Early days with Type 1

Hi. I assume he is on Basal/Bolus? Has he got the Basal balanced which needs to be got right before you can really get the Rapid ratio right? With insulin it should only take a few weeks but the honeymoon period can be a factor. I was lucky and have hardly changed my insulin since starting 2 years ago.

2 weeks in is still early days yet , just get him to keep a detailed bg diary so he can show this to his diabetes team and they will advise further on adjusting his insulin doses, any other questions do come back and ask.

semk said:

Hi, my partner was recently diagnosed with Type 1 (as in 2 weeks ago). He's working so hard at keeping his blood glucose levels correct, carb counting and watching what he eats, all of that... and yet his counts are often still really high, and he's had two hypos.

His doctor said his body is still learning how to respond to the insulin, but I was wondering how long it takes (roughly - like months? years?) to start regularly having "controlled" BG levels?

Apologies if this is not the right forum for this type of question - and thanks!

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Hi lovely.
First of all, well done to your partner for working hard on controlling his sugar. I send lots of love to you both. Its not easy and I know what you're going through, my husband was diagnosed a month ago and he's doing really well now. It was so scary, I thought our lives were ending!

we're not up to carb counting yet, confuses the hell out of us. Eventually things will settle down for yourselves. Its all about balance and learning to recognise different signs and symptoms of high and low blood sugar. Please please message me with any worries or questions. I know exactly what you're going through. After 3 weeks we had fallen into a good routine lots of love xxxkirstie

Hi there,
Your partner might find it useful to cut right back on carbs whilst he's getting to grips with his diabetes.
Lower carb intake = lower blood glucose levels = less insulin = less chance of making a mistake.
(Next year you might like to consider this event: ) find gbdoc at: www.gbdoc.co.uk

kirstiemarie91 said:

Hi lovely.
First of all, well done to your partner for working hard on controlling his sugar. I send lots of love to you both. Its not easy and I know what you're going through, my husband was diagnosed a month ago and he's doing really well now. It was so scary, I thought our lives were ending!

we're not up to carb counting yet, confuses the hell out of us. Eventually things will settle down for yourselves. Its all about balance and learning to recognise different signs and symptoms of high and low blood sugar. Please please message me with any worries or questions. I know exactly what you're going through. After 3 weeks we had fallen into a good routine lots of love xxxkirstie

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what a lovely heartfelt post @kirstiemarie91

I would add my full agreement with the way you are getting to grips with this and would recommend the same to @semk .
this race lasts a long time ( like a marathon -- not a sprint) so taking your time and trying to establish a routine are first on the list of things to do.
there is plenty of time in the future to look at all the options.

I am tagging @daisy1 as she provides a great starter of online reading material.

And @noblehead 's comments are spot on -- keeping records of everything is an invaluable aid to yourselves instead of relying on your memories and provides your diabetes care team with real data to assist in making adjustments .

all the best !

@semk

Hello and welcome to the forum

Here is the information we give to new members and I hope you will find it useful. You have had some good help from members and if you ask more questions you will get some more helpful replies.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 Semk, echo what others have said, and apart from that, try to be calm and to set yourself expectations that aren't too high. In six months' time you'll be so skilled you wont recognise yourselves. Fir now, try to set yourselves targets that you can achieve reasonably easily, and support yourselves, sleep etc.

Data is key, so as noblehead said, write everything down. You'll want to analyse your data, so I'd advise an app myself rather than a notebook. I use mySugr and DiaConnect, both very good. Check them out. DC has better graphs, mySugr generally has better analysis.

Then generally your insulin doses and wildness of BGs can be reduced if you restrict carbs. You don't have to go right down - you could start by limiting carbs to 100g a day say and see how it goes. Some of us go for 30g a day, gives brilliant consistent BG and low insulin doses, but I would look into that gradually.

For reading, Id recommend you read Think Like a Pancreas, which gives all the practical help you need, and also Dr Bernstein's Diabetes Solution. The Bernstein method works. He is why I am managing to extend my LADA honeymoon and keep my insulin doses low and why basically I am in good health again. Have a read.

If you want really good control, carb counting is inescapable. It doesn't take that long to learn though. Weigh everything at home in the beginning. Apps to help you: I use Carbs & Cals, which you can customise so as to make it much more useful. Others use MyFitnessPal. Cook and Count is very good I find.

Once you're recording insulin doses, BGs and food, then you're in business. You will start to see patterns, and then you can modify, and then - voilà - control !!!

It takes time though. So be patient, take a step at a time, and good luck.

LucySW said:

Then generally your insulin doses and wildness of BGs can be reduced if you restrict carbs. You don't have to go right down - you could start by limiting carbs to 100g a day say and see how it goes. Some of us go for 30g a day, gives brilliant consistent BG and low insulin doses, but I would look into that gradually.

