Diagnosed Type1 relatively recently and puzzled.

[Nafu9]

Hi all,

I've been lurking for a while now and figured it was about time to pipe up. A little heads up this is part(/mostly) rant part support request!

So I'm 22 and called Nathan.
I was diagnosed type 1 in January of this year and it was a bit of a shock, No family history, bar my younger brother, wasn't showing any symptoms and went to the hospital for something completely unrelated, they happened to do a bg test and it read 26mmol. Got sent to my GP the following day then spent a couple of weeks going to the diabetic clinic then a few follow up visits, but mainly just keep email contact with my nurse.

I managed pretty well for the first couple of months, but then I started slipping and kinda feel that I'm just sliding down, my routine went out the window and my levels started swinging either way, usually veering towards high. Admittingly my diet isn't great due to my work shifts, I'm a chef I work 10am-10pm+ usually without a break, eating whatever happens to be made for staff lunch and dinner, and usually average 60-70 hours per week across 5 days in a high stress role. I now frequently swing between 2.5 and 25 in the same day.

I don't really know what I'm doing with my Novorapid, I just kinda work it on a 1 units sort of deals with 3 mmol (very roughly) and with my Insuman Basal I just do what my nurse advises which is 9 units in the morning and 6 in the evening.
I consistently feel overwhelmed and confused by it and frequently feel quite depressed by it and just drained, I want to just turn my back and ignore it but I'm sensible enough to know that would be a very bad thing to do.

It doesn't help that at work I have to stop frequently to do blood checks and injections and the other chefs view me as slacking because of it which I myself am starting to feel that I am. Yet I don't like mentioning that I kinda have to do it and don't have a choice.

So I guess the tl/dr version is that i have no idea what I'm doing and need some advice/guidence/support.

Thank you for reading this rant

 

[Brunneria]

Hi Nathan,

I'm a type 2, not a type 1, so I can't help you with advice on handling your insulin.

But I can reassure you that this sense of bewildered denial is something we all go through. And it DOES pass. Diagnosis is such a shock, isn't it? There are so many feelings that come up in the months that follow, anger, numbness, exhaustion, confusion, fear... All of them perfectly normal.

Fortunately, you have come to the right place. Everyone here has been through a version of what you are experiencing, especially the type 1s who have all had the steep learning curve with insulin! And there are some who deal with long hours, lack of work breaks and unhelpful colleagues too.

Stick around, and read as much of the forum as you can. There are a lot of people and information here that will help.

 

[himtoo]

hi Nafu9
welcome to the forum
it is an absolute mountain of stuff to take in at first and everything you describe is the sorts of thing I along with many other people on here have experienced so you are not alone.

practical things to do short term
contact your DSN at hospital and ask to get on a DAFNE course ASAP ( to learn about carb counting )
have a look at this online carb counting course in the meantime http://www.bdec-e-learning.com/

there are some great tools available in the form of books and some online apps to help with understanding food and carb content.

this book - carbs and cals is great with pics that show what the food looks like on the plate http://www.amazon.co.uk/Carbs-Cals-...qid=1435475706&sr=8-1&keywords=carbs+and+cals
other people have said this is available as an app too

finally -- going to tag a few of my lovely friends on here to come along and offer their support and wisdom
@Mrsass , @noblehead , @becky.ford93 , @mammamia2006 , @Heathenlass , @urbanracer

 

[Mrsass]

Hiya Nathan, well done on managing the first few months well, you really want to try and avoid the fluctuations (which im sure you already know) 2.5-25 is huge!
It must be hard with your job, I don't know if there's other chefs on here that might be able to share with you, I work in a busy retail job and am lucky to have staff that can spot when I'm being a bit stranger than I usually am so the support from your colleagues is something I would try to get, others may disagree with me but having this helps me, have your tried explaining to them?

As @himtoo said you need to get yourself on a DAFNE course, you will learn so much.

