5 things any newly diagnosed type 1 should know

Nai nai said:

Just a quick one, thanks for the info and good job with the diabetes. Why do you think the doctors think it's ok to have a higher a1c after 50? Never made sense to me to change anything if it was working?

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Hi Nai Nai: Congratulations! You've had a long road and looked after yourself along the way. Very good question. I was first dx'd at 69 with T2. I freaked of course. They put me on Metformin, however, that didn't work for me. I researched and found Dr. Richard Bernstein's book "Diabetes Solution" and followed his low-carb way of eating. Things were great except the GP and Diabetes Educator were against a low-carb way of eating...despite my great A1C and blood results. Then at 71 I had a bad DKA episode which landed me in the hospital for four days. Turns out with the proper tests I was actually T1. It's been up and down ever since. I want my A1C to be in the 5 zone again, however, medical folks want it around 7 because of my age, now 76. Dr. Bernstein has been T1 since around 1935, then decided at 45 to become a doctor...to study diabetes and how he can help. He is now 89 or 90...my point being...if he can live that long with the A1C of a normal person without diabetes, why can't I, not to mention others? I get so frustrated that I sometimes eat things I know are not good for me...hence the ups and downs. My own fault. I have been a carboholic since my teens and I sometimes falter...not much, but enough. Then I get so angry at myself. It's a vicious circle...that I'm still trying to conquer. Good luck on your journey.

Lynnzhealth,

Hello,

Have you spoken to a diabetic nurse / consultant who knows what are talking about ? ( you must have ? )

Being a T1 . I assume you have two types of insulin to take ?

1)A fast acting insulin - you take just before each of your meals ( called the bolus ) usually at a ratio of usually 1 unit per 10g carbs you are going to eat . This ratio varies for different people ( mine is 1 unit per 7g carbs I eat during the day and the ratio changes for my evening meals to 1 unit per 6g carbs) This insulin can also be taken after your meal ( like you forgot to take some INSULIN before eating, or you did eat and you did inject but your levels went higher say 2-4 hours after eating to what is deemed acceptable for T1 DIABETICS this as far as I am aware being 9-10 mmol/L . This is called a correction dose. The ratio for this differs again for different people. For some its 1 unit per 5mmol/L over , for others like me its 1 unit for every 3 mmol/L over ( example I've injected for a meal , carb counted etc. 2-3 hours later Im reading at 16mmol/L, I'd do a correction for this my correction ratio is 1:3, so I'd take 2 units to reduce my level by 6mmol/L, but usually for me unless it goes pretty high as in more than 15, two or three hours later I won't bother doing a correction , I'd just wait till my next meal. I'd then see what my levels were like before my meal and as well as doing injections for that next meal ( as in carb counting and ratios for this ) I do a bit extra insulin for correction because I was a bit high before the meal - I hopeI havent confused you too juch ! )

2) The slow acting / background insulin ( called the basal ) usually taken once or twice daily . Lots of people just do one injection at night.
Others like myself do it at night and first thing in the morning. Once thisis figured out. ( it takes some time ) This amount doesn't vary on a daily basis.
It is imperative to get this dosage correct and requeires various testings , trials and errors to get the right dose. Once this is determined as being the correct amounts - only then your bolus insulin ( for the food ) will work much better and correctly. Very important. Figure this out and half the battle is won . It took me ages to figure out mine ( often getting hypos as well as many hypers ) I'm still not 100% I've got it spot on ! ( this is 6 months of insulin regime )

Get yourself a CGM ( continuous glucose monitor ) it helps you track things and your phone or receiver can alert you to upcomong highs or lows and you can adjust for this ( like having a sweet drink for hypos etc ) or if your going too high often - you can note this etc ( drink some more water , try excercise a bit to get the numbers down again )
Its very helpful to keep a detailed diary of what you ate , what bolus insulin you took at what time and what your readings were 2 hours later and what it was before the next meal.
This helps you figure our first and foremost if your background insulin amounts are correct or not ( too little basal , you will keep getting highs even with a sensible carb counting ratio when using fast acting insulin , conversly if your basal intake is too high your going to get hypos and your fast acting insulin ( for your food ) feels too strong / effective.


