Type 1 for 1yr, still getting the hang of it!

[MPetzsch]

Hello, I was diagnosed a year ago and to begin with I was good at managing levels, increasingly feels harder (suspect it should be the other way around!)

I still eat carbs but sometimes seem to get it completely wrong. Today was on 7 before breakfast (good for me on fasting); had a bagel for breakfast, took 8 units as not very fit at the moment, and ended up on blood sugar 16 two hours later... as if I hadn't taken anything. Anyone know how/why this happens?! So frustrating feeling like I can't manage it.

 

[GrantGam]

Hello, I was diagnosed a year ago and to begin with I was good at managing levels, increasingly feels harder (suspect it should be the other way around!)

I still eat carbs but sometimes seem to get it completely wrong. Today was on 7 before breakfast (good for me on fasting); had a bagel for breakfast, took 8 units as not very fit at the moment, and ended up on blood sugar 16 two hours later... as if I hadn't taken anything. Anyone know how/why this happens?! So frustrating feeling like I can't manage it.

Hey @MPetzsch

Good work on your progress to date, it's hard at the start, but equally as hard if not harder shortly after diagnosis - there's a lot going on and a lot of variables changing, so don't worry too much!

Things such as basal rates (doses), insulin to carb ratios, correction factors, etc do change from time to time with diabetics - especially with the newly diagnosed.

Have you ever conducted a basal rate test? If not, it's a good thing to do:

https://mysugr.com/basal-rate-testing/

This is also a cracking book, that will explain almost everything you want and need to know:

https://www.amazon.co.uk/gp/aw/d/B06XCDTPP1/ref=tmm_kin_title_0?ie=UTF8&qid=&sr=

Are you in the UK? If you are, you can always ask your diabetes care team to attend the DIANE course (carb counting in Scotland) or DAPHNE (carb counting in England). I'm sure that would help a great deal in getting to grips with bolus dosing. I'm unsure of the course name in Wales and NI.

One thing I may add about bagels: they do spike my BG pretty high. Although I'll bolus accurately, I'll still be high at the 2hr mark, but back in range at 4 hours. How I do manage to get back in range at 2 hours though, is by taking my bolus insulin a bit earlier (usually 20-30 mins for high GI foods like bagels) - and it works.

The advance bolus technique is something best discussed with someone in your care team before undertaking as it can land you in a hypo if not done properly. We're all different and that's why using our BG meters regularly is extremely beneficial

 

[Ch.R.]

Hello, I was diagnosed a year ago and to begin with I was good at managing levels, increasingly feels harder (suspect it should be the other way around!)

I still eat carbs but sometimes seem to get it completely wrong. Today was on 7 before breakfast (good for me on fasting); had a bagel for breakfast, took 8 units as not very fit at the moment, and ended up on blood sugar 16 two hours later... as if I hadn't taken anything. Anyone know how/why this happens?! So frustrating feeling like I can't manage it.

Hello MPetzsch,
It’s not so easy and people do invent even more after times. For example the wording
“Basal Test” which in the very beginning need to be done and where principally every
morning fasting measurement is a Basal Test as known.
If you interested to know how to set the Basal Insulin then you
have to go to my Introduction.
If you have that Base not right, anything during the day cannot been better !

.

 

[azure]

Hello, I was diagnosed a year ago and to begin with I was good at managing levels, increasingly feels harder (suspect it should be the other way around!)

I still eat carbs but sometimes seem to get it completely wrong. Today was on 7 before breakfast (good for me on fasting); had a bagel for breakfast, took 8 units as not very fit at the moment, and ended up on blood sugar 16 two hours later... as if I hadn't taken anything. Anyone know how/why this happens?! So frustrating feeling like I can't manage it.

Hi @MPetzsch

If your honeymoon period is ending, then control can get harder. GrantGam has given goid advice above about basal testing. Your meal ratios might also need looking at.

One thing you didn't mention is how far in advance you bolused for your bagel. Advance bolusing can help enormously.

I second the advice to buy Think Like A Pancreas. It's a fantastic book for Type 1s

I was a little confused by your statement that you still eat carbs. Carbs aren't forbidden for Type 1s. All you need to do is count them and perfect your bolus timing, etc

 

[Deleted Account]

I was a little confused by your statement that you still eat carbs. Carbs aren't forbidden for Type 1s. All you need to do is count them and perfect your bolus timing, etc

Absolutely, total, 100% agree.
As 9 out of 10 people with diabetes have type 2, it is not surprising that the majority of contributors to this forum are type 2. The treatment for type 2 differs from type 1 and many people with type 2 have found a low carb diet helps them control their BG without drugs.
Some people with type 1 also like to follow this diet, but carbs are not forbidden or need to be rationed.

 

[Daibell]

Absolutely, total, 100% agree.
As 9 out of 10 people with diabetes have type 2, it is not surprising that the majority of contributors to this forum are type 2. The treatment for type 2 differs from type 1 and many people with type 2 have found a low carb diet helps them control their BG without drugs.
Some people with type 1 also like to follow this diet, but carbs are not forbidden or need to be rationed.

I've mentioned this before but many T1s like myself do need to ration the carbs to avoid weight gain so controlling the carbs is usually good for most of us; all depends on your activity levels and metabolism.

