Insulin and Carb Counting

[debzg]

Hiya,

I was originally on Levemir and Novorapid for around a month last year (with good results as I recall...although the memory is slowly failing me due to frequent bouts of hyperglycemia!), until it was decided that I should be on Novomix instead. It has never really worked and sugars have gradually crept up with periods of being in the 30s, but as a rule staying between 15 and 20ish, which is pretty bad really. Even on 56 units of Novomix before each meal, my sugars have remained high. I nagged and nagged about returning to my previous insulin, and now following a change of diabetic team, I have.

Tomorrow I start on 6 units of Novorapid before each meal and a daily dose of Levemir at 30, which maybe a bit low after being on so much Novomix, but I am certain that regular doses of insulin will be the key to control...well I am hoping so.

Once this has been kick started, I will be looking at dose adjustment of the Novorapid in relation to carb control (appointment with diabetes dietician is booked for end of April) and I have tried to look online to have a read about it, but I just don't understand it (maths was NEVER my strong point!!).

Can anyone point me in the right direction to something like an idiots guide please? I am feeling like an idiot right now!! I really would like to get some kind of control as I have been diagnosed diabetic since 2007 and it has never been controlled really. I have been in hospital twice with hyperglycemia (an experience I don't really want to repeat!!), the last time I was given insulin. And despite a brief period of feeling "normal" when I was on this type of insulin to start with, I need to stop feeling so ill every day (banging head, knackeredness, dizziness etc) which comes with having high blood sugars.

The weight gain after being put on Novomix is another matter (that came of feeling like I could eat everything in sight and then struggling to exercise to get rid of it!), but once I feel normal, I can get my backside back to the gym!! :lol:

Thanks ever so much!

 

[daisy1]

Hi Deb. I was looking through your posts and saw that you had never been given the basic information we give to new members. I am wondering if something in this might help you now with your control - especially the sections on diet and carbs. It doesn't teach you carb counting but other members will soon be along to help you with their knowledge about it. This advice was written by the Forum Monitors mainly for newly diagnosed diabetics which obviously you are not but it still might be useful information for you. It can be a good idea every now and again to get back to the basics. Even if you saw it before somewhere it has just been updated and contains a lot more information now. Give it a read...

Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.