trying to reduce Hba1c down from 8.3 so can try for a baby. on insulin pump any advice please xx

[Type1insuliner]

Hi there. Im a type 1 diabetic on insulin pump with underactive thyroid and pcos trying to get my hba1c down. I really need adcice on what to eat to get my hba1c down to 7 from 8.3. What do other people do. Im really struggling. I struggle especially as I work on a busy ward as a nurse so never know whats best to eat to keep me going n how much insulin to take

thanks lizzie x

 

[noblehead]

Ask to go on the DAFNE course (Google)if you haven't done so already, there's an on-line version of it in the following which by all accounts is very good:

http://www.bdec-e-learning.com/

 

[Type1insuliner]

Hi noblehead. Ive been on the dafne course twice now. Ill check out the website too. Thanks, Lizzie

 

[Moaney]

Dafne will help u so much. It's difficult to say what to eat otherwise. But if u wrote up what u've eaten for a week or two and what insulin u've taken each time ur dietician can then work out ur units to carbs ratio. Then u can eat what u want but take insulin accordingly. My HBA1C was 9% when I fell pregnant thanks to carb counting I got to 6.9% and I have a healthy little 3 week old girl!!


Sent from the Diabetes Forum App

 

[JessP]

Hi Lizzie,
don't panic, I can completely understand where you're coming from because I was there 10 months ago. I am a doctor, so completely agree with you about the hectic work patterns and what a nightmare it can be even with a pump. Over a 5 month period I got my HbA1c from 8.3 to 6.7 and then to 6.0 a few months later. It is now 5.4 and I'm 12+4 weeks pregnant so it is do-able.
I agree with the comments above about DAFNE although I still found that even with meticulous carb counting I would get a huge post-prandial spike at one hour and then crash. The biggest change I made (after resisting for a long time) was to change to a very low carb diet. So I essentially only eat carbs now when I hypo or if needed pre-exercise etc. The low-carb forum on this website is really useful and the other thing I found brilliant was Dr Berstein's book, Diabetes Solutions.
A low-carb diet is not for everyone but I had honestly tried everything (DAFNE, pump, CGMS etc) prior to trying it and the numbers speak for themselves I think.
Let me know if you're interested and if I can give you any more help.
Good luck!
Jess

 

[Type1insuliner]

Dafne will help u so much. It's difficult to say what to eat otherwise. But if u wrote up what u've eaten for a week or two and what insulin u've taken each time ur dietician can then work out ur units to carbs ratio. Then u can eat what u want but take insulin accordingly. My HBA1C was 9% when I fell pregnant thanks to carb counting I got to 6.9% and I have a healthy little 3 week old girl!!


Sent from the Diabetes Forum App

I may give the DAFNE another go, I didn't get on well with the ones I did as I was just angry n upset and didnt have m depression under ontrol so the last thing I wanted to do was count....I hate hate hate maths and I struggled with the different ratios and the thought of measuring everything.

Congratulations on your baby girl, and well done for being so strong and determined, helps to know that it can be achieved! I soooo want a little baby girl xxx

 

[Type1insuliner]

Hi Lizzie,
don't panic, I can completely understand where you're coming from because I was there 10 months ago. I am a doctor, so completely agree with you about the hectic work patterns and what a nightmare it can be even with a pump. Over a 5 month period I got my HbA1c from 8.3 to 6.7 and then to 6.0 a few months later. It is now 5.4 and I'm 12+4 weeks pregnant so it is do-able.
I agree with the comments above about DAFNE although I still found that even with meticulous carb counting I would get a huge post-prandial spike at one hour and then crash. The biggest change I made (after resisting for a long time) was to change to a very low carb diet. So I essentially only eat carbs now when I hypo or if needed pre-exercise etc. The low-carb forum on this website is really useful and the other thing I found brilliant was Dr Berstein's book, Diabetes Solutions.
A low-carb diet is not for everyone but I had honestly tried everything (DAFNE, pump, CGMS etc) prior to trying it and the numbers speak for themselves I think.
Let me know if you're interested and if I can give you any more help.
Good luck!
Jess

Hi Jess.

Well done and fab news about your pregnancy! Its great to hear it can be done. I've been type 1 for 6 years and its always been above 8.3 my HBA1c.But I'm married and 32 so I want the chance of having at least one child.
I am really interested in this low carbing you have done to your HBA1c to be so good. I always get the high spikes (e.g. BM 18-20) post meal and if I take extra insulin I get hypos and the nurses at work are like "you should have this sorted by now Lizzie" or "are you not looking after yourself Lizzie" "you shouldn't be getting hypos" grrrr! Nurses haven't got a clue, and are more judgemental than people who have no healthcare experience!

