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Type 1'stars R Us

Moggely said:
@Mel dCP this is probably a silly question as i am not type 1 but very interested. So you guys can eat pretty much what you want and then inject for it is that how it works?. Of course i understand that many wouldn't as some may have to watch weight and so on. Also does the insulin cause a lot of weight gain. I'm type2 but it was so high on diagnose early this year that the doctor said.." not to me but to my husband" which i'm still angry about:banghead: because he doesn't have the condition i do. anyway he says insulin is a fat explosion and we don't want her on that. Needless to say i got it down to 5.8 from 11.4 in 3 months. Still i was curious about food and then injecting for it. Actually any type 1's can answer that.
Click to expand...
Hi @Moggely, I view it as a balance between food, insulin and weight (with exercise and stress on the sidelines making a nuisance of themselves sometimes). The more food, the more insulin is required to help the lid on BSLs.
So yes you can put on weight with insulin, and I have noticed that the mix insulins (ratio mixtures of say 30:70, 50:50 etc of short- and long-acting insulin in the one ampoule/pen) are more problematic weight-wise than others.
So right diet, right insulin, right doses doses with best BSLs and normal weight is the ideal - a real juggler's tale to be sure.
 
Morning all, had a lovely meal last night of roasted veg (cauliflower, broccoli, green pepper and a little beetroot) with a whole sea bream roasted in lemon and goat butter - didn’t get the dosing right. Not sure if I underestimated the carbs, or the white fish protein or what. I’d estimated at 14g carbs, so took 1.35u for those as I was at 4.8; and an extra 1.65u over two hours for the 35g protein in the fish. Shot up to 8.6 in an hour and a half, and had to chuck in an extra 1.15u to bring it down - took five hours to get back into range. I didn’t prebolus for the veg, perhaps I should have? I don’t normally as I don’t eat fast carbs, but I don’t usually eat lots of beetroot either. So I think that caught me out! I’m boring myself here so shall shut up. Prawns for lunch, I do like being an ongoing science experiment...

@Moggely - forgive the lengthy reply! This is my personal opinion so I shall type it in purple. We are taught in our initial insulin use training and then later when we do a carb counting course like DAFNE (dose adjustment for normal eating) that we can eat what we want and dose for it. Personally (and I must stress that this is my PERSONAL OPINION that I try not to bang on about unless asked, but you asked so.... ;) ) I think it’s the biggest disservice they have done to T1s. While T1 is fundamentally different to T2 in that our metabolisms are very different - we basically have a “normal” metabolism but with major organ failure, our methods of trying to mimic the functions of a pancreas are very clumsy. A healthy pancreas starts shooting out insulin the moment food goes in the mouth pretty much, in order to be there for when the glucose hits the bloodstream, this takes a matter of minutes. There’s then a second phase a little later, to deal with the slower breakdown of the rest of the food. It then stops as soon as it’s not needed, it’s a very sensitive organ. Injecting an artificial insulin one or a half unit at a time and getting a snapshot of what the levels are with a blood test is like trying to mend a watch with a sledgehammer. Newer tools such as the Libre sensor and an insulin pump make it more like mending a watch with a domestic hammer. Still clumsy but it’s the best we have now, and fortunately technology is always improving, but being able to truly replicate the clever human pancreas is still a long way off. The insulin we inject hangs around for a very long time, up to 5 hours, so we need to bear that in mind as well.

Now, we have many people here, especially on this particular thread, who are successfully able to manage their carb intake and balance it with the correct amount of insulin taken at exactly the right time. Most of the fast acting insulins kick in somewhere between 20 and 60 minutes, so folk take it a little while before they eat (depending on their own personal timings), and calculate or guesstimate the amount of carbs in their food. As you’ll see from reading this thread, sometimes it works and sometimes it doesn’t. Brains might be able to do the numbers but bodies don’t always pay attention. What works one day might not work the next - our insulin response is affected by so many things: hormones, weather, if the day has a y in it, colour of underwear... I’m in quite a few T1 groups on Facebook, and there are many people swinging wildly from high to low, and in despair because it makes them feel so unwell. They just can’t balance their carbs and insulin, despite having all the tools to do it, supposedly - I’ve been there myself and it’s miserable. It doesn’t seem to have a consistent onset time for me, so pre-injecting has proved to be a dangerous game, with hypos before the food has had a chance to hit my bloodstream. I don’t do exercise, so can’t really comment on that, but if I’m having a busy day, my levels tend to run lower.

