Beginning again

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7
Good morning diabetics!

I am resolving to improve the management of my blood sugar. I'm sure the issues I face are not uncommon and I hope posting here can help increase my commitment and hopefully connect with anyone willing.

I wish to be honest and frank about my situation/ my intentions moving forward/ and my fears.

Situation factors:

1.I'm now 28 years old, T1 for 27 years

2. I take 8 units of levemir in the evening and 8 in the morning
morning

3. I test regularly but often am disappointed

4. Readings in the mid teens are not un common (often daily), however, I'll always correct with Novorapid. I put this down to incorrect guess work of correct NOVORAPID doses to meet varying carb/glucose loads in meals/ also snacking (few prawn crackers here/glass of wine there/ bite of chocolate etc) can all build up unconsciously until bam I'm 18 before bed :(

5. I test at least 5 times a day and the corrections almost always bring me back in range.

6. I am a healthy weight and exercise regularly

7. I am also coeliac

8. I have not developed any other complications apart from mild background retinopathy which I was advised not to be overly concerned with.


Intentions

1. I am re-starting a low carb diet today. I had success with this in the past (during lockdown) and noticed better test results, I have since slipped back into old habits. I can only start from where I am and i wish to re-introduce this diet back into my life.

2. for the meals I eat with carbs (ie some oats with breakfast) I intend on injecting my NOVORAPID at least 20mins prior to the meal, I fall into the habit of injecting with the meal and find this often leads to spikes.


Fears.

1. going blind and losing my feet! My partner often laughs at me when I say this somewhat in jest but long term complications are a true concern for us all I imagine. Out of interest, is there any data/research into the general range and duration of high blood sugar that leads to complications? I appreciate it must be on a sliding scale of risk, but is it common for someone with my profile to develop complications?

2. I am comfortable injecting but have a real phobia of having my blood taken, the last time I had this happen was 5 years ago, as such I dont have an up-to-date hba1c. This is obviously something that I need to address. There is always an excuse...


Thank you for reading and I hope to read your responses or questions.

Best wishes. Charlie
 

porl69

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Hey Charlie. Good on you for wanting to improve your management.......with regards to your higher BG readings....have you done a basal test recently? Getting your background insulin correct makes life a lot easier to gain control over your meal doses. My diabetic team at my local hospital can do a HBA1C test using a finger prick blood sample. They started using that machine around a year ago
 
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NicoleC1971

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Hello Charlie and I hope day 1 is going okay?!
I think you've got a good idea there i.e. going low carb to take the guess work out of bolussing but I'd suggest that you do a basal test day to check that your levemir is right. If it isn't then you will end up forever correcting and as you know this is frustrating. You could do this by doing a fat fast i.e. eat nothing but fat/tea/coffee for 1 day.
I exclude protein because you sometimes need a little bolus for that (about half of the amount you may need for carbs in my experience). It will be a long day but you will get some useful data from that.
Re complications, I think you are right to be concerned as the average onset can be after 20 years and this was my experience although it was complicated by pregnancy. Australian pathologist Ken Sikaris commented on this
(I think it is this one). Getting hba1c below 7.0% is the recommended clinical aim based on trials that took place 10 years ago) though those advocating the very low carb (30g daily or less) feel that near normal sugars can be acheved without risk of hypos).
Are you scared of the process of getting the blood drawn or of the judgement that comes with the result? For me it is more the latter as it feels as if my homework for the last 12 weeks is being marked!
I think it would be useful for you to know not only what your daily sugars are but to know your starting hba1c so as to measure your success! This is going to involve work in changing your diet and possibly insulin regime so why would you not want to know?!
 
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Messages
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Hello Charlie and I hope day 1 is going okay?!
I think you've got a good idea there i.e. going low carb to take the guess work out of bolussing but I'd suggest that you do a basal test day to check that your levemir is right. If it isn't then you will end up forever correcting and as you know this is frustrating. You could do this by doing a fat fast i.e. eat nothing but fat/tea/coffee for 1 day.
I exclude protein because you sometimes need a little bolus for that (about half of the amount you may need for carbs in my experience). It will be a long day but you will get some useful data from that.
Re complications, I think you are right to be concerned as the average onset can be after 20 years and this was my experience although it was complicated by pregnancy. Australian pathologist Ken Sikaris commented on this
(I think it is this one). Getting hba1c below 7.0% is the recommended clinical aim based on trials that took place 10 years ago) though those advocating the very low carb (30g daily or less) feel that near normal sugars can be acheved without risk of hypos).
Are you scared of the process of getting the blood drawn or of the judgement that comes with the result? For me it is more the latter as it feels as if my homework for the last 12 weeks is being marked!
I think it would be useful for you to know not only what your daily sugars are but to know your starting hba1c so as to measure your success! This is going to involve work in changing your diet and possibly insulin regime so why would you not want to know?!

Thanks. It's the taking of the blood, I can handle the results psychologically no problem!
 

ert

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Welcome, Charlie. I find I don't need as much background insulin on an LCHF diet, so follow your numbers. Good luck.
 

NicoleC1971

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Thanks. It's the taking of the blood, I can handle the results psychologically no problem!
Ahhh. I used to just look away and always let a professional blood person do it (phlebotomist) rather than a doc!
I'd also try and wangle a freestyle libre gadget to take the hassle of finger pricking away. You can get 2 for a month at £48 which might be useful just to set you up with your new routine.
 

michita

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All the best to you :) If you are coeliac, low carb diet should work well. Do you like meat and fish ? I find becoming a diabetic made me a healthier person overall. I cook daily now and I can appreciate what I have now which I didn’t think about previously. I don’t like my blood taken either and I am always tense and I have to look away. Phlebotomists are normally very good at trying to make us feel comfortable, I think they are used to patients being a bit scared. I normally find them to be super friendly:)
 

MarkMunday

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421
Type of diabetes
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The first thing to do is get the low-carb diet going, then test basal to ensure 24 hour basal insulin coverage. Finally, work on refining bolusing and getting blood glucose back into the target range after meals. Following that sequence is important. Trying to fix bolusing before diet is stabilised and there is good basal coverage is too hard.

The Libre CGM is a big help in doing this. Seeing continuous blood glucose readings highlights patterns and doing what is required becomes obvious. It shortens the trial-and-error adjustment process enormously. You can doing it using a smartphone now.