advice

[eddy007]

I was diagnosed with diabetes 4 weeks ago (treating me as type 1) witha blood suger of 37+.

After a few days in hospital I came home and i gradually got my blood suger down to a sensible level (slowly increasing insulin etc..) all was ok until i suddenly started to get lows out of the blue when i got a urine infection.

This has had a dramatic impact on my health and I have not been able to get to work as I feel ill and these **** lows keep hitting me (im new to this and they are very scarry)

As a new diabetic I am VERY careful with diet etc... I am getting a little frustrated with the progress I am now making as I was hoping that now i have found out that I am diabetic, my health would improve (had 3 years of hell as I am a teacher and carer everyone assumed it was all stress so been in bad health for last 2/3 years).

How long does it take for suger levels to be controlled?
Is it normal for lows to make you really tired afterwards for hours? (lows are <2.6 suger in my case)?
Is it normal for sugar to Drop 2/3 points in 10 minutes?

Clive

PS im a maths teacher don't diss the english i try me best

 

[HLW]

How long does it take for suger levels to be controlled?

Depends what sort of insulin you are on. A few hours if it is a rapid acting one. But realistically it takes as long as it takes you to work out how much of each type of insulin to take when, it differs for different people which is why the hospital can't just spell it out to you. I felt more alert the next day after starting insulin, I assume this is due to having normal blood sugar levels for the first time in months/years.

Is it normal for lows to make you really tired afterwards for hours? (lows are <2.6 suger in my case)?

I've only recently started insulin so have only had blood sugar <3 once. It was after midnight, I was also awake until about 4 being poisoned by metformin so felt tired from lack of sleep anyway.

Is it normal for sugar to Drop 2/3 points in 10 minutes?

No idea. Is that after injecting the rapid insulin? It does say on with the instructions to make sure to eat something within 10 mins of injecting, so I assume it is starting working quickly. Also are you sure you meter is working ok? You can probably get calibration solution for free from the manufacturer's website.

PS im a maths teacher don't diss the english i try me best

Use Firefox, it underlines misspelt words on red.

Have you spoken to the diabetes dr/nurses about these repeated lows? And the rapid drop in blood sugar too. Maybe your insulin dose needs adjusting?

 

[CarbsRok]

y

 

[phoenix]

Hi,
I relate to your story, I too was a teacher and attributed my symptoms to stress.I actually gave up teaching.
Carbs Rok mentions a honeymoon, if your have been developing type 1 over this length of time this suggests a slowly developing form of type 1 (LADA). If so you may have some of your own insulin left for some time, in some ways it helps you don't really reach high glucose levels but you are more susceptible to hypos.It can also sometimes be a bit unpredictable.
In any case your very high levels at diagnosis will have been toxic and caused some insulin resistance. This means that to start with you would have needed relatively large amounts of insulin, at lower levels your cells become less resistant and so your insulin needs fall considerably.

As mentioned, learning to carb count is important. Get yourself a nutrition info booklet, some scales and start reading labels. I was taught how to carb count in hospital but this was in conjunction with eating a prescribed number of carbs at each meal. Although I eat more flexibly now this was extremely useful as it meant there was one less variable to consider when working out how much insulin was needed for each 10g of carb. Using this method meant I got control very quickly. I think it is worth working out how many carbs you normally eat for breakfast lunch and dinner...should be easy for a maths teacher! and keeping them consistent for a while.
This is a primer explaining the basics of carb counting and dose adjustment
http://medweb.bham.ac.uk/easdec/prevention/insulindoseapproach.htm
there is also an online course but it might be better to wait a short while before doing it
http://www.bdec-e-learning.com/

Unfortunately you can drop quite quickly, for several reasons. (insulin amount/timing/exercise /food eaten are the main variables) As you begin to learn how food and exercise affect your body you will be able to prevent a lot of hypos. At the moment it will be more difficult and as CarbRok says it's important to work out which insulin was too much and adjust it accordingly.

Sounds horribly complicated, it becomes far easier and I now have a really good quality of life.Far better than in the period before diagnosis.

 

[eddy007]

Wow

Thanks for the advice

I relate to your story, I too was a teacher and attributed my symptoms to stress.I actually gave up teaching

I have had to change from head of maths to ICT teacher (which I must admit was a good move for me) my dalary is protected for 3 years (2 to go) but Yeh everything is put down to stress and depression (even convinced myself). I bet this is really common with diabetics as they symptoms are very similar until you reach the crisis point. I just hope i get this all under control b4 the head has that conversation with me again about my job.


Now

They are treating me as type 1 but they say I am in a grey area, at the moment I take a 30%/70% Quick/slow insulun twice a day b4 breakfast and tea (7:30am and 5:30pm), and 500 Metformin slow acting after these 2 meals.

Ask you team about carb counting so you know what you are doing with your insulin.