I was diagnosed twenty years ago, and was always told to eat what I want and inject for it. So I dutifully did as I was told, followed an NHS approved low fat, high carb diet, as far as I was able. To inject one unit of insulin for 10g carbs (but not to count veg, unless it was roots) at the time of eating, and only to correct at mealtimes. So I did all that and felt ill the whole time, taking massive doses of insulin to go with my plates of pasta, rice, etc. I’d be either high or low, and had some epic and frightening hypos, especially at night. HbA1c was usually in the double figures under the old system (over 100 in the new one), and my BG levels would regularly be in the 20s. So for me, following the official guidelines doesn’t work. After a very frightening hypo after I misread the raw and cooked carb values on a packet of spaghetti and needed paramedics to help me, I decided that I needed to try something different. I could see here how much low carb was helping T2s, and a few T1s were doing it too with great results. I started doing keto (<30g carbs a day) in January and dropped my HbA1c from 94 to 43 in five months. My sugar levels are great, I almost never hit double figures and hypos are rare unless I’ve been drinking. I’m having a few more now as I’m getting used to my new insulin pump and getting the settings right. But usually my glucose levels run in the 4s and 5s - I’m aiming for non diabetic levels. I mostly follow the Bernstein book, but not religiously. I really like his “small numbers” idea - fewer carbs means smaller doses of insulin and therefore less chance of a hypo. That works really well for me. I have a Libre sensor with a transmitter so I’m aware of my levels at all times, and an Omnipod pump, so I can fine tune doses down to 1/20 of a unit. However, I do need to dose for certain protein as well, usually at half the ratio I would for carbs, and over an extended period.

So while this is my personal opinion, and very much counter to the official guidelines, at all of my appointments at the hospital Diabetes clinic with a consultant, and dietician, they’ve told me (very much off the record) that they totally agree with this approach but have to push the NHS eatwell guide. My diabetes consultant says he’s rather I stayed out of ketosis because he has to tell me that, while literally shoving a prescription for loads of blood ketone strips under the desk so I can monitor them :D The dietician says my diet is very healthy, I print out a full food diary each month for my file and take it to my appointments - I use the MyFitnessPal app to calculate my carbs and protein for accurate dosing, and it provides full printable reports. Even the pump training lady (she’s a former DSN) looked knowingly at her colleague when I had some follow up Omnipod training last week and said “I told you this was the way to go for everyone, not just type two” when I explained how I was getting such good results. They all agree unofficially that they are doing all diabetics, including T1s a major disservice by telling them to eat so many carbs. Whether through insulin resistance or organ failure, we can’t process them without medical intervention, and that intervention isn’t nearly good enough to do the job. But it’s the government line, so they have to promote it.

Tl;dr - carbs and lots of insulin work for some T1s, but it doesn’t work for me :rolleyes:
 
Last edited:
Mel dCP said:
Morning all, had a lovely meal last night of roasted veg (cauliflower, broccoli, green pepper and a little beetroot) with a whole sea bream roasted in lemon and goat butter - didn’t get the dosing right. Not sure if I underestimated the carbs, or the white fish protein or what. I’d estimated at 14g carbs, so took 1.35u for those as I was at 4.8; and an extra 1.65u over two hours for the 35g protein in the fish. Shot up to 8.6 in an hour and a half, and had to chuck in an extra 1.15u to bring it down - took five hours to get back into range. I didn’t prebolus for the veg, perhaps I should have? I don’t normally as I don’t eat fast carbs, but I don’t usually eat lots of beetroot either. So I think that caught me out! I’m boring myself here so shall shut up. Prawns for lunch, I do like being an ongoing science experiment...

