woke up to see 1.5 mmol/L when i took my 1st test reading of the day?

[budapest7]

I was diagnosed 3 weeks ago while in hospital with D2 so still a newbie, finding the whole thing with being diabetic daunting with my levels all over the place and trying to get some sort of normality back in my life. I'm a 58 year old retired British ex-pat living in rural area of Hungary. I was taking insulin amounts of 8am 12 units (R) Rapid Humelin, 12am 8 units(R), 5pm 8 units (R), 9pm 12 units (N) slow insulin. Yesterday visited local diabetic dr at town health centre first time, was very unhappy with the visit as i only got 10 minutes while the nurse connected my blood glucose monitor (Mery Pille) to some device in his office after measuring my blood glucose which was 12, wrote a paper so my GP could write prescriptions for 1 year, he answered very briefly 3 questions i could squeeze out, told me there were lots of patients and should come back in February. my week in hospital was great with very good care by the doctors and nurses, 7 types of examinations, a visit to the Emergency Diabetologia Dept were 2 lady doctors gave an extra 2 insulin pens, a whole wad of info and brochures on Diabetes 2, they walked me through the basics and I'm not fluent in Hungarian but grasped the most. My ward dr spoke English in the Internal Medicine Dept, so felt I was in very good hands after my GP called an ambulance the week before when i was at his surgery to give him the lab test results i made the day before. My blood glucose was 29. First 4 days in hospital it was 14 to 17, then guess they adjusted the meds, 11 to 13, then 6.5 to 9.3.
It's really difficult trying to get my head so many fluid factors into getting stable levels. The hospital dr wrote down a diet plan next to amounts and times of insulin injections, 180 grams total of carbohydrates per day, eating 6 times a day. I saw that's the weight of a large tube of toothpaste. A slice of brown bread is 50 grams, so wish there was just a few simple meals to find on the web showing me an example with figures what i can eat and how long that food takes to digest releasing glucose? This morning my monitor showed 1.5 mmol, so i took 2 sugar dextrose sweets to bump up my level. What would have happened if I hadn't woken up having 1.5, i mean how long does it take to fall into a coma? What are the dangerous numbers that i need seek immediate medical care, ie call an ambulance? I live alone, so this worries me. Grateful of any advice and tips.

 

[azure]

@budapest7 Hi If you've been given a prescribed diet with corresponding doses of insulin, it's important to stick to it to avoid hypos like that.

I can guess what your mistake may have been. It is NOT the total weight of the bread you need to look at - it's the amount of carbs. Unless you were eating a giant slice of brown bread!

Have you been shown how to count carbs?

Edited to add an example in case I didn't explain that well:

http://www.tesco.com/groceries/product/details/?id=255000362

The slice weighs 40g but only 15.1g of that is carbs (scroll down to nutritional info). So that slice would be counted as 15g carbs towards your daily amount not 40g.

 

[Brunneria]

Hi, yes, I think azure has hit the nail on the head.

You need to look at the packaging on the food. I don't know what the Hungarian packaging conventions are, but here in the UK, we get a table showing the nutritional content of the food.

Like this:

http://www.tesco.com/groceries/product/details/?id=255000362 (this is an entry for a Tescos brown bread loaf, on Tescos website)

It lists all the nutritional content:

The number you want is the amount of carbs in each slice (15.1g) so if you have a sandwich with 2 slices of bread, the carbs will be 30.2g

Hope that makes sense!

And well done for treating your hypo so promptly with the glucose tabs. That was exactly the right thing to do. Remember to carry them with you all the time, and hopefully once you get the carb counting sorted, you won't need them often.

One of your questions was 'what are dangerous numbers?'
And the answer is that you should treat anything under 4mmol/l with glucose tabs, whether you are feeling grotty or not, and you should aim to stay above 4 at all times.

 

[budapest7]

Thx for your reply. Do you have any links with ready calculated meals giving the amounts for diabetics? Also the digestion time for different types of food? Some sample readings of people similar to my age and weight, maybe a diary so i can compare? It's frustrating so much of the info is from the US when they use completely different measuring system, i'm used to the metric system and mmol/L.
What levels of blood glucose are dangerous? Anyway thx

@budapest7 Hi If you've been given a prescribed diet with corresponding doses of insulin, it's important to stick to it to avoid hypos like that.

I can guess what your mistake may have been. It is NOT the total weight of the bread you need to look at - it's the amount of carbs. Unless you were eating a giant slice of brown bread!

Have you been shown how to count carbs?

Edited to add an example in case I didn't explain that well:

http://www.tesco.com/groceries/product/details/?id=255000362

The slice weighs 40g but only 15.1g of that is carbs (scroll down to nutritional info). So that slice would be counted as 15g carbs towards your daily amount not 40g.

