Help with my type 1

Hi Ollie,

Well; you're doing the right thing coming here. This is the home of answers.

First off, I'd say try and make things as simple as possible for yourself; the advice about reducing carbohydrates as much as possible is key. There are pages and pages of ideas on here about what low-carb recipes/foods there are that you could eat. At lunch it you are back home make an omelette.

The first thing you need to do is sort out your background insulin. I see from your other post that you are on Lantus.

I would go to your GP and get them to change that to Levemir and then split that dose in 2; 1 when you get up and 1 when you go to bed. Lantus is famous for not really lasting 24 hours no matter what the manufacturer says. Levemir has a flatter profile, also doesn't last 24 hours but can be split more easily.

In the meantime you need to do the basal testing; you were given a link for that. Follow that and do it.

Then you need to sort out what your short acting insulin to carbs ratio is. The starting point is 1 unit of fast acting insulin to 10 grams of carbohydrate. You may be very different to that so use discretion and common sense and test to see what works.

If you are drinking avoid beer and never drink full sugar mixers. I find wine, thankfully, doesn't seem to have much affect on my blood sugars.

Smoking dope in and of itself is probably fine on your blood sugars but puts you at risk from munchies; so make sure you have low/no carb munchies if that is a problem for you. Macadamia nuts whilst expensive are low carb, you can also get a mix of seeds from Food Doctor that might hit the spot, or cheese; cheese is always good.

As you are at Uni I'd try and get into a regular sports situation; you will have a lot of opportunities there and lots of exercise is the best way of controlling diabetes.

So, there you have it; sort your basal, drop carbs, carb count and insulin match, take up sports.

Lastly, do you know what your blood sugars do over night? When do they start to rise? It could very well be dawn phenomenon; google it. If it is then you may have to start getting up to take insulin in the morning. I'm assuming that you are following strict Uni tradition and not getting up until the crack of noon? If so that might have to be addressed. If it's a general rise not associated with what you ate or your night time short acting then increase your basal; much easier to do when you split it so get a Levemir prescription as soon as possible.

You are not f**ked - you can get a handle on this. All the resources and information you need are here.

Best

Dillinger

Olifa said:

I know it sounds mad but I think it's due to keytones, I injected 1 unit this morning and my BG still has gone up.
I've injected 2units about 40-1h ago and I can feel my BG is still rising.
If I take insulin with food it works. Me having insulin on its own isn't working.

I mean it will normally. If my BG was lower and I did an injection I would start seeing the BG lower. However when I'm really high it doesn't bring me down. It doesn't even effect my BG.

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Insulin has different affects on blood sugars depending on how high the blood sugars are. If you need 1 unit of insulin to bring your blood sugars down by 4 when you are below 10 you may need 2 units to do the same when you are above 15.

So, if your bloods are 10 and the above ratio was correct (it's not by the way; it's just a guess) you'd take 1 unit to get you to a target blood sugar level of 6.

If you were 16 you might have to take 5 units of insulin to get you down to 6.

Also, don't forget that your sensitivity to insulin may change over the course of the day; I'm much more sensitive (i.e. I need less) in the evenings than I am in the mornings.

Best

Dillinger

Take a few deep breaths Ollie, you cannot speculate over whether damage has been done or not, Azure is right you need to ask for help, they can't help unless you ask.

There is no point getting angry as that won't help you manage your BG as it will push your levels higher, instead read through the advice given here, there is some very good advice. It's easy to get frustrated I know but take stock of what you can do to manage this and try and let go of some of this anger you have.

Make a list of all points you wish to discuss with your team so when you do get to speak to someone you can clearly explain this to them. Stay positive above all else

Olifa said:

I'm really at a loss of what to do I've been this way for so long that The damage has been done n I feel as if I'm f***ed now. I have no idea what to do
Or how to do it n I've got to wait atleast a week to speck to a doctor. I can feel my BG going up n up right now even though I've injected
Feel so angry that no doctor or nurse has helped me or pointed anything out.

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For what it's worth, there is a wealth of information to read here on this forum. I've had only six diabetes-related appointments in my entire life: four of those appointments occurred on the day I was diagnosed (including the ER visit) and the day after. The other two were a couple weeks after to get prescriptions for my insulin, test strips, Dexcom, etc.

Now, you've been diagnosed with type 1 for 24 years and I've only been diagnosed for a little over two months so I'm not going to suggest for a second that my situation is as difficult as yours is. However, there's only so much you can learn in a 1 hr appointment with a doctor. That's why I mention my six appointments. I've spent, on average, 2-3 hrs a day reading and learning about diabetes now that it is a part of my life. Over the course of 2.5months that equates to 150-225 hrs of total research time vs the 6 hours I've spent with doctors/nurses.

