New type 1 diagnosed 1990

[M80]

Hi! I am new here, just been reading some threads the last two weeks and already have found some very useful advice on basal testing.This has never been presented to me and I can not understand why. We talked about doing the fasting with my previous nurse, then she retired and it was forgotten about. I do generally think most of the nurses and doctors want to help, but I also think the focus is not always where it should be. I use and LOVE the Libre, if we could all have one, if it was not so expensive, and if everybody got the carb counting course for those using insulin pump (I have used Omnipod and Medtronic but now have gone back to pens) we could see a lot of improvement and cut the costs on repairing bad bs control side effects.
I am from Scandinavia and have followed the LCHF.However parts of it feels wrong for my body and I do not do it now.However I use a lot of butter and Olive oil, coconut fat,and try to make food from scratch.I have read Bernstein books, and I wonder about getting think like a pancreas after seeing posts here. My bs is not perfect but it is getting better and better. This mostly because of the Libre.
The explanation of the dawn phenomenon also has been very useful, and the effect of lots of protein coming the day after.Still interested in finding ways to lower the DP.But can not eat string cheese straight in bed..like suggested.Keep thinking if there was something like green tea the evening before that would be good. Also have issues with histamine rich food (google histamine intolerance.Book called what HIT me) so no vinegar..

 

[himtoo]

Hi @M80
what a great and useful and informative post --- thank you for that !!.
I also have found the Libre invaluable -- it definitely helps to prevent hypos and high BG's with the indicative arrows.

perhaps going back on a pump would be useful with your better understanding of basal testing and DP that you have gained from being on the forum.

a pump has helped me eliminate my DP( most of the time )

 

[M80]

Hi!
I liked the Omnipod, and if it was on the NHS I would possibly go back to it.But it is not, so it would just be too much money on top of paying for the Libre.When I used it, I lived in Sweden, and it was funded. Today I woke 4,5 and stayed good for hours.Just had tiny bit of banana and coffee .Later porridge, which did cause too high bs after one hour, then took extra, it went too low, fixed it, too high soon, then fixed that,too low again..one of those days.In general though, my bs is really getting lower (and that is good) so it is tricky as my sensitivity to insulin is slowly getting better.Very happy despite having these challenges! Looking like things are moving in the right direction

 

[catapillar]

Hi!
I liked the Omnipod, and if it was on the NHS I would possibly go back to it.But it is not, so it would just be too much money on top of paying for the Libre.

Omnipod is available on the NHS. It might not be available via your particular clinic, but there's always an option to be referred to a diabetes clinic that does provide omnipods.

My Omnipod is NHS funded.

 

[M80]

Really? I live in Scotland and it definitively is not available to me here, I have tried. And the other ones just really get in the way I think.

 

[azure]

I would definitely get Think Like A Pancreas - it's a fantastic book

The only thing that sorted my DP was a pump (I have an Animas Vibe currently).

Just with reference to,your porridge issues, have you tried advance bolusing? I always have cereal for breakfast and I find advance bolusing stops spikes extremely well

 

[M80]

You mean taking it how long before? I have read we can be in need of ten to 15 min injection when it is morning.And actually I wonder if just that would sort it.It goes back down but like yesterday by then I had tried to fix it and ended up too low.This really is so much help!Thankyou! Will order book today!

 

[azure]

You mean taking it how long before? I have read we can be in need of ten to 15 min injection when it is morning.And actually I wonder if just that would sort it.It goes back down but like yesterday by then I had tried to fix it and ended up too low.This really is so much help!Thankyou! Will order book today!

It would depend on what worked for you. Move your bolus 5 minutes more in advance and then 5 minutes again if that's not long enough, but proceed cautiously and carefully.

You will probably find you need different timings for breakfast, lunch and evening meal as most people are the most resistant to insulin at breakfast. For example, using Humalog at breakfast, I need to inject 30 minutes in advance usually.

 

[catapillar]

Really? I live in Scotland and it definitively is not available to me here, I have tried. And the other ones just really get in the way I think.

It's certainly available on the NHS in England & wales. Apparently it's unusual for an omnipod to be prescribed in Scotland and ipag are making pressure for availability in Scotland - www.ipag.co.uk - you might want to get in touch with them to see if there's any advice they can give you on accessing omnipod.

 

[M80]

Thankyou!
We will see, it was really helpful to have omnipod when my daughter was a baby.Having two free hands ..So far now it is something I will find out about but hope to get the dp sorted without it.Will now have to lower my basal my average bs is under 10 finally (I know I have quite a bit to go but it is great, seems to have been stuck on 11 whatever I did) and my sensitivity increasing.Book ordered today

 

[M80]

Halfway through the book.Yesterday got strangely high bs overnight, and put 2 and 2 together realising I had taken double dose of asthma medication from a new inhaler.Thinking it is better to take the preventer at lunch time rather than before bed.Anybody got any experience with this?

