diet.. any feedback would be good.

[master mouse]

I have been a diabetic for 15 years now, type 2 .. now being treated by insulin, novo rapid 16units x3 a day and lantus 62 units daily
I also am on Sitagliptin .I was advised to increase my insulin to 18 units from 16 novo rapid a few days ago and since then I have had two episodes of low blood sugar (4 and 3.8).
Now knowing what to do now and need advice about what to do as dont want any more nasty episodes of low blood sugar.My DN says this isnt very low figures and it should settle. I rang my DN but still waiting for a call back and that was hours ago.
Also the DN has referred me to Weightwatchers because of my weight gain since coming on insulin..how would I adjust my insulin to deal with the weight watchers diet(just was advised to vary the dose (no advice what to)according to the carbs I ate.. but I thought the whole point of weightwatchers diet is that you follow the diet exactly for it to work.I am not very mobile due to my heart condition.
Any help, advice or whatever would be appreciated..getting mightily sick of it now as everything I have been put on was meant to help me and I keep feeling worse and worse.

 

[Daibell]

Hi. Those insulin units are quite high and imply you have some insulin resistance due to being overweight. This will make it more difficult to avoid swings from high blood sugar to possible hypos. My advice would be to match the carbs to the insulin and not the other way round. What I'm really saying is that by reducing carb size as far as is necessary you should be able to gradually lose weight and be able to reduce your insulin units. Weight Watchers may achieve the same objective but note that it's not fat that makes you fat but carbs and the carbs add to glucose in the blood.

 

[donnellysdogs]

I would advise that you ask to go on a dafne, desmond etc course, as the idea of being on a bolus/basal regime is that you can change your insulin according to the food and carbs you eat.

Under 4 is classified as being on the floor... This is WAY to low levels. Especially if you are handling any mechanical or electrical equipment or driving.

 

[donnellysdogs]

You do not have to follow weightwatchers diet exactly... But WW do tell you about their own products that they make such as ready meals... However a tv documentary not long ago did not recommend their products as being ideal because of some of the ingredients WW use in them.

Bdec have a good course online to follow ref carb counting..

Do you use a daily log for blood tests?

Are you going low 2-3hours after you eat or possibly at night?

I dont know much about insulin and weight gain, but I believe some insulin can lead to weight gain?? Not sure on this?

 

[Daibell]

Hi. My earlier post was a bit mis-leading and incorrect;sorry. Donellysdogs has put it correctly and is in fact what I do with my Bolus i.e. adjust my insulin to the carbs (carb counting). However, the target is to reduce the insulin gradually by reducing the carbs to a level that gets your insulin lower and your weight should gradually reduce as well. As this happens any insulin resistance should also fade away and you should find it easier to manage sugars. Well, that's the theory anyway and a DAFNE course may well help.

 

[elaine77]

Hi there,

I agree with Daibell that fat doesnt make u fat and carbs do! There has even been mention that the massive increase in diabetes stems from the late 80s onwards when the country was told to eat carbs and hav a low fat diet because fat is bad. I dont believe it, im on a low GI carb and high fat diet and I have lost about 8lb since diagnosis which doesn't sound like much but considering my BMI was only 23 at diagnosis it is alot because its usually harder to lose weight the less of it u have... I dont inject insulin yet though and so can't comment on that..

Sent from the Diabetes Forum App

 

[sandysan]

my husband is on lanctus and nova rapid pen insulin , he is high still 14 plus ive just been diagnosed last week and trying to do low carbs my hubby is trying to do the same with me as he was all haywire with his eating before i was diagnosed ,,
tonight i done his blood and it was 4.6 ? is this to low for my husband ?
thanks

 

[Daibell]

Hi Sandysan. Your husband will inevitably have sugar swings on insulin as you can't always get the carb count right (or whatever way he works out his Rapid units). 4.6 is OK although the DVLA look for 5 and above for driving. My lowest has been 3.5 with a hint of going hypo but we are all different. He should avoid going below 4 to avoid hypos.

