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Living in the stone ages....

Discussion in 'Diabetes Discussions' started by gingerfluff, Mar 12, 2019.

  1. gingerfluff

    gingerfluff Type 1 · Member

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    Hello,

    I was wondering if someone might be able to give me some advice.
    Ive been diabetic for almost 18 years now. Diagnosed when I was 11. Ill be 30 latest this year.
    I have been prick testing my blood and injecting myself 4 times a day for what feels like forever.
    When I would go to my yearly reviews they would test my weight, hight, blood and over all blood sugar levels for the past whatever months. They would then say well done and off I would go.

    I have been waiting to go on the DAFNE course for 5 years and they told me I have another 4 years to wait. I have no idea how to carb count or now ive heard of this low carb diet? I dont have the new automatic blood reader thing and when I finally got to speak to a dietitian a few months ago she told me I was so far behind everyone else I was in the *Stone ages*...

    For the past 3 months I have been struggling to get my blood under control. I am going from extreme highs to extreme lows and I also feel like my weight is going up and down. Im starting to lose faith on how much insulin i should take per item of food I eat. I have always counted the sugar quantity not the carbs. Ive looked at the low carb diet and it looks good! Does this mean I can just kinda cut out carbs so I dont have to inject as much?

    Like how much insulin should I take for 2 slices of white bread? Or a bag of rice? or even two digestive biscuits?
    Im sorry for my long message. But i might not be able to see my Diabetic Dr for another 6 months so im just trying to figure this all out since my body feels poorly.

    Thank you for reading this. I REALLY appreciate any comments or advice :)
     
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  2. bulkbiker

    bulkbiker Type 2 · Master

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  3. JAT1

    JAT1 Type 1 · Well-Known Member

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    Hi there ! I am also type 1. To find out the net carbs in any food read the nutrition label if there is one. Subtract the fiber content from the carbs to get net carbs. If there's no nutritional label like on vegetables then google it, like "broccoli carbs" and you'll get the information. I am roughly 1 unit of fast acting insulin to every 10 carbs as are many others. Don't get mixed up between the weight of the food which is in grams and the carb content which is also in grams! Finger prick before eating and taking the insulin and then 2 hours after taking the insulin. If you are within 2 units of where you were before eating than you took a close enough amount of insulin. You need to find out what your own insulin to carb ratio is.
     
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  4. dancer

    dancer Type 1 · Well-Known Member

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    @gingerfluff you said your dietician said you were in the dark ages, so what is she doing about it? She could at least have given you a quick lesson on carb counting. Are you in the UK?
     
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  5. Jaylee

    Jaylee Type 1 · Expert
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    Hi @gingerfluff ,

    Sorry you've had this experience.

    Gotta ask. What insulin regime & insulin/s are you prescribed?
     
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  6. EllieM

    EllieM Type 1 · Well-Known Member

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    @gingerfluff , Are you at least on a basal/bolus regime? (I'm thinking you might not be, as if you're on that they should have at least talked to you about carb counting etc).

    If it's any consolation, though I've been carb counting since childhood (T1 since I was 8, so 49 years), I only learnt about formal insulin/carb ratios and correction doses recently, otherwise I sort of winged it .... As a child I learnt the contents of my blue book of "Proprietary food carb values", plus the white booklet of values for things like bread and potatoes, and made my carb total correspond to the allowed amount for each meal. (Apart from in my teens, when I pretty well ignored it all. :))

    I remember when I was twenty and given my first glucometer, I was told that injecting 4 times a day would be so much more convenient, as I would be able to choose my own meal times and amounts. \And it was....

    So she should give you advice and some booklets with carb values and you can learn from them. If it's any consolation, I survived two normal T1 pregnancies without knowing about insulin ratios (the dietitian gave me a long chat about lots of high fibre carbs and I came to the conclusion that dietary advice for T1s is a fashion which changes every decade). I've never been on a DAFNE course (left UK in 1999).

    The dietitian in New Zealand (I've been living here two years) looked at my food and blood sugar diary and explained how to formally calculate insulin ratios and correction amounts.

    I suppose I shouldn't be suggesting this, but maybe you should tell your doctors you are thinking of having a baby (even if you're determined to be childless forever), as then they would have to give you some more timely help about managing your diabetes....

    Are you sure you're doing that? No sugar in a potato, but plenty of carbs. I 'd be surprised if you weren't counting the carbs in unprocessed food. On the other hand, if you've been looking at labels on supermarket food, your issues may well be because you're counting the "of which sugars" line rather than the total carb line.

    Good luck, from one stone age veteran to another.
     
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  7. DCUKMod

    DCUKMod I reversed my Type 2 · Expert
    Staff Member Administrator

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    Gingefluff - there is an online carb counting course, used by many T1s, in similar binds as yourself. It is an accredited course, written by the folks in Bournemouth. It is free to sign up to and complete.