 

[budapest7]

Thx for your reply. I used to eat very little processed supermarket food, but now guess unless can count the correct amount. Cooking has been my passion for nearly 40 years, mostly slow food and produce from my garden or local, so have put cooking anything special on hold
Hungary quite similar to Western European, have the usual Lidl's, Tesco, Aldi etc, but try to buy as little as possible in supermarkets. For example, a slice of ham weighing 20 grams, how does protein effect blood sugar, and how long does digestion take? i made a salad yesterday with 10 different ingredients, how does that effect my levels? What food can fill you up with least impact?

Hi, yes, I think azure has hit the nail on the head.

You need to look at the packaging on the food. I don't know what the Hungarian packaging conventions are, but here in the UK, we get a table showing the nutritional content of the food.

Like this:

http://www.tesco.com/groceries/product/details/?id=255000362 (this is an entry for a Tescos brown bread loaf, on Tescos website)

It lists all the nutritional content:

View attachment 20780

The number you want is the amount of carbs in each slice (15.1g) so if you have a sandwich with 2 slices of bread, the carbs will be 30.2g

Hope that makes sense!

And well done for treating your hypo so promptly with the glucose tabs. That was exactly the right thing to do. Remember to carry them with you all the time, and hopefully once you get the carb counting sorted, you won't need them often.

One of your questions was 'what are dangerous numbers?'
And the answer is that you should treat anything under 4mmol/l with glucose tabs, whether you are feeling grotty or not, and you should aim to stay above 4 at all times.

 

[azure]

@budapest7 You need to count the carbs in your meal separately as meals will vary. There are some apps that will help, and also you can buy a book like Carbs and Cals that will help.

You don't need to stop cooking. I work out the carbs for my favourite recipes and then I have that written down for future reference.

Say your allocated carbs for a meal was 50g, you could fulfil this in a number of ways. For example, a 6oz raw weight potato is 30g carbs. That then leaves you with 20g carbs to fulfil. You could have an apple (15g carbs) plus half a digestive biscuit (5g carbs) or you could have two digestives plus cheese (20g carbs) etc etc.

You need to get familiar with the carbs of your favourite foods, and then you'll find it a lot easier.

Yes, it's a nuisance counting, but what I did when I was first diagnosed was keep a notebook of meals that worked for me, and that made it a lot easier.

I wouldn't worry about protein at this stage. It does have a small effect on blood sugar, but if you're eating carbs with it just ignore the protein for now. Same with veg, unless it's carby veg like potatoes or parsnips.

In a meal like potato, roast meat, carrots, cabbage, all I count is the carbs in the potatoes.

 

[Brunneria]

Thx for your reply. I used to eat very little processed supermarket food, but now guess unless can count the correct amount. Cooking has been my passion for nearly 40 years, mostly slow food and produce from my garden or local, so have put cooking anything special on hold
Hungary quite similar to Western European, have the usual Lidl's, Tesco, Aldi etc, but try to buy as little as possible in supermarkets. For example, a slice of ham weighing 20 grams, how does protein effect blood sugar, and how long does digestion take? i made a salad yesterday with 10 different ingredients, how does that effect my levels? What food can fill you up with least impact?

There are lots of foods that are basically nil-carb-impact. As azure says, most veg (unless starchy root veg) is effectively 'free'. So you can fill up on delicious salads and slow cooked stews stuffed full of courgettes, peppers, aubergines and suchlike.

And cauliflower and broccoli are my saviours.
If you have used up your carb quota on stuff like bread or a dessert, then a nice pile of mashed cauliflower with butter and/or cheese grated into it, will be a very low carb but satisfying alternative for potato.
Likewise with broccoli. Admittedly, mashed broccoli looks a little odd, but it tastes nice, and is an alternative to carbs. Delicious with blue cheese stirred in.

Don't worry about cooking and the carb content of non-processed foods. You will soon get back into the swing of things, and you can probably do one calc per favourite recipe, and then know how many g carbs there are in a portion. That notebook will come in very useful. Just look up stuff once, online (even unprocessed foods are listed by Tescos), and if it is something you eat regularly, note it in your book. You will very quickly get the hang of it.

Of the 3 major food groups (carbs, protein and fat) you only need to worry about carbs. So protein and fat can be used to fill you up. They also digest more slowly than carbs, so they will keep you fuller for longer, too.

 

[budapest7]

Thx, that's the best news all day it's been raining cats and dogs outside. Do all people with D2 have to inject themselves with insulin?
So i can gorge myself on salads and some meat. I have been using stevia now for 3 years, is that ok?
After I had a major stroke 16 years ago, i have been pre diabetic, so annoyed with myself for now being full diabetic. what is the norm in the UK for newly diagnosed Diabetics, i'm sure it must be better than just getting a 10 minute appointment and told to come back in 3 months? Mind you this is a small town and probably way better in Budapest.

