insulin crab ratio getting worse very fast

[Cliodb]

I was diagnosed as type 1 in June this year, took various amounts of insulin depending on my crab intake for the first few months, then in my Dr said i was on to high an amount of insulin and to take no more then 10units of novo rapid with meals. For about a month the 10 units would cover me for 40/50 grams of carbs and my Bloods were good, and then my Blood sugar started going high again after meals so i started reducing the amount of crabs unit i was on 25 grams of carbs with my 10 units of insulin and this was ok for a few weeks. now my blood sugars are once again going high after food, not all the time but im worried im going to have to reduce my carb content again. Im a very fussy eater and a veterinarian so im really struggling with the diet, and pretty much eat the exact same thing everyday and i know its not a healthy diet. The whole thing has got me really upset and worried what its going to be like later on. I have been trying to to do everything i can to help the situation, im losing weight , reduced my steroids and exerciser more but things just seem to be getting worse not better.

I am on 12 units of toujeo as well but have done basel testing so i dont think the problem is with that.

 

[Jacriley]

I am the same, I have been type 1 for only 18 months, thought I was doing ok but just lately my bsl are either sky high or I'm hypo. I'm sorry I don't know what the answer is, I think I am not reducing my insulin enough when excersising . One day I can have the same food and same insulin and be in target then the next day i eat the same and bsl is too high. Sorry I don't feel like I have been any help except to let you know you are not alone.

 

[Cliodb]

it is helpfull to know im not alone I do feel very jealous of those having "honeymoon periods" which i dont seem to have gotten. my whole experience makes no scene to me really, or may i had a over simplified view on what being type one would be like.

I dont really have to problem with going low, blood sugars haven't gone lower then 4.2 in ages , may because i do gentle exercises a few times a day rather then one strenuous work out. But i do find it the same that i can eat the same thing one day and get a blood sugar of say 5 and then next day get a reading of 9. And because of work my days are very much in a routine, i have meals at the same times and Weigh literally everything i eat so know i am definitely taking the same amounts of the same foods at the same time :/

 

[catapillar]

There's no such thing as too high an amount of insulin. Whatever insulin dose you need to keep you're blood sugar in range is the right amount of insulin. It is only too much insulin if it is sending you hypo. What sort of doctor told you to limit to 10 units per meal? That isn't what carb counting is. If you're on a 1:2.5 i:c ratio that's fine. It's perhaps a little suggestive of insulin resistance for a newly diagnosed type 1, but that's probably related to your steroid medication. There's no reason you should be limited to 10 units bolus, you should query this with your doctor, or ignore this advice.

 

[ickihun]

I was diagnosed as type 1 in June this year, took various amounts of insulin depending on my crab intake for the first few months, then in my Dr said i was on to high an amount of insulin and to take no more then 10units of novo rapid with meals. For about a month the 10 units would cover me for 40/50 grams of carbs and my Bloods were good, and then my Blood sugar started going high again after meals so i started reducing the amount of crabs unit i was on 25 grams of carbs with my 10 units of insulin and this was ok for a few weeks. now my blood sugars are once again going high after food, not all the time but im worried im going to have to reduce my carb content again. Im a very fussy eater and a veterinarian so im really struggling with the diet, and pretty much eat the exact same thing everyday and i know its not a healthy diet. The whole thing has got me really upset and worried what its going to be like later on. I have been trying to to do everything i can to help the situation, im losing weight , reduced my steroids and exerciser more but things just seem to be getting worse not better.

I am on 12 units of toujeo as well but have done basel testing so i dont think the problem is with that.

Sounds like you need insulin for your protein too.
I found the lower I went carb wise the more insulin I needed to cope with protein as my body reverted to burning protein but it takes longer to be converted so you may have a touch of insulin resistance? Due to insulin in your system awaiting to convert protein?

 

[Cliodb]

how do i count insulin for protein ? thank you

i dont think i eat lots of protein.
At the moment i have 500ml of mil for bf, 5 tux crackers with cream cheeses for lunch, 1 and 1/2 potatoes waffles with fish for dinner (i know this is not a healthy diet but its whats been keeping my blood sugars good)

 

[Cliodb]

There's no such thing as too high an amount of insulin. Whatever insulin dose you need to keep you're blood sugar in range is the right amount of insulin. It is only too much insulin if it is sending you hypo. What sort of doctor told you to limit to 10 units per meal? That isn't what carb counting is. If you're on a 1:2.5 i:c ratio that's fine. It's perhaps a little suggestive of insulin resistance for a newly diagnosed type 1, but that's probably related to your steroid medication. There's no reason you should be limited to 10 units bolus, you should query this with your doctor, or ignore this advice.

so if i wanted pasta for dinner (as like a treat) it would be ok to take a large dose of insulin for it ? i think pasta is like around 60 carbs so that would be 24 units of insulin. i guess what im worried about is if i take more insulin then my body might get used to the higher amounts and that they just keep going up.