 

[Kristin251]

I've mentioned this before but many T1s like myself do need to ration the carbs to avoid weight gain so controlling the carbs is usually good for most of us; all depends on your activity levels and metabolism.

Agreed. Low carbs help me maintain stable weigh and good bs control.

One of the greatest things I learned on this forum was when @azure explained advanced blousing. It changed my control emmensly. It does take a lot of testing and experimenting until you find your sweet spot. But it certainly does work. I advance bolus 20 min for just a high fat moderate protein meal. However it does take humalog about that long to start working.

The trick is to get your food and insulin there at the same time, mimicking a healthy pancreas. You don't want insulin there first or we drop and you don't want food there first or we spike.

 

[noblehead]

I still eat carbs but sometimes seem to get it completely wrong. Today was on 7 before breakfast (good for me on fasting); had a bagel for breakfast, took 8 units as not very fit at the moment, and ended up on blood sugar 16 two hours later... as if I hadn't taken anything. Anyone know how/why this happens?! So frustrating feeling like I can't manage it.

Don't worry I'm not the Food Police, but if you can't find a solution to the spikes brought on by eating a bagel then try something else like porridge, I eat traditional porridge oats for breakfast most days and can control the spike by pre-bolusing.

Here's an article called Strike the Spike (it is written by the author of Think like a Pancreas) which discusses pre-bolusing methods:

https://www.diabetesselfmanagement....blood-glucose-management/strike-the-spike-ii/

 

[Deleted Account]

I've mentioned this before but many T1s like myself do need to ration the carbs to avoid weight gain so controlling the carbs is usually good for most of us; all depends on your activity levels and metabolism.

Apologies @Daibell. I should have been more specific. Does this read better?
Some people with type 1 also like to follow this diet (e.g. for weight control), but carbs are not forbidden and I am not aware of any research which suggest they need to be rationed for type 1.

 

[azure]

I've mentioned this before but many T1s like myself do need to ration the carbs to avoid weight gain so controlling the carbs is usually good for most of us; all depends on your activity levels and metabolism.

Absolutely. We're all different - and, indeed, it might be different for Type 1.5s or those with some level of IR Moreover, even people without diabetes might need to alter their diet as they get older or at different times of their life.

But, in general, the implication that for Type 1s carbs are somehow forbidden or should be eliminated is wrong.

 

[MPetzsch]

Thank you so much to everyone for your posts - these are so helpful! The advice my DN gave me was not to cut out carbs as well, just to think about what you are eating and dose accordingly. You could well be right that it's about taking the novorapid at the right time before eating to help with spikes so I will definitely start keeping that in mind. At the moment I am trying to cut down carbs just so I can see where my body is at naturally, so that I then have a better idea about how to build in carbs and the correct doses. It is a bit of trial and error, really - I also feel nervous of eating things like bread (which I love - and definitely don't want to give up) but getting it wrong and feeling grumpy...!

I am also trying to exercise (even if it's just walking to work) as much as possible as I find that invariably helps to bring things down a bit. Loving yoga especially at the moment, as it's gentle exercise but really seems to help both mood and body. I confess it is as much of a mental struggle as a physical one to stay positive when the blood sugar levels go awry...!

 

[MPetzsch]

PS if anyone has any tips about when they take insulin before eating particular meals or foods, or foods that cause spikes, then I would love to hear - I know it's different for everyone but always useful to know how others deal with it! Thanks

 

[azure]

PS if anyone has any tips about when they take insulin before eating particular meals or foods, or foods that cause spikes, then I would love to hear - I know it's different for everyone but always useful to know how others deal with it! Thanks

With Humalog, I inject 30mins before breakfast (which is a large bowl of cereal) as this is my most insulin resistant time.

For lunch, ideally around 15mins before.

Evening meal - around 10-15 mins before.

I also adjust these times depending on my blood sugar.

There's good info in the link Noblehead posted above.

Don't be afraid of eating bread! Choose a sliced variety with the carbs on, and see how you go. NO Type 1 has perfect sugars all the time. You need to learn how to 'be a pancreas' and live your life as close to normal as you can.

 

[Kristin251]

For me humalog takes about 20 minute a to start working so I bolus 20 before but this also depends on where I'm starting. I'll wait 30 min if I want it to come down a bit and 15 if I want it to go up a bit. Or I eat a tad more.

Please note I am vlc HOWEVER, I do convert protein to bg quickly. Almost as quick as carbs. Since I am vlc I also bolus for roughly 50%!of my protein as if it were carbs

 

[MPetzsch]

Thank you. Last night we went for dinner and had Mexican (tacos etc.). I dosed about 15-20 mins before and by bedtime was within target range (4-7) Sounds like that might be something to keep trying in the future!

 

[Kristin251]

Thank you. Last night we went for dinner and had Mexican (tacos etc.). I dosed about 15-20 mins before and by bedtime was within target range (4-7) Sounds like that might be something to keep trying in the future!

Pre bolusing is magical!! The other thing to remember is if you eat a very large meal, or very fatty it can require a dual bolus to avoid an initial hypo as well as to pick up the tail end of the delayed food. What's another small jab lol?