Husband Type 1 Diagnosed 7 Wks Ago - HELP!!!

[skirk]

Hiya,

What a shock, is all I can say, to give you a little insight, my husband is 43 a soldier in the army and we are currently living in Germany. Around 7 weeks ago he was diagnosed Type 1 and sent to Hospital due to how high his levels were, the Germans gauge them differently than in the UK so I won't bore you with numbers other than his reading on the day of admission was 580 and for a coma it would be 620, so very high.

Anyway I have for some reason found it really difficult to cope with, I keep telling myself that thousands of people have it and I know if it's too low then sugar him up and too high, hospital. I was prescribed Betablockers for hurrendous anxiety and they seem to be working.

I will get to the point, he can't seem to keep his levels, level if that makes sence. For instance for his dinner last night I made, boiled new potatoes in skins, carrots, broccolli, and a Homepride CHicken in a white wine sauce, we ate at about 7pm and by 9pm his levels had dropped really low, having to have a Dextro tablet, he hadn't been doing anything other than watching TV??? He is on his way back from the Medical Centre now and his Doctor has signed him off work for another 2 weeks and told him he needs to see the dietician but she is not available for appointment until 15th May. What the hell do I feed him on, he is fussy at the best of times and prefers not to have pasta, rice, salad etc. I am at a real loss. So really for all you experts out there who have been living with diabetes for some time and know your stuff, can you give me a clue as to why his levels drop so frequently, thankfully they never go very high. Its almost as though his mentabolism is burning off food too quickly, any clues or reasurrance, his diabetes seems such a huge deal to me and it worries me alot. Unfortunatley as he is in the army he has been downgraded to P7 fitness which basically means he is undeployable to Iraq and such like and can't go on exercises etc. He is very active and has given up smoking virtually but still has around 4 cans of lager a night, he is fat, in fact he is 5ft 8" and a size 30" waist jeans. So again I am at a loss. Oh and before I forget living in Germany doesn't help, when he sees someone at the hospital their information is obviously all in German about the German diet and recipes online so faffy. Thanks for reading

 

[fergus]

Hi skirk,

You sound really stressed out by your husbands type 1. I hope we can help ease the trauma and give you some first-hand advice. Those of us who've had it for a while have usually learned the hard way.

I've been type 1 for 27 years and, once you have struggled up the learning curve, the view from the summit is a bit clearer.

Your husbands 580 reading equals 32mmol/l in the UK, and that's really very high. A normal non-diabetics blood sugar will usually be between 4-5mmol/l. If his blood sugars are dropping too low a couple of hours after eating, without exercising, he's taking too much insulin for the food he's eating. By trial and error, you can reduce the pre-meal dose gradually and this will prevent the post-meal hypos.

The safest way to reduce insulin use is to cut out sugars, obviously, and starchy carbohydrates. If he doesn't like pasta and rice, he's doing himself a great favour! I believe that the best diet for diabetics is a low-carbohydrate one. You'll find lots of advice here on what that involves, but in a nutshell it means avoiding things like breads, pasta, potatoes, rice and anything made with refined flour or sugar. What's left to eat, then! Well, how about all types of meat, fish, eggs, cheese, dairy foods, nuts, vegetables. These foods are full of nutritional goodies, but have the lowest impact on blood sugar levels. If he tries eating this way, he'll quickly find his blood sugars returning to normal levels and he'll need much less insulin too, which will make the hypos much less likely.

Keep us posted, and we'll help all we can.

All the best,

fergus

 

[Vicky]

Hi, I've been diagnosed type 1 for 26 years now and it does get a lot easier with time.

The recommended starting point for carbohydrate and insulin for the average person is to start at 1 unit fast acting (bolus) insulin per 10g carbohydrate and then adjust it depending on your results. So if you were having a meal with 60g carbohydrates then start with 6 units of insulin before a meal and check your sugars 2 hours afterwards (this should be around 8 if the insulin and carbohydrate ratio is ok if not then adjust your insulin or carbohydrate accordingly).

The long acting (basal) insulin is the one that keeps you steady throughout the day. As you know you use energy all day (even if you were sleeping) and this needs covering by a basal background insulin. This insulin does not have the peaks of short term insulin and acts steadily throughout the day. I don't know what the starting dose is for this insulin but if you can get the background insulin sorted then everything else seems to fall into place as you'll then be able to just adjust your mealtime insulins depending on what you want to eat and if you find your ideal insulin carbohydrate ratio then you can within reason eat whatever you like as long as you cover it by insulin.