When i got back into work I had a chat with another diabetic pupil in the 6th form (diabetic budies now lol) and she has to count every meal time to adjust the medication per meal which seems a sensible idea to me rather than a constant dose and trying to make meals more level.

I will take your advice on the carb counting as I was very slap dash with me food b4 the diagnosis so has been a big change in my diet following all the advice given.


My main problem is the hypos seem to knock me out causing a severe migraine type headache (which was put down to stress b4 I assume thats why I got them b4 work in morning). Takes me ages to recover from these headaches.

Have you managed to get some antibiotics for your infection?

I have and aparantly its clear although the diabetic nurse has adviced me to drop in a sample to the hospital to do a proper test (doctor just did a dip test) so maybe its still there. The lows continued after the infection was clear

I am worried that because I was at such a high for a long time and I has high ketones (2.5 i think) I hope that I did not damage anything inside me, the nurses dont seem worried about it tho so perhaps I am just being paranoid.

Now some more questions

When should I go to hospital what sort of blood sugar levels ?

Am i right to be worried about <2.6 blood or is this just normal and just take the glucose tablets?

why do some people do the insulin per meal and I do it just twice a day?

How long does it take to settle your bloods down i.e am i expecting to much to be sorted in 4 weeks from diagnosis?

Many thanks all

Clive

 

[iHs]

Wow




Now

They are treating me as type 1 but they say I am in a grey area, at the moment I take a 30%/70% Quick/slow insulun twice a day b4 breakfast and tea (7:30am and 5:30pm), and 500 Metformin slow acting after these 2 meals.

The insulin you are using is probably Novomix 30/70 which is biphasic so you are not using bolus/basal like members thought.

Ask you team about carb counting so you know what you are doing with your insulin.

When i got back into work I had a chat with another diabetic pupil in the 6th form (diabetic budies now lol) and she has to count every meal time to adjust the medication per meal which seems a sensible idea to me rather than a constant dose and trying to make meals more level.

This is bolus/basal which means that basal insulin is injected once or twice a day and then fast acting bolus insulin is injected for every main meal (not small snacks).

I will take your advice on the carb counting as I was very slap dash with me food b4 the diagnosis so has been a big change in my diet following all the advice given.

With insulins that are injected twice a day, although you need to add up the carb that you eat for every meal, you do not need to use an insulin to carb ratio like people do with bolus/basal. You do though have to eat set amount of carbs and at set times of the day to get the best control. It's not as bad as it might seem to be and can all be worked out ok as long you test your bg frequently so that you can see what effect the food that you eat and the insulin you've injected has on your sugar levels. If you only want to eat 3 times a day, then you might have trouble in balancing yourself up so eating little and often usually gives better results.


My main problem is the hypos seem to knock me out causing a severe migraine type headache (which was put down to stress b4 I assume thats why I got them b4 work in morning). Takes me ages to recover from these headaches.

Have you managed to get some antibiotics for your infection?

I have and aparantly its clear although the diabetic nurse has adviced me to drop in a sample to the hospital to do a proper test (doctor just did a dip test) so maybe its still there. The lows continued after the infection was clear

I am worried that because I was at such a high for a long time and I has high ketones (2.5 i think) I hope that I did not damage anything inside me, the nurses dont seem worried about it tho so perhaps I am just being paranoid.

Now some more questions

When should I go to hospital what sort of blood sugar levels ?

On twice daily insulins try and get your fasting bg to be between 5-7 and then 2hrs later to be between 7-10. On a bg of 7 you will need to eat a snack of some sort so that you don't go hypo later. With a bg of 10 you'll probably be able to miss out on eating the snack and then just wait for the insulin to slowly get your bg down towards your target by lunchtime and by the time you eat your evening meal. With everything diabetes, bg testing is the only way for you to be able to figure out when to eat and when not to. You will learn how to control your bg levels by the mistakes that you make.

Am i right to be worried about <2.6 blood or is this just normal and just take the glucose tablets?

No it's not normal and means that you are well into hypo land. Try and eat a bit more carb to prevent them.

why do some people do the insulin per meal and I do it just twice a day?

This will be down to your consultant. It is probably due to you being new to diabetes and your consultant wants to start you off going the easy route using twice day insulin than using bolus/basal.

This is just my opinion, (other people will feel differently) for all the pros that bolus/basal has there are cons. Asking people to inject 4-6 times a day can be pushing it a bit and people that I have met complain of bruising and find the injections inconvenient especially if they are not at home or working in a building. Also, people have problems with hypos and unless they test frequently will more like carry on doing so. This is why DAFNE type courses have been set up so that people can use bolus insulins with a bit more accuracy than just using guesswork and coming unstuck with either low or high bg levels.

How long does it take to settle your bloods down i.e am i expecting to much to be sorted in 4 weeks from diagnosis?
Give yourself a bit longer and you'll get the hang of everything

Many thanks all

Clive