You said " I will have an occasional treat, but make sure I dose for it, although I'm not sure how one does that"
You look at the treat and work out it's carb value ( there are books / nutrition guides that illustrate all this info, pr look at the packaging of the food it sometimes tells you )
Lets say your basal levels are correct and you've ascertained for example the carb counting ratio for you ( bolus / fast acting insulin ) is 1 unit per 10g of carbs . Say the treat ( a cake etc ? ) is 30g of carbs . That would be 3 units of bolus insulin ( 30g divided by 10 = 3 ) to take for that.
Ideally you'd take this usually 10-15 minutes before you eat it.

Good luck. Keep your chin up.

Shoran .

As the parent of a newly diagnosed T1D child, this was a very helpful first forum to read. Thank you for posting!

Relatively new to the forum, but not T1D, for which I celebrate 50 years in November. (Someone asked facetiously "will there be cake?" - which is how I like my friends...) . But the title of this thread: 5 things a new diabetic should know, I'd like to add:

"I am a diabetic" defines what I am. it does not define who I am.

Over the (many) years I've done some daft things, some risky things, and some which can't be published in a family forum. I was rowing competitively before Steve Redgrave made it fashionable for T1Ds; I've been to the Arctic, and treking in Namibia. I've run a half marathon - admittedly not recently - and been skiing forever (and will continue to do so until they take away my pass).

I've met people who say "I can't, because I'm a T1D". To me, that's sad. Don't let diabetes set your boundaries or your ambition. Say 'yes', and then (if necessary), work out how.

Awareness and planning are all you need for a fulfilling and enjoyable life.

Fabulous! @JimW

I’m the same. Diagnosed at 72 with type 1 and I’m low carb eating so very low insulin doses but still can’t lose any weight. Am getting very fed up and wonder what the point is

Barbie3 said:

I’m the same. Diagnosed at 72 with type 1 and I’m low carb eating so very low insulin doses but still can’t lose any weight. Am getting very fed up and wonder what the point is

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When you say very low insulin doses, approx from ? to ? on average? I'm still struggling with getting the insulin dose correct. I'm low carb and I keep track daily. One day my BG can go high, the next low for some strange reason, even when I eat the same breakfast, every day. Then I'll take the dog for a walk and bam, down it goes ... especially in hot/humid weather.

Then, sometimes it's great for a few days in a row. What the heck? I find T1D very confusing. I wonder what causes the big fluctuations.

My latest blood work showed my A1C as 6.8, although I'd rather it be lower than that. The Doc likes it in that range because I'm 77. HUH? And, I'm in the normal ranges for all the other things they check. I guess that's a good thing. So, I'll keep on keeping on.

Lynnzhealth said:

When you say very low insulin doses, approx from ? to ? on average? I'm still struggling with getting the insulin dose correct. I'm low carb and I keep track daily. One day my BG can go high, the next low for some strange reason, even when I eat the same breakfast, every day.

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How much insulin someone else needs doesn't tell you anyting about how much you need. Some people need as little as 10 units total (basal and bolus combined), others need a couple of hundred units.
I am T1 and currently need about 50 units of basal and 10 to 25 units of bolus on a mostly low carb diet. I used to be on 100-120 units of basal plus bolus, also on a low carb diet.

Lynnzhealth said:

My latest blood work showed my A1C as 6.8, although I'd rather it be lower than that. The Doc likes it in that range because I'm 77. HUH?

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This makes some sense.
On insulin, you always run the risk of going dangerously low, and if this happens suddenly it can mean falling down the stairs and breaking your neck or crashing your car, killing all the people in the other car. So dangerously low hypos are to be avoided.

The problem with elevated blood glucose is that it causes nasty complications down the line, but this usually takes decades, especially with only mildly elevated numbers like an hba1c of 6.8.
A child may have another 90 years for high bg to cause damage, at 77 you're looking at a shorter time unless you plan to live until a 167 years old.
And a child or someone in their 30's is much less likely to do serious damage from a fall than a 77 year old, and hypos can cause falling.
This is why doctors prefer hba1c to be a little higher in older people.

Totally agree — diabetes might be part of our lives, but it doesn't define who we are. Yes, it takes discipline, planning, and constant awareness, but that doesn’t mean life stops. If anything, it teaches us to live more fully, more mindfully.