Alcohol lowers your blood sugar so be very careful about night-time hypos.

Good luck and don't worry.

 

[Tattoo azz]

Hi
first rule for newly dx'd diabetics DON'T PANIC!!
I agree with the previous suggestions about starting at 1u to 10 g carbs and increasing if needed. A small tip for converting the bg levels to English is to divide by 18. Most Dr's over here suggest that 1 unit of fast acting insulin reduces your blood glucose by three (in theory but everyone differs slightly) ie if your hubby has a reading of say 12.0 mmol then he needs to inject roughly 2.5 - 3 units to bring him down (this is not including any food he may have had).
Do you have keto sticks at all ( these are to test your urine for ketones) because if he's running high for a while he may develop ketones which can lead to hospitalisation. I would have thought the Army would have pretty good info for you. Keep us informed.
Azz

 

[skirk]

Wow, thank you you have all been really helpful. The army is ok, but trouble is living in Germany we get conflicting information, my husband infuriates me as he is a man of few words and never thinks to asks questions like I would. Any slightest thing I would ask the question "was this ok" but he assumes it is ok, which yes I know what your thinking if that's how he wants to play it then let him crack on.

A couple of weeks ago my brother and family came to visit, hubby and brother got hammered on beer and Jack Daniels, hubby didn't get to bed until 3am and when he woke me up coming to bed I spent the remainder of the night tossing and turning, terrified he was gunna have a hypo or is it hyper? He had to be at the hospital the next morning for 9am for an appointment, I couldn't get him to wake up, because he was still drunk, being a soldier and being drunk is part and parcel of army life although the MOD deny it flatly. Anyway I finally got him to get up at around 11am and he spent the rest of the day lying on the settee sleeping, pre-diabetes this is the norm after a sesh but this time it was different he was complaining that he felt ill and not hungover ill, I offered to take to the Medical Centre but he didn't want to. He really worried me and I spent the day glued to the chair with severe anxiety, after asking a nurse she said his blood sugar will have been too high that is why he was feeling ill, I am just hoping that it will have taught him a valuable lesson that he can't drink like this anymore.

I desperately want to move back to the UK where there is more available. The army medical side of things is ok but no way near as good as the NHS, did I just say that out loud!! Our medical centre have a habit of giving the worst case scenario before they have bonified proof, they told my husband he was type 1 diabetic before all the proper tests had been carried out and yes he is type 1 but they didn't know that. The German hospitals are brilliant but its very different than in UK for a start they don't have MRSA which is a bonus and their only concern is with the patient, they have limited visiting hours for certain patients and they wouldn't hesitate to hoy someone out of the door if they weren't conforming, which is good, however the language barrier is a real problem and its times like this when I want the **** NHS just so I know I could walk in A & E and be able to sit with a Doctor and explain everything knowing they understand what I am talking about.

I am very gradually getting my head around his diabetes but I think in the beginning when he was being stabilised in hospital he was been given German diet of sandwich meats, bread rolls, cheese etc and yoghurts, but it does my head in that with virtually every meal he has to have a bread roll with it, its like he thinks that without it his levels wouldn't be right. If I am cooking potatoes then he always wants them mashed now? He has been told his colestrol is too high and has been put on tablets for it. He was told also that his blood pressure was too high but yesterday it was normal so god knows what's happening with that? I could do with having a list of easy to cook everyday meals which are ok for him.

Anyway thanks again for your words of wisdom they really are a help, I never realised prior to all of this that there was so much involved with diabetes, esecially type 1, my husband has to inject 6 times a day, well 2 of those times he injects twice he said something along the lines of rapid and slow, I'm sure you will all understand what he means.

Thanks again.

 

[weepete]

I suggest you show him the recent copy of balance the diabetic magazine.It has an article about a freefall sgt instructor in the RLC. Being an ex soldier I was very surprised that they now allow diabetics to stay in the forces.However your husband will have to realise that there will probably be no further promotions for him.

I can imagine what he is going through at the moment, he will need time to come to terms with his condition,but he will HAVE TO come to terms with it..Now is the time to start thinking of a new career that will see him and your family in to civvy street.

