Newly diagnosed type 1, not a clue what I'm doing!

Hi Samblease73. Welcome to the Forum. I will tag @daisy1 and some information will be sent to you shortly. If you have any questions to ask? Someone will come along and answer. We are all friendly, helpful and supportive on here.

Welcome @Samblease73

It sounds like you're doing pretty good Type 1 is a hard thing to get a handle on, especially in the very early days. If you'd like a book to buy, Think Like A Pancreas is highly regarded by many people here Its got lots of info, but you can absorb as much or as little as you want as you go along and according to your needs.

I was started on mixed insulin when I was first diagnosed. I was also taught to count carbs and given fixed amounts of carbs for each meal to 'balance' the insulin. Were you shown how to count carbs?

Regarding exercise, yes it's not uncommon to go low some hours after. If you're worried about dropping again during the night, you could set an alarm to get up and test and eat a little if necessary.

Hiya Sam, welcome to the forum.

Exercise is great for keeping BG levels stable, however, depending on the type of exercise the effects can materialise hours later when your muscles are still using glucose, hence the lows, the easiest way to treat is by eating a higher carb snack, if you learn to carb count then count the carbs of what you ate last night and try to increase it in future by say 25% or 50% to stop this happening. As a type 1 our lives are ruled by carbohydrates as this is what raises our blood glucose levels, and for those of us on multiple injections we inject a quick acting insulin for the carbs we eat.

In regards to exercise and diabetes have a look at http://www.runsweet.com/ this is a great resource for type 1's.

I would suggest contacting your team to discuss your exercise and hypo situation, they may suggest changing your insulin to multiple injections to help you manage your exercise.

It's all a learning curve but with knowledge and time it does become second nature

Samblease73 said:

Thanks for the replies! It sounds like I need to learn to carb count. I'll ask at my next clinic appointment on Friday. I am feeling a little bit like I've been left to deal with this on my own, I really have no idea how to regulate my blood sugar levels properly, I'm just guessing & hoping at the moment

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That's sad. You may have to push a little to get the help you need. Don't be afraid to do that politely and to ask your Diabetes Nurse lots of questions.

Yes, apart from lots of testing, carb counting is key to good diabetes control.

A move to multiple daily injections (MDI) would also help a lot with flexibility.

Samblease73 said:

Hi there,

I was diagnosed with type 1 diabetes on 21 December 2015 at which time my blood sugar level was in the high teens / low 20's. I have been put on fixed doses of mixed insulin. I take one dose in a morning when I get up and another before my evening meal. I was told to test my blood sugar levels before each meal and before bedtime, which I have done every day. My levels are now mostly under 10 aside from the occasional blip as I'm really still learning what foods affect me. I am very active though, I go running several times per week and also attend many classes at the gym. I have been finding that my blood sugar level can suddenly drop very low a few hours after exercise and this is scaring me a little. One example is that I had a BS of 9.8 at 10:30pm when I went to bed but at 12:45am (just over 2 hours later) it had dropped to 3.3. I had eaten a starchy snack before bedtime as my healthcare team had suggested following exercise - hence the elevated sugar level at 10:30pm - but this didn't seem to help any. Does anyone here have suggestions of what to do during / after exercise to stop hypos occurring?

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Hi Sam, insist that you are changed over to MDI (basal/bolus) this will enable you to adjust your insulin to what activity you are doing or not as the case may be. Until you are sorted to a more realist method of control best option is to have a snack straight after exercise if you are dropping low a couple of hours after the exercise. Obviously if you are low before the exercise then have something to eat before.

Using mixed insulin means you have to eat exactly the same thing every day and at the same time plus do exactly the same amount of exercise. Which obviously is not practical.
Invest in a couple of books called using insulin and think like a pancreas (amazon) They will help you no end to understand how to help yourself.

@Samblease73

Hello and welcome to the forum Here is the information we give to new members and I hope this will help you with your blood sugar levels. Ask more questions 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.

