• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Newby Type 1 On The Open Seas

Coopsy91

Coopsy91

Member
Messages
13
Hello all,

Been recently diagnosed type 1(6 months) and thought id join the online community to get a better insight and possible answers from peoples experience.

Im 26, im a marine engineer from the west coast of scotland and currently sailing through the Med. I thought my career was over after getting medically debarked with a roaring BG over 30. All is well now and i feel fighting fit again.

I have been doing a mainly Low carb diet, i have the freestyle libre link and try to stop spikes in BG as best as i can. I have noticed that when i have my morning meal (carb free) that i get a spike in BG from say 6 upto 11, even if the meal has no carbs ? Has anyone ever experienced this? Ive managed to mitigate this by taking a 3unit shot of novorapid, but the meal is eventually a salad with a small portion of meat so it slightly confuses me as to why i have a BG spike from this.

Anyways hello, and thank you for any responses. I hope to share some experiences and help within the community.

ryan
 
Welcome to the forums, and congratulations for getting control of your diabetes so quickly.

There are a couple of things I can think of that might cause your morning spike
1) If you're having your basal (am assuming you're on a basal/bolus regime?) in the morning it's possible it's running out before 24 hours are up.
2) This is the most likely imo. The dawn phenomena consists of the liver dumping glucose when you wake up so that you're ready to face the day (go and chase down an elk, or whatever). Lots of us find that we need extra morning insulin as a result. Some people on pumps even program their pump so that it delivers extra insulin at this time of day.
 
Hi @Coopsy91,
Welcome from Australia. Very glad to hear you are well and continuing your work at sea !
To better understand your queries would you be able to supply the insulin you are prescribed, times and doses ?
And any early morning BSLs (like around 4 am)?
This information ( similar I guess to fuel flow, temperature readings etc) can help provide a better understanding of what is happening with your BSLs. Each of us can plumb the depths of your own experiences and find some possible answers.
And just to stir the pot a bit, is haggis on your menu ??
Best Wishes !!
 
Hello and welcome to the forum.
 
Welcome to the forum @Coopsy91! I'mType 2 so I can't answer your questions, but I expect some of the T1s will be along to give you some advice.
 
Hello and welcome @Coopsy91 :)

Apart from a possible dawn phenomen rise, eating protein will also cause a blood glucose spike, as your body isn't getting glucose from carbs it will cleverly convert protein into glucose, gluconeogenesis, as long as you can counter the rise with a bolus shot then it's fine. A good book for newly diagnosed is 'think like a pancreas' written by a type 1 ideal for getting your head round type 1 management.
 
Regarding your evening meal spike: as well as the protein effect others have mentioned, are you sure it is carb-free.
Many veggies contain carbs so if you are eating a large salad with tomatoes, peppers, carrots, pulses, etc. the carbs will add up.
A true carb-free salas is incredibly rare.
 
Wow huge response, thanks!

Yes so im on Levemir and novorapid.
I take 12 units levemir morning/night 12AM/PM
and 1unit/10 grams novorapid with meals. I hadnt heard of this basal bolus term until now so i had to look it up there.

I guess i have a small amount of carbs with the morning meal which im talking about, usually i have lettuce, cucumber, tomato, beans and whichever meat or fish is on for the day. Im used to taking around 3 or 4 units of the novorapid for like a roll or a sandwich, so my thinking was that this much was a little excessive for the amount of carbs in the salad. My understanding of the meat is that i would get a spike later on from the meal, im noticing the spike about 1hour after waking up and 15 minutes after the meal.

I work a split shift, so my "morning spike" is around 12am, which is the time i also take my morning dose of levemir.

And yes, freshly shot haggis is always on the menu ;)

@EllieM @kitedoc @Juicyj
 
Well I'm T2 and don't inject, but other T1s will know about that.
 
Coopsy91 said:
i was told by my dietician that you dont inject for carbs from beans as they are digested different by the body and dont create a glucose spike...?
Click to expand...
My understanding is that we vary in the way we digest the carbs in pulses like beans, lentils, chickpeas.
Some of us digest the carbs in them and for others they "just pass through".
Over time, we learn how different foods affect us individually.

And if you are referring to baked beans, there is quite a lot of carbs in the tomato sauce.
 
