My mate is type 1

Yes, in theory we can take enough insulin to cover whatever carbs we eat.

In practice if we ate high GI foods like xmas pudding and trifle our blood sugars would be spiking up into the 20s (unless we were really clever at timing our injections). Those kind of spikes are what causes inflammation in the arteries which is where the trouble starts.

I carb count the best I can (using a book) so that I can still eat the food I like. I have tried low carb but it cuts out too much food I like and I'd have to eat foods I don't like.

celast said:

He is ,I think a real fool, what he does is eat most things, he said at xmas he has xmas pudding, trifle, and all the other goodies,
he said if his blood goes high he takes another jab,is he at an advantage by being able to do this ? because with us on type 2 we cannot do anything like that,all I think we can do is excercise

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If your mate is otherwise healthy and his diabetes is well controlled then Xmas pudding at Christmas and trifle as an occasional treat shouldn't be a cause for concern, the 'takes another jab' he is referring too means he is giving a correction dose which is normally given at meal-times together with the meal insulin when preprandial bg is higher than it should be.

Type 1's or even type 2's on insulin do have a greater flexibility on what they can and cannot eat and their diet is less restrictive than those who are diet controlled, that said I don't eat puds, trifles or any other desserts but that's my preference and I don't begrudge or condemn those that do.

Depends on the kind of person your friend is. He is right that as Type 1 he can theoretically inject enough insulin to cover the carbs he eats although as Robert says he risks some big spikes unless he is really well controlled. The other thing he risks is that insulin has a tendency to make you put on weight which then means you need more insulin which makes you put on more weight etc... If this spirals out of control you pretty soon become very overweight and run very high risks of heart attacks and strokes. I think those weight related problems actually kill diabetics more than what are normally considered diabetic complications. If he's lucky and can eat all that sweet stuff without being overweight or just accepts the risks he's taking then maybe he's ok.

As Type 2 you can always ask your doctor to go on insulin so you can eat a wider range of things. If you do that just be aware that the same weight gain issues will then apply to yourself and of course you start risking hypo's and all the other downsides insulin can have. Also Type 1 diabetics seem to get far better advice in terms of education and training that then allows them to have "cleverer" insulin regimes than Type 2's who elect for insulin. Most Type 2's on insulin are denied access to the training and education courses that Type 1's can attend.

Type 1s on insulin can take a day off from a strict diet occasionally. We can eat 'treats' then test after two hours and inject a correction dose if necessary. It's all about enabling the sugar to enter the cells with adequate insulin.

Ambersilva said:

Type 1s on insulin can take a day off from a strict diet occasionally. We can eat 'treats' then test after two hours and inject a correction dose if necessary. It's all about enabling the sugar to enter the cells with adequate insulin.

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Yes that's what I mean. Being informed and having the ability to do that correction dose and even attending a carb counting course so that you can work out how much insulin you should inject are all things that most T2's on insulin are denied access to. In a worse case an insulin using T2 is supposed to just stick to roughly the same amount of carbs every day and always take the same amount of insulin.

xyzzy said:

Ambersilva said:

Type 1s on insulin can take a day off from a strict diet occasionally. We can eat 'treats' then test after two hours and inject a correction dose if necessary. It's all about enabling the sugar to enter the cells with adequate insulin.

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Yes that's what I mean. Being informed and having the ability to do that correction dose and even attending a carb counting course so that you can work out how much insulin you should inject are all things that most T2's on insulin are denied access to. In a worse case an insulin using T2 is supposed to just stick to roughly the same amount of carbs every day and always take the same amount of insulin.

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I am learning to carb count at the moment and am quite hesitant to eat what I call HIGH RISK foods too often because of the implications if I dont get the dosage correct! I know that the only way to learn is to try but it is much easier to control sugars with the correct insulin and foods that are low GI. The Key is that once you have cracked it it gives one more flexibility.

Also what is the point of giving a type 2 insulin without the correct education!!! Mind you I was on insulin for 6 yrs before carb counting! Its as bad as not having test strips!

I know I keep saying that I am learning but its true. I have been mostly self taught up until now and now having sessions at the hosp and with my DSN. Just because carb counting means one may be able to eat high risk foods does'nt mean going mad with them!

