INJECTING RE FOOD INTAKE

You need to learn carb counting. there are websites which can help and Br. Bernstein's Diabetes solution is a book that can help too.

Hi Dizzy,

Have a look at www.dsolve.com

They have an online course that you can follow that will show you the basics of how to match your carb and insulin to get the best control. There are various training courses run around the country for type-1s, but these tend to have a long waiting list and you would probably be happily settled in Zante long before your name came up.

καλοτυχία!

'Carb counting' assumes that 1 unit of carbs will (reliably) take up your BG by 'x units' doesn't it? However, general responses on the forum suggest that this is not the case - so how does 'carb counting' work when your BG response varies widely to the same number of carbs? :?

This online course on dose adjustment was produced by the Bournemouth diabetes team, it follows similar principals to the DAFNE course. (Dose adjustment for Normal eating) http://www.bdec-e-learning.com/
Cynical
You obviously have to do some testing to work out your own carb correction and insulin sensitivity factors You also take into account the nature of the meal , your BS before eating and possibly account for exercise (or alcohol!)Basically you learn how insulin and food tend to react in your individual circumstances It can work very well. Like many people I taught myself and it has become second nature. If for some reason, a miscalculation , extra exercise or stress it doesn't work out
and BS are not in the target range ,you are also able to adjust up with extra sugar, or down with extra insulin.
An alternative is to eat fixed meal types with a predetermined dose, though still varying up or down for existing BS etc. This involves less adjustment but can work well if a person leads a very regular lifestyle.

Increasingly cynical

How long have you been on insulin?

The reason I ask is that my daughter was diagnosed in April 2008, I believe she is still honeymooning! She is on fairly small doses of insulin and depsite carb counting and adjusting insulin according to her BG levels - it still swinging. Throughout yesterday she had about 4 hypos!

This morning I have cut her novorapid back, because she had such bad hypos at school yesterday (she is only 10). I can only think that at times her body is still spurting little bits of its own insulin. I'll be interested to see what her BG is at lunchtime today...

Orchid x

Hi Orchid,

I am not on insulin (or, indeed, currently any meds), I posted my original comments re '1 unit BG' and how it relates to lowering via 'X units insulin' because it is clearly a critical issue and I cannot find any clear logic in the research evidence and/or medics advice. People on the forum have been extremely helpful, but there seems to be a huge amount of individual variation in experience. With regard to your child's experience of several hypos per day, I personally feel that this neeeds to be addressed very quickly, as hypos are more immediately life-threatening than hyperglycaemia and can have as devastating longe term outcomes. I would (again from a personal understanding of the literature rather than any vast experience) push to make sure that your medics have exhaustively addressed potential causes of your child's hyperglycaemia (do they know for definate that the child is not producing adequate insulin for example?) The NHS does not look for causes - but if a root casue is identified some 'diabetes' is reversible (there is a tendency to assume that 'diabetes' is a disease - it is not, it is the name given to a blood glucose above 7 mmol/l - hyperglycaemia, as it is more correctly known is a symptom NOT in itself an underlying disease process).

Good luck.

Hi Dizzy64

Of course I check my daughters BG before she goes to school, every single morning. She also has a meter at school which she checks when she has a hypo and before her lunch. I check her again when she comes in from school.

Increasingly cynical

I wish I knew the answer to some of the points you make. We are an unusual family with so many so called "type 1" diabetics in the family. I had my own blood checked for the gene mutations HNF1Alpha and HNF4 alpha - but neither of these were found, therefore the diabetes teams will only treat us "type 1" There somewhere has to be another gene mutation that fits our family - but apparently I have been told - it has yet to be discovered.

Carb counting and adjusting your insulin accordingly is one of the best methods available to achieve good control, while maintain flexibility for an individual… It does seem to be a mind boggling thing to start, but once you’ve got your carb counting book it’s pretty easy to sort the rest out and see what is going on…

Cynical

The biggest problem faced by a diabetic is that; there diabetes is as individual as they are! You are mystified by the guidance that 1 unit of quick acting insulin 2-3mmol/l and there are a lot of us that this would either too much or not enough…

But it is all the other factors that goes to make up the equation that effect this and the individuality of this to the individual that makes control so different for each of us…

Other factors will be hormone activity, such as adrenalin rushes caused by anger, shock stress… A individuals metabolic rate, ambient temperature, illness are all factors that need to brought into the equation, along side the normal activity range of a individual… As these factors themselves can’t really be measured then you can see why everything is a guideline… and we need to work out a lot for ourselves as individuals…

And the only real way of getting a reasonable workable idea to our individual needs, is to know what we are putting in to our bodies, I.E carb amount + insulin, monitoring the out put… in all the different environment factors as we can are we stressed, unwell exercising resting etc…