Hi Sam you are doing well and you have learnt more than you give yourself credit for. It was probably easier to put you on a fixed amount of insulin at you diagnosis as you had lots to learn.Carb counting does help with your levels but do you not get bored with having to eat the same amount of carbs at every meal.If you were to be changed to basal bonus regime with different insulin so

Hi it's me again. Yes if you were to be placed on basal bolas regime you would find it much easier to prevent the highs and lows of pre and post excercise. Also you can learn carbohydrate counting and then you wouldn't necessary have to eat at the same times each day with the same amount of carbohydrate.Good luck and you really are doing well.

Why on earth are people being put on to mixed insulin regimes at diagnosis, especially when they regularly exercise? Seems ridiculous to me.

I was diagnosed in December 2014 and thank god I was put on basal-bolus. @Samblease73 - it sounds like you're doing a great job. It gets SO much easier and less overwhelming after the first couple of months, and you'll soon start to learn how your body responds to all the variables. I agree with @CarbsRok and @azure that Think Like a Pancreas is a fantastic book to read - I read it the moment I got home from hospital and everything became so much clearer, as there is A LOT to learn and so much strange terminology. Good luck with everything!

pinewood said:

Why on earth are people being put on to mixed insulin regimes at diagnosis, especially when they regularly exercise? Seems ridiculous to me.

I was diagnosed in December 2014 and thank god I was put on basal-bolus. @Samblease73 - it sounds like you're doing a great job. It gets SO much easier and less overwhelming after the first couple of months, and you'll soon start to learn how your body responds to all the variables. I agree with @CarbsRok and @azure that Think Like a Pancreas is a fantastic book to read - I read it the moment I got home from hospital and everything became so much clearer, as there is A LOT to learn and so much strange terminology. Good luck with everything!

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Whats the NICE protocol in this situation, I could hypothesise a situation where this is the simplest way to manage new T1s and then introduce them to MDI once they gave got to grips with the basics?

steve_p6 said:

Whats the NICE protocol in this situation, I could hypothesise a situation where this is the simplest way to manage new T1s and then introduce them to MDI once they gave got to grips with the basics?

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NICE guidance below, specifically states that basal-bolus should be prescribed straight away from diagnosis:

Do not offer adults newly diagnosed with type 1 diabetes non‑basal–bolus insulin regimens (that is, twice‑daily mixed, basal only or bolus only).

Hi Sam- some excellent advice from others so I'll just comment on my experience with exercise and sugar levels. I used to do a lot of mountaineering and climbing, as well as caving, and soon discovered that your body is in a recovery mode for hours afterwards. Like you this caused a few mishaps in the early days but I gradually cottoned on and by either increasing carb intake or reducing the night injection or a bit of both got it under control. It does take you by surprise as to how long the body is recovering (depending on type/length of exercise). Several hours on steep snow covered ground in minus C temps and you definitely up the carbs!
You'll soon find the best way for you to deal with it and the worries start going away. You've already learnt a lot without realising how much! Keep going!

I actually think that mixed insulins regimes are much easier for a beginner, no matter what the NICE guidelines say. Basal bolus regimes CAN be better but require more carb counting ability to be flexible.

Samblease73 said:

I have just been switched to basal bolus and enrolled on a DAFNE course. Feeling much more positive about being more in control. Clinic is very happy with me so far, fingers crossed I'm getting this right! I'm probably still in the honeymoon period you're all talking about but hopefully being armed with all the tools I need to do battle!!

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That will suit you so much better, still not easy but gives you a fighting chance

I was diagnosed in June last year and am still on the mixed insulin, morning and before and dinner. I can almost guarantee my blood sugar is 12-17mmol 2 hours after eating and I keep getting told by the "professionals" this is normal as everyones blood sugar goes up and down during the day. Leaves me feeling awful most days with a dry mouth a few hours after most meals.