Diagnosed 2 weeks ago (type 1)

[harshasp]

Hello
This is the first time I am posting here. I am 21 year old engineering student who was diagnosed as type 1 diabetes 2 weeks ago. I was DKA by the time I reached the hospital. I am now on multiple injection therapy (3 rapid acting (Humalog) before meals, and one long acting (Lantus) before bed). I was already underweight (50 Kg with 170cm height) and the onset of diabetes made me lose about 9 KGs and made me dangerously underweight. I feel fine after insulin therapy and am gaining weight (about 45 KGs now).

I take 12U of lantus every night, 12U of Humalog in the morning and afternoon, and 11U of Humalog at night. I am still learning how to control my BGs. I am currently on CGM that my doctor put (Freestlye Libre. Works for 14 days and only they can extract its measurements during hospital visits). I asked the clinic if they could give me the data but they refused to do so and only gave me the graphs. Also, they gave me no way to know the CGM reading without visiting the hospital (Librelink is not available in India). So I found another way (Glimp) to extract data from the sensor and I am using it daily to track my BGs. My blood sugars averaged at around 205 mg/dL for the first few days. It significantly improved and my average today is 121 mg/dL with the highest reading today being 161 mg/dL. It is sad that after the 14 day period, I cannot afford a CGM and have to go back to testing with strips. The convenience and data given by CGM is unparalleled and I will miss it. I have been taking a walk after every meal (about 12000 steps per day).

I am hungry all the time and I'm eating a lot of food. The doctor said it is because of the insulin. My carb intake is also relatively high , standing at 260g per day (All good carbs and low G.I food, though). The only high G.I food that I believe I'm having is the mix of brown and white rice in the afternoon. It is actually the staple food in my country and it is difficult to avoid. I plan to switch completely to brown rice, however.

My C-Peptide test gave a fasting C-Peptide level of 0.16 ng/ml. Do I have a chance of having a honeymoon phase? Does niacinamide help in preserving beta cell function for the first 2 years? (I found multiple studies saying that it does but my doctor isn't convinced).

What should be my target BG levels for the first few months?

The injection with pens sometimes hurt and cause bleeding. Any tips to prevent this?

Apart from the questions I asked.... Is there any advice that any veteran type 1 diabetic can offer regarding T1D management?

Sorry for the long post.

 

[azure]

Welcome @harshasp

I've had Type 1 for more than 20 years. It's very hard to start with as it's such a big change to your daily life, but it does get easier Knowledge is power. Learn as much as you can and then you can control the diabetes not let it control you.

Most Type 1s can't afford CGM so test by fingerpricks. Testing is key to control, as it carb counting and adjusting your insulin to match the carbs you eat. If you haven't had that explained to you yet, push really hard to get that help.

I recommend the book Think Like A Pancreas. It's fantastic for Type 1s and very popular.

Feeling hungry for the first few months is normal. That's because your body is 'rebuilding' itself after not being able to use food properly prior to your diagnosis. The hunger will go away gradually as your body settles and you regain any weight you lost.

 

[harshasp]

Thanks for the response @azure . The doctor is monitoring my diet and the CGM readings and said they would tell me my Insulin sensitivity, I:C ratio, and carb counting after the sensor's life ends.

I did hear about that book before. I am currently reading "Dr. Bernstein's Diabetes Solution" and Think Like A Pancreas is next on my list.

 

[noblehead]

Welcome to the forum @harshasp

Sounds like your doing absolutely fine for someone newly diagnosed, as @azure says the book Think Like a Pancreas comes highly recommended by the forum members here and will help get you on the road to good bg control. Best wishes.

 

[Chas C]

When injecting with a pen, try pinching up the skin between two fingers.

I've been IDD since 1970, its never stopped me doing anything

 

[harshasp]

Welcome to the forum @harshasp

Sounds like your doing absolutely fine for someone newly diagnosed, as @azure says the book Think Like a Pancreas comes highly recommended by the forum members here and will help get you on the road to good bg control. Best wishes.

Thanks for the encouraging words. I will definitely read the book.

 

[harshasp]

When injecting with a pen, try pinching up the skin between two fingers.

I've been IDD since 1970, its never stopped me doing anything

Thank you for the reply. It does feel like high maintenance to keep up with the BG testing, insulin shots, and carb counting but I'm sure I'll get used to it. I hope to get a pump when I start earning.

I actually have to pinch skin because I have little fat in my body. I feel like it hurts more if I pinch tightly. It might be isolated incident. I will try again and let you know.

Great job on the 6.1 A1c, btw.

 

[azure]

Don't pinch tightly, just pinch enough to hold the skin up - so quite gently. You want the skin to be held loosely

 

[harshasp]

Don't pinch tightly, just pinch enough to hold the skin up - so quite gently. You want the skin to be held loosely

Ah! Thank you! Will try in a while and let you know.

