Travel Question and some Bolus Advice...

[BethTwydall]

Hi Forum!

I have a couple of questions that I would love to find the answers for! I wasn't sure whether to do two threads or one,but I thought i'll stick it all in one and see what happens!

Basically me and my boyfriend are travelling for a year as of February, visiting California, Mexico, all through Central America and then finally the Caribbean. I have traveled a lot so am pretty well practiced at keeping insulin cool, taking lots of supplies/spares etc. My main concern is not being physically able to carry enough insulin with me for a year, and where to buy it from! When in Aus I went to a doctors and got a prescription which was fairly straight forward in an English speaking country. I've tried to research online wheres the best place to buy it from, the States or something in Central America. I'm also concerned about different strengths of insulin (I take only Novorapid in my pump). If anyone has any advice for me then I will be very grateful! Also any suggestions on Insurance companies (Diabetes UK quoted me over £2500!!)

My next question is on Bolusing. I have recently tested my basal rate so I know thats all okay. I eat low carb as to try and avoid post meal BS. However even when I do have a small amount of carbs, the insulin seems to take forever to work. And when my blood sugar is high, my correction dose also seems to take forever to work (maybe even 4-5 hours for it even to start working slightly). I have upped my correction dose and it still doesn't seem to have a quicker effect. I'm just concerned about the amount of time my blood sugar is around the 9-11 mark, as i'm really trying to keep it within range (aren't we all!). I've tried taking the bolus earlier but still doesn't seem to help. I try and exercise everyday to help with 'insulin sensitivity'.

ANY ADVICE? I'm inbetween diabetic teams at the moment as I've just relocated to Somerset to be nearer family before we go, have an appointment at the beginning of December so will hopefully have a chat with them then, lets hope they are more useful then my last team - but i'm not holding my breath!

 

[tim2000s]

However even when I do have a small amount of carbs, the insulin seems to take forever to work. And when my blood sugar is high, my correction dose also seems to take forever to work (maybe even 4-5 hours for it even to start working slightly). I have upped my correction dose and it still doesn't seem to have a quicker effect. I'm just concerned about the amount of time my blood sugar is around the 9-11 mark

A couple of things. When eating low carb, the body's reaction to carbs can be accentuated until it is reacclimatized. You may be seeing this.

Secondly, how long have your issues with slow absorption of insulin been going on? There could be multiple reasons for it. Also, how long have you been on a pump and how often do you rotate your infusion sites? Are you getting back to within 2mmol/l of your pre-prandial bg levels after the insulin has taken effect?

 

[BethTwydall]

I've been eating low carb for probably about a year, very low carb for the past 3 week or so. This has been going on a while, I've had other issues that i've been sorting out including allergies to needles amongst other things, so now time to crack the spikes.
I've been on the pump for coming up 2 years. I would say I change it ever 2-3 days max, 3 days I know its not working how it should be. I would say yes, but it takes a really long time, and by that time I'm on to my next meal so it feels like im constantly correcting. Maybe I need to look at my boluses again....

 

[tim2000s]

Maybe I need to look at my boluses again....

I was going to suggest that next. Are you sure that your I:C and correction ratios are correct?

 

[BethTwydall]

Yes think thats my next step! I can reasses after I guess! Thank you

 

[azure]

Do you move to different body areas? I use one body area for sets for a few months then change to a different body area, adjusting my insulin if necessary. I've found this avoids areas getting poor absorption.

 

[noblehead]

I've been eating low carb for probably about a year, very low carb for the past 3 week or so. This has been going on a while, I've had other issues that i've been sorting out including allergies to needles amongst other things, so now time to crack the spikes.
I've been on the pump for coming up 2 years. I would say I change it ever 2-3 days max, 3 days I know its not working how it should be. I would say yes, but it takes a really long time, and by that time I'm on to my next meal so it feels like im constantly correcting. Maybe I need to look at my boluses again....

Check your basal rates again, if you find your bg levels remain stable in the absence of food then its almost certainly your I:C ratio.

If on your very low-carb diet you've increased your fat intake this could be why your bg control has risen , in some type 1's a high-fat diet can cause insulin resistance which may explain why your having to take correction doses all the time.

 

[BethTwydall]

Thanks guys! I just use my stomach at the moment, i try and use the whole area and move them from each side every time I change the cannula. I used to use my leg but I caught it and got a REALLY bad infection which knocked me out for weeks, so slightly scared of using my legs again. My fat intake has always been pretty high. Gah sometimes I feel like you can't win, high carb = unstable blood sugars, LCHF = insulin resistance

 

[noblehead]

Do check your basal rates and double check your I:C ratio's, insulin resistance due to your higher carb diet is only a possibility.