Lucy.

I am Type 2 on Insulin. I 'chose' insulin because the pills... one kind I was allergic to, the other kind would make me so sick I couldn't leave the house, and the third kind I tried, I would have stomach cramps bad enough to make me pass out. One kind I managed to put up with for 6 months and they had no effect on me either.

I want to lose weight as I'm a big girl, so I do the same as the Type 2s without insulin injections - low(er) carb and exercise and I tend to split my meals up a bit more than I did before to avoid spikes too.

I can however now and then give myself a little extra insulin. It happens that I 'cheat' like that and have a bit of something sweet. My insulin rarely works fast enough for me to not have a spike, but it makes it not go all the way through the roof and brings it down again in a few hours, maybe.

I was in hospital a couple of months ago with 25-30 blood sugars and ketones, so it is still to be determined if I am a true Type 2 or maybe LADA, which is a slow-onsetting Type 1.

I think if say once a month, or at Easter and Christmas you have 1 serving of something like your friend seems to do and then take extra insulin, it may be fine. If he does it all the time, he will either get bigger, or be running too many risks.

Insulin has been good for me, but it is hassle too - it's just a different kind of hassle as when I am doing exercise, I have to test all the time, I have to have my meter and my insulin with me when I go out, I have to inject 5-6 times a day and I risk suddenly 'turning off' because my blood sugar got low and I'll be really confused and sleepy and pale for a while until I get it fixed and currently I am having trouble with my thigh injections as I keep getting bruises and somehow hitting a small blood vessel.

Also, as someone said, noone told me how to take insulin exactly - I was just told inject then and then, nothing about food, nothing about reducing before exercise, nothing about lenght of needles, nothing about sick-day rules or carb-insulin ratio. That was learned in a hurry off the web and especially this forum. Type 1s I think have more targeted education available.

Type 2s have less options in the short term, I suppose, than does a Type 1. But a Type 1 will 'never get better'. They can get better control, better at managing, but they'll always need the jab or things will go awfully wrong. As a Type 2, you can get such good control that watching what you eat and making sure you get some exercise is the only thing you might need for a long long time. So it's a different level of freedom depending on your viewpoint.

-M

Mileana said:

Also, as someone said, noone told me how to take insulin exactly - I was just told inject then and then, nothing about food, nothing about reducing before exercise, nothing about lenght of needles, nothing about sick-day rules or carb-insulin ratio. That was learned in a hurry off the web and especially this forum. Type 1s I think have more targeted education available.

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Thanks for that as its made it a lot clearer. I never understand why Type 2's on insulin aren't given the same options as T1 if or when insulin is required. I've always thought that if as a diet only T2 you lose weight, low carb to control your levels and then over a period of time pick up a healthy lifestyle why at some point you shouldn't then consider insulin as an option even if you have some pancreatic function left as it would widen your choices in some ways.

The fact that it appears as a T2 I couldn't adopt an "advanced" insulin regime like a T1 actually has made me reconsider the insulin option as I can see you would potentially lose a lot of control. It is something I am going to discuss with my GP at some point. Similarly even if you were the best controlled T2 in the country with a history of superb hBA1c's you could never hope to be prescribed an insulin pump as again they are never prescribed to T2's.

I have, I think, learned loads, it just wasn't from the Nurse or Endo Doc.

I am on NovoRapid and Levemir - I had to split my Levemir, noone told me how, so it was just carefully moving 2 units at a time until I had it where I wanted it.

I read about carb ratio stuff on a related webpage after the doc's units according to blood glucose sent me in hypo pretty badly and I thought something must be off here.

They considered me insulin resistant, which I struggle to see the truth of as 1 unit of insulin covers about 12-15g carb depending on time of day.

And many many more of those examples.

The dietician I saw told me off for carb-counting...

However, last time I mailed my blood sugar levels to the DiabNurse along with some questions and considerations, she told me Oh my god, how did you learn all this stuff so fast - well done, you!

I live in Denmark though, so a few things are different, but still you get it everywhere that you need to be super-proactive and sometimes not afraid to fight.

I will keep experimenting with it until I get it right - I will be careful to get as much information as I can, but I won't let what they will or won't tell me dictate whether I achieve my goals and stay safe and healthy.