My problem is in the evening when I get in and finally stop, and try to chill out! I'm always starving and need to fill up and then want something sweet aswell. Or when I've had a stressful shift on the ward.

I could really do with your help, thank so much

Lizzie xx

 

[jack412]

Hi Lizzie,
don't panic, I can completely understand where you're coming from because I was there 10 months ago. I am a doctor, so completely agree with you about the hectic work patterns and what a nightmare it can be even with a pump. Over a 5 month period I got my HbA1c from 8.3 to 6.7 and then to 6.0 a few months later. It is now 5.4 and I'm 12+4 weeks pregnant so it is do-able.
I agree with the comments above about DAFNE although I still found that even with meticulous carb counting I would get a huge post-prandial spike at one hour and then crash. The biggest change I made (after resisting for a long time) was to change to a very low carb diet. So I essentially only eat carbs now when I hypo or if needed pre-exercise etc. The low-carb forum on this website is really useful and the other thing I found brilliant was Dr Berstein's book, Diabetes Solutions.
A low-carb diet is not for everyone but I had honestly tried everything (DAFNE, pump, CGMS etc) prior to trying it and the numbers speak for themselves I think.
Let me know if you're interested and if I can give you any more help.
Good luck!
Jess

I'm on lchf and from what I read it's best to stay above ketogenic level because of rat studies and not enough data to say it's ok

 

[noblehead]

Hi noblehead. Ive been on the dafne course twice now. Ill check out the website too. Thanks, Lizzie

Sorry I missed your reply and just seen your thread bumped up the forum. This member posted last night that should give you some inspiration to achieve your goal:

http://www.diabetes.co.uk/forum/threads/success-story.62907/#post-610174

Good luck and best wishes!!!!

 

[JessP]

Hey Lizzie,
If you're keen to go low carbs definitely recommend looking at the low carb forum and also look at buying the Bernstein book on Amazon, it looks like a heavy read but is actually easy reading and I found it quite funny in bits!

There is a lot of resistance out there re low carbs, especially among more traditional diabetes people, nurses and docs. One argument is that we apparently need carbs in our diets, I have yet to have anyone convince me why. The ketone argument doesn't stand with me as I've kept a close eye on ketones since changing my diet and they've never gone up.

Like you I had a real problem with spikes then crashes with carbs and this is the only thing that has worked for me.
I get serious munchies between 4-6 and find nuts are a good low carb snack to delay until dinner time.
Looking at my diary I've only had to bolus once today, for a 10g snack mid morning. One thing I have had to play around with is bolusing for protein at times, if I have a large protein load, eg steak (sadly not when preggers though) I need some insulin to cover it but not nearly as much as carbs would need.

Let me know if anything you want to know.
Good luck!
Jess x

 

[jack412]

With your ketones not going up with your LC is good going by what I read. I'm actually in ketosis to lose weigh because I'm 105 kg and very LC. I wasn't being critical about LC or ketogenic diets

 

[Type1insuliner]

I'm on lchf and from what I read it's best to stay above ketogenic level because of rat studies and not enough data to say it's ok

Hey Lizzie,
If you're keen to go low carbs definitely recommend looking at the low carb forum and also look at buying the Bernstein book on Amazon, it looks like a heavy read but is actually easy reading and I found it quite funny in bits!

There is a lot of resistance out there re low carbs, especially among more traditional diabetes people, nurses and docs. One argument is that we apparently need carbs in our diets, I have yet to have anyone convince me why. The ketone argument doesn't stand with me as I've kept a close eye on ketones since changing my diet and they've never gone up.

Like you I had a real problem with spikes then crashes with carbs and this is the only thing that has worked for me.
I get serious munchies between 4-6 and find nuts are a good low carb snack to delay until dinner time.
Looking at my diary I've only had to bolus once today, for a 10g snack mid morning. One thing I have had to play around with is bolusing for protein at times, if I have a large protein load, eg steak (sadly not when preggers though) I need some insulin to cover it but not nearly as much as carbs would need.

Let me know if anything you want to know.
Good luck!
Jess x

Hey jess

Only meat I eat is turkey chicken and fish and i love quorn. Do you know roughly how much insulin to take for these.....a reasonable filling side with cucumber lettuce salad with olives and balsamic vinegar.

today I had scrambled eggs for breakkie no milk or cream with olive lettuce salad...no insulin but had to correct with pump as sugars 12.5 couple hours after eating.

lunch had feta, lettuce, olives and 50g tuna salad with balsamic vinegar...sugars went to 15.9 couple hours after
As no idea how much insulin to take

snacks bowl of sugar free jelly
one banana 10.5g carbs
10 almonds
100g natural fat free yogurt with 100g fraozen cherries n berries 20g carbs

Evening meal
3 turkey sausages and cucumbr n lettuce n balsamic vinegar
and a options hot chocolate

any advice on this? Thanks for getting back in touch, really appreciate it x

 

[Sezzy1313]

Have U looked to do basal rate testing which means you eat non carb food and then you can test your blood every two hours. This shows what your background insulin is going and whether you are getting enough.