I'm on a pump and have way better control than i ever did on injections, I think this would be a good option for you to look into as it means not going to inject when at work, and having much more stable levels, if I don't want to eat I don't and I can stay well within bg range the whole day, you do need to test a bit more, especially when you first get it but a bg test takes all of 5 seconds

Anything you feel confused by, even if you think it sounds very silly, ask on here, we are all here to help and support each other, I know it can be hard sometimes but you don't sound like the type that would turn your back, you sound like you have a really sensible head on your shoulders!

Abbie

 

[Robinredbreast]

Hi and welcome, you are working very long hours as a chef, so you do need breaks. You said things have slipped, could it be because you don't have the time or because you don't want your diabetes to hinder your work ( I'm sure you're not a shirker )? It can be a lot to take in when diagnosed with type 1, especially with younger people. Obviously your boss and work colleagues do know, but please have a talk with your boss about getting proper breaks and rest and try not to let your diabetes slide. Being a chef requires teamwork, so try and be honest about what you have to do and your medical needs. I'm sure it will get easier in time for you and your workplace should be trying to accommodate your needs as good chefs are always sort after and I'm sure they wouldn't want to lose you. Good luck and all the best, remember your health is important.
Best wishes RRB

 

[urbanracer]

Hi all,

I've been lurking for a while now and figured it was about time to pipe up. A little heads up this is part(/mostly) rant part support request!

So I'm 22 and called Nathan.
I was diagnosed type 1 in January of this year and it was a bit of a shock, No family history, bar my younger brother, wasn't showing any symptoms and went to the hospital for something completely unrelated, they happened to do a bg test and it read 26mmol. Got sent to my GP the following day then spent a couple of weeks going to the diabetic clinic then a few follow up visits, but mainly just keep email contact with my nurse.

I managed pretty well for the first couple of months, but then I started slipping and kinda feel that I'm just sliding down, my routine went out the window and my levels started swinging either way, usually veering towards high. Admittingly my diet isn't great due to my work shifts, I'm a chef I work 10am-10pm+ usually without a break, eating whatever happens to be made for staff lunch and dinner, and usually average 60-70 hours per week across 5 days in a high stress role. I now frequently swing between 2.5 and 25 in the same day.

I don't really know what I'm doing with my Novorapid, I just kinda work it on a 1 units sort of deals with 3 mmol (very roughly) and with my Insuman Basal I just do what my nurse advises which is 9 units in the morning and 6 in the evening.
I consistently feel overwhelmed and confused by it and frequently feel quite depressed by it and just drained, I want to just turn my back and ignore it but I'm sensible enough to know that would be a very bad thing to do.

It doesn't help that at work I have to stop frequently to do blood checks and injections and the other chefs view me as slacking because of it which I myself am starting to feel that I am. Yet I don't like mentioning that I kinda have to do it and don't have a choice.

So I guess the tl/dr version is that i have no idea what I'm doing and need some advice/guidence/support.

Thank you for reading this rant

Hi Nathan,

A bit late to the party here so not sure I can add much of any value to what's been said above. But just trying to pick up on a couple of points, you say that the other chefs view you as slacking, is this for real? Have they actually made comments or is this just your perception?

You write that 1 unit of insulin sort of deals with 3mmol. My interpretation (which may be rubbish) is that you are reacting to highs rather than trying to prevent them. Most of us would try to judge how many grams of carbohydrates we will be eating and inject 20mins (approx) beforehand. Normal advice from medical people is start at 1 unit of insulin to 10g of carbs and then adjust your ratio from 1:10 to suit your own individual needs as time goes on. (It changes over time by the way.)

From diagnosis it can take a while for blood sugars to stabilise (took me 12 weeks) but you really do need to do something about those numbers because they will harm your long term health. Don't you get toilet breaks, fag breaks, - can you time them to be 20-30 mins before you eat and then have a quick injection? Or inject when you can and try to eat something 20 mins afterwards.

And sorry to burden you further, but you also need to manage stress, it's not good for diabetics because it's likely to raise your blood sugars.

Good luck sorting this out - please come back with more questions if you need to.

