Husband just diagnosed with type 1

Don't worry - diabetes is a pain but it's controllable People of all ages can get Type 1. It's an auto immune disease. Your husband was just unlucky to get it - he did nothing wrong.

The 4 injections sounds like a very normal basal/bolus regime. The basal insulin is a background insulin that controls the blood sugar over very approximately 24 hours. The bolus injections are injections before meals to cover the food he's eating. Most people here adjust their insulin according to what they eat, but your husband may not be taught that to start with. He can ask though.

Tell your husband to ask lots of questions when he's feeling better. Also, he may want to join the forum himself for advice and support. We all know what it's like being diagnosed and living with diabetes.

Once your husband's blood sugar comes down, he should feel a lot better.

The key is to test blood sugar often once he's home. Get some hypo treatments in case his blood sugar goes too low eg Dextro tablets or Lucozade - anything like that.

Tell him not to panic. There are lots of us with diabetes living good lives

im going to tag @daisy1 for you as she has some basic info.

He can eat normal food - don't bother to buy the food marked 'diabetic'. Ask if he can see a dietician while he's in hospital so he can get some advice.

In a weird kind of way, it was one of the best (worst) things that ever happened to me. I was diagnosed with type 1 myself in September 2015.

Of course, I'd prefer to not have diabetes, but it helped add structure back into my life.

What will it be like?
-I was a terrible cook like you, but this has made me want to learn. My girlfriend and I now cook dinner every night. We used to go to restaurants nearly every night and have probably saved at least an extra $2000usd as a result.

-your routine won't need to change much. However, I always need to remember to bring my insulin and glucometer with me everywhere I go.

-he will eventually have his first hypo at nighttime. While I don't have kids, I'd imagine it's very similar to having a newborn: waking up every couple hrs throughout the night to test. It's not something he should be dealing with every night and I've only had one in the last four months.

-he will need to learn EXACTLY what he is eating. Counting carbohydrates is the most effective way to measure insulin needs (in my opinion). At first, it's reading the back of food labels, but after a while you start to memorize most things.

It's very scary at first because there's so much that isn't known, but as long as he takes his diagnosis and management seriously, theres no reason why it should negatively impact your lives (both short and long-term).

I say it was a good thing that it happened to me because it reminded me how much I enjoy fitness and being active. I ran a 5k last year, plan to begin competitively powerlifting again, and I wake up at 4:00am each day and can't wait to go to the gym.

Firstly, i'm glad he's ok and getting treatment.

Try not to worry it shouldn't impact hugely on his life, there is an initial learning curve with absorbing information, but learning as much as you can will help alot. I won't lie, it is a life changer but once he adapts there is no reason why he can't do everything he was doing before, the trick is to not let it rule your life.

This forum has been an invaluable tool for me to share my worries and gain advice from more experienced type 1 folk, so use and abuse it to help you as much as you need

@Goodomens830

Hello and welcome to the forum to you and your husband. Here is the information we give to new members and I hope this will be useful to you especially with regard to diet. Ask as many questions as you need to and a Type 1 will be able to help.

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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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.

Hypos at night can be a concern. If your husband is worried, he can set an alarm to test during the night (this might provide useful info for his diabetes team too). It depends, but a good time to test could be somewhere between 1am and 3am. Keep hypo treatments by the bed.

Does he know the signs of a hypo?

When he felt shaky after his tea did he test his blood sugar? It's always wise to test if he's feeling different in any way. It's also a good idea to test frequently to see how his insulin doses are working eg first thing before breakfast, 2hrs after breakfast, before lunch, 2hrs after lunch, etc, and always last thing at night.

Yes, his blood sugars will probably be high to start with. His team may gradually adjust his insulin to bring his blood sugars in range. Personally, I'd say 20 was a little too high, but it depends what his team told him, and as he's so newly diagnosed I wouldn't worry too much.

If he can keep good records of what he eats and his blood sugar results that'd be very useful.

Yes, hypo is low, hyper is high

During the night, his blood sugar will largely be controlled by his basal insulin (the long acting insulin). In theory, if he's high at the moment then a hypo is less likely, but it's not impossible.

The sooner he learns to count carbs, the more flexible he'll be able to be about what he eats. I can't stress enough the importance of testing lots. I test 7 to 10 times a day.

Tell him it'll get easier. Type 1 is a big thing to get used to to start with.

Goodomens830 said:

Looking for someone to tell me what to expect. He's just been diagnosed with type 1. He's 41 and previously very healthy. Was ill last three weeks, made him go to the doctors who sent him to hospital with acidosis (?). He is still in hospital at the moment and been told he will need 4 injections a day. I'm so upset. What kind of routine will it be when he gets home? What can he eat?! I'm such a terrible cook, I'm really worried. Please someone put my mind at rest.