@Moggely - forgive the lengthy reply! This is my personal opinion so I shall type it in purple. We are taught in our initial insulin use training and then later when we do a carb counting course like DAFNE (dose adjustment for normal eating) that we can eat what we want and dose for it. Personally (and I must stress that this is my PERSONAL OPINION that I try not to bang on about unless asked, but you asked so.... ;) ) I think it’s the biggest disservice they have done to T1s. While T1 is fundamentally different to T2 in that our metabolisms are very different - we basically have a “normal” metabolism but with major organ failure, our methods of trying to mimic the functions of a pancreas are very clumsy. A healthy pancreas starts shooting out insulin the moment food goes in the mouth pretty much, in order to be there for when the glucose hits the bloodstream, this takes a matter of minutes. There’s then a second phase a little later, to deal with the slower breakdown of the rest of the food. It then stops as soon as it’s not needed, it’s a very sensitive organ. Injecting an artificial insulin one or a half unit at a time and getting a snapshot of what the levels are with a blood test is like trying to mend a watch with a sledgehammer. Newer tools such as the Libre sensor and an insulin pump make it more like mending a watch with a domestic hammer. Still clumsy but it’s the best we have now, and fortunately technology is always improving, but being able to truly replicate the clever human pancreas is still a long way off. The insulin we inject hangs around for a very long time, up to 5 hours, so we need to bear that in mind as well.

Now, we have many people here, especially on this particular thread, who are successfully able to manage their carb intake and balance it with the correct amount of insulin taken at exactly the right time. Most of the fast acting insulins kick in somewhere between 20 and 60 minutes, so folk take it a little while before they eat (depending on their own personal timings), and calculate or guesstimate the amount of carbs in their food. As you’ll see from reading this thread, sometimes it works and sometimes it doesn’t. Brains might be able to do the numbers but bodies don’t always pay attention. What works one day might not work the next - our insulin response is affected by so many things: hormones, weather, if the day has a y in it, colour of underwear... I’m in quite a few T1 groups on Facebook, and there are many people swinging wildly from high to low, and in despair because it makes them feel so unwell. They just can’t balance their carbs and insulin, despite having all the tools to do it, supposedly - I’ve been there myself and it’s miserable. It doesn’t seem to have a consistent onset time for me, so pre-injecting has proved to be a dangerous game, with hypos before the food has had a chance to hit my bloodstream. I don’t do exercise, so can’t really comment on that, but if I’m having a busy day, my levels tend to run lower.

I was diagnosed twenty years ago, and was always told to eat what I want and inject for it. So I dutifully did as I was told, followed an NHS approved low fat, high carb diet, as far as I was able. To inject one unit of insulin for 10g carbs (but not to count veg, unless it was roots) at the time of eating, and only to correct at mealtimes. So I did all that and felt ill the whole time, taking massive doses of insulin to go with my plates of pasta, rice, etc. I’d be either high or low, and had some epic and frightening hypos, especially at night. HbA1c was usually in the double figures under the old system (over 100 in the new one), and my BG levels would regularly be in the 20s. So for me, following the official guidelines doesn’t work. After a very frightening hypo after I misread the raw and cooked carb values on a packet of spaghetti and needed paramedics to help me, I decided that I needed to try something different. I could see here how much low carb was helping T2s, and a few T1s were doing it too with great results. I started doing keto (<30g carbs a day) in January and dropped my HbA1c from 94 to 43 in five months. My sugar levels are great, I almost never hit double figures and hypos are rare unless I’ve been drinking. I’m having a few more now as I’m getting used to my new insulin pump and getting the settings right. But usually my glucose levels run in the 4s and 5s - I’m aiming for non diabetic levels. I mostly follow the Bernstein book, but not religiously. I really like his “small numbers” idea - fewer carbs means smaller doses of insulin and therefore less chance of a hypo. That works really well for me. I have a Libre sensor with a transmitter so I’m aware of my levels at all times, and an Omnipod pump, so I can fine tune doses down to 1/20 of a unit. However, I do need to dose for certain protein as well, usually at half the ratio I would for carbs, and over an extended period.