 

[Brunneria]

If untreated, most T2 diabetics will progress from pre-D to T2 on tablets, then eventually move on to insulin. Usually takes a few years, but they get there in time. You have kind of jumped a stage. But T2 develops at different rates, depending on genetics, diet, lifestyle and environment, so believe me, you are not unusual.

Actually, most of the T2s who arrive on the forum are also confused, without enough information or support. The NHS has a culture of blaming T2s for eating too much and not looking after themselves. Please don't fall into that trap yourself! There are many reasons why people get T2, and it isn't necessarily those reasons.

I think that the insulin users usually get a bit more advice than you have had, but not always! and of course it will have been in English.

Stevia is fine. I use it myself. Also xylitol and erythritol. There are a lot of artificial sweeteners out there, but those three are the least synthetically chemical (to my taste buds). Do you have a dog? If so, I would advise against xylitol, since it is poisonous to dogs.

If you have a rummage around the forum, you will read a lot of comments (mainly by T2s) about carbs, carb counting, low carbing, and something called LCHF.

You may find them interesting, but please don't feel that they are pressurizing you to cut your carbs down further than the 180g carbs that your doc has advised. The difference is that you have been told to take specific amounts of insulin to cope with specific amounts of carbs. If you drop the carbs (like you did with the bread) you will get hypos.

All the T2s who chunter endlessly about low carb, and LCHF (I am one of them) are doing so because we are controlling our T2 with diet, or tablets, not with fixed doses of insulin, so we get to play with our carb quantities. - I just didn't want you to be confused it someone tells you that they eat less carbs, and suggest that you are eating too many. You aren't. You are eating the correct amount for YOUR diabetes, treated by YOUR amount of insulin.

Hope that makes sense.

 

[azure]

Thanks, Bruneria. That's why I've moved @budapest7 's post to the Type 2 on Insulin section so he can get appropriate advice from other insulin users

 

[budapest7]

Thx @Brunneria, your advice does make perfect sense. I have a Pekines dog called Peeky and ONLY use stevia. One of my best friends in Stockholm, Sweden was on this LCHF diet, she was doing it as a diet, and raved on about it, so I was interested, but that was in 2013 and I should have tried it out. I have been on a special diet over a decade since Y2K, but sometimes fell off the waggon. During the summer, i might have pushed my limits, eating 2 or 3 ice creams sometimes on hot nights. The week I got sick when i banged my ankle on my iron gate, scrapped off a lot of skin, the leg got very swollen, the wound might have got infected, i was hospitalised 5 years ago with pancreatis, then while laying in my bed with my leg raised with a wet towel around, binged a packet of mini Snickers, guzzled litres of flavoured mineral waters,so with my immune system down, that might have been a contributing factor?

 

[shivles]

Just wanted to add I saw you asked about the numbers and what is dangerous but haven't seen an answer from anyone, you're aiming for between 4mmol and 8.5mmol, 1.5mmol is very low

 

[Mep]

welcome @budapest7 it sounds like you've had a rough time getting things sorted with your sugars.

Considering you're on insulin and you're learning about carbs.... this online free course is very good (link below). I just did it not long ago myself. It has plenty of good tips and helps you work out how many carbs are in your foods as well. It says it's for type 1, but honestly it would apply to anyone on insulin therapy and would help you in some way I'm sure. As you can see by my signature, I'm insulin dependant T2 myself. I have insulin deficiency which developed over time as I was diagnosed back in 1998. I wish you the best.

http://www.bertieonline.org.uk/admLogin.asp

 

[budapest7]

Just wanted to add I saw you asked about the numbers and what is dangerous but haven't seen an answer from anyone, you're aiming for between 4mmol and 8.5mmol, 1.5mmol is very low

Thx

 

[budapest7]

welcome @budapest7 it sounds like you've had a rough time getting things sorted with your sugars.

Considering you're on insulin and you're learning about carbs.... this online free course is very good (link below). I just did it not long ago myself. It has plenty of good tips and helps you work out how many carbs are in your foods as well. It says it's for type 1, but honestly it would apply to anyone on insulin therapy and would help you in some way I'm sure. As you can see by my signature, I'm insulin dependant T2 myself. I have insulin deficiency which developed over time as I was diagnosed back in 1998. I wish you the best.

http://www.bertieonline.org.uk/admLogin.asp

Thx for your reply, i am following the LCHF diet, Diet Doctor...well the basics..gone from 120 to 116 kgs in last 16 days, seems to change by around 1.5 kilos depending on time of day.

still trying to figure out using this app