4.2 post lunch reading

Hello Emma, Welcome to the forum. I've found great inspiration and support here. I'll tag @daisy1 who will send you lots of information which will help, I'm sure. I cant help with your question as Im not on insulin but people will reply to you who can help. Chin up!

@Emma158

Hello Emma and welcome to the forum Here is the information we give to new members, mentioned above, and I hope you will find it helpful. Ask more questions and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

What did you have for lunch? I have been asked not to inject with some no carb meals. Might be the same with some tablets?

Hi, What I was suggesting was it might have been low because you were carb free at lunch? I have been told not to inject with veg and fish type meals. Thought it might be the same for you?

Postscript - was because I often went hypo after fish salad for lunch... Or omelette.

Emma,

Please tell us more about the name of the insulin you are injecting and whether you are on fixed doses at specific times.

Diakat said:

Postscript - was because I often went hypo after fish salad for lunch... Or omelette.

Click to expand...

Oops I think we've got crossed wires here Diakat, I think you were messaging Emma not me, we'll tag her and see if she will reply to you. Sorry for mix-up. @Emma158

Emma158 said:

Hi everyone and thank you for the replies.

Ambersilva I am injecting 4 units of Insulatard in the morning and the evening.

Diakat I actually did have salmon and salad.....(although I did have a slice of wholemeal bread with it)

Perhaps I need a more carbtastic lunch.

Click to expand...

@Emma158 I am on a different regimen, Basal/MDI, and have never used Insultard or Gliclazide..

Insultard is a long-acting insulin. Onset of action is within 1½ hours, reaches a maximum effect within 4-12 hours and the entire time of duration is approximately 24 hours. I do not know how it works in combination with Gliclazide. There is a guide to Insultard here.

I copied these two paragraphs from the guide:
The amount of Insulatard you need to control your blood sugar levels will be worked out by your prescriber or your diabetes team. You may be advised to measure your blood sugar regularly and vary the amount of Insulatard that you use depending on the result of the measurement. Your prescriber or a member of your diabetes team will show you how to measure your blood sugar. If you are having problems controlling or measuring your blood sugar, you should contact your prescriber or a member of your diabetes team.

At times the amount of Insulatard you need to use may change depending on your circumstances. These could include changes to your diet; irregular meal times, changes to your health during periods of illness or emotional stress; changes to the amount of physical activity that you are doing; or if you change to a different insulin. For more information about how to vary your dose when your circumstances change, make sure you have spoken to your prescriber or a member of your diabetes team.

In the days following diagnosis blood sugar can be quite unpredictable. You recognised that you needed to have eaten more carbs because of the 4.2 reading after two hours. Carry on monitoring and recording your blood sugar at the recommended times. In addition, test if you feel different or not quite right or if you think you are heading for the low 4 readings. Record how you feel when you are in the 4s and lower numbers. Have you been told how to recognise and to treat hypo symptoms?

Share your results and findings with your Diabetic Nurse (DN) early in the week for her recommendations based on the results.