Hi again @Coopsy91,
The cause of Dawn phenomenon (DP) or Dawn effect is still not fully sorted ( or the gurus cannot make up their mind) however part of it seems to be that about that at 4 amish the adrenal glands (sitting up there on top of the kidneys) decide to kickstart the body for the day ( like a priming of a pump) by releasing some cortisol (steroids) and other hormones may get in on the act.
The result: Liver is influenced to release some stored glucose (it is among other things a reserve fuel cell or tank) Cortisol also makes insulin less effective (which ordinarily is no problem because the pancreas gland just releases more insulin) but being Type ones means that we have to make allowances if the DP happens to be pronounced - it varies, some people have it, not others, sometimes it settles or appears over time).
So even with a small amount of carbs for breakfast ( e.g. beans maybe ?) it takes more insulin to deal with the DP + carbs and so more insulin is needed than at other times for the same amount of carbs..
As mentioned, with an insulin pump the basal program (sort of equivalent to your Levemir) which is the low background insulin as opposed to the bolus (your Novorapid) before meals) can put in a larger amount of insulin near 4 am for some hours or whenever to cover the expected rise in Blood sugar. Fine control vs coarse control.
Sometimes people have to take a dose of short-acting insulin like Novorapid nearer 4 am to stop the rise. Sometimes they can up their night time Levemir dose to counter it. You would need to call your doctor about that. ( does he/she know Morse Code )??!!
I imagine hypos is another thing on the watch list. Knowing the likely causes like exercise etc, recognising the early signs, having fellow crew who can observe what your particular early signs and behaviour are, will be important. Some dogs are very good at sensing hypos in their owners too so if you are a dog mascot on board .... There is a section on the site about hypos.
I have been on insulin for 51 years (and still learning !!). Before retiring I had worked in a very exacting field for many years and hypos were a threat not only to my health but to performing my job to the best of my ability. I had to build in 'fail-safe' strategies to allow for a hypo which might just slow or distort my judgement sufficiently to lead to a bad call. I would double check my work; sometimes run it by a colleague to make sure; not skip meals, or delay them and thus risking a hypo happening. Knowing that if a hypo did happen, it would take me a good hour or two to be handling things physically and mentally well again. So temporising was the better part of valour. If that time was not available, such as in an unavoidable emergency I had practiced so much that second nature would kick in - but this was only as a last option - I can recall 2 very mild instances in a career spanning 35 years in that field. And thinking ahead; what if I am out of the office and are delayed getting back for lunch ? --> take food and insulin along (?pen) to tide me over just in case.
What if there is an emergency at lunch, dinner, breakfast time ? hold off bolus ? bolus, eat and run. ? take insulin and food with me - realising that the stress of an emergency would send the sugars up but exercise could bring then down, including possible hypos 6 + hours afterward when the muscles dip in and extract glucose from the blood to refill their stores of sugar. ( say auxillary engines deplete their own battery power, and, uninvited, recharge/suck up power from main electricity lines and battery/generator some hours after their use, leaving computers (like the brain) short of power !!
And I have to relay some bad news: Haggis is not likely to be a good remedy for hypos; I gather 4 oz = about 20 g carbs but the fat content slows its uptake of glucose once eaten. The Hypos site has good suggestions/remedies, remembering that the sucrose (as opposed to pure glucose) ain't good for teeth !!
Best wishes on your diabetes journey. Please keep posting (or keep us posted) and if regulations and weather permit fly a kite sometime !!
 
@kitedoc Thanks for that reply, you have included a great deal of information.

Yes im still hyper aware and paranoid about everything which is happening currently, why do i feel this way, will i make it through this, impending sense of doom haha. Ive have not yet noticed a drop in glucose levels from exercise, its something im conscious about but have not yet experienced. perhaps im not pushing hard enough in the gym...
I too have been preparing for hypo's, ive been put as fire team leader as one of my emergency duties so i have some dextrose tablets in my suit aswell as my guys have some in theirs.

One of my concerns is travelling with the insulin, i work away for 3 month periods at a time, and i packed my insulin for this duration in a cool bag with some ice gel packs inside, my thoughts were the airline would allow me to put this into a fridge on the plane and i could extend the lifetime of the gel packs but they did not allow this, on my next contract i will be flying to either AUS or New Zealand so these long haul flights are making me a bit nervous. I need to plan properly in order to keep my insulin cool as a cucumber for the long travelling time (took me 37 hours door to door last time)

I bought a power kite from ebay a few years back, took it to the beach and nearly landed in ireland..... my kiting experience is not a good one so far lol:wideyed:
 
Coopsy91 said:
i was told by my dietician that you dont inject for carbs from beans as they are digested different by the body and dont create a glucose spike...?
Click to expand...
Not sure if you are talking about green beans or chickpeas, kidney, haricot etc. The latter certainly have carbs but they are absorbed quite slowly compared to say, cereals according to various dietary sources but for example a cup of cooked chickpeas has about 45 g carbs in it. (healthyeating.sfgate.com)
 
Coopsy91 said:
@kitedoc Thanks for that reply, you have included a great deal of information.

Yes im still hyper aware and paranoid about everything which is happening currently, why do i feel this way, will i make it through this, impending sense of doom haha. Ive have not yet noticed a drop in glucose levels from exercise, its something im conscious about but have not yet experienced. perhaps im not pushing hard enough in the gym...
I too have been preparing for hypo's, ive been put as fire team leader as one of my emergency duties so i have some dextrose tablets in my suit aswell as my guys have some in theirs.

One of my concerns is travelling with the insulin, i work away for 3 month periods at a time, and i packed my insulin for this duration in a cool bag with some ice gel packs inside, my thoughts were the airline would allow me to put this into a fridge on the plane and i could extend the lifetime of the gel packs but they did not allow this, on my next contract i will be flying to either AUS or New Zealand so these long haul flights are making me a bit nervous. I need to plan properly in order to keep my insulin cool as a cucumber for the long travelling time (took me 37 hours door to door last time)

I bought a power kite from ebay a few years back, took it to the beach and nearly landed in ireland..... my kiting experience is not a good one so far lol:wideyed:
Click to expand...
There are forum questions and good answers on travelling, including to Australia (Oz) and NZ. and also about managing exercise.
I think you will find all you need to know but by all means ask questions if they do not answer what you need to know.
Briefly, UK (NHS) has reciprocal healthcare arrangements with Oz and NZ (+ Canada etc) so obtaining insulin in either is far less of a hassle than some other countries. Like other health services there are special schemes for diabetics obtaining needles and glucose meter test strips. You may not qualify for these and so could cost more (but for Oz I shall endevour to find out). Best bet is probably to bring sufficient for the time away (plus some extra just in case)
If you look at the leaflet inside your insulin packages, it quotes that insulin is stable/active out of the fridge for 30 days if kept below 30 degrees C (and not frozen). The fridge range for storage is 2 to 8 degrees C. So to be on the safe side, stocking up after a month in Oz or NZ with a new supply is wise and keeping it in a fridge if possible ( or at least a part of it).
I am glad you did not end up in Ireland - apart from the cold, the lack of fresh water, eating raw fish etc it could be a wee bit difficult injecting insulin whilst holding onto the kite. If you happen to be travelling thru Adelaide, free kite lessons are on offer !!!
 
Back
Top