Advice type 1 for 2 years

[Kerryannhogan]

Hi, I'm not usually one to post anything ! But I have been diabetic for 2 years I have a really good HBA1C it is 47, and my weight is good I am 5ft3 and only 8 stone, when I first got diagnosed I was pregnant thought it was gestational but turned out to be type 1, I lost a lot of weight and became under 7 stone over the 2 years I've put on a stone thank god, anyway my problem is, I've developed diabetic peripheral neuropathy and background retinopathy also problems with my kidneys going under investigation at the moment, im so confused why all this is happening when I'm constantly having hypos, my bloods do peak to about 12-14 in an hour but drop like a horse fly to about 4.5 after another hour, they are constantly up and down but mostly low I have really good readings every morning, I have to eat with my night insulin which ur not supposed to do but I tend to hypo even at low doses, can anyone help me understand why I've developed these problems is it cause I'm constantly eating sugar to bring off the hypos or the odd highs after every meal? I need advice anyone!

 

[Daibell]

Hi. Can I check that you are on the Basal/Bolus insulin regime? There is a hint from what you say that your Basal may be a bit too high and your Bolus not high enough? Do let us know more and discuss with the nurse.
+

 

[noblehead]

The postprandial spike of 12-14 is very high Kerry, do you inject just before or after eating or do you inject ahead (say 15-20mins) before you eat to give your insulin time to work?

What I would do is start from the basics, so do some basal testing to see if your lantus dose needs adjusting, after that you can then look at your insulin-to-carb ratio's and carb counting skills, you shouldn't have to keep eating sugar to avoid hypo's if you get all the basics right.

 

[Kerryannhogan]

Hi yes I'm on basal and bolus, humalog and lantus, i have started injecting 15 minutes before sometimes I eat ten minutes after cause my child is distracting and I don't want to have a bad hypo, even tho my bloods go to 14, they tend to shoot down to 4.5 after an hour so if I inject more than what I do I will still hypo but more worse and I don't even want to eat after cause I'm full, when I eat brown basmati rice I eat 60 carbs but I only inject 3 units of humalog they never go high of that but I hypo an hour after eating it then I've got to keep eating more sugar and I'm wondering what has caused my complications I'm constantly checking my bloods I get 200 strips a month but I literally go through them in 2 weeks I constantly get kidney infections too I've had one each month and I'm not even exaggerating taking antibiotics now for them but my results from the urine test keep coming back no germ growth which means all the antibiotics haven't been working .. I'm so stressed

 

[azure]

Sorry you're not well - it sounds miserable for you.

I know it's tedious and annoying, but do do a basal test. As Noblehead says, if things aren't working for you, you need to,start from basic and build things back up again. Sometimes a fresh start like that can really help your control.

You say you're eating 60g carbs of basmati rice and having 3 units? I believe basmati is one of the lower GI rices so would be absorbed slower, which might be causing the hypo an hour later.

Do carry on taking the antibiotics for your kidney infection, but you may also want to try cranberry tablets. I used to get infections that showed negative on the tests, and taking cranberry tablets really helped me (tablets not juice to avoid the carbs).

As for why you've had some complications, no one can say. Sadly, it could just be one of those bad luck things. Have your doctors suggested any reasons?

 

[Kerryannhogan]

Thanks for all the replies, I think starting from scratch definitely needs to be done, so with the rice should I take the insulin 15 minutes after ?

I'll try the cranberry tablets cause I'm sick of these infections thanks for the tip

My doctor said it could be that I've had diabetes for while and never known so could of already caused the damage but he doesn't really know just said I'm very unlucky x

 

[azure]

I have a pump so I'm not sure what will work for you with injections. I suggest you experiment a little and see what gives the best result. Everyone's body reacts differently. If you normally take 3 units you could try splitting that dose in various ways and see if it helps at all eg you could try 1 unit 15 mins before, then take the other 2 units after you've eaten. That's just a suggestion of the kind of thing I mean, not a dose recommendation as only you can decide that. Whatever you try, test frequently so you can see the affect on your blood sugar.

I hope the cranberry tablets help you I've also found that making sure I drink enough water each day helps. It sounds obvious but I know how easy it is to rush round and forget to drink water, especially if you have children!

