Greetings to all

Hello,

I am Josephine and 2 years ago, I was diagnosed with Diabetes Type 1.
Since, I am on a prolonged honeymoon period.

Currently, I am on 18 units of Tresiba basal insulin and 2 metformin pills per day along with a very strict low carbohydrate diet. So, far this regime has served me well however, I know that sooner or later I will need to enter a basal/bolus scheme.

I have information from my doctor that 1 unit of Novorapid = 10-15 grams of carbohydrate but, I understand that this is a rough guidance and does not always apply. (depending on the person and the sensitivity during the day).

My question is, how do you manage to estimate how many units of quick acting insulin you need to cover your meals?

I feel that my doctor and diabetes nurses are on a guessing game and they always reply to me “diabetes is a trial and error process”. As you understand, such a reply feels as if they are declaring a psychological war against me because, if my doctors don’t know then, how am I supposed to know…

Please, can you explain to me the process of figuring out what I must do to calculate my insulin intake correctly?
Also, if you feel like it, please share with me your journey with diabetes to help me understand our condition. I will need all the guidance I can get.

Thanks ever so much
Josephine.

Thank you both so much for your replies.
I really need and appreciate your kind support and guidance as I feel that diabetes is such a lonely journey where I need to figure things out completely on my own and I find this frustrating. I feel scared and lost…
Please, keep in touch!
Regards
Josephine

himtoo said:

you are sooooooooo not alone -- this is an outstanding community of people that do much to support each other.
in my real life i don't know any other type 1's so this really is my friends and family all rolled into 1.

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I don’t know of any other Type 1s either and, I feel that, if someone is not experiencing the problem then they cannot fully understand it (and that includes doctors and nurses who just follow bibliography.)

So far, whenever I talk about my condition I get the disappointing response of “Oh no how did this happen to you… and you are such a nice girl…” (As if diabetes is a punishment.) or “Oh God how can you do this? I could never do that, never…”

I hope that the forum will help me figure things out. At least I am able to communicate with people who have been down the same road…

himtoo said:

to bring a bit of joy , happiness and general merriment have a look at this earlier topic and the "best" things a doctor has said to you
guaranteed to bring an ironic smile at the very least

http://www.diabetes.co.uk/forum/threads/best-things-doctors-have-said-to-you.79347/

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I am currently in the office and I am sitting here giggling on my own (making a hard effort to not laugh out loud…)
Thank you, this thread made my day!

becky.ford93 said:

Sadly I'm afraid they're right, as frustrating as it is, carb ratios do take some trial and error to get right. It's always better to start with a ratio too high though, to avoid hypos. For example, I too am slowly coming out of the honeymoon and was initially on a ratio of 1:20g, though this now varies through the day from 1:18 for breakfast, to 1:16 at lunch and 1:17 at dinner. Some like to use the 500 rule: Add up the average units of insulin you take each day (both basal and bolus) and divide 500 by that number to give you a rough ratio. Then just adjust it depending on the results you see, usually only by 1-2g at a time. Be aware though that this rule is very vague and depends a lot on body type, diet, exercise etc. so is really as rough guide.

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Hello Becky,
How do you manage to find your bolus ratio with such precision? Is it something that you doctor finds out for you? I mean, will my doctor tell me “Right, your ratio is 1:18 for breakfast, to 1:16 at lunch and 1:17 at dinner, now off you go.” Or is it something that I will find out on your own? And how do I do it? What is the process to find it out?

Could you help me please by explaining to me what is the way to find the bolus ratio?

Thank you.
Josephine

busy_lizzie25 said:

Hi Josephine.

I feel that loneliness very often with this disease and as its something you have to manage every day, there really I no escape. Though I must say since becoming type 1 diabetic, I have surprised myself on how much of a change I have made to my life. You will have good and bad days, but you will do it, and you will be proud of your future achievements . I work as a nurse in Leicester and as there are so many type 2 diabetics here, I get painted with the same brush so to speak! And most doctors and nurses do not have a clue about type 1 diabetes so having a forum like this is a godsend! Stay strong n give ur doggie a cuddle xxx

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Hello, thank you very much for your sweet, heartfelt message.
Please stay in touch.
Regards
Josephine

urbanracer said:

If diabetes is not a punishment for something, then it's doing a *&^%*£ good impression of one. Welcome to the forums.

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Hello Urbanracer,
Thank you so much! Nice to be here!
I am certainly not a veteran in Diabetes but, I have a different perspective.

Actually, I love my Diabetes!
I am very afraid of it. Some days I feel already tired…
I respect it immensely.
My Diabetes rules me (at least, for the time being) and I run after it all the time.
But, I love it! Because it’s mine.

Maybe my thinking is incorrect but, if I had a child that fell and hurt its knee, I would kiss the child, kiss the bleeding wound, hold the child and caress it. Assure it that I am there to make everything alright. I would not hit the child, shout or abuse it for hurting.

I perceive myself as this child and my diabetes is my wound. I have to do the parenting for myself.
It is not my fault that I have a wound and, I do not intent to punish myself or blame myself or degrade myself for it.

Instead, I will learn to love myself even more (just like I would do with a hurting child) and I will learn to love my wound as well because, it is part of who I am.
I am not my wound but, the wound is mine. And I love it just like I love everything else about me.

I will continue loving my Diabetes even though I know that it is a wound that will keep bleeding for the rest of my life.

Regards
Josephine

becky.ford93 said:

Sorry for responding to you so late. I was initially put on a ratio of 1:20, just based on the 500 rule as mentioned before. That worked pretty well to start, but as I started experiencing higher readings at certain times of day I would adjust the ratio of the meal before and see what difference it made. The important part is just doing things slowly, you don't wanna cause hypos by massively altering the ratio, just go 1g at a time. I have an accu-chek aviva expert meter which is a huge help for bolus calculations

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Thank you very much Becky.
I understand now.