newly diagnosed type 1 advice needed

Hello,

It's daunting but don't worry too much; you'll get used to it.

The starting assumption for insulin to carbohydrate ratio is 1 unit of fast acting to 10 grams of carbohydrate and your 4 units of Humalog seems to be along those lines.

There are a number of apps for phones that will give you information on carb content (My Fitness Pal being one) that can be pretty helpful.

You need to be testing your blood sugar a lot at the moment until you get a handle on what effect different foods have on you.

Also, you should ask to do a DAFNE course which will teach you about carb counting and dose adjustment.

Keep asking here as well; people will be happy to help.

Best

Dillinger

jenni34 said:

Hi I was diagnosed with type 1 diabetes after suffering ketoacidosis
I haven't had much help regarding meal time insulin ratios at the moment I'm taking 14 units of lantis in the morning and 4 units of Humalog with meals .

I'm not sure how many carbs I'm covered for or when extra insulin is required .

My daughter has just done her GCSES and leaves school next week id really like to be able to take her out for a meal but I'm worried about ordering the right thing and being covered so I don't end up to high.

any help would be much appreciated .

Click to expand...

Welcome @jenni34

You can get an idea of how many carbs your 4 units cover by counting the carbs in your meal then testing before eating then again 2 hours after the start of your meal. Or you could ask your DSN what their rationale was with that set dose. Imwas given a set dose at diagnosis but I was told how many carbs to have. It seems like you haven't been given this piece of information.

If you're looking for a good book about Type 1, Think Like A Pancreas is brilliant

There's no reason why you can't go out for a meal. Just choose sometjing with similar carbs to what works at home if you're nervous about having a larger bolus. Also, test frequently so you can make sure all's going ok.

Hi!

I really recommend getting this book - Carbs and Cals - which I've linked below. You can also get it as a handy app on your phone for when you're out and about.

https://www.amazon.co.uk/d/Books/Ca...coding=UTF8&psc=1&refRID=WN1V4F3ZXER6G739EF8A

It tells you the carbohydrate count for literally everything, so you can easily work out how much insulin you need, according to your insulin to carb ratio.

I rely on this heavily, and it hasn't let me down so far.

Hope that helps!

jenni34 said:

Hi I was diagnosed with type 1 diabetes after suffering ketoacidosis
I haven't had much help regarding meal time insulin ratios at the moment I'm taking 14 units of lantis in the morning and 4 units of Humalog with meals .

I'm not sure how many carbs I'm covered for or when extra insulin is required .

My daughter has just done her GCSES and leaves school next week id really like to be able to take her out for a meal but I'm worried about ordering the right thing and being covered so I don't end up to high.

any help would be much appreciated .

Click to expand...

Welcome to the forum. Do you keep a log of insulin doses and blood glucose levels? From this you can track your progress and see trends in your day to day management. Get to know what you can have and what to avoid. It makes life a little easier.

Being recently diagnosed, I too was on a fixed insulin dose to start too.
You will have to learn how many grams of carbs each unit of humalog covers. Be aware that this could be different at dinner, breakfast and lunch.
I recommend testing a lot and recording blood glucose, dose, and meals (for meals: number of carbs, type of carbs, how fatty, how much protein).

Also bear in mind that things can change early on - your pancreas might toss in some insulin of its own from time to time.

jenni34 said:

at the moment I'm taking 14 units of lantis in the morning and 4 units of Humalog with meals .

Click to expand...

On fixed doses of bolus you should have been given some advice on how many grams of carbs that dose was designed to cover.

The first thing to figure out is, is 4 units actually covering your meals? What is your blood sugar before eating and bolusing and 2 hours after eating?

If it's covering, you can work out how many grams of carbs it's covering by working out how many grams of carbs are in the meal you ate that turned out to be well covered by 4 units. Then divide by 4 and you'll have a good idea that 1 unit covers X grams of carbs.

Then for food you can work out how many grams of carbs is in what you are going to eat, divide by X (of 1 unit covers Xg of carbs) and that gives the number of units required to cover it.

That's your insulin to carb ratio. And that's carb counting. Do bear in mind that the I:C ratio might be different at different times of day, or at weekends, or depending on activity level.

There's a free online NHS course on carb counting - https://www.bertieonline.org.uk

It is hard to accurately work out how many grams of carbs are in a plate of food you are presented with at a restaurant, much easier at home where you're cooking and have weighing scales etc. But the carbs & cals book or app is good with pictures of food/portion sizes to give a good idea of carb content. But it would be good to underestimate to avoid giving too much insulin.

Hi @jenni34,

I agree with all the above comments; I would just add that, personally, while experimenting with dosages, I would prefer to stick to meals with exactly the same number of carbs, taking the same amount of insulin for each.

For example, if for a couple of days, all your meals contained 40g of carbs, you could get a clearer picture more quickly of how the 4 units works with each meal, and any variation there might be in the day. Bear in mind that 4 units could also cause you to go low if there aren't sufficient carbs in the meal, so it's a very good idea to test as often as you can while getting used to this.

I'd also add that, in my experience, there's no such thing as getting it "perfect" - the margin of error is too great for that; but if you can get a firm base from which to work and to make any necessary adjustments, that's an extremely good start. Carb-counting is also crucial - though I can assure you it will become more natural over time! Happy to help anytime