetic team is not as simple I live really far away from the medical facility where I was diagnosed so my appointments are spaced out I have an appointment again sometime next week so I will see some of the alternatives I have.
BTW thank you for the welcome I have only been here a couple days and you guys make me feel like family.

 

[EllieM]

I have been on insulin about 1 month now and I am definitely a type 1 but I only use 1 insulin it's already mixed for me it's the 70/30 and as for having conversations with my diabetic team is not as simple I live really far away from the medical facility where I was diagnosed so my appointments are spaced out I have an appointment again sometime next week so I will see some of the alternatives I have.
BTW thank you for the welcome I have only been here a couple days and you guys make me feel like family.

Good luck with your appointment next week. Going forward, is it possible to talk to them by phone or email? I would expect you to need regular help in adjusting your doses....

 

[PeterBeggs]

Good luck with your appointment next week. Going forward, is it possible to talk to them by phone or email? I would expect you to need regular help in adjusting your doses....

Thanks, and am not sure I will ask if possible

 

[CheeseSeaker]

Hi @PeterBeggs,

The whole carb/sugar thing is a bit confusing at first.

Essentially there are lots of different types of carbohydrate (the bit we're interested in as diabetics) - Sucrose (sugar - brown, white, demerara etc and all other types are the same ), Fructose (fruit based carbs), Lactose (milk based carbs) etc.

All of these are digested by the body and broken down into glucose particles - which can pass through the cell walls of the intestine and enter the bloodstream (glucose attaches to the red blood cells for transport round the body).

Carbohydrate is the generic term for the glucose that can be derived from the food (carbohydrate is carbon and hydrogen and oxygen so its in everything - even a table leg... )

Confusingly some foods are labeled 'sugar free' because they don't contain sucrose - but have carbs cos the manufacturers replace it with fructose, glucose or whatever for marketing etc - its true but misleading.

Pretty much everything has carbohydrate available (to some degree) apart from a glass of water - a cucumber has a small amount of carbs - but not enough to bother counting (you'd need to eat shed loads of them to equal a packet of crisps).

As others say - counter carbs with insulin (it allows the carbs to be used by the body from the bloodstream, so you don't end up with high Blood Glucose), its tricky to get the amount right though - you'll only know by experimenting, but do it slowly so you don't get low BGs

To make this work you need to count carbs (know how much is in foods - ask you healthcare team about a Dafne course to learn how to do this, and match it to your insulin.

 

[becca59]

Am I right @PeterBeggs that you are not in the UK. If you are in the UK the guidance here now is for a basal bolus insulin regime. Not a mixed insulin. If not in the UK it may be how they treat diabetes where you live. It is an old fashioned way of doing it and unfortunately makes spontaneous eating of cookies exceedingly difficult.

 

[PeterBeggs]

Hi @PeterBeggs,

The whole carb/sugar thing is a bit confusing at first.

Essentially there are lots of different types of carbohydrate (the bit we're interested in as diabetics) - Sucrose (sugar - brown, white, demerara etc and all other types are the same ), Fructose (fruit based carbs), Lactose (milk based carbs) etc.

All of these are digested by the body and broken down into glucose particles - which can pass through the cell walls of the intestine and enter the bloodstream (glucose attaches to the red blood cells for transport round the body).

Carbohydrate is the generic term for the glucose that can be derived from the food (carbohydrate is carbon and hydrogen and oxygen so its in everything - even a table leg... )

Confusingly some foods are labeled 'sugar free' because they don't contain sucrose - but have carbs cos the manufacturers replace it with fructose, glucose or whatever for marketing etc - its true but misleading.

Pretty much everything has carbohydrate available (to some degree) apart from a glass of water - a cucumber has a small amount of carbs - but not enough to bother counting (you'd need to eat shed loads of them to equal a packet of crisps).

As others say - counter carbs with insulin (it allows the carbs to be used by the body from the bloodstream, so you don't end up with high Blood Glucose), its tricky to get the amount right though - you'll only know by experimenting, but do it slowly so you don't get low BGs

To make this work you need to count carbs (know how much is in foods - ask you healthcare team about a Dafne course to learn how to do this, and match it to your insulin.

This is very helpful but with the mixed insulin if I eat wheat bread and wheat crackers and the sugar free cookies I posted does it mean that my sugar will always be high because of the carbs? And if so can I not up my dosage? Because it's already mixed? I would have to talk to my doctors to give ne a insulin that is different that cab fight the carbs?

 

[PeterBeggs]

Am I right @PeterBeggs that you are not in the UK. If you are in the UK the guidance here now is for a basal bolus insulin regime. Not a mixed insulin. If not in the UK it may be how they treat diabetes where you live. It is an old fashioned way of doing it and unfortunately makes spontaneous eating of cookies exceedingly difficult.

Unfortunately I am not in the UK, I am from a carribean country so probably that's why they have this meager health care solutions sometimes I feel like I am at a disadvantage but I think it will be possible to order the basal bolus regime I've heard almost everyone speak on it and it sounds like a very good insulin.

 

[HSSS]

This is very helpful but with the mixed insulin if I eat wheat bread and wheat crackers and the sugar free cookies I posted does it mean that my sugar will always be high because of the carbs? And if so can I not up my dosage? Because it's already mixed? I would have to talk to my doctors to give ne a insulin that is different that cab fight the carbs?

I’m not type 1 or an insulin user but I can say in simple terms whatever carbs you eat (which most definitely includes bread and crackers of any type as well as actual sugar) needs to match the insulin you are taking.

If you don’t have enough insulin for the amount of carbs in your diet your levels will be high. You either need to have more insulin (the right type, the right amount and at the right time mind you) or have fewer carbs (but not less than the insulin you take caters for or else you’ll go low).