I've been on the pump 5 months now and have managed to reduce my HBA1c from 8.2 to 7.5 in that time.

Basal rate testing showed me where I was having BS Rises and I was able to adjust my hourly background rate accordingly

I fell pregnant in 2009 and have a lil boy who is now 4 however my HBA1c came down to 6.2 whilst I was pregnant and caused me to have proliferative retinopathy because of the quick reduction in HBA1c x

Low carbs is a great way to go but drf test your basal rate first to make sure your background is 100% before you do the no or low carb

Good luck xx

 

[noblehead]

Busy Lizzie, you still have to bolus for meals that contain few carbs due to the protein and fat content.

 

[Type1insuliner]

Have U looked to do basal rate testing which means you eat non carb food and then you can test your blood two hours. This shows what your background insulin is going and whether you are getting enough.

I've been on the pump 5 months now and have managed to reduce my HBA1c from 8.2 to 7.5 in that time.

Basal rate testing showed me where I was having BS Rises and I was able to adjust my hourly background rate accordingly

I fell pregnant in 2009 and have a lil boy who is now 4 however my HBA1c came down to 6.2 whilst I was pregnant and caused me to have proliferative retinopathy because of the quick reduction in HBA1c x

Low carbs is a great way to go but drf test your basal rate first to make sure your background is 100% before you do the no or low carb

Good luck xx

Have U looked to do basal rate testing which means you eat non carb food and then you can test your blood every two hours. This shows what your background insulin is going and whether you are getting enough.

I've been on the pump 5 months now and have managed to reduce my HBA1c from 8.2 to 7.5 in that time.

Basal rate testing showed me where I was having BS Rises and I was able to adjust my hourly background rate accordingly

I fell pregnant in 2009 and have a lil boy who is now 4 however my HBA1c came down to 6.2 whilst I was pregnant and caused me to have proliferative retinopathy because of the quick reduction in HBA1c x

Low carbs is a great way to go but drf test your basal rate first to make sure your background is 100% before you do the no or low carb

Good luck xx

Im gonna check my basal rate out. How many hours domi need to sarve myself to check out the basal rate again? I always forget. Ive found I need more basal rate in the summer and when im pre menstrul....nightmare!!

Im well shocked to hear u got retinopathy from a quick reduction of your Hba1c, u poor thing xx

 

[Type1insuliner]

Busy Lizzie, you still have to bolus for meals that contain few carbs due to the protein and fat content.

Hi noblehead

How much insulin do I need to take for protein is it like 1 unit per 10g carbs minus 50%?

 

[JessP]

Lizzie we can't tell you how much to take for certain foods I'm afraid, it'll be trial and error because we're all different.
I definitely think you need to check you basal rates. Do it for 10-12 hrs at a time over a few days that reflect normal life and work with your DSN to interpret the results I think.

Nb balsamic vinegar has carbs in it, swap to another type of vinegar.
X

 

[noblehead]

Hi noblehead

How much insulin do I need to take for protein is it like 1 unit per 10g carbs minus 50%?

As Jess quite rightly says it's trial & error, I don't think there is a calculation as with the one you've quoted above. The best advice is to start with a low-dose and adjust up if necessary according to your postprandial bg readings.

Personally I need nearly as much insulin for a a protein/fat based meal as I do for one that contains carbs, however others do find they need significantly less so experiment and see.

 

[Sezzy1313]

Im gonna check my basal rate out. How many hours domi need to sarve myself to check out the basal rate again? I always forget. Ive found I need more basal rate in the summer and when im pre menstrul....nightmare!!

Im well shocked to hear u got retinopathy from a quick reduction of your Hba1c, u poor thing xx

The hospital forgot to check my eyes the whole time I was pregnant x a swift change from bad control to good is what I've been told causes complications x

Basal rate testing is for 4-6 hours at a time x

Good luck x

 

[jack412]

Hi noblehead

How much insulin do I need to take for protein is it like 1 unit per 10g carbs minus 50%?

As noble replied, you need your ratio
For further googling, TAG total available glucose, is the term they use for bolusing for protein and fats, there are online groups that TAG