 

[Chas C]

Are you taking your humalog before each of your three main meals, breakfast, lunch, dinner ?

 

[harshasp]

Are you taking your humalog before each of your three main meals, breakfast, lunch, dinner ?

Yes, I am.

 

[harshasp]

Ah! Thank you! Will try in a while and let you know.

@azure Tried it with my Lantus. It does ease the pain. Lantus still stings after injecting, though. Probably because of its acidic pH. Thanks for the tip!

 

[kay2409]

Get on a DAFNE course as soon as you can, it'll help you at Uni with carb counting so you will be able to eat a more varied and nutritious diet. I was diagnosed a year before I started Uni and went on a Dafne course in my 8th month of my t1 diagnosis. Helped out so much. You will go through a honeymoon period as some point in the near future so be careful with Hypoglycaemia. Just push your medical team to get on a DAFNE course. Good Luck

 

[Chas C]

The amount your needing to inject will also cause it to sting too, when I used to inject and also now on a pump I'd never given more than 5 units at a time, even though that meant injecting twice maybe.

Your doses are high as your looking to put on weight but hopefully as you gain weight and settle down they will reduce.

 

[harshasp]

Get on a DAFNE course as soon as you can, it'll help you at Uni with carb counting so you will be able to eat a more varied and nutritious diet. I was diagnosed a year before I started Uni and went on a Dafne course in my 8th month of my t1 diagnosis. Helped out so much. You will go through a honeymoon period as some point in the near future so be careful with Hypoglycaemia. Just push your medical team to get on a DAFNE course. Good Luck

There are no DAFNE centers in India. However, with some research, I found an alternative:

BERTIE Type 1 Diabetes Education Programme (www.bertieonline.org.uk)

I'm not sure if I can persuade my hospital to become a DAFNE center, but I'll try. If I can't, I'll do BERTIE.

 

[harshasp]

The amount your needing to inject will also cause it to sting too, when I used to inject and also now on a pump I'd never given more than 5 units at a time, even though that meant injecting twice maybe.

Your doses are high as your looking to put on weight but hopefully as you gain weight and settle down they will reduce.

My doses are high because my stomach is currently a bottomless pit. I'm eating about twice the amount of food that anyone in my family eats. I'm sure it will reduce after the constant hunger subsides.

I think the sting is easier to bear than two injections.

 

[azure]

There are no DAFNE centers in India. However, with some research, I found an alternative:

BERTIE Type 1 Diabetes Education Programme (www.bertieonline.org.uk)

I'm not sure if I can persuade my hospital to become a DAFNE center, but I'll try. If I can't, I'll do BERTIE.

BERTIE is often recommended here. It's very good

 

[Chas C]

My doses are high because my stomach is currently a bottomless pit. I'm eating about twice the amount of food that anyone in my family eats. I'm sure it will reduce after the constant hunger subsides.

I think the sting is easier to bear than two injections.

Understood, but please think again in a few months to a year if your having to inject such large doses. I used to do this when I was a teenager and now cannot use my legs do to the lumps caused by large injections.

Also try your hardest to rotate your injection sites - try not to go back over an old one for a few weeks too, this is quite hard when on a pen but will help you in the long term.

BERTIE is a great course (the hospital I'm at developed it), its on line too so you should be able to take/follow it even if your hospital is not interested.

Best wishes

 

[Scott-C]

So I found another way (Glimp) to extract data from the sensor

There's been quite a few posts about frustrations with Libre Pro (the "doctor" version where the patient can't read it) so I'm deeply impressed you've been able to figure out a hack for it. You're a student just now, but when you start going to job interviews, try to throw in some references to that in relation to problem solving - it shows a huge amount of initiative, which is what most employers are looking for.

Another good book is Sugar Surfing by Stephen Ponder. He's an endocrinologist who also happens to be T1, so he's seen both sides of it.

You're an engineer, so you want to measure things. That's quite correct, and you're obviously taking time to read up on the condition, but remember that, while you can measure and balance insulin/food/exercise, there's a lot of things going on in the background which can upset that balance and simply can't be measured or controlled with existing technology. That sounds a bit negative, but all I mean to say is that when you think you've done the sums right but it still goes wrong, it's not really your fault - there's too many random factors, so, as long as we're right most of the time, that's good enough.

 

[harshasp]

Understood, but please think again in a few months to a year if your having to inject such large doses. I used to do this when I was a teenager and now cannot use my legs do to the lumps caused by large injections.

Also try your hardest to rotate your injection sites - try not to go back over an old one for a few weeks too, this is quite hard when on a pen but will help you in the long term.

That is scary. I am trying my best not to frequently use the same injection sites. I am planning to try the i-Port advance. Do you think it'll easily cause lumps because it'll be stuck at the same spot for 3 days?

BERTIE is a great course (the hospital I'm at developed it), its on line too so you should be able to take/follow it even if your hospital is not interested.

Great. I started doing it already.