Thanks for the reply, so at the minute I’m on novarapid - 8 units in the morning, 6 for lunch, 10 for evening meal and 14 for the toujeou at night .. I’ve had the libre fitted in for 3 weeks now ( changed for the first time last week) been on the injections for around 6 weeks now. Doses have been given to me by the nurse but I’m hoping to move onto a more suitable regime soon… it’s difficult for me lately to know just how much carbs I need to maintain a consistent level on my glucose levels. I think the part where you said about avoiding nasty complications is what worry’s me most.. it took me a while to get my head around the fact that this is a serious illness and I think I’m still naive at how dangerous it is.
Question for everyone.. how often do you get hypo’s ?
I don't get hypos very often, maybe once a week or less. This is because I keep very tight control and rarely go over 8, so consequently I occasionally take fractionally too much insulin, and get a moderate hypo which I quickly fix.
Did they tell you to inject fixed amounts of novorapid for meals? I do worry that the NHS doesn't seem to explain things very well, or give correct advice, which is why the internet is full of newly diagnosed diabetics asking how to do things, which ought to have been explained already, but I know they often aren't.
I think you could write the information necessary to inform patients how to maintain excellent control almost all the time, on one side of a piece of A4 paper. No need for DAFNE courses or books. We each have to figure out our basal dose, and rapid insulin to carbs ratio, because it varies for all of us. And then count carbs for each meal and inject rapid insulin accordingly. Trial and error at first to figure out our ratios, and then each day test regularly, count carbs, do the maths and inject as applicable. Injecting fixed doses of rapid insulin is guaranteed to fail because it will either be too little or too much, more often than not.
There is a little more to it than that, but not much. Protein will raise your blood sugar slightly if eaten without carbs - but this isn't significant in my experience and not much more insulin is needed. Exercise or illness can raise it too, regardless of what you've eaten, so this is why we need to test regularly. Figure out how much one unit of insulin lowers your blood sugar, so you know how much to inject to correct any high. The other thing is the 'pizza effect' of eating a meal with a lot of carbs and fat, so the blood sugar can spike hours later. Personally I just avoid foods like that now, to avoid that problem.
Alcohol without carbs (ie. spirits) will tend to lower your blood sugar, so you may need to eat some carbs to avoid a hypo.
Finally, eating takeaways or other meals you haven't prepared yourself, means you will inevitably be guessing the carb content, which means you could get it very wrong. You can figure out your dose for these from trial and error (assuming you eat the same takeaways and portion sizes) or better yet, avoid those and keep good control, and avoid diabetes complications like blindness. (Don't be one of those unfortunate people who has high blood sugar for hours every day, for years, and thinks everything is fine, and then one day is surprised to be told they are going blind.)
Oh the other thing in my experience is the NHS are useless, the professionals don't know as much as they should do, and they set very low expectations for people. So you could have rather high blood sugar and they will say you are doing well, which will lull you into a false sense of security. I advise figuring it out for yourself and taking it very seriously, because nobody else is going to be there with you 24/7 and do it for you.
