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Diabetes 1 course

Without meaning to sound flippant, we put up with it because it is keeping us alive.
8 years in I daily cook a whole meal from scratch, then scan, inject, plate up and be at the table in minutes with steam still rising. For my husband and myself. I still weigh, but can also do many things by eye. As for logging I do what needs to be done for me now, so just put insulin units into Libre reader and food. Not how many carbs. As time goes on this is what your wife will do. To make it easier pre plan the food, and amount and you plate up whilst your wife does the recording and injecting. I tend to work out how much insulin I am going to need and have my insulin amount primed and ready to inject.
As for spontaneity, this will come. Perhaps just not whilst on this course. As they are doing monitoring to try and help your wife.
As for logic, unfortunately with type 1 there is very little logic to results sometimes. We just have to pick ourselves up and try again the next day.
 
I have two criticisms to make about the way you’re being taught to bolus for meals, they’re both based on personal experience and I know we’re all different :
Getting blood sugars down to 7 or less before eating helps maintain a healthy blood sugar level so I’d not eat yet if my blood sugars were 12. I’d inject the extra 2 units I’d need (1 unit = 3 bs calc) as well as the amount for the meal and wait, testing, before eating. It’s easier with a Libre. I’d do this ahead of the meal being ready.
I’d look at the profile of the bolus insulin to find out how long it took to become active after being injected. Once I knew this I’d know how to pre-bolus.
Rather than sitting waiting while food gets cold, I’d do this before the meal was ready to eat. It’s easier if it’s a home cooked meal, but it can make eating out a bit of a nightmare so there’s an occasional need to relax.
 
Thank you both for your advice which raises the following questions:-
1- how do you put insulin into the libre reader we don’t put insulin units or carbs into the reader we use the reader to tell us what the blood glucose level is and then work out the insulin dosage

2 - how can you tell when the insulin becomes active by looking at the profile we are told it starts becoming active after about 10 minutes an reaches maximum after a few hours ie when food has digested

We have the third session of the course today we have sent in all the food and exercise diaries cannot see any relationship between the food we eat and the readings.
66% of the readings are over 10 which are too high but they don’t seem worried about it
Keytons are 0.1 or 0.0
Only one hypo 1.9
A few over 20
You are correct in that there is no logic so we have stopped looking for any logic just following instructions from the experts
We had a pub lunch today and took in 10 units of insulin before we went into the pub just to play safe, no logic just a guess
 
Point 2- I borrowed this primarily from Steven Ponder. A drop of 0.3 shows the Inuslin is active.

Whilst yes the Insulin SHOULD become active at 10 minutes (though I’d say 15 would be more accurate and was what I was taught on my course), there are quite a few circumstances where that won’t happen. My insulin is quite fast and it takes a minimum of 20 every morning sometimes a lot longer. Whilst I understand why they simplify things for the purposes of the course, I do feel they’re giving people skewed expectations of what their Insulin can and will do.

The most important thing is to be mindful the insulin doesn’t become too active before eating as any hypos this might cause are a nightmare to treat (because the food is going to spike is still coming, and the Blood Sugar might start “rollercoastering”).
 
I don’t understand your final paragraph
We had our third session today and when we told them that it sometimes hurt when the insulin is administered, the nurse said that this should never happen.
A previous nurse said that this could happen so we thought that it was normal for it to hurt several times a week.
Anyway they immediately set up an appointment and we are going to the hospital today (Friday) to establish what is happening, they are worried that the insulin is not going in properly and therefore not working hence the high readings!
Why does it take 10 months to find this out?
Time will tell ………
 
As with everything with diabetes time and experience counts for a lot ! Carb counting in the beginning is daunting ! Just like diabetes itself , but given time it becomes 2 nd nature , I eat what I want when I want and after years of failure I can now judge quite accurately the amount of carbs , insulin ratio etc , as we all know diabetes isn’t totally consistent what works today may not work tomorrow plus there are always what I call “ magic “ foods which no matter how accurately you calculate ( using labels , scales etc) blood sugars still don’t react as they should, for me Weetabix is a culprit ,again pasta can be tricky , but at the end of the day it’s all about seeing what works for you , what I will say is don’t panic if bloods aren’t exactly what is targeted , it’s a marathon not a sprint
 