 

[LittleSue]

Hi
I've had Type 1 nearly 35 years, I don't envy you & your hubby having to learn all this. A lot is trial and error cos everyone's a bit different, but actually that's good because its mostly self-managed anyway, so you and he need to become experts in *his* diabetes. There's certainly lots of trial and error in establishing the dose at the start.

Re the BG drops, if BG has been high you can get hypo (low blood sugar) symptoms when it reduces, without it actually going too low. Does he test when he feels hypo? If he really is hypo of course he needs to treat it. If not actually hypo, just lower than before, he doesn't need anything sweet, but eating a few nuts can help. The protein makes you feel full and stops the hypo symptoms without actually raising the BG, fooling the body that the "hypo" has been treated.

One other possibility is he maybe entering the "honeymoon" period. This is when you need significantly less insulin for a few weeks/months, fairly soon after starting insulin. Any body (diabetic or not) needs up to 50% more insulin when under mental or physical stress. Undiagnosed diabetes puts the body under huge stress, but obviously it cant produce the extra insulin because that's the cause of the problem, hence BG climbs and diagnosis happens. Once settled on treatment the stress begins to reduce and therefore needs less insulin than at the time of diagnosis. So your hubby can expect his insulin requirement to fall for a while, but he shouldn't be disheartened when the reverse happens later. It's just one of those things that happens. It may be a little early for this to happen just yet, I'm not sure - my honeymoon period was around 1975 so the details are a little hazy!

Reduced carbohydrate diet is good, but don't go overboard with eliminating carbs as his body needs them for fuel and its likely he lost weight pre-diagnosis. OK he'd need less insulin, but with little insulin on board he's likely to be lacking energy and surviving on ketones which is rather dangerous. Its generally the ketones rather than straight high sugar that causes diabetic coma.

Hope this helps.
Sue

 

[fergus]

LittleSue,

I'm sure you're trying to help, but a veteran diabetic should know better than to perpetuate the confusion between ketosis and ketoacidosis. There is nothing harmful or energy deficient in a diet low in carbohydrates, even zero carbohydrates. The body actually operates extremely efficiently on ketones as fuel.

It is ketoacidosis that is harmful and that is entirely a result of insulin deficiency, NOT low carbohydrate diets.

Anyhow, skirk needs our support to help her husband, so let's not complicate matters. He needs to get his blood sugars under control, and the best way to achieve that is to restrict the foods most likely to disrupt that control. Carbohydrates.

All the best,

fergus

 

[terry-s]

TIMING hints for: Husband Type 1 Diagnosed 7 Wks Ago - HELP!

Dear skirk ---

All sympathies to your husband and to you, and best wishes to you both, for managing his new type-1 diabetes. I agree with the other posts -- you'd probably find it really useful to contact Diabetes UK and join up if you haven't already done that.

There's one big thing, that doesn't seem to have been mentioned specifically yet -- that's _timing_. It can be crucial, and you can both use it, it can be a big help.

The thing is, you can measure blood sugar, and you want to keep it in range, but you can't directly control its absolute level.

What I mean by that is, that when your husband eats, he doesn't immediately change his blood-sugar: he puts it on an up-slope from wherever it is, until the food is all digested.

When he takes insulin, he puts the blood-sugar on a down-slope (till the insulin wears off, that is).

Other things make up-slopes or down-slopes, as well. Exercise is good for making a down-slope. Beer can sometimes make a big upslope. Stress can sometimes add an upslope.

These up-slopes and down-slopes can be faster or slower. It depends on the type and amount of the food, the exercise and the insulin. Everyone who manages this, develops experience, and learns how fast these slopes are, for every individual and his own habits.

So those are the tools that he and you both have, for keeping his blood sugar roughly on track.

Very roughly, for instance, if blood sugar is measuring high and going up, then he probably needs insulin first to start him going down -- and the food should maybe wait a bit, before he adds an up-slope. If the sugar is a bit low or no higher than normal and it's before mealtime, he might want a bit of an up-slope food-boost before his insulin, so as not to go down too far first with the insulin, before the food kicks in and starts bringing the sugar back up. And so on.... But keep cool, because it's easy to over-react too fast, and end up swerving around like a car that's steered too much, until you both get the hang of it. A bit like learning to drive.