 

[Kerryannhogan]

Aw haha thanks for the advice, I've been asked to go on a pump lots of times by my diabetic nurse but it just doesn't appeal to me at the moment, don't like the thought of something being attached to me 24/7, yeah I use to drink 6 litres I'm lucky if I can drink 2 now haha! But the water helps lower my bloods quickly too. My doctor keeps telling me to leave my bloods when they're peaked at 14 too cause I'm causing too many hypos, but with all the damage that's going on I don't even want to, that's why I have resorted to the diabetes forum, I've read that you can reverse damage if bloods are lower than 7, I don't even know how to keep my bloods below 7 without it shooting down so quickly I panic when I see a 7.0 cause I know it's going down ,

Thanks again anyway

 

[michaeldavid]

I've been type1 since '83. My last HbA1c was 26mmol/mol - normal for a non-diabetic.

I manage this, firstly, by feeding the insulin: I take the same insulin each day.

Secondly, and most importantly, I feed the insulin with around 250g of rye bread per day - normally eaten with pear and apple spread.

By steadily eating rye bread throughout most of the day, I'm able - safely - to keep my blood sugar near normal, (Spelt is just as good, but expensive.) I don't eat any after mid-afternoon, or my blood sugar would rise later in the evening and/or overnight.

The only slow-acting insulin I take is a little Insulatard, last thing at night.

I test my blood-sugar a lot - more than once per waking hour.

But mostly I use ultra-cheap visually read strips: Glucoflex-R. They are very good - really quite precise - for near-normal readings, which mine are most of the time. And with a good pair of scissors, each strip can be cut into 4 or 5 striplets.

Any questions?

 

[Daibell]

Hi. Can I check that the kidney infections aren't candida (thrush)? I think at the moment you need to smooth your carb intake during the day to minimise peaks and troughs until you have better control. Yes, do try to get the Basal right.

 

[Kerryannhogan]

I've been type1 since '83. My last HbA1c was 26mmol/mol - normal for a non-diabetic.

I manage this, firstly, by feeding the insulin: I take the same insulin each day.

Secondly, and most importantly, I feed the insulin with around 250g of rye bread per day - normally eaten with pear and apple spread.

By steadily eating rye bread throughout most of the day, I'm able - safely - to keep my blood sugar near normal, (Spelt is just as good, but expensive.) I don't eat any after mid-afternoon, or my blood sugar would rise later in the evening and/or overnight.

The only slow-acting insulin I take is a little Insulatard, last thing at night.

I test my blood-sugar a lot - more than once per waking hour.

But mostly I use ultra-cheap visually read strips: Glucoflex-R. They are very good - really quite precise - for near-normal readings, which mine are most of the time. And with a good pair of scissors, each strip can be cut into 4 or 5 striplets.

Any questions?

Hi michaeldavid, this helps a lot, so do you mean when you feed the insulin do you eat the rye bread when your in hypo or lowish bloods? I'm always drinking lucozade I must go through a bottle a day which can't be healthy, I got told to eat a digestive after but I don't think they're healthy either ... Does the spread not push your sugars up too high ?

And thanks for the tip about the strips my doctor keeps moaning that I'm testing too much but I always want to know where my bloods are at in case I have a hypo or if they're too high and need correcting

 

[Kerryannhogan]

Hi. Can I check that the kidney infections aren't candida (thrush)? I think at the moment you need to smooth your carb intake during the day to minimise peaks and troughs until you have better control. Yes, do try to get the Basal right.

Hi,
No it's definitely not candida they keep finding a lot of white blood cells in my urine and blood so they know it's kidney infections, I do get candida with taking antibiotics so I know it's not that

Yeah i have just swapped ordinary toast for Melba toast which has just 12 carbs ... Just need to find the right foods maybe.

 

[michaeldavid]

The idea of 'feeding the insulin' is that you eat according to what insulin you've taken, rather than take insulin in anticipation of what you expect to eat.

Rye bread is no good if you need glucose fast - unless you just quickly spread on some normal jam or marmalade.

But if you need it fast, just eat the jam or marmalade!

Pear and apple spread is NOT like normal jam or marmalade - there's no added sugar. (Get it from a health-food shop.)

