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DKA - feeling like I'm losing it again.

Robynberrill

Robynberrill

Active Member
Messages
40
Type of diabetes
Type 1
Treatment type
Insulin
Okay so in May this year I was rushed into hospital after I collapsed in front of my mum. Turns out it was DKA. I admit I had been naughty with what I was eating and not taking the correct doses of insulin. I was in hospital for just over a week and the doctors saw a dramatic decrease in my blood sugar levels.

Since then I have been very careful with what I eat and making sure I am taking the correct doses of my insulin.

But I feel like I'm going downhill again. I am still very careful with what I am eating. I dread injecting insulin every day because it still seems to hurt and leave nasty lumps and bruises even though I should be used to it all by now (been diagnosed a year)

I'm really finding it hard and I just want some advise or if anyone has/is feeling the same.

X
 
Robynberrill said:
Okay so in May this year I was rushed into hospital after I collapsed in front of my mum. Turns out it was DKA. I admit I had been naughty with what I was eating and not taking the correct doses of insulin. I was in hospital for just over a week and the doctors saw a dramatic decrease in my blood sugar levels.

Since then I have been very careful with what I eat and making sure I am taking the correct doses of my insulin.

But I feel like I'm going downhill again. I am still very careful with what I am eating. I dread injecting insulin every day because it still seems to hurt and leave nasty lumps and bruises even though I should be used to it all by now (been diagnosed a year)

I'm really finding it hard and I just want some advise or if anyone has/is feeling the same.

X
Click to expand...

Hiya I have just read this post after responding to your other thread.

Glad you are well now and understand the dangers of not taking the right amount of insulin. Taking insulin is essential for your energy levels, if you don't take enough then you run high and your body slows down with too much glucose on board, so hence why your energy levels are poor. I mentioned in my other response about routine and it's pants I know but you need to get into a routine of testing and injecting, looking after yourself and getting good health is a priority.

If injecting is becoming a problem then speak to your DSN and tell them this, as you will need to do this for the rest of your life, well until they find a cure that is..
 
its quite common to lose momentum from time to time throughout your diabetic life the trick is to be able to get back into the swing of things........

for me this is made easier by having the knowledge and experience of dose adjustment/carb counting.......

have you had any formal training on this?
 
novorapidboi26 said:
its quite common to lose momentum from time to time throughout your diabetic life the trick is to be able to get back into the swing of things........

for me this is made easier by having the knowledge and experience of dose adjustment/carb counting.......

have you had any formal training on this?
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I haven't had any training in regards to carb counting. I'm still on set doses of insulin so I'm taking the same amounts every day. I wouldn't even have a clue about carb counting if someone asked me about. My dietician said they don't want to start carb counting until my BG are on more of a normal level. I do want to start trying it but I don't know if I'll be able to get the hang of it. Just seems like another thing that I will have to learn again.
 
Hi :)

Type 1 is hard no matter your age, but once you get it uner control and get a bit of a handle on it, you do feel better because you feel like your more in charge.

I'm going to tag @daisy1 so she can give you some info. I know you're not newly diagnosed but there's some helpful stuff there.

Carb counting isn't hard, and once you carb count you can vary your insulin does for each meal which gives you more flexibility.
 
Robynberrill said:
I haven't had any training in regards to carb counting. I'm still on set doses of insulin so I'm taking the same amounts every day. I wouldn't even have a clue about carb counting if someone asked me about. My dietician said they don't want to start carb counting until my BG are on more of a normal level. I do want to start trying it but I don't know if I'll be able to get the hang of it. Just seems like another thing that I will have to learn again.
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I would suspect the decision to keep you on set doses it to let any honeymoon period [your own insulin still being produced] to die off......it can go on for a while right enough but I think after a year you can definitely start trying to count....

I wouldn't personally advise you to start changing the doses but if it were me I would.........of course you need to know how before you start....

a basic rule of thumb for adults is that 1 unit will deal with 10g of carbohydrate............I would say its perfectly safe to start thinking about your meals on that basis, see what kind of doses you get, then compare to your set doses and if you feel comfortable try an adjusted dose....

you should approach your team and say you want to start carb counting...........

in the long term though a proper educational program would do you good as that teaches about how to adjust your background/basal insulin, which is actually the most important dose, as well as how to adjust for illness and exercise etc.....

in the mean time you could have a look at this: http://www.bdec-e-learning.com/

;)
 
I'd also add that if you're on set doses of insulin and aren't carb counting (through no fault of your own) that would probably affect your blood sugars as you might be inadvertently having different amounts of carbs each day but the same doses of insulin. So one day your blood sugar could be high, another day low.

Carb counting would allow you to get better control of your diabetes and that would help make you feel better in yourself. Swinging blood sugars make you feel like rubbish and can be exhausting.
 
azure said:
I'd also add that if you're on set doses of insulin and aren't carb counting (through no fault of your own) that would probably affect your blood sugars as you might be inadvertently having different amounts of carbs each day but the same doses of insulin. So one day your blood sugar could be high, another day low.

Carb counting would allow you to get better control of your diabetes and that would help make you feel better in yourself. Swinging blood sugars make you feel like rubbish and can be exhausting.
Click to expand...


