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[Paulgrayston]

just seen diabetic nurse. don't think she has a clue what she is on about. don't do this don't do that. now this one says only use insulin if eating carbs. the other one said if sugar is high then up the insulin.

 

[fletchweb]

just seen diabetic nurse. don't think she has a clue what she is on about. don't do this don't do that. now this one says only use insulin if eating carbs. the other one said if sugar is high then up the insulin.

You know that's been my greatest struggle living with Type 1 for the past 50 years - finding a Health Care Team that know what they're talking about. I have encountered two doctors in the last 50 years who seemed informed and progressive. The rest seem to fall in that dullard category. You should adjust your insulin for both carb and sugar intake but determine the dosage adjustment yourself.
I find many Health Professionals try to treat diabetes the same way regardless of the individual. Kind of a text book approach. The best advice I can give to you is to test regularly when eating all food groups and get a sense as to how your body metabolizes food intake. We all have different metabolisms and genetics that dictate the results of carb and calorie intake.

 

[Paulgrayston]

been told 10g carbs =2 units of insulin. some articles says 15g-1 unit

 

[tim2000s]

been told 10g carbs =2 units of insulin. some articles says 15g-1 unit

Neither of these is correct and both are. Insulin Carb ratio is something that is worked out personally. Typically, T1s are started on 10g per 1u of fast acting insulin. From there you go up or down, depending on what happens to your glucose levels as a result of eating and taking insulin. You might find this helpful: http://www.bdec-e-learning.com

 

[azure]

been told 10g carbs =2 units of insulin. some articles says 15g-1 unit

There's no set dose for insulin. We all vary.

Your DSN should be able to help you find a ratio that suits you.

I strongly suggest you get the book Think Like A Pancreas. You don't have to read it all and digest every word in one go as it has a lot of information in, but it's a great book and really useful.

 

[azure]

just seen diabetic nurse. don't think she has a clue what she is on about. don't do this don't do that. now this one says only use insulin if eating carbs. the other one said if sugar is high then up the insulin.

The warning about not taking insulin without food is sensible. It can be confusing when you're first diagnosed, and some people don't immediately connect the meal time insulin with food, instead they can get up, take their fast acting insulin but then decide they don't fancy breakfast. That could lead to a dangerous hypo.

The other nurse is also correct - although it's not clear if she's talking about your basal insulin or your meal insulin. Your basal insulin might need upping in consultation with your DSN if your blood sugar is higher than desired. Also, you can use your mealtime/fast acting insulin to correct a high sugar eg if you miscalculated your carbs.

I'm not sure if you already do this, but if not, take a pen and paper to your appointments and write everything down. Also, never be afraid to ask questions if it's not clear exactly what they're saying or you want further explanation.

 

[catapillar]

just seen diabetic nurse. don't think she has a clue what she is on about. don't do this don't do that. now this one says only use insulin if eating carbs. the other one said if sugar is high then up the insulin.

They are both right.

"Only use insulin if eating carbs" - generally you usually only bolus for carbs. Yep, sometimes you might want to have some insulin to correct a high blood sugar when you aren't eating. But if you are newly diagnosed and not yet confident with using insulin and your correction factor, it's probably sensible to try and correct with meals so as to try to avoid dropping your blood sugar too quickly and having a hypo.

"If sugar is high then up the insulin" so this could mean a couple of things:

1. If you test before a meal and your sugar is high you might want to round your dose up or add on a correction
2. If your sugar is remaining high you might need to think about adjusting your insulin to carb ratio
3. If youre drifting high without food, you might need to think about increasing your basal dose
4. All of the above or a combination of several - you should have a chat with your DSN about any changes.

been told 10g carbs =2 units of insulin. some articles says 15g-1 unit

Everyone has their own individual insulin to carbs ratio. It takes a bit of trial and error to figure out what suits you and you have to start somewhere. For some people insulin to carb ratio can change throughout the day.

It's really frustrating that there aren't any black and white answers. I'm afraid that's the way it is. Not necessarily the nurses' fault - although perhaps they haven't explained it very well. If they are saying things that don't make sense or sound contradictory, it's fine to ask them to explain again. There's a lot to take in and diabetes is tough to get to grips with. I agree the recommendation to read "Think Like a Pancreas" it's a great introduction to things that it would be useful for someone with type 1 to know.

 

[Paulgrayston]

They are both right.

"Only use insulin if eating carbs" - generally you usually only bolus for carbs. Yep, sometimes you might want to have some insulin to correct a high blood sugar when you aren't eating. But if you are newly diagnosed and not yet confident with using insulin and your correction factor, it's probably sensible to try and correct with meals so as to try to avoid dropping your blood sugar too quickly and having a hypo.

"If sugar is high then up the insulin" so this could mean a couple of things:

1. If you test before a meal and your sugar is high you might want to round your dose up or add on a correction
2. If your sugar is remaining high you might need to think about adjusting your insulin to carb ratio
3. If youre drifting high without food, you might need to think about increasing your basal dose
4. All of the above or a combination of several - you should have a chat with your DSN about any changes.

Everyone has their own individual insulin to carbs ratio. It takes a bit of trial and error to figure out what suits you and you have to start somewhere. For some people insulin to carb ratio can change throughout the day.

It's really frustrating that there aren't any black and white answers. I'm afraid that's the way it is. Not necessarily the nurses' fault - although perhaps they haven't explained it very well. If they are saying things that don't make sense or sound contradictory, it's fine to ask them to explain again. There's a lot to take in and diabetes is tough to get to grips with. I agree the recommendation to read "Think Like a Pancreas" it's a great introduction to things that it would be useful for someone with type 1 to know.

wow that makes alot of sense thank-you very much