 

[phoenix]

Mastermouse
I agree on the need to learn how to use insulin effectively. Unfortunately the DAFNE course is not available for people with T2. There is an X-pert insulin course in some areas.
As you also use an oral medication in addition and the larger basal insulin dose suggests insulin resistance you do have some different problems to someone with T1.
There are books such as Think Like a Pancreas by Garry Scheiner.
Diabetes UK also has a free Ebook introducing carb counting and a list of carb counts to accompany it. (it is probably more aimed at T1 but for meals the same principles apply)

https://shop.diabetes.org.uk/store/lite ... -book.aspx
There is also an online course with the same caveat (aimed primarily at T1)
http://www.bdec-e-learning.com/

Weightwatchers newer points system takes into account fibre so attempts to favour higher fibre hence (probably) lower glycemic index carbohydrates
. My daughter (not diabetic) has attended weight watchers and lost and kept off a lot of weight. I've never seen her eat a weightwatchers product, it's not compulsory. I know she had bought recipe books and calculators so I think that's probably what they push at meetings in the UK though of course their ready foods are available in supermarkets.
When I visit her, I am quite able to adjust my insulin to eat meals made using weight watchers recipes, indeed I've taken some of the recipes to use at home. A lot of people knock the system but for some people it works well. I've been sorting out my mother's belongings and found her lifetime membership letter and badge. It dated back to the early 1980s. She got to her goal weight and managed to maintain it for 30+ years.

 

[sandysan]

thanks for your replies ,,, oops I forgot to ask being a newbie ,, what is the daily limit of carbs ,,, im t2 and no meds as yet

 

[sandysan]

thanks for your replies ,,, oops I forgot to ask being a newbie ,, what is the daily limit of carbs ,,, im t2 and no meds as yet

 

[master mouse]

I would advise that you ask to go on a dafne, desmond etc course, as the idea of being on a bolus/basal regime is that you can change your insulin according to the food and carbs you eat.

Under 4 is classified as being on the floor... This is WAY to low levels. Especially if you are handling any mechanical or electrical equipment or driving.

hi,Thanks for the reply.I was asked to go on a desmond course and then when I enquired they wouldnt take me as I was type 2.I have no idea how to work out the carbs/insulin formula.. how do you do that? ie How much insulin do you have to give yourself per carb.My diabetic nurse just told me to inject 18 and no reason why it should be that number.
I dont drive or operate machinery, and dont work due to my poor health and i am a carer,, but at 4 I am starting to sweat heavily and feel unwell as my blood sugar is low.

 

[master mouse]

You do not have to follow weightwatchers diet exactly... But WW do tell you about their own products that they make such as ready meals... However a tv documentary not long ago did not recommend their products as being ideal because of some of the ingredients WW use in them.

Bdec have a good course online to follow ref carb counting..

Do you use a daily log for blood tests?

Are you going low 2-3hours after you eat or possibly at night?

I dont know much about insulin and weight gain, but I believe some insulin can lead to weight gain?? Not sure on this?

I have started to log every blood test and what I eat.I seem to go low if I do more physical things during the day or about 3 hours after I eat.I have gone low a couple of times at night when I am going to sleep.
I did buy the carbs and calorie book but it doesnt really explain how to adjust your insulin to what you eat.

 

[donnellysdogs]

No the carbs and cal book wont tell you how to adjust your insulin.

If you are going low 2-3 hours after food then you are having too much bolus (fast acting insulin) with your food. Ideally, if your insulin pen delivers in 1/2 units, it would be better to try and eat the same food again at some point... And give yourself 1/2 unit less. If your pen only does 1unit changes, then lower by 1 unit.

Most people when they start carb counting are told to start off by giving themselves 1 unit of insulin for 10g of cards. So if you look at the carb n cal book and look at say a shortbread finger... That equals 10g of carbs so that would be 1 unit of insulin... A piece of 30g malt loaf is 19g carb, so that would be 2 units of insulin... So if you ate both together you would give 3 units..

However..... Its not quite so straight forward as that...as 1 unit to 10g carb is just the starter point that HCP's give... We all vary....I myself have breakfast at 1 to 11g, lunch at 1 to 10 and dinner at 1 to 9g.

This is just a very basic guide..... However, you really should be seen by a dietician or go on a course offered by your hospital BEFORE going alone with adjusting your doses....

It is imperative that anybody who takes insulin on a bolus basal regime has the ability to change their dosages according to what they eat..... Whether you are type 1 or 2, if you are having basal and bolus you have to be able to eat more or less as YOU want to...

 

[donnellysdogs]

By the way... If an increase from 16 to 18 units is making you low.. Then if it was me I would lower the dose to 17....