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I'm not disagreeing with @LucySW but please don't feel like you have to restrict carbs in order to maintain good control. I was diagnosed in December and I have not changed my diet at all - but through working out an accurate carb:insulin ratio, exercising regularly and injecting ahead of eating to counteract spikes I have maintained good blood sugar control and a HbA1C of 5.7%. When first diagnosed I think it's unhelpful to hear people say you need to change your eating habits. A type 1 diagnosis is a big enough impact on your life as it is and there are enough changes in terms of getting used to insulin etc. without also worrying that you'll never be able to enjoy your favourite foods again! There are countless people who have "normal" diets and still maintain good control - low carb is an option to make that easier for some people but you can do what works for you!

Due to your exercising Pinewood? Insulin - carb intake - exercise = the three-legged stool ...

Diabetes is a condition of carb intolerance. Some may manage to match bolus to normalish carb intake; good luck to them while it lasts. The Law of Small Numbers works, though:

http://www.diabetes-book.com/laws-small-numbers/

LucySW said:

Due to your exercising Pinewood? Insulin - carb intake - exercise = the three-legged stool ...

Diabetes is a condition of carb intolerance. Some may manage to match bolus to normalish carb intake; good luck to them while it lasts. The Law of Small Numbers works, though:

http://www.diabetes-book.com/laws-small-numbers/

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Possibly, yes, but then if a low carb diet is being advocated in lieu of an exercise regime I'd argue that you're better to up the exercise and keep your carb intake the same as before diagnosis (assuming you followed a generally healthy diet).

I think I said something like this before but I feel strongly that the arguments for and against low carb'ing with T1 can be summarised very simply: "if you're struggling for good control on a 'regular' diet, then try it" and "if you're not, then no need to unless you want to low carb for other (non diabetes related) reasons".

My opinion is that, as a newly diagnosed, the focus should be on getting used to how your body responds to insulin on your regular diet before worrying about having to change your eating habits.

Pinewood, as I stressed set simple targets and don't try to go too fast, I think we agree here.

Hope things are looking up for you and your partner I'm sure they are!xxx

pinewood said:

Possibly, yes, but then if a low carb diet is being advocated in lieu of an exercise regime I'd argue that you're better to up the exercise and keep your carb intake the same as before diagnosis (assuming you followed a generally healthy diet).

I think I said something like this before but I feel strongly that the arguments for and against low carb'ing with T1 can be summarised very simply: "if you're struggling for good control on a 'regular' diet, then try it" and "if you're not, then no need to unless you want to low carb for other (non diabetes related) reasons".

My opinion is that, as a newly diagnosed, the focus should be on getting used to how your body responds to insulin on your regular diet before worrying about having to change your eating habits.

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I agree... Personally, I'm not all that interested in a low carb diet unless I absolutely cannot find any other way to regulate my bs levels. What can I say? I like my carbs... I have cut down on them to an extent, but not to the point of "low carb'ing". I would say that my carb intake is in the moderate range. If I had the option of either an exercise regime, or a strict low carb diet, then I would rather exercise. However I understand that we are not all the same in terms of lifestyle, metabolism, etc...

@semk I'm new to all of this myself, and I've had the same thing happening to me ... However, it has gotten easier over time, as I believe I am gradually getting a better understanding of how to match my carb intake to my insulin dosage and activity level. For me, that took some trial and error. I can't say whether your partner should try a low carb diet or not, but I suppose it is an option (that apparently works for a lot of people,) albeit a bit restrictive. In my opinion, I think it is better to find out if it's even necessary before making such a change.

LucySW said:

Then generally your insulin doses and wildness of BGs can be reduced if you restrict carbs.

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After a few months of reading these boards I have to say that I am no longer convinced that is true. I don't want to name anyone because we all share our numbers to help each other and naming will pair in some people's minds with "shaming". But I see numbers on here that indicate that those on LCHF are absolutely NOT on lower insulin doses than those of us carbing. I see examples of low-carbers who apparently weigh less than me, exercise more than me, eat less than me, and still use 30-50% more insulin than me. So I am starting to think that claims that LCHF actually causes insulin resistance may have some merit.

@RuthW, should the question not be does low carbing reduce the amount of insulin a user needs rather than is it less than me? In the former case I would suggest it is doing a good job. As we have all said many times, as a t1 we are all similarly unique...

tim2000s said:

@RuthW, should the question not be does low carbing reduce the amount of insulin a user needs rather than is it less than me? In the former case I would suggest it is doing a good job. As we have all said many times, as a t1 we are all similarly unique...

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Yes, obviously people have to run their diabetes the way that suits them best, and that is quite a complex decision. There are multiple factors that each of us takes into account.

To make it clearer what I mean, I think low carbing would be much harder for me and, from what I see here, it wouldn't have enough benefits for me to make it worth my while. My own major motivator after keeping my blood sugar in range is to keep my insulin doses as low as I can, and I agree with what said up thread - exercise is the key for me because it increases insulin sensitivity.

Obviously, also we come on these boards to share our experiences and that allows making some comparisons. That's pretty helpful because it means I don't have to try out every possible way of running my diabetes one after the other. I can observe what other people do, pick up tips and learn from their experiences. (I eat even more nuts than I used to these days because of the LCHF lobby here and the info they provide, for example. I always though nuts were a bit carby, but apparently not.)