    Many folks say thy got a great deal from the DAFNE course, n excess of just carb counting - meeting other T1s in the flesh, etc, so please stay on th list but the BERTIE course could be helpful in n the meantime.

    https://www.bertieonline.org.uk/
     
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  8. mike@work

    mike@work Type 1 · Well-Known Member

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    Thank You @bulkbiker , for tagging me.
    And to @gingerfluff I say greetings, and welcome to this forum :)
    I'm also tagging @daisy1 , as you will get some additional info posted directly here. It is common practice around here, that new members get some intro to, what all can be offered right on this forums own web-pages.

    Hmm - It is of course better and in the long run easier, if you get used to count carbs. So I can only encourage you to start counting. We are all at some point beginners, so don't let that trouble you - you can be sure there will be smaller and bigger errors in the beginning, but you will also learn from the mistakes, if I may say more or less immediately ;)
    I sadly don't know the procedures needed to be able to get on a DAFNE course, as I'm not from the UK, but that seems like a ridiculously long time to wait, for something that should have quite a high priority. Any reasons given to you, why you after 5 years waiting, still have to wait for 4 more years? Absurd in my opinion.

    Your weight going up and down, could very well be a side effect of your blood sugar levels also going up and down. A good possibility to get things much more in control, is to start eating low-carb. You only have to take into high priority consideration, that lowering carb intake, will also lower your need for insulin. As many times said here before - we can only give suggestions, but not more. If you wish to start on a diet, I also suggest that you speak with your dietitian about it. A dietitian should be able to to help you change directions for your carb-intake. Do not be alarmed, although you probably do NOT get immediate support for low-carbing. It is in many dietitians opinion best to follow the so called Eat Well plate, but many evidence found around this forum, speaks against that assumption. If you think low-carbing is the best way, and you don't get any support for your thoughts from your medical staff, then you can start asking around here for advice. Here are many of low-carbers on this forum, and some are beginners, while some others are very experienced.

    Well to put it still a BIT civilized - Type 1 can be a P in the A.
    Depending on your momentary BSL, and your physical well-being, also the bolus for a certain amount of carbs can be different. This means that there is no absolute amount of insulin, corresponding to an absolute amount of carbs. This varies and is depending on many different things - for example: Fat content, amount of proteins faster/slower carbs and so on.

    I hope this will give you a bit of hope, and although much of it maybe seems fearsome and new, then keep in mind, that you have probably already gone trough a lot of problems. I also believe, that of all the problems you already have encountered on your way, have added to your experience, and this means that new things coming up, maybe after all seems quite familiar.
    You already have a solid "knowledge base", you only maybe don't know it yet :)

    You are welcome, and keep on asking.
    We'll try to give you good answers :D
     
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  9. LooperCat

    LooperCat Type 1 · Well-Known Member

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    Thanks for the tag, I’m at clinic myself this morning, so will reply properly later!
     
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  10. daisy1

    daisy1 Type 2 · Legend
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    @gingerfluff
    Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it interesting and helpful.


    BASIC INFORMATION FOR NEW MEMBERS

    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 well over 220,000 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

    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.

    Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

    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 blood glucose 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.
     
  11. Antje77

    Antje77 LADA · Moderator
    Staff Member

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    We don't know, as the amount of insulin one needs is very different in each person. You can find out, however. This only works if you're on a basal/bolus regime (2 insulins, 1 long acting and 1 quick acting which you use before eating). DON'T try this if you're on a mixed insulin!

    Test your blood glucose
    Inject what you normally would for the 2 slices of bread.
    Test again after 2 hours (or even a couple more times to see what is happening).

    If your bg is too high you need more insulin for this meal. If it's too low or close to it you need less insulin for this meal. If you can adjust your own doses, try again tomorrow with an adjusted dose. Otherwise, contact your DN for advice.

    When you get it about right, check the back of the bread bag for the amount of carbs per slice (ignore the 'of which sugars'). Now you know how much insulin you need for the amount of carbs in 2 slices of white bread.
    This is carb-counting in a nutshell.

    Mind, there's more to it to complicate things. I'll mention a couple of the sneakier problems:
    You might find that your bg shoots too high first, and then comes down again before your next meal. In that situation you do not need more insulin for what you ate, it was the food acting faster than your insulin, and the insulin catching up with it after. If you take more insulin next time you'll go hypo after 3 or 4 hours. 2 slices of white bread would definetely do this to me.
    The amount of insulin you need may vary throughout the day. I need twice as much insulin for the same amount of carbs in the morning than I do in the evening.
    Exercise trown in changes all the rules.
    Time of month changes the rules.

    Your basal or long acting insulin should keep you relatively stable when not eating. If your basal dose is off, it's very hard to get the mealtime dose right.
    You wrote that you've been testing 4 times a day. This means you don't know what happens between testing times. Before I used the Libre (one of those automatic blood reader things) I tested a minimum of something like 11 times a day. That might seem excessive, but it allowed me to understand what was happening when.
    I used a sheet of paper, devided in 24 for hours and used different rows for BG, food and exercise, making it easy to spot patterns. Of course, for many people, using some computer program would be easier, but this worked very good for me, and it's easy to carry around :)

    Good luck!
     
    • Agree Agree x 2
    #11 Antje77, Mar 13, 2019 at 11:43 AM
    Last edited: Mar 13, 2019
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