Fixed doses V carb counting

[Rose22]

Hello, I’ve been taking insulin for around two weeks, the nurse has started me on fixed doses and said not to try carb counting yet as early days.
I still produce some of my own insulin but it is sporadic. I have always tended to go low late morning, and high by the end of the day. I’m finding it really tough going. My blood sugars ranged between 3.4 - 23.1. I eat low carb breakfasts and if I’m active it’ll drop faster. I had a hypo this week at 3pm, right as needed to get the kids from school. I couldn’t get my bs up fast enough so was 1/2 hour late. This has really knocked my confidence. It’s made me fear going low now and I worry about doing the dose nurse has said to try before meals.
Do most people aim to learn to carb count and get better control? I worry if I say to the nurse she will tell me it’s too soon, but I want to feel more control than I do now. Don’t have any appointments, it’s via phone. See consultant for review in July.
Feeling confused with the whole insulin thing. I’m novorapid with meals and levemir at bedtime. I really want this to get better than I feel it is now!
Thankyou for any advice...please be gentle I’m on an insulin rollercoaster at the moment! And I want to get off hehe!

 

[LooperCat]

It's YOUR diabetes, your nurse doesn't live you life. You can certainly learn to carb count, and make some small adjustments to suit. Google the Bertie Online course, and have a look at that - fixed doses assume you eat the same for each meal every day and who does that?

Keeping good records is key here, apps like MySugr can help you spot patterns and see what's going on.

 

[Rose22]

It's YOUR diabetes, your nurse doesn't live you life. You can certainly learn to carb count, and make some small adjustments to suit. Google the Bertie Online course, and have a look at that - fixed doses assume you eat the same for each meal every day and who does that?

Keeping good records is key here, apps like MySugr can help you spot patterns and see what's going on.

I will have a look at that thankyou. She gave me a paper with the Bertie course but told me not to try and carb count, wrote it in the letter to my gp as well. Although they never seem to read those! I will try carve out some time (move house end of month and stressing) to make it a priority and try tweak the doses a bit. As the better and more level they are, without all this up and down like crazy, the better I should feel.
Will start logging what I eat, dose and afterwards...I’m so used to highs and all those side effects..but the fear of going too low seems to have intensified.
That’s so true, I don’t eat the same meals and I don’t eat as high carb as I think she expects. I’ve not heard of the app will have a look, great help thanks.

 

[LooperCat]

the fear of going too low seems to have intensified.

Never go out without hypo treatment - I find dextrose tablets are the fastest acting and dont take up much space in a pocket or bag. Things will be up and down for a little while during the terribly named "honeymoon" period when your pancreas is still splurging out the odd bit of insulin. Things settle down a lot after that.

 

[JPW1]

I've found the maths bit of carb counting very straightforward, and I've only been doing it a few weeks now "its not rocket science" or some kind of black art! Of course there are plenty of foods and meals that aren't simple to work out how much carbs are in them or in how much you are taking but apps like Cabs and Cals help a lot. Eating out is a bit of a lottery at first - or insulin russian roulette!

Also getting your carb/insulin rate can be tricky as it can change throughout the day. I use Mysugr app to keep a track of insulin which is especially important if you take an extra dose for a mid morning croissant or something - otherwise you end up insulin stacking i.e. end up taking too much with you next meal which puts you at risk of a hypo.

But......I'm not really in any honeymoon period kind of thing - I'm pretty predicable at present thankfully - you may not be! I was on fixed dose for a few weeks - but it just kept increasing every week! Carb counting has been brilliant - I can eat pretty much what I want and dose accordingly.

 

[Daibell]

I have never understood this business of delaying carb-counting and sending you on a 1 week 'course' or whatever to 'learn' about it. My DN started me on carb-counting the day she started my Bolus insulin. It took all of 20 minutes including giving me a Roche leaflet with pictures of typical crbs plates with portion sizes - simples. I sometimes despair of the NHS and it's silly rules. This one encourages patients to go hypo rather than avoiding it. So, to the OP it's your decision. Just do a little bit of research and keep the Bolus insulin shots/ratio down a little until you find the ratio that works safely for you.