New diagnosis 1.5, scared of injections

Hello and welcome @Sgathach

In regards to insulin injections it doesn't matter when you take it as long as you're ok to consistently take it at this time each day, it's a good routine to settle into taking it at a particular time as well as ensuring the efficacy of the insulin and it's actions are maintained where possible, also doesn't matter about taking it in relation to food as your lantus is your background insulin so covers the background needs of the body rather than matched to the carb value of food, which is how a quick acting insulin would work.

In regards to side effects, we are all different, but it's ideal as your just starting out to keep a diary of your readings, insulin taken to see how effective the dose is and will help your team decide if it needs adjusting.

Please also carry quick acting glucose at all times too so glucotabs, jelly babies and by the bed too so always within an arms reach as you may experience hypos if the dose is too much, so best to err on the side of caution.

Let us know how you get on

I'm really sorry to hear about your diagnosis and wish you luck with your management.

I was wondering about the units you quote with the c-peptide as C-peptide test results are classed within 3 ranges/values. The normal range for a c-peptide test is: 0.51 to 2.72 nanograms per millilitre (ng/mL) This may also be expressed as: 0.17-0.90 nanomoles per litre (nmol/L)
Also, the c-peptide is not to be interpreted as low without a high fasting glucose. If you have a normal fasting glucose then you can get a low c-peptide result due to an overnight fast.

Also, have you had tests for antibodies?

Anyway, these are the questions I'd be raising with the GP before accepting I needed to start insulin. I accepted I needed to go on insulin after receiving a c-peptide of 0.078 nmol/l and fasting blood sugar of 9 mmol/l. It was time.

Another vote for changing your doc here. Type 1.5 is not a mix of type 1 and type 2, and if your doc said this he doesn't know even the basics of diabetes.

Type 1.5 is effectively a slow onset type 1. Your body is very slowly destroying your insulin producing cells. Unlike in children, where this process takes days or even hours, in type 1.5 this can go on for years, during which the insulin dose you need will be very slowly increasing.

About your insulin, for a completely flat basal (a constant insulin release) it doesn't matter when you take it, as long as its about the same time each day. The timing of food, exercise etc. is irrelevant. One thing about Lantus, it's supposed to last 24hrs, but many people find it doesn't. There is an easy fix to this, two injections 12hrs apart.

You should have a blood glucose test kit, and testing will show any blood glucose patterns that you need to adjust your doses for.

If you're lucky, this first insulin the docs try you with will be right for you. If you're unlucky, there are other insulins out there to try until you find a good match.

The actual injecting can be the biggest barrier. I was slightly needle phobic, I can remember sitting there for two hours trying to force myself to put the needle through the skin. Miserable. Does it hurt? Honestly, sometimes it does, like a scratch when gardening - an ouch forgotten within a couple of minutes. Sometimes I don't feel anything and have to look to check the needle has gone in. The more tense and stressed you are about injecting the more likely it is to hurt.

"can I be sure it was injected properly?" If the insulin has gone from the injector to under your skin, that is pretty much job done. You should have had someone go through the basics with you, possibly a nurse at the GPs, so no air bubbles, not pinching the skin too hard etc. If you haven't, someone here will be happy to walk you through either a pen or syringe and vial injection I'm sure.

Nice to meet you, and please come back with any questions you have.

ert said:

I'm really sorry to hear about your diagnosis and wish you luck with your management.

I was wondering about the units you quote with the c-peptide as C-peptide test results are classed within 3 ranges/values. The normal range for a c-peptide test is: 0.51 to 2.72 nanograms per millilitre (ng/mL) This may also be expressed as: 0.17-0.90 nanomoles per litre (nmol/L)
Also, the c-peptide is not to be interpreted as low without a high fasting glucose. If you have a normal fasting glucose then you can get a low c-peptide result due to an overnight fast.

Also, have you had tests for antibodies?

Anyway, these are the questions I'd be raising with the GP before accepting I needed to start insulin. I accepted I needed to go on insulin after receiving a c-peptide of 0.078 nmol/l and fasting blood sugar of 9 mmol/l. It was time.

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Hi. I've discovered there is no standard C-Peptide test or range which is really confusing. Medichecks who I used gave 1.1 to 4.4 ug/L for the range they use. Also views vary on whether it should be a fasting test or not. Not helpful but you just have to assume that if the reading is noticeably below the bottom of the range then you need insulin.

Daibell said:

Hi. I've discovered there is no standard C-Peptide test or range which is really confusing. Medichecks who I used gave 1.1 to 4.4 ug/L for the range they use. Also views vary on whether it should be a fasting test or not. Not helpful but you just have to assume that if the reading is noticeably below the bottom of the range then you need insulin.

Click to expand...