We had the appointment at the hospital and the nurse and dietitian were completely baffled since there was no pattern to the readings.
After discussion they changed the long acting lantus insulin to another one
I don’t think that this will change anything for at least 3 days then we will see
It was 100 years ago this month that the first human was treated with insulin and even now after all that time there is still a lot to learn
 

All I can say is as time goes by it gets easier.. I can now look at a plate of food and have a very good guess at the carb content.. and I can see my bg and instantly know the correction needed

99 percent of the time it works out

I waste no time in a day as I don't have time to waste
 
I have read this with interest, I had very unpredictable results until they changed the needles, what needles is your wife using? Microdot silicone coated and longer needles (now using Microdot 8mm) made the insulin much more effective, reduced stinging and bruising and gave me more consistent results.
 
They changed the needles from 5 m to 3 ml
At night if the reading is high as it was last night then calculate the adjustment dosage divide it by 2 and inject that before going to bed
Eg
Reading was 14
Deduct 8
= 6
Divide by 2
= adjustment factor
Then divide that by 2
= 1.5 rounded up to 2 units of insulin
We will see what happens

When we were doing 8 to 10 units per meal without adjusting to suit the carb intake it was never consistently high as it is now
The good thing is that there are no more hypo’s
The insulin dosage after adjustment now ranges from 2 units to 10 or 12 units of insulin before meals
 
We had a prearranged pub lunch a few days ago, they couldn’t tell us what the carbs intake would be so we said “stuff the counting, inject 10 units of insulin and that will allow up to 100g of carbs to be eaten “
It seems that it doesn’t matter what you do it doesn’t make a scrap of difference
We enjoyed the lunch and then went back to following the rules .
 
Do you think the course has helped in any way?
 
yes the course has definately helped and the Nurse and Dietition who adjudicate are very good and helpful and we are pleased that we are participating.
The other participants have had Type 1 for between 15 and 25 years whereas my wife was diagnosed in May last year so it was useful to hear what they had to say. Everyone says that it will get easier and that is the hope we are hanging on to.
Counting carbs is the mantra and the course has helped in that way.
It is very stressful but we have not given up.
We have made the decision not to go on any long holidays until the levels are within range, it is not worth the stress
 
That’s good to hear you have got some more useful information and as often the case the others on the course are very helpful. My name is on a list for an online course, sounds similar to your online course. I eat low carb though so I don’t know what they are going to think of that! My nurse is ok with it, but I have met some that aren’t. I hope the stress gets less as time goes on and your wife gets used to which foods fit in with her insulin requirements and follow the rules and which don’t!
 
@grahamrb please don’t put off holidays, or doing anything for that matter. Part of the doing, no matter how stressful, is part of the learning and feeling comfortable and confident in this new way of living. About 2 months after my diagnosis I went to Malaga, with 30 11 year olds as part of our yearly year 6 trip. There were times when I was dancing in the dark, but my DN just told me to go for it, don’t worry about running too high, and carry lots of hypo stuff. I walked miles in heat, ate strange incalculable food and was heavily involved in supervising those children 24 hours a day. But I survived and it gave me the confidence to continue living my life as I always did pre diagnosis. I was 54 at the time.
 
T he new regime which we are using has not changed anything all readings are still very high
 
Course now finished
Ratios now changed, correction factor changed
Supposed to allow 3 days to see what effect it has
We await with bated breath
Only one hypo last week which is an immense improvement
Highest reading last week now down to 20
Still very stressful
Still coming to terms with having to plan everything cannot do anything spontaneously any more
 
grahamrb said:
Still coming to terms with having to plan everything cannot do anything spontaneously any more
Click to expand...

Hopefully the course plus more experience will give you the tools that allow you to become spontaneous again. You won't get it right all the time, and those ratios may still need tweaking, but as time passes you should find it easier to make corrections.
Plenty of spontaneity in my T1 life, but when I go out I have my cgm, my glucose and my fast acting insulin. (Before I had a cgm, I would have had my glucometer).

Good luck with it all.
 
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