My point isn't to compare my health situation to yours because they're completely different. My point is to say that what I've learned through his forum in a few short months would take decades to learn through occasional Doctor visits.

@Olifa

When I first started mdi, it was a new way of controlling bg levels that was meant to give most diabetics better bg levels with whatever food they wanted to eat but the terrible downside was that there was no guidance on how to use it safely and so much was guesswork with some hypos and highs and complications with eyesight damage etc, hence the reason for DAFNE courses to be set up but unfortunately there is usually a long waiting list to go on one of these courses.

I never went on a DAFNE course as the waiting list to go on one was about 6 months so I just took matters into my own hands and started to read other msgs posted on forums about carb counting using a ratio to calculate the bolus dose a bit more correctly and looked at the 100 rule to try and calculate my correction bolus. I kept my calculations based on a bg target of 6mmol before a main meal and then used a target of 8.5mmol 3hrs later to allow for the 4hr acting time of most bolus insulins to lower my bg levels safely. I started using 1u to 10g carb but then changed to 1u to 8g to achieve the ideal targets that I wanted

As a first off..........jump on some weighing scales to see what your bodyweight is. Its thought that most diabetics wil need roughly 0.5 to 1.0u of insulin per 1kg of bodyweight if your bodyweight is normal that is. Use 0.7u for good measure. Whatever your bodyweight is multiply it by 0.7 to get a rough idea of what your total daily dose of bolus and basal needs to be. Then divide that by 50 so that half of the insulin dose is with the basal and the other half is with the bolus. The basal can be adjusted and the bolus can as well as long as you can do bg tests and write down the carb amounts that you are eating (look at the packaging info on the food wrapper). Be careful when ordering take away food over the phone or websites as ideally you need to know the carb info. Start with 1u for 10g and see if the amount you bolused gives you an 8.5mmol 3hrs later. If it doesnt and bg is well over the 8.5mmol, then adjust the dose for the next day to be a bit more bolus and use 1u for 8g instead and then test it out. Regarding getting the correction dose correct, its easier to do with the TDD being correct first but until you get your carb ratios correct for different times of the day, use a correction factor of 1u to make bg drop by 3mmol so if bg was 12mmol before a meal, then adjust to the target of 6mmol (12-6=6mmol). 6mmol divided by the 1u to make bg drop by 3mmol = 2u needed for the correction, then add that to the bolus dose for the next carb ratio meal to achieve the 3hr target of 8.5mmol. You will of course need to adjust the ratios as you go along and you may need to adjust the correction factor as well but as @CarbsRok always says.......Rome aint built in a day so start with the basics and then adjust.

Olifa said:

I know it sounds mad but I think it's due to keytones, I injected 1 unit this morning and my BG still has gone up.
I've injected 2units about 40-1h ago and I can feel my BG is still rising.
If I take insulin with food it works. Me having insulin on its own isn't working.

I mean it will normally. If my BG was lower and I did an injection I would start seeing the BG lower. However when I'm really high it doesn't bring me down. It doesn't even effect my BG.

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When my blood sugar goes above a certain amount I find I need more insulin to correct it. I believe many other people find the same. That could be the problem you're seeing there.

To me, the problem seems to be that you're starting the day high and then don't want too eat too much because your blood sugar is high, so by the evening you're starving (not surprisingly). This isn't right - that is, you shouldn't have to put up with this. I completely understand why high sugars are making you feel short tempered.

No, it's not 'normal' to be high lots of the time and feel generally bad. That's not good for anyone, physically or mentally. Could you speak to your GP and ask them to push to get help for you so that you can get advice about bringing your sugars down? You must feel pretty miserable : (

Olifa, I'd also say don't be afraid to start with the basics again in your learning about diabetes. There's a lot of technical info around, but sometimes it's good just to start with easy stuff. When I was first diagnosed, I got some very basic books out from the library. They were simple but helped me feel more relaxed and more like I understood the very basic principles of diabetes.

ME/CFS can't be helping and I'm sure the high sugars just make you feel more tired. Take baby steps. You don't have to do everything at once. Any improvement is an achievement.

I would also mention that we all eat different amounts of carbs. You need to find what suits YOU.

@Olifa also go on to Twitter and facebook and find ninjabetic. She spent years not really managing or paying attention to her diabetes and is now a patient advocate. It sounds like she and you went through something very similar and she may be able to provide you with some insight into getting everything under control.