Best wishes and good luck to you both --
terry

 

[diabetesmum]

Hi All,
terry-s that was a really good description of fluctuating sugar levels, should help skirk a lot!!

Also Skirk, perhaps you could consider buying a couple of diabetes books, from Amazon if you can't find any English ones locally. There are loads to choose from, try to get ones published in the Uk as although American ones can be very informative they do things slightly differently there sometimes. Having said that, it sounds like they use the same BG values as in Germany,so you may relate to that more easily.

Another thing I thought of was that alcohol can in fact LOWER blood sugar levels as it prevents the liver from releasing stored glucose. It can therefore make hypo's potentially more dangerous, and Type 1's should test more often and have carby snacks before going to bed after a drinking session.

All the best
Sue

 

[skirk]

Dear All,

Thank you for your tips and advice and wish I had your knowledge, Jesus there is so much to learn !! As each day goes by it gets easier I must admit which is such a relief at least I don't panic everytime I hear the beep of his BG monitor gadget!!

His diet to give you a better idea is pretty much as follows: breakfast consists of cereal like corn flakes with chopped up banana on or this morning he had a wholemeal breadroll with ham and cheese on, for his lunch he had to pop into work (still on sick leave) so he grabbed a steak bake pie from the Naafi, he came home around 3pm had something but don't know what he had, for tea he cooked and it was sauseages, home-made chips and beans, lovely for a change we don't normally each that sort of meal. Here it's now 9.50 pm and he is on the phone in the cellar to a mate and he will be having his first beer for the night, he is drinking around 4 lagers (German Lager) a night. He seems fine and doesn't get hammered he is getting up at a reasonable hour and seems fine. I have just gone and got his diabetic day book where he records all his readings which are as follows for today and he has started recording them in English now which will help you all:

9am = 6.3
12pm = 4.9
3pm = 8.8
7pm = 5.3

So by the looks of these readings they are fine today, 3pm was a little over the norm but still ok. I really don't have much idea what is what which I am embarrassed to say really as I should be nearly as clued up as he is. Anyway we are getting there, slowly.

With regards to his career, the army did use to discharge diabetic soldiers but its all changed now thank God. He is in the AGC (Adjudant's General Corp) which is clerical , he is a Staff Sergeant with another 6 or 7 years to go. The only way it affects your career in the army is by the physical side and he has been given P7 which is the bottom of the fitness gauge and means at the moment he is undeployable and can't go on exercise, do the standard BFT (Basic Fitness Test) and go to war zones such as Iraq or Afghanistan. He was due to go to Iraq this month but that's all off for him which he was quite peaved about. In time his P7 should rise to a P3 or P4 which to be honest I am not sure exactly what that means but it is significantly better than P7. For him being an ex para and always pretty fit this is a real blow to put it mildly, his fitness was always P1 and to go from that to P7 is really hard to digest. I must say though he is really dragging out the sick leave, we are now into week 8 since his diagnosis and when he came home from visiting the Doctor earlier this week he had a glint in his eye and chuckled when he said they had signed him off for another 2 weeks, me on the other hand, I could do with him going back to work for some normality back!!!

One thing I must say though is that prior to his diagnosis his personality has changed, he used to be really aggressive and angry all the time, constantly sleeping, now we have a laugh and he is up in the morning at a reasonable hour and he is alot more mellow, whether that changes when he returns to work I am yet to see, but at the moment its an extremely welcome change.

It was strange how it all started as it was me feeling a bit under the weather and had been to the doctors thinking I could be diabetic, just paranoid as it happens. Anyway I had shrugged off the fact that he had said he had lost 2 stone since Christmas and was unaware of how worried he secretly was, to be honest I had not noticed the weight loss which I am sirprised about especially as he is a thin man. Anyway it was the Saturday and he suddenly turned to me and said I think I may be diabetic, I asked him why and he said I am always thirsty. I looked up the symptons and low and behold he had virtually all of them such as unquenchable thirst, always hungry but losing weight, blurred vision, thrush, sleeping alot. The following day (Sunday) he rang the Medical Centre and broke down on the phone and I had to take over the conversation, it was dredful him just crying like that which shocked me that he must have been really worried he went to the Med Centre and I stayed home with are two kids (aged 7 & 2) and when he came home he broke down again and said they reckon he was type 1 and had to go to hospital straight away to be stabilised, his reading was 580 which was well off the scale, he came home on the Thursday.