What tests made them think you’ve had this for years if you’ve only just been diagnosed and started insulin?

 

[PeterBeggs]

I’m not type 1 or an insulin user but I can say in simple terms whatever carbs you eat (which most definitely includes bread and crackers of any type as well as actual sugar) needs to match the insulin you are taking.

If you don’t have enough insulin for the amount of carbs in your diet your levels will be high. You either need to have more insulin (the right type, the right amount and at the right time mind you) or have fewer carbs (but not less than the insulin you take caters for or else you’ll go low).

What tests made them think you’ve had this for years if you’ve only just been diagnosed and started insulin?

I did blood and urine tests when I fell very ill about a month ago and hospitalized and they looked at my results and said I am definitely a type 1 diabetic and from the looks of my results I was diabetic for many years but my body probably wasn't reacting that way until now idk why but it was dormant because I usually would have seeds and stuff but never affected me till now

 

[EllieM]

@PeterBeggs your insulin regime used to be very common (I was on it for my first 12 years of diabetes) but it depends on you balancing the carbs you eat to your insulin.

So typically you'd have fixed amounts of carbs to eat at meals which also need to be at (reasonably) fixed times. (eg As a child I had 40g of carbs for breakfast, 10g for morning tea, another 30g at lunch and then more for afternoon tea and supper.) It can work well but is much less flexible than a bolus/basal regime. But bear in mind that the bolus/basal will require a lot more injections.

As you aren't in the UK you won't be able to access DAFNE but there is an online course you might find useful

Welcome - BERTIE Online

www.bertieonline.org.uk

 

[HSSS]

I did blood and urine tests when I fell very ill about a month ago and hospitalized and they looked at my results and said I am definitely a type 1 diabetic and from the looks of my results I was diabetic for many years but my body probably wasn't reacting that way until now idk why but it was dormant because I usually would have seeds and stuff but never affected me till now

Sorry to detract from the help you seek by asking questions about your diagnosis. Feel free to ignore me . But it’s very interesting to read about the experiences of others.

That explanation is curious. I’m aware that tests can show how high your blood glucose is, if you have antibodies that cause type 1 and also how much insulin of your own you make but to my knowledge there is no way to know how long it’s been that way beyond the fact it’s at least 3 months (Hba1c test covers the last 3 months). If you have copies of the names of the tests you had it would be enlightening to some of us here

Hope you get the help you need at your next appointment if you can go armed with some relevant questions from here

 

[PeterBeggs]

Sorry to detract from the help you seek by asking questions about your diagnosis. Feel free to ignore me . But it’s very interesting to read about the experiences of others.

That explanation is curious. I’m aware that tests can show how high your blood glucose is, if you have antibodies that cause type 1 and also how much insulin of your own you make but to my knowledge there is no way to know how long it’s been that way beyond the fact it’s at least 3 months (Hba1c test covers the last 3 months). If you have copies of the names of the tests you had it would be enlightening to some of us here

Hope you get the help you need at your next appointment if you can go armed with some relevant questions from here

Tbh I don't know the fancy terms and the fancy way u would talk about my recent diagnosis because all of this is new to me I am just going along with wat they told me so eventually u hope I can be well versed and educated in the topic as you are and one day maybe I can explain it in better terms for all that us going through the same thing I am. Thank you for your concern and you words of wisdom @HSSS

 

[CheeseSeaker]

This is very helpful but with the mixed insulin if I eat wheat bread and wheat crackers and the sugar free cookies I posted does it mean that my sugar will always be high because of the carbs? And if so can I not up my dosage? Because it's already mixed? I would have to talk to my doctors to give ne a insulin that is different that cab fight the carbs?

Hi @PeterBeggs - essentially any carbs will put your BG up, and you need more insulin to bring it down again.

The sugar free cookies will have carbs - so count those just the same as you would if you had sugar in your coffee (carb amounts should be on the packet for most things)

You're aiming to have a BG level between 3.9 and 10mmol or 70 and 180 mg (depending on which system you use in your country) so increasing the insulin to cope with the food you eat is necessary

Depends on which insulin regime you use - Single injection per day of mixed insulins, multiple injections of different insulins etc - you will probably need to tell your doctors what you eat (keep a log during the day for a few days) so they can adjust your insulin levels to match it.

Hope that helps a bit

 

[EllieM]

You're aiming to have a BG level between 3.9 and 10mmol or 70 and 180 mg (depending on which system you use in your country) so increasing the insulin to cope with the food you eat is necessary

But if you are on a mixed dose insulin it isn't that simple, as increasing the dose for meals will also increase the dose at night when you aren't eating and so may cause hypos (low blood sugar) then...
@PeterBeggs really needs help from his team to sort this one out.

But I agree a good diary of food and blood sugars will help a lot.

 

[CheeseSeaker]

But if you are on a mixed dose insulin it isn't that simple, as increasing the dose for meals will also increase the dose at night when you aren't eating and so may cause hypos (low blood sugar) then...

Hi @EllieM - Was meaning if hes consistently high across the day will need to increase insulin - yes needs to talk to his team to sort this out - either the regime needs changing to suit lifestyle, or thorough review of the current one.

 

[urbanracer]

hi @PeterBeggs

I am sorry but I haven't been on the forum much lately and just came here for a catch up.

I see that @ANTJE tagged me above and just wanted to get back to you regarding the mixed insulin issue.

I'm going to (initially) steer you in the direction of something I posted a few years back whilst I look for soemthing else.

Try this.

Your doctor might be able to give you a rapid acting insulin which you can take in addition to the premixed insulin to effectively change the ratio.I did this for a while before switching to a proper basal/bolus regime. Having a separate rapid acting insulin also comes in handy on "sick days" when your blood glucose will rise all by itself.