doing it all wrong

gemma2530 said:

Hi I am new to this forum. I'm a 31yo T1 and have had it for 13 years I know I'm now newly diagnosed but I feel new to it as I'm reading these posts. When I was first diagnosed I was always told to have carbs with every meal, so I feel like I have been doing it wrong over the years. My readings have always been high and have dkd 4 times on the last 13 years the last time I was 30 mins from dying, my last hba1c was 64 and that was my lowest result. I need help with what I need to be doing. I don't go to the doctors regularly or keep up with most of my appointments due to mental health problems.

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The advice to low carb is for people with type 2 diabetes. For people with type 1 you can eat carbs if you want, or not if you don't want. The most important thing is to make sure the carbs you are eating are adequately covered by your insulin doses.

So eating carbs with every meal is not doing it worng.

Always being high does however suggest you don't have a brilliant grasp of how to use your insulin. What insulins are you using? Do you carb count?

You should be having a diabetic review at least annually. You should be having retinopathy screening annually. Do you have friends/family who could take you to your hospital appointments? They aren't challenging reviews, they are just a check ups but if you've had poorly controlled diabetes for a while it is important you get checked so you know if the highs are causing any damage that you need to address.

@gemma2530 it sounds as if you're not well supported.
I would suggest that you check your basal dosage first. Here's how to do it
http://www.diabetes.co.uk/insulin/adjusting-basal-bolus-insulin-doses.html
After that I would reduce the amount of carbs you eat, because it makes blood sugar spikes smaller and EASIER to control.
Are you dosing your bolus according to your meter readings ? If your readings are always high, then your insulin is insufficient to deal with it. Make small changes until your meter readings come within range
http://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html
Keep asking questions, and someone should have an answer !
Geoff

gemma2530 said:

I was just told to do 18 units 4 times a day I don't change my dosage

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Doesn't surprise me. That's not support. Insulin doses are meant to be appropriate for what you're eating. Your basal is meant to be appropriate for your lack of insulin production. After going on insulin 14 months ago I had to ring my Diabetes Clinic every so many days with doses and readings, which they then altered to bring results within range. I was then allowed to control my own dosing.
A one-size-fits-all standard levelof dosing wouldn't work for any diabetic e.g. fish and chips would require far more insulin than a cheese salad.
So it's up to you whether you're in a position to take control or need to jump up and down demanding more support.
Pushing for help is something most need to do, so don't let that put you off.
Geoff

gemma2530 said:

I was just told to do 18 units 4 times a day I don't change my dosage

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I'm not T1, but from everything I've read the issue is that the more carbs you eat, the more you have to be very clued up about how much you dose and when. This is a very interesting article about an tracked experiment of eating 12 days of high carb and 12 of low carb - that might give you some ideas.
https://diatribe.org/low-carb-vs-high-carb-my-surprising-24-day-diabetes-diet-battle

gemma2530 said:

I use novorapid 3 ties a day (supposed to) and lantus at night. no I don't carb count at all. I don't really leave the house unless I really have to so I fail to make the appointments as I find it difficult to go. I don't have anyone who can take me and make me go to the either

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Hi @gemma2530 , your Lantus is your background or basal insulin. it should be set to keep your blood sugars level throughout the day if you don't do anything different from usual. When you eat anything with carbohydrate you would inject your fast acting or bolus insulin; your Novorapid at a ratio calculated specifically for you. For example 10g carbs (for me) means I inject 1 unit of insulin. Can your GP help you with a telephone consultation if you are unhappy leaving the house? There are carbohydrate counting courses online which might help if you are unable to attend a course? Hope this helps, and if you need any more info please shout up x

Hi. I'm afraid your GPs have been giving you poor advice over the years. First you don't need to have carbs with every meal but whenever you have carbs you need to adjust the Bolus insulin to match the carbs using the 'Bolus ratio'. This is typically 1 unit of Bolus to 10gm of carbs but will vary slightly for each person. Note that if you eat too many carbs you may gain weight. Note that you must have a diabetes review with the GP or DN at least once year.

The information you recieve on onset is frequently not too helpful, you will learn as you progress. As results vary from person to person, there are not a lot of hard and fast rules. It help to learn from others who have long term experience. Don't worry, we are here to help you through.