So while this is my personal opinion, and very much counter to the official guidelines, at all of my appointments at the hospital Diabetes clinic with a consultant, and dietician, they’ve told me (very much off the record) that they totally agree with this approach but have to push the NHS eatwell guide. My diabetes consultant says he’s rather I stayed out of ketosis because he has to tell me that, while literally shoving a prescription for loads of blood ketone strips under the desk so I can monitor them :D The dietician says my diet is very healthy, I print out a full food diary each month for my file and take it to my appointments - I use the MyFitnessPal app to calculate my carbs and protein for accurate dosing, and it provides full printable reports. Even the pump training lady (she’s a former DSN) looked knowingly at her colleague when I had some follow up Omnipod training last week and said “I told you this was the way to go for everyone, not just type two” when I explained how I was getting such good results. They all agree unofficially that they are doing all diabetics, including T1s a major disservice by telling them to eat so many carbs. Whether through insulin resistance or organ failure, we can’t process them without medical intervention, and that intervention isn’t nearly good enough to do the job. But it’s the government line, so they have to promote it.

Tl;dr - carbs and lots of insulin work for some T1s, but it doesn’t work for me :rolleyes:
Click to expand...

That is brilliant @Mel dCP.
Love the explanation "Like trying to mend a watch with a sledgehammer" is absolute class.....and something I am going to remember :)
 
helensaramay said:
Is Cumberland the same as Cumbria?
If so, I suspect they are trying to dumb down a bit with their naming.
If not, I'll go back to my rock
Click to expand...

According to wikipedia, Cumbria was created in 1974, though it's larger than Cumberland, we will have to assume that seeing as @Cumberland chose that as his name, he has a purist instinct.
 
porl69 said:
That is brilliant @Mel dCP.
Love the explanation "Like trying to mend a watch with a sledgehammer" is absolute class.....and something I am going to remember :)
Click to expand...
I’m married to an old school biker. His toolkit comes in two pound increments. As a silversmith I have tiny 1oz hammers. We like hammers. I guess dextrose tabs are the diabetic equivalent of gaffer tape...
 
Mel dCP said:
I’m married to an old school biker. His toolkit comes in two pound increments. As a silversmith I have tiny 1oz hammers. We like hammers. I guess dextrose tabs are the diabetic equivalent of gaffer tape...
Click to expand...
A big up to the hammer selection :p mine ranges down from a large sledge to the finest pin hammer, with dead blow mallets and copper ones in there too :)

If you can't fix it with a hammer it's an electrical fault....
 
kev-w said:
A big up to the hammer selection :p mine ranges down from a large sledge to the finest pin hammer, with dead blow mallets and copper ones in there too :)

If you can't fix it with a hammer it's an electrical fault....
Click to expand...
My late brother in law had a theory that electricity was in fact smoke. Because when it escapes it usually does so in clouds of the stuff...
 
Alison54321 said:
According to wikipedia, Cumbria was created in 1974, though it's larger than Cumberland, we will have to assume that seeing as @Cumberland chose that as his name, he has a purist instinct.
Click to expand...

Cumbria was formed in 1974 by merging all of Cumberland all of Westmorland and a small part of Lancashire and Yorkshire

Cumberland covered the northern and western area of the newly formed county and the northern and western part of the Lake District

My birth certificate states I was born in Cumberland and I am Cumbrian

Cumberland was fought over by the English and Scots although at one point it was a kingdom in its own right
 
Knikki said:
The answer to that is really a yes no one.

It is like a lot of things, yes we can eat most things but all things in moderation.