By steadily eating rye, I find that any hypos I might have are far more manageable. You know how a hypo can be like falling off a cliff? Well, for me - unless I'm very careless - a hypo is more like going over the edge of a windswept sand-dune: I get a chance to climb back up.

Throughout the day, I have low readings without any problem.

The visually read strips are not much use unless your blood glucose is very well managed. Like yourself, I used to fear any reading below 5 or 6. Now, I really have any readings above 7mmol/l.

If you make any significant changes to the routine you're used to, please be very careful.

Why Lucozade?! What's wrong with fruit juice?

 

[azure]

Most people nowadays prefer not to feed the insulin, but to adjust their insulin to the food they eat. Once you get the hang of carb counting and how your body reacts, this isn't too hard. It means you can eat a balanced and varied diet - and have very good control.

When I was first diagnosed. I was on set doses of insulin so I had to feed it every day. However, I very soon got the hang of adjusting my doses, and my HbA1C is actually better now than it was then, and has remained so on my carb counting/dose adjusting regime for many years.

 

[Kerryannhogan]

The idea of 'feeding the insulin' is that you eat according to what insulin you've taken, rather than take insulin in anticipation of what you expect to eat.

Rye bread is no good if you need glucose fast - unless you just quickly spread on some normal jam or marmalade.

But if you need it fast, just eat the jam or marmalade!

Pear and apple spread is NOT like normal jam or marmalade - there's no added sugar. (Get it from a health-food shop.)

By steadily eating rye, I find that any hypos I might have are far more manageable. You know how a hypo can be like falling off a cliff? Well, for me - unless I'm very careless - a hypo is more like going over the edge of a windswept sand-dune: I get a chance to climb back up.

Throughout the day, I have low readings without any problem.

The visually read strips are not much use unless your blood glucose is very well managed. Like yourself, I used to fear any reading below 5 or 6. Now, I really have any readings above 7mmol/l.

If you make any significant changes to the routine you're used to, please be very careful.

Why Lucozade?! What's wrong with fruit juice?

Hi, yeah I'm kind of the same I worry about hypos as my hypo awareness has dropped I don't get any warnings sometimes I'm lucky to catch them, the diabetes nurse made me run my sugars High for nearly a year and now I'm wondering if it's caused my complications ... Going to try and find the rye bread tomorrow ! Give that a try

And fruit juice doesn't help with my hypos it doesn't push my sugars up as quick

 

[Kerryannhogan]

Most people nowadays prefer not to feed the insulin, but to adjust their insulin to the food they eat. Once you get the hang of carb counting and how your body reacts, this isn't too hard. It means you can eat a balanced and varied diet - and have very good control.

When I was first diagnosed. I was on set doses of insulin so I had to feed it every day. However, I very soon got the hang of adjusting my doses, and my HbA1C is actually better now than it was then, and has remained so on my carb counting/dose adjusting regime for many years.

Hi, yeah I don't really like the idea of feeding the insulin cause that's what I have to do now every time I hypo and it's causing weight gain !

I'm just going to stick to a very strict healthy diet and hope my neuropathy reverses !

 

[tim2000s]

@Kerryannhogan I think that the suggestions to go back and basal test are the first place you should start as has already been mentioned. Details can be found here: http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

Regardless of whether you decide to feed the insulin or take insulin to manage what you choose to eat, having your insulin levels and ratios set incorrectly will still result in troublesome management and notable swings in BG levels.

Many of us find that reducing carbs makes it easier to manage glucose control as we require lower amounts of insulin and the carbs we do eat have less of an impact.

 

[Kerryannhogan]

@Kerryannhogan I think that the suggestions to go back and basal test are the first place you should start as has already been mentioned. Details can be found here: http://www.salforddiabetescare.co.uk/index2.php?nav_id=1007

Regardless of whether you decide to feed the insulin or take insulin to manage what you choose to eat, having your insulin levels and ratios set incorrectly will still result in troublesome management and notable swings in BG levels.

Many of us find that reducing carbs makes it easier to manage glucose control as we require lower amounts of insulin and the carbs we do eat have less of an impact.

Thanks Tim I will have a read