The c-peptide certainly has a range. My specialist monitored my c-peptide for two years before I went onto insulin. Below 0.2 nmol/l on diagnosis is the indicator of type 1. I was below this on diagnosis but managed for two years by not eating carbohydrates and exercising a lot. My c-peptide deterioration matched my need for insulin, where I could no longer get my blood sugars down through diet and exercise.

https://www.diabetes.co.uk/c-peptide-test.html

Some laboratories have more accurate measurements than others. My GP surgery's laboratory doesn't do c-peptide tests that would give enough detail to diagnose so I was referred to a specialist and they have a hospital laboratory whos reference range for c-peptide match the descriptors on the link above.

@Sgathach

How are you feeling this morning? And how did the injection go?

It is a heck of a lot to process, especially at the start, and with a language barrier to cope with too.
Keep posting and asking questions.
There are a lot of T1s on the forum who have all been through what you are going through, and understand exactly the stages of adjustment that you will experience.

How long are you away from the UK? And is there someone you could take to future health appts as a translator? Friend? Family? Neighbour? Co-worker?

Also, if it is possible, could you fill in your profile details more? It will help other members understand where you are coming from with questions, especially about hypos, hypers, medication, and so on.
To update your profile, click on your profile name, and then select Personal Details, and update all the fields. Some of that information will then appear under your name beside your posts, so that members can see what type of diabetes you have. That then saves you having to answer the same questions over and over again...

Sgathach said:

With 10units of lantus....I am best to start taking it now tomorrow morning or hold off and wait for the antibodies test? My blg is still around the low 200mg/dL.
How big is the margin of taking it at the same time? About 30 minutes or less than that?
I need to leave my house about 7.45, so if I take it at 7.45 am to be able to do it at home and not in public, I'll need to set an alarm at the weekend to wake up early?

Lastly, you said it doesn't last 24h - i usually exercise 2 or 3h pretty intensely every evening- this wouldn't be an issue if insulin isn't stable, i mean if it doesn't last it means my blood sugar will rise again in the evening but thats ok because I'll be exercising or does it mean I'll be at risk of a huge drop and hypos?

Are any candy or chocolate ok or mainly jellybabies?

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Hi there - the background insulin or basal insulin is to cover your bodies needs over a 24 hour period as the body produces glucose in the absence of food, intense exercise produces hormones which can impact of our bodies requirement for glucose, so it can either drain glucose stores or the hormones produced can increase the levels of glucose in our blood, the only way to know for certain how you will respond to intense exercise is to test before, during if possible and afterwards, always make sure you have glucose to hand as I said earlier, chocolate is a no no as the fat in the chocolate can delay the absorption of glucose, so when we refer to quick acting glucose its the rate at which the body can absorb it, using jelly babies or glucose tablets or a glucose drink is ideal, I generally take 3 glucose tabs, if I take more then my blood glucose levels can increase greatly so taking a measured amount is best.

If taking it in the morning is difficult then take it in the evening, but you need to take it around the same time, so within an hour is best, some people find that it doesn't last the full 24 hours but only you will know for sure with regular testing and keeping a log and also keeping a regular contact with your team to update them as they will suggest any changes for you.

Sgathach said:

Do i need to worry now I'll drop super low during the night and should I try a dose of 5 units tomorrow instead of 10 and see how it goes?

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Basal/long-acting insulin lasts for around 24 hours and if you're at normalish blood glucose level at bedtime and when you rise then you're more or less on the right dose. It's not really designed to be changed day to day in terms of dose. Of course if you find yourself too low or too high at those times it may need adjusted, but any adjustments should only be done in liason with the medics especially as you've just been diagnosed.

The amount of excercise you do will impact on the dosing of your lantus, but again you'll just have to see how that goes for a few weeks.

I don't need to eat food outside meal times like at the gym if I exercise 3 to 4 hours after taking short-acting. I worry about my weight so don't like to snack. I always run 90 minutes in the morning on black coffee before food, with only background insulin - it's when I'm the most stable, my blood sugars don't move down with this exercise.

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What is type 1.5 only ever heard 1 and 2

Just in case you weren’t told when injecting, count to 10 before withdrawing the needle to ensure all insulin has gone in.
Regarding exercise, we are all different and different types of exercise will also affect us differently. It is a steep learning curve but one that is individual and will only emerge over time. I would maybe be more inclined to sip from a bottle of juice whilst active, or munch the odd dextrose/Jelly Baby if you feel you are dropping too quickly. They will put you right quicker, enabling you to continue. And if you take in moderation will not make you higher than you would like later on. I have been known to munch a dextrose in the 15 second end lane rest between lengths during my swim fit sessions. Some exercise makes us continue to rise hours afterwards, so eating too much would just make this worse.