Insulin will cover, but you have to calculate for it and even then we can get it wrong espically if eating fatty slow digesting foods like curry, Chinese, pasta etc.

I think, some T1D gain weight before they are diagnosed because of the excess amount of sugar floating so the body will metabilise the stuff and store it as fat (I think thats how it works) but generally start to lose it once there on insulin and regain control of their BSL and also alter their diet.

And just to throw a spanner in the works, and no doubt upset some, I do eat anything. I survived the 70, 80 and 90's boil in the bag fish, £1 cottage pie etc. Now a days I do, with the help of Mrs K, watch what I eat simply because as I get older my metabolism is changing and my appetite is not as it was some 30+ years ago :)

On a side note I had a sausage casorole last night with couscous and green veg type things worked out the carbs and inject 2 units :eek: That has to be the least amount of insulin I have EVER injected for an evening meal and stayed in the 6s all night woke with a 7.3.
Click to expand...

Hi Knikki, would the couscous not be a lot of carbs, maybe 30/40 g. Oh and I do love a good sausage casserole.
Well done with the BG after the meal
 
Mel dCP said:
Morning all, had a lovely meal last night of roasted veg (cauliflower, broccoli, green pepper and a little beetroot) with a whole sea bream roasted in lemon and goat butter - didn’t get the dosing right. Not sure if I underestimated the carbs, or the white fish protein or what. I’d estimated at 14g carbs, so took 1.35u for those as I was at 4.8; and an extra 1.65u over two hours for the 35g protein in the fish. Shot up to 8.6 in an hour and a half, and had to chuck in an extra 1.15u to bring it down - took five hours to get back into range. I didn’t prebolus for the veg, perhaps I should have? I don’t normally as I don’t eat fast carbs, but I don’t usually eat lots of beetroot either. So I think that caught me out! I’m boring myself here so shall shut up. Prawns for lunch, I do like being an ongoing science experiment...

@Moggely - forgive the lengthy reply! This is my personal opinion so I shall type it in purple. We are taught in our initial insulin use training and then later when we do a carb counting course like DAFNE (dose adjustment for normal eating) that we can eat what we want and dose for it. Personally (and I must stress that this is my PERSONAL OPINION that I try not to bang on about unless asked, but you asked so.... ;) ) I think it’s the biggest disservice they have done to T1s. While T1 is fundamentally different to T2 in that our metabolisms are very different - we basically have a “normal” metabolism but with major organ failure, our methods of trying to mimic the functions of a pancreas are very clumsy. A healthy pancreas starts shooting out insulin the moment food goes in the mouth pretty much, in order to be there for when the glucose hits the bloodstream, this takes a matter of minutes. There’s then a second phase a little later, to deal with the slower breakdown of the rest of the food. It then stops as soon as it’s not needed, it’s a very sensitive organ. Injecting an artificial insulin one or a half unit at a time and getting a snapshot of what the levels are with a blood test is like trying to mend a watch with a sledgehammer. Newer tools such as the Libre sensor and an insulin pump make it more like mending a watch with a domestic hammer. Still clumsy but it’s the best we have now, and fortunately technology is always improving, but being able to truly replicate the clever human pancreas is still a long way off. The insulin we inject hangs around for a very long time, up to 5 hours, so we need to bear that in mind as well.

Now, we have many people here, especially on this particular thread, who are successfully able to manage their carb intake and balance it with the correct amount of insulin taken at exactly the right time. Most of the fast acting insulins kick in somewhere between 20 and 60 minutes, so folk take it a little while before they eat (depending on their own personal timings), and calculate or guesstimate the amount of carbs in their food. As you’ll see from reading this thread, sometimes it works and sometimes it doesn’t. Brains might be able to do the numbers but bodies don’t always pay attention. What works one day might not work the next - our insulin response is affected by so many things: hormones, weather, if the day has a y in it, colour of underwear... I’m in quite a few T1 groups on Facebook, and there are many people swinging wildly from high to low, and in despair because it makes them feel so unwell. They just can’t balance their carbs and insulin, despite having all the tools to do it, supposedly - I’ve been there myself and it’s miserable. It doesn’t seem to have a consistent onset time for me, so pre-injecting has proved to be a dangerous game, with hypos before the food has had a chance to hit my bloodstream. I don’t do exercise, so can’t really comment on that, but if I’m having a busy day, my levels tend to run lower.