 

[ickihun]

how do i count insulin for protein ? thank you

i dont think i eat lots of protein.
At the moment i have 500ml of mil for bf, 5 tux crackers with cream cheeses for lunch, 1 and 1/2 potatoes waffles with fish for dinner (i know this is not a healthy diet but its whats been keeping my blood sugars good)

For me it's been trial and error but remember the more insulin the higher risk of a hypo. Just increase slowly and small increases or decreases for insulin resistance.
For type1s your main objective is to cover your carbs and some have to cover their protein too, in absence of carbs.
Maybe you have your body trained to need insulin for protein currently. This needs changing back to just covering carbs and eating enough carbs for a type1. Getting rid of any insulin resistance.
Are you currently overweight due to steriods? Steriods can make insulin resistance worse.
However both can be managed til steriod need is no longer and insulin resistance can be dispersed.
Like @catapillar is saying. You can have carbs as long as covered by enough insulin. 10units may not be enough. You may need a food diary to log what insulin you need per carb product. Carb content by testing before your waffle dinner and 2hrs later. Use it as a marker. If bg too high at 2hrs. Then try a few more units of novarapid instead next time. Write it down for future reference. You can have pasta but you must not take huge dose regularly and guess your insulin need.
Test test test. Note note note. Use to your advantage. Don't take huge doses of insulin as routine is I guess your drs idea too! Keep your insulin as low as possible but prevent double figures. A one off is ok but not constant.

 

[Neoncat]

@catapillar is right, the correct dose of insulin is one that covers you for the food you have eaten. There is zero shame in needing more than 10 units for a meal (I am looking at you the dinner I just ate!), and it is wrong of your doctor to say that (where did he even get 10 units from?) . Everyone has a different insulin to carb ratio and it is more important to understand what that it is so you can enjoy a healthy varied diet and adjust the dose accordingly. Do you have a diabetic nurse helping you or is it just your GP?

 

[Neoncat]

Also try not to be too hard on yourself, sometimes diabetes does just do something strange. 17 years in and I still have those days but I am still here @ickihun suggestion of using your current meal as a marker is good one. Try something else and apply the same ratio
If you are worried about the pasta why not try a little bit at lunchtime so it is then easier to keep an eye on yourself for the afternoon? What ratio are you on? Have you been offered a carb counting course?

 

[becca59]

so if i wanted pasta for dinner (as like a treat) it would be ok to take a large dose of insulin for it ? i think pasta is like around 60 carbs so that would be 24 units of insulin. i guess what im worried about is if i take more insulin then my body might get used to the higher amounts and that they just keep going up.

Pasta is 10 carbs for 30 Grammes. Try eating 30 carbs worth with your insulin to carb ratio and see how it affects you. Trial and error. I personally find wholewheat pasta raises my sugar levels a lot more slowly than white. When eating out my choice is limited, but at home I always eat brown. Never too much, but to not eat at all makes the restrictions on food enjoyment a drag. I would then limit the rest of my meal and perhaps not overdo carbs at other times in the day. Everything in moderation and carb counted.

 

[catapillar]

If you're eating meals with a decent amount of carbs in you don't need to worry about bolusing for protein @Cliodb

Have you done a DAFNE course? If not you should seek a referral to a carb counting course, and there they will confirm the advice not to bolus more than 10 units is wrong. In the meantime you can do the Bertie online course - https://www.bertieonline.org.uk

 

[mibby]

10 units per meal maximum is absolute nonsense. Everyone is different. I often take as many as 60 units before a meal, I don't suffer from hypos and my HbA1c is 42. Take the insulin you need, don't starve yourself or run high BG which can lead to all sorts of long-term problems.

 

[Juicyj]

Hi @Cliodb Agree setting a limit of 10 units of insulin per meal is utter nonsense, you take the amount of insulin you need to cover the food you eat, I have also been told this in the past and suspect it's just said as precautionary advice as the NHS are trying to offer guidance on insulin doses. If you don't take enough quick acting you will run high (as a long as you've ruled out your basal requirements first), also your carb insulin ratios can change as well as the steriods impacting on your control.

Getting yourself onto a DAFNE course is important, you will be able to make more informed decisions about your self management and it will give you the confidence to move forward with adjusting your doses and understanding more about insulin doses. Speak to your DSN tomorrow and ask about getting onto one asap.

At the moment you need to record your results, so time, carbs eaten, insulin taken, what will help is seeing patterns in this, your DSN can help you learn more at this point about looking for patterns and making adjustments.

 

[Cliodb]

thanks everyone for the replies

I haven't done a DAFNE course , but would love too , i really wish i could eat "normally" as i find with limiting myself to a max of 10 units or 25 carbs make my chose of food limited at home and impossible for me to eat out if away from home (my car always has food in it just encase). my clinic dose not do the DAFNE course but i think i might look into transferring clinic so i could do the course and because i dont have full faith in my current dr. I was unsure if he was correct or not in telling me to take 10 units, i actually started crying in the office when he told me as i had already cut down on my meal sizes and carbs as much as i could and knew i would be starving on just 10 units, but then after then after a few weeks my blood sugars did get better and my huger pains went away so i started to believe perhaps he was right, but long term i dont think its sustainable, im not getting enough nutrients and vitamins with the foods im eat and im begin to get scared of any situations where i dont have complete control over what i eat (where i would not have weighed and crab counted everything).

Thank again everyone, you have all helped me feel more positive