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Newly diagnosed and a little befuddled

castaliath

Newbie
Messages
2
Type of diabetes
Type 1
Hi there. I'm newly diagnosed, only a couple of weeks after I was admitted to hospital with a DKA followed by two weeks of hospitalisation (a wonderfully dramatic way to be informed you're now type 1 diabetic). I have another medical condition that means that diabetes is almost the least of my problems, but I admit that my head is kinda spinning with all the new stuff I have to do. The testing/injecting 4 times a day isn't too bad, and I've been given a fixed dose by the diabetic team, but now they've started suggesting that I can tweak doses depending if I go too low and too high, and I admit that it's all kinda intimidatingly confusing. I like to think that this is just a bit of a logistics thing, but it's all so much at once.

I guess I'm not really looking for 'omg how do I fix this', but sort of... how long did it take folks around here to get used to the whole confusing mess of it all? It all feels kinda overwhelming. I've been sort of used to a lot of the ideas about carbs and whatnot because my mother diet controlled her type-2 diabetes for five years, but for me it's the doses and whatever that's really doing my head in. Anyone have any idea how long before they let you off the leash and let you figure things out for yourself? That's the scary thing for me.
 
Sorry to hear this ... but welcome to the forum!

You can get off the leash and do it yourself as soon as you feel ready. My advice is to read "Think Like a Pancreas" - it's an easy read and will quickly set you up with the basics.

It's so overwhelming at first but it'll be second nature in no time.

I realise it's scary; I think back to December 2014 when I was diagnosed and I was terrified of even going to sleep at night in case I had a hypo and wouldn't exercise for fear of dropping too low. As you're newly diagnosed and have recently had such high levels you'll likely have excellent hypo awareness so will be able to recognise an approaching hypo effectively.
 
Welcome @castaliath :)

Let me tag @daisy1 for you as she has some basic information.

As for how long it took to get my head round diabetes, I think emotionally it took a few months - it's a huge shock and a big change to daily life. Practically - testing, injections, carb counting - it was much quicker.

If you don't feel confident adjusting insulin according to what you're about to eat, then leave that for a while, but do carb count if you're on fixed doses as it'll be easier to control your blood sugar if you eat the same carbs at each meal to match your fixed dose of insulin.

My top tips are to test lots, count carbs, keep hypo treatments near, and learn as much as you can. You really do have to 'be your own pancreas'. I too would recommend the Think Like A Pancreas book. There's a lot of information in there, but you can dip into it and get a general overview to start with.
 
@castaliath

Hello and welcome to the forum :) As mentioned above, here is the information we give to new members and I hope it will be useful to you. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 over 150,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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 bloodglucose 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.
 
@castaliath

Welcome to the forum. Firstly congrats on joining, I'm a new diabetic too and have found this place really helpful!

As previously suggested the think like a pancreas book is often recommend, I have it but haven't had time to read through it yet!

I've been injecting for a little over three weeks. I started out on fixed doses (15u Levemir once a day and 3x 5u of novarapid with meals). Fixed doses seem a great way to start but obviously food choices vary and my diet may not be anything like yours. However i'm sure you'll agree that some meals will contain a lot of carbohydrates, which break down into sugar. The more sugar you eat the higher your blood sugar (BS) will be. If you inject a fixed dose of say 5u of insulin for a very carb heavy meal your BS will be higher than if you inject 5u of insulin for a very carb light meal. Diabetes is about keeping your blood sugar normal for as much of the time as is possible. Your team will give you the ranges that they want you to keep within.

Diabetes is a very individual condition and your treatment will be very different from mine. We help by sharing our experiences with each other but essentially we are left with the approach of trial and error where by we keep track of what we do each meal / day and see if that's worked for us. So it will be important, especially as you start making changes yourself to your treatment of what you are doing and what's working. Some days will be good, and some days will be not so good.

Food diaries become a very useful part of working out what you've eaten and keeping a record of that, alongside of your BS is incredibly useful. Lots of people use paper diaries and lots use digital diaries. What I can suggest that has worked very well for me is a smart phone app called MySugr for keeping track of things if you have a smart phone that is! But certainly keep a track of what insulin you are giving and your response to food is essential.

Another book that is often recommend is a book called Carbs and Cals which helps identify how much carbohydrates are in what foods. There is also a smart phone app. I've found it very helpful, both the app and the pocket edition book. I'll be buying the bigger version of the book after my next pay day!

Your team will give you advice about how to alter your medication, and i've used this forum to help me work out how best use that information with given by your team to safely adapt slightly to be able to eat the food you like. An example of that is how I've used the forum to eat porridge without giving myself too much or too little insulin and having a sensible (for me) blood sugar before and after. That thread can be found in the link below

http://www.diabetes.co.uk/forum/threads/help-with-breakfast-porridge.101325/

Please don't hesitate to ask if you have any questions and keep us posted on how you're getting on.

Josh

**Edited because I have a kitten that helped me write this, and it got into an awful mess due to misplaced paw prints on my keyboard!**
 
Thank you everyone for being so great with the really helpful replies. I'm really really gratified that folks are so welcoming and informative. I'm in a bit of an unusual situation probably that I've been on steroids (my doctors inform me the diabetes is in fact steroid induced) so I'm on a slowly reducing dose over the next few weeks and when I come off it all my diabetic nurse and community team are going to reassess everything. I think this probably adds to my lack of self confidence when it comes to adjusting things since there's an added element in play. I'm starting to examine the carbs I consume and work out what I'm eating, though again, new process. I'm sure I'll get the hang of it eventually.

I will get to reading the suggested books at once though! Thank you again so much guys. <3
 
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