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Christmas and illness

William_68

Newbie
Messages
2
Type of diabetes
Type 2
Hi It's coming up to Christmas and I'm not sure about insulin amounts. I'm Diabetic 2 and taking Humalog before meals and Lantus every evening. I have two queries one If I have a mince pie or a glass of red wine in between main meals how much insulin should I inject? and 2 If I become ill with a virus where i can't eat what should I do about my insulin injections. I would appreciate any advice as I've only been on insulin alone for a short time and was on Metfomin + Lantus before.
 
Hi It's coming up to Christmas and I'm not sure about insulin amounts. I'm Diabetic 2 and taking Humalog before meals and Lantus every evening. I have two queries one If I have a mince pie or a glass of red wine in between main meals how much insulin should I inject? and 2 If I become ill with a virus where i can't eat what should I do about my insulin injections. I would appreciate any advice as I've only been on insulin alone for a short time and was on Metfomin + Lantus before.

Are you carb counting? How do you decide how much insulin to take for your meals? If it is based on an insulin to carb ratio (carb counting) you should apply the same ratio to the mince pie to decide how much insulin to take for it. You shouldn't take insulin for red wine because it has essentially no carbs in and it's not advised to bolus for alcohol because it can cause hypos later on: when your liver is busy dealing with alcohol it won't be doing its usual job of trickling glucose out, the trickle of the glucose is what your lantus deals with so if that's not there you might hypo.

Have you been given sick day rules - http://www.mydiabetesmyway.scot.nhs.uk/resources/leaflets/SickDayRulesForType2.asp ? If not, it's worth asking your DSN to go through sick day rules for type 2s on insulin.
 
Are you carb counting? How do you decide how much insulin to take for your meals? If it is based on an insulin to carb ratio (carb counting) you should apply the same ratio to the mince pie to decide how much insulin to take for it. You shouldn't take insulin for red wine because it has essentially no carbs in and it's not advised to bolus for alcohol because it can cause hypos later on: when your liver is busy dealing with alcohol it won't be doing its usual job of trickling glucose out, the trickle of the glucose is what your lantus deals with so if that's not there you might hypo.

Have you been given sick day rules - http://www.mydiabetesmyway.scot.nhs.uk/resources/leaflets/SickDayRulesForType2.asp ? If not, it's worth asking your DSN to go through sick day rules for type 2s on insulin.
No I don't count carbs, I do a glucose test and if it is above 7.8 mmol 140 mg I inject 21 units of Humalog If it's below 7.8 I inject 20 units.
 
@William_68

Hello William and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask questions when you need to 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 well over 235,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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 blood glucose 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.

Take part in Diabetes.co.uk digital education programs and improve your understanding.
  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
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