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Advice, please

add

Well-Known Member
Messages
148
Location
Earth
Type of diabetes
Type 1
Treatment type
Insulin
Hi!
I've been a T1 diabetic from age 17, I'm now 19. Everything was fine. My A1C was 7.7, three months after I was diagnosed and it fell to 6 last year. But lately, I feel something isn't right with my diabetes. Like I have blurry vision sometimes, which never happened before. And my levels keep fluctuating. Sometimes it is 279 mg/dL(15.4 mmol) and sometimes it is 70-80 mg/dL(3.88-4.44 mmol). It's happening since four months and I really don't know what to do.
 
Hi and welcome to the forum!

Telephone your diabetes nurse, or your regular clinic or GP, whichever is possible for you, and tell them what's happening. It may be that you will be advised to tweak your insulin doses, but it's not something that forum members can advise on at a distance. I would advise that you telephone and sort this today or ASAP.

Let us know how you get on.
 
Hi and welcome to the forum!

Telephone your diabetes nurse, or your regular clinic or GP, whichever is possible for you, and tell them what's happening. It may be that you will be advised to tweak your insulin doses, but it's not something that forum members can advise on at a distance. I would advise that you telephone and sort this today or ASAP.

Let us know how you get on.

My doc told me to reduce intake of insulin by 4 units if my glucose level is not normal...and increase it by 4 units if it is high. I find them high one day and low the other day. They keep fluctuating and thinking about all that and also blurred vision I am really going mad. Is it with my food or exercise,I am not at all understanding.
 
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I'm not contradicting your doctor, but I do think the advice of 4 and 4 is too inexact. I really think you should talk to your diabetes nurse and/or consultant to help you with this.

Yes, food and exercise are part of the equation, but first I'd get more help with determining your insulin ratios. Are you able to give them a call?
 
My doc told me to reduce intake of insulin by 4 units if my glucose level is not normal...and increase it by 4 units if it is high. I find them high one day and low the other day. They keep fluctuating and thinking about all that and also blurred vision I am really going mad. Is it with my food or exercise,I am not at all understanding.
Yes, it probably is to do with variations in your food and exercise. You need now to learn how to plan your insulin regime to match your daily activities. My guess is that as you have left school recently, your daily regime is less rigid and predictable and this is having an effect on your control. And as you are now of an age where you are relatively independent you need to know more about how to manage your routine in different situations.

So you should go to the diabetic clinic and ask for help. They need to know this too. It is typical in your age group. They also can give a you a course which will help you. There are also books that can help. For your present situation, I would recommend, "Think Like a Pancreas" by Gary Scheiner. But I too think you should go to the diabetic clinic. I don't think you should try to work this out on your own.
 
I'm not contradicting your doctor, but I do think the advice of 4 and 4 is too inexact. I really think you should talk to your diabetes nurse and/or consultant to help you with this
Well, when I told this to my doc 3 months ago, he told me to me to increase or decrease the intake by 4 units. First, I used to change it by 2 units
 
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Ok, @daisy1 will be along shortly with helpful stuff to read on controlling your blood sugar.
Your blurred vision could be due to your blood sugar being too low. As before, I'd say give some time to discussing all the variables with your clinic nurse or doctor.
 
Agree with what's been said @add, if possible try and get seen by a diabetes specialist clinic as they are the best people to advise you further on adjusting your insulin doses.
 
Agree with what's been said @add, if possible try and get seen by a diabetes specialist clinic as they are the best people to advise you further on adjusting your insulin doses.
yeah, i'll be going to the clinic in a week
 
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@add

Hello and welcome to the forum :)

Good advice already from members. Here is the information we give to new members and I hope you will find it helpful, especially with diet and carbohydrates. Ask as many questions as you like and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

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.
 
@add

Hello and welcome to the forum :)

Good advice already from members. Here is the information we give to new members and I hope you will find it helpful, especially with diet and carbohydrates. Ask as many questions as you like and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

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.
Thanks for the info @daisy1..:)..
 
Hi @add,
Are you matching your injections with what you are eating? - So I mean matching your insulin injection to the number of carbohydrates you are eating?
(Apologies if my question sounds patronising, but I don't know what diabetic care is like where you live) If you are exercising more, it can certainly impact on your levels. (See the link below to get a better understanding of what to expect)
Keeping notes of what you are eating and doing and what your blood glucose readings are, should help you understand better what is going on, and also help your doctor give you more informed advice.

 
Hi @add,
Are you matching your injections with what you are eating? - So I mean matching your insulin injection to the number of carbohydrates you are eating?
(Apologies if my question sounds patronising, but I don't know what diabetic care is like where you live) If you are exercising more, it can certainly impact on your levels. (See the link below to get a better understanding of what to expect)
Keeping notes of what you are eating and doing and what your blood glucose readings are, should help you understand better what is going on, and also help your doctor give you more informed advice.

I do match my insulin injection to the number of carbs I eat. I think it is because of exercise, my levels are fluctuating. That is because I haven't exercised for 2 days and I can see that there is increase in my BG levels.
And btw, thanks for the link.
 
I think it is because of exercise, my levels are fluctuating. That is because I haven't exercised for 2 days and I can see that there is increase in my BG levels.
That's something that a few of us find. On days when I am not exercising I use a higher basal overnight, for example./
 
Hi and welcome. Yes, exercise can have a big effect on blood sugar. Do see the clinic. It may be that your Basal needs a tweak to re-balance but as you are carb-counting the Bolus is probably OK. My DN told me sensibly to aim for a morning fasting level between 5-7 mmol and I use this as a guide to get my Basal right.
 
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