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I feel for you,my wife will know exactly how you feel I also was ill for round about 3 weeks and then went into doctors to say i thought i had diabetes,anyways ended up in hospital on a drip for 3 days. My wife was at home looking up all the complications of diabetes,bad idea that!! But for now it ll feel like an emotional roller-coaster for you at this moment but as time passes it gets alot easier.I learned really quickly,no thanks to any1 at hospital mind they say you can eat what you want,ok then!!! this site is amazing for advice and helped me alot. exercise is an amazing thing for your blood sugars and for eating all i can advise him is to keep on testing before and after meals.his bloodsugars will be all over the place for the first few weeks but it does get easier all best its not the end of the world,it may feel like it but it isn't

Something to be prepared for (if not already) are his mood changes. High or low blood sugar can make us act very unusual. It's not an excuse for him to always act like a jerk, but there are times you will need to be patient with him.

Hypos are an interesting one as each person reacts differently. When I have very low blood sugar, I start to act (I would imagine) like a drug addict who needs his fix. I get frustrated and angry very easy, get the shakes and cold sweats, and it's hard to avoid panic.

If you think about it, the two aren't much different from a scientific standpoint. It's why we can sometimes get hypos even when our blood sugar isn't very low. Our bodies can develop a "tolerance" to glucose in our blood and when your body is used to 20 mmol/L, a drop down to 10 mmol/L can trigger false hypo symptoms.

Again, hypos are a realistic concern, but you shouldn't live in fear of them. It's kind of like cooking. When you first learn to cook, you may burn your food a few times. It doesn't mean you should stop cooking. Even the best cooks burn their food once in a while, but over time you'll learn how to avoid it from happening as often.

Hello,

As your husband is on fixed doses be careful about cutting out too much carbohydrate. Make sure that he tests his blood sugar before he eats and two and four hours after eating. If he goes out away from home make sure he has his kit and his emergency hypo treatment. Glucose tablets are the quickest to relieve a hypo.

Goodomens830 said:

Thank you guys. It's very reassuring to read your advice and stories. He was 9.8 this morning, had toast and a banana and is now 13.3. I assume that's the toast??? He is on fixed amounts of insulin at the moment and been told to eat what he likes basically. But I know he should limit carbs. I will make ham salad for lunch as that's no carbs. I have no idea if this is correct. But we have an appointment on tuesday with the diabetes team. In sure they will go over his numbers then and hopefully clarify some things!

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It would have been both the bread and the banana; banana is high in sugar and would cause a blood sugar spike if the right amount of insulin was not injected sufficiently far in advance of consumption.

If he is on fixed doses you should try to keep the amount of carbs in each meal the same for the time being; if you suddenly serve up a meal with no carbs his blood sugar will drop rapidly if he has taken the same usual dose beforehand.

It probably feels like an absolute nightmare at the moment but trust me, it gets so much easier once you've got your head around the basics. In no time at all he will be able to adjust his insulin to the meal he is having.

My number one piece of advice is to invest in a book called "Think Like a Pancreas" - it is a fantastic resource. I read it as soon as I got home from hospital and it helped me understand everything so quickly.

Goodomens830 said:

But if he has carbs, wont his numbers go even higher?

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No, not once they get his insulin to carbs ratio sorted. This is why he should push to learn carb counting as soon as possible. He will find a certain amount of carbs needs a certain amount of insulin, then he'll be able to count the carbs in his food and have the right dose of insulin. That's a simple explanation.

When people don't have Type 1 their pancreas controls this automatically. Your husband will gradually learn to do the job of his pancreas.

For my breakfast I had a large bowl of cereal with milk, and for my lunch I had a sandwich and a small banana. For my evening meal, I'm having a weighed baked potato and salmon plus lots of veg. Just giving you that as an example of what I eat.

Edited to add that that's why it's important he records his food and blood test results as that will help his team adjust his insulin. They used to do this while people were in hospital, which was much easier for the newly diagnosed person. So if you and he are feeling all at sea at the moment, that's natural.

Goodomens830 said:

But if he has carbs, wont his numbers go even higher?

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Only with no or insufficient insulin. It's a balancing act - inject too much insulin before the carbs and the numbers will drop. Not enough and the numbers will rise.

As @azure says, once he works out roughly how many grams of carbs are "covered" per each unit of insulin he will be better able to keep his numbers steady. It takes trial and error and becomes much easier with time. He doesn't need to avoid carbs altogether - I had porridge and soya light milk for breakfast (about 20g of carbs) but my blood sugar stayed level at between 5 and 6mmol because I've worked out that, for me, 2 units of NovoRapid injected 30 mins before I eat will do the job for that meal.