 

[Daibell]

Hi. You certainly need better support from your surgery and to attend a course. First you need to ensure the Basal is right. This is more difficult with twice daily injections. Your morning fasting level should be between 5-7 mmol and you need to adjust the two Basal injections to allow the Basal to counteract the background glucose output from the liver. It may be the current injection rate is OK and only very small changes should be made if needed. You need to change the way you use Novorapid as others have said. You need to count the carbs at each meal and inject at the start of the meal. The standard start advice is to inject 1 unit of rapid for every 10 gms of carb. This can then be tweaked based on experience and meter readings 2-3 hours after a meal. Use the meter frequently to avoid risk of a hypo.

 

[Nafu9]

Hi all, thank you for all the advice

I'm booked in for a T1DE course in September, not sure if this is the same as a DAFNE course just under a different name? I have the carbs and cals app, but I must admit I don't use it as much as I should simply because I don't have the time to fill in my meals.

I've had a brief look at the pump and it kinda scares me, I'm relatively clumsy and am scared I would end up ripping it out, either day to day or when I'm with my girlfriend.

I think it's slipped due to a combo of not having time and not wanting to have to stop doing whatever I'm working on to do it.

It may just be a perception but I feel they think I use my diabetes as an excuse, I could well be wrong but I'm sure you know what it's like when an idea settles in your head.

I think you are right that I'm reacting as opposed to preventing. I have no idea about carb counting and because I need to get back to work tend to just wolf my food down instead of figuring out if it's good for me.

I get toilet and fag breaks but again tend to just do my business quickly and get back to work. I'll start seeing if I can time them better. Which raises another question, how do cigarettes (hand rolled) affect, if at all, sugars/diabetes in general?

Thank you again for all your input

Nathan.

 

[urbanracer]

Hi all, thank you for all the advice

I get toilet and fag breaks but again tend to just do my business quickly and get back to work. I'll start seeing if I can time them better. Which raises another question, how do cigarettes (hand rolled) affect, if at all, sugars/diabetes in general?

Thank you again for all your input

Nathan.

As a non-smoker all I'd say to you is that we diabetics need to look after ourselves a lot better than non-diabetics generally do. I've no idea what it does to BG's.

 

[June_C]

I confess I'm a smoker and apparently along with diabetes it increases the possibility of heart disease Not sure if it has an effect on bg levels.

 

[urbanracer]

I confess I'm a smoker and apparently along with diabetes it increases the possibility of heart disease Not sure if it has an effect on bg levels.

June, June June! ( and @Nafu9 )

http://www.diabetes.co.uk/diabetes-and-smoking.html

 

[lizdeluz]

Hi, and welcome to the forum!
You've said some interesting things here:

• Smoking isn't good for diabetes, or for anyone. Maybe you'd consider vapping as a way to stop altogether? Sorry if this is not a welcome idea for you.
• Your comments on fag and toilet breaks and getting back to work quickly, and the sense you have that colleagues think you are using your diabetes as a wheeze to get a break, shows that you are under a lot of pressure at work. I recognise it and I used to put work before diabetes myself. The trouble is that diabetes won't be put on the back foot, a person with diabetes has to look after him/her self. So maybe you can get the opportunity to tell colleagues or a manager how you have to manage your diabetes. This is difficult at the moment because you are recently diagnosed and it's all new to you as well. You will be able to decide better on your priorities when you have been on the T1DE course.
• Meanwhile, although your job is important to you, try to find some time in the day to relax, because being stressed can raise your blood sugar levels. If you can find time, some exercise and relaxation would really help you.
• Many, but by no means all, T1s use a pump, but you don't have to go down this road, so don't stress about that.
• I know what you mean about not having the time to keep a record of your meals. However, you will find, if you do decide to use an app, that recording meals gets easy quite quickly as you build up your database of favourite foods/meals. If you can get started on carb counting, you will be ahead of the game when you do your course.

Again, welcome, and keep checking in to the forum, because there are lots of people on here able and willing to help.

 

[Natalie1974]

Although I realise it's a difficult conversation to have...it may be worth trying to confide in your colleagues that you don't feel you're coping with your diabetes too well. The first few weeks and months...even years after diagnosis there is a lot to take in and a lot of adjustments to make...I would think most especially in the job that you do which is well known (we've all seen Gordon Ramsay in action...lol) for being a very stressful environment that juggling insulin doses...testing and tossing salads etc is going to be a nightmare...perhaps as a trade off you could offer to stay back and do some of the grottier jobs that no one likes in exchange for them cutting you a little slack until you get into the swing of things?