Are you taking a basal injection as well?

 

[master mouse]

thank you all for your wonderful advice. I have looked at the on line course and learnt a lot from it.I also have the book think like a pancreas so that will help.Going to go to weightwatchers on monday and attempt to do their diet and carb count and try to adjust the insulin accordingly. wish me luck!Any queries I shall nag my diabetic nurse and doctor until I get some weight shifted and start to feel better. Once again thank you for bothering to reply.

 

[master mouse]

By the way... If an increase from 16 to 18 units is making you low.. Then if it was me I would lower the dose to 17....

Are you taking a basal injection as well?

Thanks for your interesting replies.. it explained what I needed well..I am on 62 units of lantus. That was increased a couple of months ago from 60 units.Then they just increased the novoraid to 18x3 .will try 17x3 today and see how that goes.

 

[master mouse]

No the carbs and cal book wont tell you how to adjust your insulin.

If you are going low 2-3 hours after food then you are having too much bolus (fast acting insulin) with your food. Ideally, if your insulin pen delivers in 1/2 units, it would be better to try and eat the same food again at some point... And give yourself 1/2 unit less. If your pen only does 1unit changes, then lower by 1 unit.

Most people when they start carb counting are told to start off by giving themselves 1 unit of insulin for 10g of cards. So if you look at the carb n cal book and look at say a shortbread finger... That equals 10g of carbs so that would be 1 unit of insulin... A piece of 30g malt loaf is 19g carb, so that would be 2 units of insulin... So if you ate both together you would give 3 units..

However..... Its not quite so straight forward as that...as 1 unit to 10g carb is just the starter point that HCP's give... We all vary....I myself have breakfast at 1 to 11g, lunch at 1 to 10 and dinner at 1 to 9g.

This is just a very basic guide..... However, you really should be seen by a dietician or go on a course offered by your hospital BEFORE going alone with adjusting your doses....

It is imperative that anybody who takes insulin on a bolus basal regime has the ability to change their dosages according to what they eat..... Whether you are type 1 or 2, if you are having basal and bolus you have to be able to eat more or less as YOU want to...

My heart consultant ASKED my gp to send me to a dietitian but he wouldn't do so.. (prob cos of costs I am assuming).I think sending me to weight watchers is the cheaper option for them .Yes I quite agree I should be able to adjust my insulin, that is what I am trying to do, by going lower carb and adjusting my insulin I hope to see some results and be better informed.I did the ecourse on dose adjustments MORE DIRECTED TO TYPE 1 and found it very informative.

 

[donnellysdogs]

It doesnt really matter what type of diabetes you have officially been diagnosed with, if you are on insulin injections then the very basics of care that you should be given is how to adjust your dose.

Weightwatchers... Friend of mine does it in Wales for 9 years now... He certainly lost weight, but has become so ovsessed with it, that his (ex) partner (still in same house at moment) has never been allowed to buy anything treat wise.. Even bread.. Unless it is WW. The WW friend is now so underweight, he looks awful..bably anorexic-and yet WW still let him attend. His partner, despite being on an imposed WW diet hasnt lost weight and put weight on actually. One difference between the pair of them...WW person does a huge amount of physical activity.

WW does work for many, many people, and the clubs give support. You would also need to give your body a kickstart though by doing an increase in exercise..

It would be intersting from my point of view to learn how many carbs WW food adds up to in a day...

 

[master mouse]

hi thanks for your reply.I have started the weightwatchers diet and been on it only a few days now, but have had 2 quite bad hypos. I have had to treat it with carbs, lucazade /glucoze tablets..and my current one i over treated so it swung the other way both making me feel awful.Not sure how my weightloss will be after having to treat hypos.
I also have a heart condition so am limited in the exercise I do.I have reduced my fast acting insulin but maybe I also need to look at how low to reduce the long acting.They have put me on 26 points a day and you get the option of another 49 extra during the week, I am still working my way through understanding the system..there is a lot to take in and they gave me 4 books to read through.I have only exercised by walking for an extra 15 mins a day so it isnt the exercise that is causing the problems. I shall have to try to get some medical advice on how to adjust the insulin as I just cant work it out correctly.
Feel very alone and frustrated as I dont seem to be able to get the answers from anyone as to what dose to do...and feel I am left in a dangerous situation,do I continue with the diet or give up on it.