Yeah I am wanting to carb count. I'm on ten units of novorapid a day and then on 17 Levimer once a day. I have mentioned that I do want to be able to have the chance to learn to carb count but my consultant and dietician are useless at times.
 
keep at them.....!!

and also have a look at that website I posted, you can basically learn it all online..........:)
 
@Robynberrill

Hello Robyn and welcome to the forum :) Here is the information, mentioned above, that we give to new members, which will give you a lot of information on carbs to help you. Ask more questions and someone will be able to reply.


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 over 150,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

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

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 bloodglucose 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.
 
Hi - I'd agree with all of what's already been said about carb counting and courses - it would help you enormously to get on a DAFNE (dosage adjustment for normal eating) course, as it will explain the whole carb-counting thing and how it applies to you (as everyone is different). The support you get from the people running it and the other people on the course is invaluable, and it will give you more confidence and motivation to know you can control your diabetes instead of it controlling you.

If you feel that your consultant and dietician aren't giving you as much support as you need, is there any possibility of changing, either within your current hospital or transferring to another? I ask this because I was in the same position as you this time last year, and wasn't at all happy with my diabetes care. My doctor recommended a different hospital, and the consultant there is just what I was looking for - I can't believe how much difference it has made, and how much better I feel now that I'm able to control my sugar and insulin levels.

You don't have to accept second-rate and unhelpful treatment, and it's important that you can find a diabetic team you can work with to give you the best chance. Good luck!
 
I had a really good consultant. He was amazing until he retired and I seen a new one. I just don't think he understood me at all. I understand they have to be strict but the first thing he did when he met me was shouted at me when he found out that I was in hospital with DKA. I felt like a child again getting told off by a teacher. I'm dreading seeing him again. Don't get me wrong my dietician is lovely and gives me the support I need but when I ever mention anything to do with carb counting she pushes the idea out of the way x
 
Well, shouting at you while you're in a hospital bed is hardly helpful, is it? I understand exactly what you mean, though - I've had a consultant like that before. I really think you should look for another consultant as soon as you can - you won't make any progress if you feel like that. And however lovely the dietician is, if she's resisting the idea of carb counting to help you control your diabetes, then she's not helping you. I've just been to see my dietician this morning - she works with the DAFNE team and knows carb-counting and insulin ratios inside out - now THAT's helpful! (Incidentally, she said in passing that a lot of dieticians don't understand carb counting unless they've been involved with DAFNE, and I can believe that from my own experience.)

If you can get some proper help and support with this, it will be easier for you stop the fixed insulin injections and go onto a regime where you can vary the insulin you take according to your needs, and that in turn will give you a much greater degree of control and flexibility with your day-to-day life. And you won't have to dread seeing your consultant either, I promise you that!
 
That's horrible that you were shouted at. I can understand why you're reluctant to see the consultant again.

When you mention carb counting to the dietitian again perhaps you could phrase it in a different way - maybe by saying something like you'd like to get better control of your diabetes and avoid DKA and learning carb counting would help you do that. Also, you might like to take someone to your next hospital appointment just for a bit of support. It sounds a little thing to do but it can help a lot.
 
Robynberrill said:
Yeah I am wanting to carb count. I'm on ten units of novorapid a day and then on 17 Levimer once a day. I have mentioned that I do want to be able to have the chance to learn to carb count but my consultant and dietician are useless at times.
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So when do you take your Novorapid? Are those 10 units divided up into individual doses over the day?
 
Robynberrill said:
No I take ten units before eating each meal
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Ok :) Thanks for clarifying that.

When I was first diagnosed, I had a set dose too, but I soon started to adjust my insulin (after checking with my diabetes team, of course). When you count carbs, if you eat a meal with more carbs than usual you can have slightly more insulin to deal with it. That's great if, for example, you go out for a meal or at Christmas or something. Alternatively, if you eat a meal that's lower in. Arbs than usual,my ou have less insulin. It doesn't sound very exciting, but being able to choose what to eat and then calculate your own insulin dose makes you feel more normal. After all, that's what people without diabetes do.

I was very down when I was first diagnosed, but being able to choose what to eat and still be able to keep my blood sugar under control made me less depressed. I felt it was a step on the path back to feeling more like 'the old me'.

Keep asking about the carb counting. As you're already having the Novorapid before each meal, you shouldn't have to make any huge adjustments in your injection schedule.
 
azure said:
Ok :) Thanks for clarifying that.

When I was first diagnosed, I had a set dose too, but I soon started to adjust my insulin (after checking with my diabetes team, of course). When you count carbs, if you eat a meal with more carbs than usual you can have slightly more insulin to deal with it. That's great if, for example, you go out for a meal or at Christmas or something. Alternatively, if you eat a meal that's lower in. Arbs than usual,my ou have less insulin. It doesn't sound very exciting, but being able to choose what to eat and then calculate your own insulin dose makes you feel more normal. After all, that's what people without diabetes do.

I was very down when I was first diagnosed, but being able to choose what to eat and still be able to keep my blood sugar under control made me less depressed. I felt it was a step on the path back to feeling more like 'the old me'.

Keep asking about the carb counting. As you're already having the Novorapid before each meal, you shouldn't have to make any huge adjustments in your injection schedule.
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The next time I see my dietician isn't until October time. She's explained to be a little bit in regards to the carb counting. But she said because of the DKA she wants to make sure I'm back on track with things before changing what I do. I do understand where she is coming from I just think it's easier if I was able to carb count. People that I know who have type one diabetes have always had positive things to say about it.
 
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