 

[Nafu9]

If I'm honest, the reason I smoke is just to get the extra few minutes to sit down at work. I plan on giving it up once I'm out of the kitchen and into a more managerial position.

As silly as it sounds I hate having to talk to my head chef about serious matters (makes it a pain in the rear when I want a raise!) and again it crops up that I don't want him to think that I'm trying to skive . I know I need to, it's just getting the courage too!

I'll check those resources about carb counting when I finish work. And from there try to start managing my insulin better with that.

Is there any difference between DAPHNE and T1DE?

 

[Natalie1974]

Smoking is not at all ideal as a diabetic...I'm also a smoker but it's second to top of my list of things to sort out at the moment...I've had several higher than should be HBA1c's over the last few years and having finally started on a path to correct and am currently winning the battle...I am viewing this as my number 1...once I get it down to a level I'm happy with...smoking will be my next target. Focus on one thing at a time...while I'm sure there are a number of people who may shoot me down in flames for saying that...you have enough to deal with at the moment...be kind to yourself...get your BG under control...then tackle it.

 

[lizdeluz]

If I'm honest, the reason I smoke is just to get the extra few minutes to sit down at work. I plan on giving it up once I'm out of the kitchen and into a more managerial position.

As silly as it sounds I hate having to talk to my head chef about serious matters (makes it a pain in the rear when I want a raise!) and again it crops up that I don't want him to think that I'm trying to skive . I know I need to, it's just getting the courage too!

I'll check those resources about carb counting when I finish work. And from there try to start managing my insulin better with that.

Is there any difference between DAPHNE and T1DE?

I understand what you are saying about talking to the head chef. It's a bit like giving someone a stick to beat you with? I'm afraid that diabetes in the work place can be a bit like this, and your instincts are therefore probably correct, so stay with your instincts. Your best bet is to be as clued up yourself as possible about diabetes, and this is bound to happen over the next few weeks and months. Put your health first and make everything else work towards that.
I've never come across T1DE but guess that it means Type 1 Diabetes Education? I can't remember what the DAFNE acronym stands for, but I would think that both are general introductory courses for newly diagnosed people with diabetes who have to learn about insulin and diet. I enjoyed the DAFNE course I went on, though I was a bit slow! It gives you a good chance to exchange info with other people with diabetes, and with the health professionals/dieticians.

 

[becky.ford93]

Hi there, I'm a few months down the line now. I'm 21 and like you my diagnosis was a total shock. It's a real pain at work having to test regularly, but I would really recommend working on your carb ratio, as you should then find you fluctuate less and can rely on testing less frequently. I would always test before a meal and at bed time though, and of course if you start getting hypo symptoms. The thought of a pump scares me a little too. I wouldn't worry about it until you're a bit further into the journey, I've heard you can only get one once your levels are well controlled anyway, though don't quote me on that. My levels were all over the place for about 2-3 weeks after my first diagnosis, so don't feel like things should instantly be perfect, it takes time, and because its early days you will probably find things are very changeable. If you need anything let me know!

 

[Nafu9]

Mine was kind of the other way around, after being diagnosed I.quickly had it to where my sugars were 6/7 each day but over the last month or 2 they have gotten.progressively worse, although it's likely that my honeymoon is ending. I've started trying to work out my carb ratio today so hopefully that will start helping soon. At the moment I test when I wake up, inject insuman, test at/after lunch (don't usually have brekkie ) test at dinner then before bed with another injection.just using my novorapid as and when.

Thanks again everyone!

 

[becky.ford93]

Is there any reason you don't have breakfast? You might find having three regular meals a day helps you, as going that long without eating may make things harder to regulate. I would really recommend keeping a diary of when your highs and lows happen. It may help you to work out what's going wrong

 

[Nafu9]

Mainly because I wake up, roll out of bed and go to work.

A diary could help, I'll have to give it a try!