New T1

rfakes

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Hi, day 1 of being a diabetic today. Had two doses of insulin so far. How long will it take for my glucose count to go downwards?
 

EllieM

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Hi, welcome back to the forums. I was afraid that this would be the case after your last posts. (Did you go to A&E in the end, or see your doctor in the morning?)

They'll be reducing your levels gradually, as some organs can be damaged by too fast reductions, and they also don't want to overdo the insulin. (If your blood sugar goes too low your brain gets starved of energy, you can get confused, pass out and go into a coma. Lucky, hypoglycemia or too low blood sugar is easily treated (just eat something sweet) and most people get plenty of warning so that they don't feel worse than a bit hungry and shaky). They don't yet know how much insulin your body needs, so they have to start low and gradually increase the dose.

But now you're on insulin the risk of DKA has gone way down (they may ask you to check your ketones for a while) so they won't be worried about high blood sugars in the short or even medium term, though I'd expect them to start going down a bit pretty soon. (Not sure about the time scale though, since I was diagnosed 49 years ago, pre blood testing glucometers, and I was diagnosed very early by a T1 mother so never went near a DKA.)

Are you at home or in hospital? On a drip for DKA?
 

urbanracer

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Hi, day 1 of being a diabetic today. Had two doses of insulin so far. How long will it take for my glucose count to go downwards?

Welcome to the forums !

You will start to see and feel the effects pretty quickly (depending a little on your dose).

But don't rush it. There is evidence to suggest that bringing your levels down too quickly can have a detrimental effect on eyesight.

I seem to remember it took about 12 weeks for my numbers to stabilise after starting insulin. I understand your desire to lower your levels but don't rush it. False hypo's ( where you get the hypo feeling when you're still above 4mmol because you're used to higher levels) can feel pretty unpleasant.
 

rfakes

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Wow thanks to both of you.

I am home now - My ketones earlier were 0.3 at hospital. So no drip or anything.

I have been setup with
Breakfast 6 doses of Novorapid/Insulin aspart
Lunch ditto
Dinner ditto
Bed 12 doses of Abasaglar/Insulin glARGine

Last night before diagnosis, glucose was 22.9mmo/l, at hospital 6 hours after eating was 15mmo/l and just before my 2nd ever dose at dinner, it was 23.9mmo/l
 

EllieM

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You've been put on a basal/bolus regime. As a T1, your pancreas has stopped or is stopping its production of insulin, so you need to inject a replacement. (T2s have the opposite problem, they generally produce a lot of insulin, but can't process carbohydrate properly so end up with high blood sugar as a result.)

The novorapid is your bolus and is meant to process the carbohydrate in the food you eat. Eventually you'll get a ratio of how much insulin you need for each g of carb you eat (eg 1 unit for 10g of carbs, but different people have wildly different ratios.) You can also use it to correct your blood sugar if it's too high, and you'll end up with another ratio eg 1 unit of insulin brings your blood sugar down by 3 mmol/L. (Insulin ratios vary widely from person to person, and even by time of day or physical activity, so there's no use comparing your dose to other diabetics that you may know.) This, in theory, allows you to eat what you like and when you like, though certain foods can be difficult to dose for (eg pizza:)). Some T1 diabetics choose to eat a low carbohydrate diet because they find it easier to control their blood sugar like that, but that is your choice. Diabetes is one of the few illnesses where the patient has a lot more control than the physician - they can advise but you'll learn how your individual metabolism reacts to food, insulin and exercise.

Your bedtime insulin is your basal dose, it's meant to carry you through when you're not eating (eg at night). Typically it lasts 24 hours and your team will try to adjust it so that your bedtime blood sugar is the same as your morning one. Theoretically, if you ate nothing at all, the basal would last all day and night to keep your blood sugar level, with no need for the bolus.

Though the basal/bolus regime is very common, particularly for new diabetics, in the long term you have other options (eg an insulin pump) which can give you more flexibility, particularly if your insulin needs vary widely across the day. There are also continuous glucose monitors which attach to your skin and allow you to give your fingers a rest, but again this is probably for the future.

And there's a thing called a honeymoon period, where the pancreas of a new T1 can go on producing (variable) amounts of insulin for a long time, thus making it more difficult to adjust insulin dosages....

Has the hospital definitely confirmed you are T1? (There are a couple of blood tests they should do to confirm this, as there is a small chance that you are a T2 diabetic, who might be able to control the illness by eating a very low carb diet. Pretty unlikely, as your symptoms sound like classic T1, but not impossible. )

Finally, (and my apologies for the wall of text), there's a lot to learn as a new T1 but you don't have to learn it all at once. Yes, it will affect your life style but there are very few activities which it rules out (astronaut is one of them but there are airline pilots with T1). Good luck.
 

Marie 2

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They always start you on too light of a dose because they would rather it not bring your BG low enough versus it being too much and you go too low. As @EllieM mentioned, you also have a honeymoon period to contend with.

As soon as you can start learning about the carbs you eat and the specific dosing for those carbs, it will help you to keep your BG's down in the more normal levels. That way you can vary your dosing with what you eat. It's just a lot to learn at the beginning so it's usually presented to you in steps.
 
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slip

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Welcome to the gang - sort of, you know what I mean......!

One thing I will say is to keep a log of injections, food, finger prick blood results, any exercise/activity - generally anything you think might give you and your diabetes team help with understanding your diabetes. Although we all have diabetes we are all different and react differently, what works for one person doesn't mean it'll work for you.

As urbanracer said don't rush into reducing BG because of permanent eye damage, nor buy any prescription glasses at the mo - your eyes will be changing so wait until everything is settled - probably many months to be honest.
 
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Circuspony

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My eyesight was all over the place for about 6 weeks after I was diagnosed. I still have packs of disposable contact lenses with random prescriptions.

Don't worry if you feel rough as they bring your sugars down. Your body has got used to high circulating levels and it's like coming off a drug! The nurse's kept telling me I'd feel better soon but one of the consultants explained to me that my body was pretty much addicted to sugar - not my fault obviously - & bringing those levels down meant it had to adjust. I was tired a lot after I started on insulin.

A diary is a good idea to help sort out ratios but soon you'll be working out what you need and when
 
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KK123

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Hi there, one more thing to add is to PHONE your diabetes team whenever you need to, hopefully they will have given you a telephone number (!!!), when I came out of hospital I was on the phone to them at least once a day and they phoned me too to see how I was getting on. x
 
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