 

[M80]

Finished the book. One thing was interesting about Protein.When I did LCHF it felt like my body was not reparing things properly,(skin issues) and this goes with what he writes about protein turning into glucose when there is not enough carbs (on strict lchf people go as low as 5 gram of carb per day.) Because the protein is used as glucose it will increase bs and there will not be much protein left to use for repairs. However, he is a very athletic person.What I love about more fat and less carbs, is how you do not feel like it is necessary to exercise so much. I walk everywhere, some days for more than two hours. So I totally know and support that sitting in the sofa is not great. However, for me going to the gym is something I do not like and having to do it would feel so stressful. So I do not think he is right about being negative about fat.I think we really need a better ratio of fat vs carbs. More fat to feel full longer,but still enough carbs to repair things and not let bs increase by the protein.I actually asked my Doctor and nurse about this last year when learning about carb counting for a pump, and they looked at me like I was crazy.(Protein becoming glucose) Good to know I am not

 

[M80]

Not going well at all.A week with hypos every day,following highs,and back at average of ten.So frustrated!

 

[himtoo]

Hi @M80
hopefully you are keeping records of blood sugars , food intake , exercise etc
that way you can have a talk with your care team to see if there are any patterns and possibly some changes could be made to our routine to assist your control.
This Diabetes is a really really long race ( like a marathon) so try not to beat your yourself up over a couple of weeks.

all the best !!

 

[M80]

Thank you.I hope they can.It is just that I know being a small person, I am very very sensitive to the smallest doses.This I know from my nurse.And it is so frustrating when you get results that are good, the following week it is as if the body is protesting against being lower and becomes even more sensitive.I know it is long.Dont worry, I am not like some (that write they just want to give up.Not now.Got over that maybe after the teen age years.No criticism there,just a fact.) It is just making me angry. Really have to get more of a "strict"schedule and hopefully more follow up.Asked to get a joint appointment with dietician and nurse to establish a typical day with the amount of carbs and insulin, it was just forgotten about. Sadly there seems not to be resources for everybody.AAH.Better luck next week.

 

[Scott-C]

Hi, M80, a fellow Scot here! I see you've got a Libre. Me too. When I was diagnosed many years ago, they told me this is fast acting insulin so take it just before your meal, so that's what I did and just took the spikes for granted. Since getting the Libre, though, I've started playing around with pre-bolusing and have figured out that for most meals, about twenty minutes before leads to hardly any spike at all. Some poking around on the internet led me to a book called Sugar Surfing by an American endo who also happens to be T1, Stephen Ponder. It's on Kindle. He calls pre-bolusing "waiting for the bend" in the sense that you wait till your levels are starting to go down so you know for sure that the insulin has started working. Given the Libre lag behind real blood, I don't quite take it that far but the principal is good. He is a fan of "nudging" levels by taking very small carbs e.g. 5 grams when the graph starts going down, and 1 unit when trending up. The whole point is that making these very small adjustments keeps things in line much better than, say, DAFNE recommendations which are generally to only test between meals if feeling hypo and save adjustments to meal times.Edinburgh Centre for Endocrinology and Diabetes has a PDF on their website endorsing the book so it's not like it's some wacky off the wall idea. The good bit is that Jelly Belly jelly beans each weigh 1 gram and are 90% carb so it's dead easy to figure out small carb loads to nudge back up.

 

[Robinredbreast]

Hello and welcome @M80

 

[donnellysdogs]

Hi, welcome..

I've had 3 pumps and back to MDI.

I had waking and dawn phenomen. Tresiba (degudec) much better than anything else.

I've low carbed for prob 35 years minimum. Helps enormously.

Basal testing helps alot.

I can get to 7am now without extra bolus for DP or waking up but not past that time.... frustrating if I desperately want a lie in'

 

[donnellysdogs]

On insulatard I had to have 3 basal javs a day at 4am, 8am and 4pm. Plus 1 unit of bolus at 4am and 2.5 at 8am.
On degludec.. I have to give. 1 unit bolus at 7am and 9 of treaiba plus another 2.5 unit bolus ;plus any correction) about 10 minutes before putting my feet to floor. Normally 8.30 to 9.30 am). I'm not lazy! Hubby does a permanent late shift!!

 

[M80]

Good replies,Thankyou all! I enjoy the books (well,mostly some times it can be dull but if they are useful I will read the.)..and will get the one you mention, Scott (for Scottish?)also have seen it mentioned before.What you write does seem to make sense, and I think it should help to take the insulin longer before. D.D I also tested pump, as mentioned at my first post, did you not like it I presume if you stopped? I started doing basal testing,and am very happy about the results as being so sensitive only half units make a difference to me. What messed it all up was being really good for a week.(Because my sensitivity increased so much.)
Anger can be a good motivation though.Feel motivated.About carbs, I have planned not to be very strict,but to have more routine.And I have found my bs is more stable if I eat breakfast around 30grams of carbs,not too late because first thing I do is drink coffee.Suspect my adrenalin goes up and without breakfast on top of that the liver starts doing its job. Does it make it better I wonder, if I drink coffee AFTER breakfast? Any experiences? I would happily swop the coffee for hot water with lemon. Well, another book to read this week then. Thanks so much for talking it really is a motivation!