That does seem a long time ago now thankfully but although the German hospitals are very good, he keeps telling me, I just would feel more comfotable in the UK seeing English Doctors and English Specialists etc and having English information etc. Anyway gotta go been waffling enough thank you for your replies they really help.

 

[skirk]

Question?

Hi all, last night we went to a friends for a BBQ, it was a last minute thing and when we got there hubby had a beer, anyway it came to having something to eat and he didn't take any insulin as he was drinking and said because he was drinking he can't take it? Anyway he later asked whether I thought he should take his long insulin, the 24 hour insulin? He took it anyway but what happens in these situations was he right to not take his rapid insulin. I am puzzled, I am kidding myself if I think he will go t-total, no chance of that but I must admit he is being careful, in other words he isn't hammering the beer like he would have done prior to diabetes. Any comments will be appreciated. Thanks

 

[diabetesmum]

Hi Skirk,

My daughters' consultants and diabetes nurses have told us NEVER to stop insulin completely, so I would say that your hubby should always have some long acting insulin. The problem with Type 1's is that in the complete absence of insulin ketosis develops, leading sometimes in a matter of hours to ketoacidosis which is extremely dangerous and a medical emergency.

As for the short acting insulin, this depends on his glucose levels, and the only way to know about those is to test often. If he is is going up, then he probably needs some, but you always need to bear in mind when his last bolus was, or you can run into insulin 'stacking' which is when a series of injections over a period of a few hours somehow 'catch up with' each other, which can result in severe hypos. This happened to my elder daughter and we were woken in the night to the sound of her convulsing, despite the fact thqat her BG at bedtime had been 8.8. She was okay after we treated her but it was pretty scary!! :shock:

Also as I mentioned before, alcohol will increase his risk of hypos, it's only experience that will teach him exactly how he is personally affected. Perhaps one beer wouldn't be a problem, especially if he's also having something to eat at the same time.

Hope this helps.
Sue

 

[LittleSue]

LittleSue,

I'm sure you're trying to help, but a veteran diabetic should know better than to perpetuate the confusion between ketosis and ketoacidosis. There is nothing harmful or energy deficient in a diet low in carbohydrates, even zero carbohydrates. The body actually operates extremely efficiently on ketones as fuel.

fergus

Indeed I was trying to help. Also, one person's "low carb" is another's "normal". But on DAFNE we were specifically warned that although skipping meals here & there is OK, sustained Atkins-style levels (around 20 carbs/day) would be dangerous. They said there'd be insufficient insulin in our bodies (despite background insulin keeping BG steady) and we'd be heading for A&E. (Maybe its more about their dislike of Atkins...?)
Sorry for any confusion.
Sue

 

[skirk]

Hi all,

Just thought I would update you all. We are getting there shall we say, but I have to be honest it is realy doing my head in and of course this is selfsih considering it's my husband who has diabetes and not me. I just long for the norm.

He returns to work tomorrow just half days to begin with and I think that this will do everyone the power of good and get back to some normality at long last. He does worry me with his total lack of question asking his limited knowledge of diabetes other than what he needs to know. I have posted another thread regarding an incident that occurred yesterday. He had a low a couple of hours after lunch, he popped around 4-5 dextros and then we heading to McDonalds, after Dextros his reading was 3.8 so it must have been really low prior to the dextros. Can't understand why after having Porridge Oats (flavour = Golden Syrop!!) with banana, why only 2 hours later he had a low? Anyway after he ate he compained of really sore eyes like he had been punched and then later he described as the same feeling as when he had his eyes dilated by the Optician for tests. It wore off by around 6pm, but it was weird?

He still drinks every night, around 3-4 cans of lager, maybe less, this worries me and to be honest I think this whole diagnosis is really diffciult for him to come to terms with, he comes across as though its not a problem but really I think it is. It has now been 3 weeks since his first appointment with an English Dietician, she said she would provide a load of written information, but she still hasn't received it all from the UK this dries me nuts, if we lived in England there would be so much more available for him. I am working on him to return to Uk, toruble is we aren't due posting until next July and to be honest the mere thought of spending another year in Germany is too much to bear. I think he would greatly benefit from some kind of group so he can get information and help him get a greater understanding of it and in turn make life so much easier.

Any clues on the eye thing?