Struggling, few questions !

[Grumpy Porridge]

Hi,

I’m struggling with this ( been diagnosed nearly 5 months ago now.

I honestly don’t know if I’m type 2 , 1 or LADA ( I know LADA is treated the same way as type 1, but they do differ slightly ( and have read certain lifestyle factors ( being sedentary and overweight etc ) can raise the risk .

It seems as though even if I do dose for snacks ( yummy chocolate etc ) it always ends up being raised for several hours later ! How come some people say with type 1 , you can eat whatever you want as long as you dose for it .

I am now on the freestyle libre 2. I have been doing lots of walking recently ( 11 mile walks , ( in 2-3 walks a day )
Yesterday for example I dosed for dinner . 3 quorn sausages, mash potato plus green beans . ( I had noticed my blood was not coming down as I thought it would after exercise) it was about 7. Afterwards , it looked like it spiked to past 11. Earlier in the day , I ate two wrap things ( about 20+ g of carbs in one , I put two units in as I had just been walking ( yet looks like despite the exercise it still needed the full dose ?

and it’s horrible how it goes very steadily down, yesterday around 11 it was about 7 ish . Yet hour or two after , it was then 6....5 .. so heading into what looks like a hypo . So rather than wait for the official hypo to start, i had a slice of bread with apricot jam . ( and also two raspberry cream shortbread sandwich biscuits ( I thought if I was heading towards a hypo I could manage them
But it raised to 11!

help .

 

[Grumpy Porridge]

( the third screenshot is last night )

 

[Juicyj]

Hello @Grumpy Porridge

Unfortunately what works for others may not necessarily work for you, I struggle with carbs, regardless of taking the 'right' amount of insulin, particularly in the morning and can easily spike then after eating and dosing for them. So I avoid carbs in the morning as more insulin resistant then, so will eat eggs/yoghurt/bacon.

I also struggle with mash, it's the fastest glucose rise for me of all potato products, I would even call it a hypo treatment, whereas roast potatoes are a slower rise due to the fat content. Adding fat to meals can slow the rise/spike, but ultimately getting the right dose of insulin is the art, as long as your back in range again 4-5 hours later you will know then if your carb/insulin ratio is right for you.

As you're newly diagnosed your body will still be adjusting and it takes time to get the balance right, it can and will change even then though depending on stress levels, activity, time of year, etc etc. It is wise to do some basal fasting tests from time to time to check your basal dose is right for you, getting your basal dose right is the basis and foundation for your control: https://www.mysugr.com/en/blog/basal-rate-testing/

 

[Juicyj]

Also to add you're only spiking to 12 mmol/l, this isn't a terrific rise, I regularly see my levels rise, as I said above as long as you're back in range before next meal time don't panic, avoiding these spikes means eating a lower carb diet, but if you don't want to restrict your diet then timing of your bolus may help, if I want to eat carbs I pre-bolus by up to 20 mins to help manage this.

 

[TashT1]

If your in your honeymoon period like me you will find that your basal & bolus ratios change from time to time. You just have to take stock & start the trial & error process again. It sounds like your doing a lot better in the last couple of months though. Maybe call your nurse & see if they recommend adjusting either of your doses.

Other than that I find mash unpredictable, it’s easy to under estimate the carbs unless you weigh it & I had a similar rise from wraps the other day, the rise was really prolonged & eventually I had to correct it.

As for the near hypo I think you over corrected a bit. A slice of toast would take me from 5 to 7+, throw in the jam & biscuits and I’d be at 11 too. If your treating at 5 you just need to nudge things up gently.

 

[ert]

Hi,

I’m struggling with this ( been diagnosed nearly 5 months ago now.

I honestly don’t know if I’m type 2 , 1 or LADA ( I know LADA is treated the same way as type 1, but they do differ slightly ( and have read certain lifestyle factors ( being sedentary and overweight etc ) can raise the risk .

It seems as though even if I do dose for snacks ( yummy chocolate etc ) it always ends up being raised for several hours later ! How come some people say with type 1 , you can eat whatever you want as long as you dose for it .

I am now on the freestyle libre 2. I have been doing lots of walking recently ( 11 mile walks , ( in 2-3 walks a day )
Yesterday for example I dosed for dinner . 3 quorn sausages, mash potato plus green beans . ( I had noticed my blood was not coming down as I thought it would after exercise) it was about 7. Afterwards , it looked like it spiked to past 11. Earlier in the day , I ate two wrap things ( about 20+ g of carbs in one , I put two units in as I had just been walking ( yet looks like despite the exercise it still needed the full dose ?

and it’s horrible how it goes very steadily down, yesterday around 11 it was about 7 ish . Yet hour or two after , it was then 6....5 .. so heading into what looks like a hypo . So rather than wait for the official hypo to start, i had a slice of bread with apricot jam . ( and also two raspberry cream shortbread sandwich biscuits ( I thought if I was heading towards a hypo I could manage them
But it raised to 11!

help .

Injected insulin is not like a normal person's inulin. It has a fixed curve and does not match the food you eat and take 5 hours to return to the pre-meal levels. You can eat normally, but you will have to ignore the spike.
As a consequence, I eat a low carb diet (less than 30 g a day).

 

[Jaylee]

Hi @Grumpy Porridge ,

I can agree with @Juicyj above regarding bolusing for certain food types.
We certainly have no control over random metabolic stuff that kicks in too.

Regarding warding off potential hypos. It's appreciated when the arrow points down or south east it can be cause for concern with a wary eye on BGs. & I agree that insulin could take us in any direction...
I tend to watch for a levelling out on my CGM set up before it hits hypo territory before I take action nudging it back in line with fast carbs.

To be fair, it's early days for you. It will get easier to read the sensor trends..

 

[Daibell]

Hi. First to clarify LADA is not the result of being overweight or having a sedentary lifestyle. It results from beta cell death. Can I ask whether you have some excess weight? It is often said that T1s can eat whatever they want which is something I strongly disagree with. Some T1s will have a high metabolism and can eat anything but for me and many others we are no different from a non-diabetic i.e. if you eat too many carbs you may gain weight. The insulin enables you to keep the blood sugar down by metabolising the carbs but doesn't stop the body storing them as fat.

 

[searley]

Hi. First to clarify LADA is not the result of being overweight or having a sedentary lifestyle. It results from beta cell death. Can I ask whether you have some excess weight? It is often said that T1s can eat whatever they want which is something I strongly disagree with. Some T1s will have a high metabolism and can eat anything but for me and many others we are no different from a non-diabetic i.e. if you eat too many carbs you may gain weight. The insulin enables you to keep the blood sugar down by metabolising the carbs but doesn't stop the body storing them as fat.

In the opening post here you state you don’t know your type.. so if type2 then chocolate etc would cause problems so working on getting a correct diagnosis will help

Also t1/LADA can also have insulin resistance like a type2

But spikes of upto 12 for short periods is not too bad I frequently get it

As for eat what you like… hmm.. yes&no

If you eat a bad diet and simply correct with insulin.. the insulin will force the body to uses all the carbs you eat.. what you don’t use for energy will be stored as fat… and you can gain weight very fast… which in turn can add insulin resistance etc

So either way an overall healthy lifestyle is needed… a reduction in the high carb foods to prevent weight gain.. the ‘sweet treats’ should be just that and not the norm…. So you go out for a meal and fancy a bit of everything and a pudding as a t1 you don’t need to be afraid of it…. But doing it every meal…