I was diagnosed twenty years ago, and was always told to eat what I want and inject for it. So I dutifully did as I was told, followed an NHS approved low fat, high carb diet, as far as I was able. To inject one unit of insulin for 10g carbs (but not to count veg, unless it was roots) at the time of eating, and only to correct at mealtimes. So I did all that and felt ill the whole time, taking massive doses of insulin to go with my plates of pasta, rice, etc. I’d be either high or low, and had some epic and frightening hypos, especially at night. HbA1c was usually in the double figures under the old system (over 100 in the new one), and my BG levels would regularly be in the 20s. So for me, following the official guidelines doesn’t work. After a very frightening hypo after I misread the raw and cooked carb values on a packet of spaghetti and needed paramedics to help me, I decided that I needed to try something different. I could see here how much low carb was helping T2s, and a few T1s were doing it too with great results. I started doing keto (<30g carbs a day) in January and dropped my HbA1c from 94 to 43 in five months. My sugar levels are great, I almost never hit double figures and hypos are rare unless I’ve been drinking. I’m having a few more now as I’m getting used to my new insulin pump and getting the settings right. But usually my glucose levels run in the 4s and 5s - I’m aiming for non diabetic levels. I mostly follow the Bernstein book, but not religiously. I really like his “small numbers” idea - fewer carbs means smaller doses of insulin and therefore less chance of a hypo. That works really well for me. I have a Libre sensor with a transmitter so I’m aware of my levels at all times, and an Omnipod pump, so I can fine tune doses down to 1/20 of a unit. However, I do need to dose for certain protein as well, usually at half the ratio I would for carbs, and over an extended period.

So while this is my personal opinion, and very much counter to the official guidelines, at all of my appointments at the hospital Diabetes clinic with a consultant, and dietician, they’ve told me (very much off the record) that they totally agree with this approach but have to push the NHS eatwell guide. My diabetes consultant says he’s rather I stayed out of ketosis because he has to tell me that, while literally shoving a prescription for loads of blood ketone strips under the desk so I can monitor them :D The dietician says my diet is very healthy, I print out a full food diary each month for my file and take it to my appointments - I use the MyFitnessPal app to calculate my carbs and protein for accurate dosing, and it provides full printable reports. Even the pump training lady (she’s a former DSN) looked knowingly at her colleague when I had some follow up Omnipod training last week and said “I told you this was the way to go for everyone, not just type two” when I explained how I was getting such good results. They all agree unofficially that they are doing all diabetics, including T1s a major disservice by telling them to eat so many carbs. Whether through insulin resistance or organ failure, we can’t process them without medical intervention, and that intervention isn’t nearly good enough to do the job. But it’s the government line, so they have to promote it.

Tl;dr - carbs and lots of insulin work for some T1s, but it doesn’t work for me :rolleyes:
Click to expand...


Excellent post Mel
 
My days running late, sat at 9.4 but on my way to the pool so that's cool :p chicken something curry & brown basmati rice for tea, dunno what the something is yet but I've a choice, maybe Yorkshire Indian or Yorkshire Thai, or a lower carb 4g/100g South American sauce....
 
smc4761 said:
Hi Knikki, would the couscous not be a lot of carbs, maybe 30/40 g. Oh and I do love a good sausage casserole.
Well done with the BG after the meal
Click to expand...

I think for a full packet once cooked yes, but it was split between me and Mrs K so not many in the end plus the casserole had naff all in it :)

As for tea, its spag boll (need to use the mince up) hopefully with smelly garlic bread :hilarious:
 
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