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Type 1 Diabetes
5 things any newly diagnosed type 1 should know
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<blockquote data-quote="SHORAN" data-source="post: 2741159" data-attributes="member: 580410"><p>Lynnzhealth,</p><p></p><p>Hello, </p><p></p><p>Have you spoken to a diabetic nurse / consultant who knows what are talking about ? ( you must have ? ) </p><p></p><p> Being a T1 . I assume you have two types of insulin to take ?</p><p> </p><p>1)A fast acting insulin - you take just before each of your meals ( <strong>called the bolus</strong> ) usually at a ratio of usually 1 unit per 10g carbs you are going to eat .<strong> This ratio varies for different people </strong>( 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 ! ) </p><p></p><p>2) The slow acting / background insulin ( <strong>called the basal</strong> ) usually taken once or twice daily . Lots of people just do one injection at night. </p><p>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.</p><p>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 ) </p><p></p><p>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 ) </p><p> 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. </p><p>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.</p><p></p><p></p><p>You said " I will have an occasional treat, but make sure I dose for it, although I'm not sure how one does that"</p><p>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 ) </p><p>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. </p><p>Ideally you'd take this usually 10-15 minutes before you eat it. </p><p></p><p>Good luck. Keep your chin up.</p><p></p><p>Shoran .</p></blockquote><p></p>
[QUOTE="SHORAN, post: 2741159, member: 580410"] 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 ( [B]called the bolus[/B] ) usually at a ratio of usually 1 unit per 10g carbs you are going to eat .[B] This ratio varies for different people [/B]( 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 ( [B]called the basal[/B] ) 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 . [/QUOTE]
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