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Newly diagnosed Type 1. Really confused

Hi,

First of all, this is all my experience ever since I was diagnosed and it's quite long so it's all up to you if you decide to read it all or not but would appreciate anyone who reads it through! (:

My diabetes specialised nurse at diabetes centre suggested me that I could get loads of information on here so I am giving a shot!

First of all, I found out I was diabetic in a very strange way.

For me having a history of anxiety disorder, it was just one of the days I was having a panic attack but probably a big one, on the 8th of march. I ringed ambulance and they came down quickly. I was sweating, my bp was around 180/135 and having all those typical panic attack episode. They calmed me down in about 1/2 hour and started asking me questions. Kept asking me if I was on any illicit drugs. I said no because I don't do drugs. They kept asking me and did that graph thing to monitor heartbeats. After that, they did a blood glucose test I don't know why (?) lol. They kept saying 15, 15. I had no idea what that meant as I am originally from America and for having a father with T2 diabetes, I know it by mg/dl. Well, they took me to the A&E. To be honest, they didn't give a **** about my anxiety but was about to drop me a serious news that would change my life. A doctor came in and said 'you have a diabetes'. I didn't know how to take it. I asked twice, are you SURE I am? Is there a chance that it may be a wrong diagnosis? And he said there is no way because your glucose level from your blood sample shows 21.6mmol/l. It was my fasting bg as I hadn't eaten all day that day. I realised that it was equivalent to near 400 mg/dl and knew it was serious as when my father was first diagnosed with his, his bg was around only 210 mg/dl or around 11.5 mmol/l. They admitted me in hospital and I was observed overnight. For a person who has no memories of how it's like to stay overnight in a hospital overseas, it seriously freightened me. An old bloke with Parkinson's disease, another old person with seem-to-be lung cancer, I was in and out of sleep all night and was given insulatad and could lower it to 16 before I could leave with humulin the next day afternoon. I came home and was probably depressed for days. Thank God my uni broke up for half-term, I could get depressed and do nothing however much I wanted to.

Now, 3 weeks since I was diagnosed, I am such a newbie. I have no idea how to do proper carb counting nor how to manage my diet. Few lab results came in saying my HbA1c is 107 mmol/mol, I believe that's around 12%? It seems quite high but I am early in the stage so hoping to lower it over time. Also my triglycerides when I was admitted was immensely high with 80 which doctors said about 50 times higher than normal people but managed to get it down to 51 on my first insulin shot at hospital and 32 on my second shot. When I went to diabetes centre for follow up, there was another blood check so hoping it came down to at least within 10. Also they said I have protein in my urine but my follow up report says there was no albumin found, further 24-hour urine sample needed or something like that.

Wow, my story was long. I had to say all this because there is absolutely no one who understands all this. People I know think diabetes are for people who are careless and lazy, also they think it's like catching a cold, can be cured completely. One of my friends even asked that how come cancers can be cured but diabetes can't? That's such a lie.

Anyhow, I just have few questions as I can't get appointments with my GP nor my specialists and answers to these questions may improve my day to day life.

1. After I was discharged from hospital, I quickly changed my regime with novorapid and lantus.

Started with 14 units of lantus along with 4 units of novorapid every meal.
This is seriously wrong I think. In 3 weeks, after a bit of extensive bg measuring (at least 20 times a day), I finally adjusted with 30 units of lantus and 3-5g carb/unit novorapid every meal. Even this makes my bg reach over 10 occasionally. Morning bg has always been late 7-late 9 range every day even after increasing lantus units by more than twice suggested. I have no idea why it's happening. So far I had 2 hypos (one was just below 3.8, had some glucose tablets and after 20 minutes it went back up to 5.7) and the second one was far scarier. I was stupid because I took 8 units of novorapid to have about 100g of peanuts for snacks. It had about 22g of carbs so 8 units seemed about right. Then from 6.7, after 2 hours I felt a bit of heart attack like symptom and my bg was 3.4. My glucose tablet was in a car and I wasn't really bothered to go out so I had some hot chocolate powder to cover it with. Then 20 minutes later, got worse, it went down to 2.1. I had three spoons of those powder and still was around 1.8-2.2. I was really dizzy and couldn't even walk to my car. Eventually made it (it was 3 in the morning) and had 5 glucose tablets, got it up to 5.6 before I went to bed (woke up with 9.8!!!)

Do i have some kind of insulin resistance or is it just because I am not used to proper carb counting? I have no idea how I can control morning bg. A step by step but I'd at least like to keep my bg under 10 all the time for time being.

2. Why is low carb diet important to diabetics? If insulin is like what human body naturally produces, as long as diabetics inject proper amount of insulin, wouldn't it put them in a same position as normal people with normal bg? (Sorry if it sounds confusing). I mean normal people eat pasta, rice and all those starches regardless and still not diabetic. If diabetics eat them and give same amount of insulin as normal people usually release from their pancreas, wouldn't it be the same? With right amount of insulin, it sounds like diabetics can eat as much as carbs they would like?

I know it's really long but I hope someone can read it and share it with me. It'd be greatly appreciated.

Thank you so much in advance

Patrick
 
Hi. I'm going to dive right in and comment on your question 2. To a large extent you are correct in thinking that you can match insulin to the amount of carbs in a 'normal' person's diet. The result may well be being overweight just like today's 'normal' person. Also insulin resistance may build-up resulting in the need for higher injections of insulin. Also large doses of insulin mean higher ranges of swing when food and insulin are mis-matched; that can result in a hypo. So, the bottom line is that it is wise to have a sensibly low level of carbs but not too low and match the insulin to that. Hope this helps a bit.
 
Hi Patrick and welcome to the forum :)

Here is the information we give to new members which I hope you will find helpful.


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 well over 30,000 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 ... rains.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

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 blood glucose 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 patrick,
I understand how hard this must be, but its hard to explain carb counting on the internet :) Ask your Diabetes hospital for help
 
Hi,

thanks everyone for replies.

I kinda get the idea of carb counting, as I understand it as you count the carbs and find the ratio of grams of carbs to units of insulin demanded. If not, I still have loads to learn!

I don't know. My nurse and specialists boosted my self-esteem by saying I am doing good. I have managed under 10 most of times even after big meals I had occasionally for the past 3 weeks. One day, I managed to get fasting bg 4.3-5.2 and after meal bg 5.5-6.8 all day. It just kinda gave me confidence that I can do this but it's still an ongoing condition and one day of controlled bg wouldn't be something to be really happy about cause I believe consistency is important here.

I need to quit smoking cigarettes too but at this point, it's just too hard. I am just trying to take it slow, one by one, so I don't fail. At the moment, diets and proper insulin doses are my priority. Already cut down on drinking dramatically but just CAN'T quit smoking!
 
If you have iPhone download Carbs & Cals ( £3.99 ). You have to pay but well worth it. Makes counting carbs very easy. If not, Google " DAFNE Carbohydrate Portion List". Again, this gives you a very good reference to easily count carbs. It even tells you how many units to inject ( based on 1 unit per 10g of carb ). Keep at it, it does get easier, I promise :)
 
Thanks a lot!

I would definitely look into that app. Mere 4 quid is worth a while if it's greatly helpful considering I am not paying for insulin or any other supplies whilst if I were back home in America, I'd probably have to pay. ( Not trying to take an advantage of UK health care! I appreciate it as much as other foreigners and expats living in the UK for free NHS care!)

By the way, I noticed that neuropathy (I think that's how it's called?) on my fingers got worse and more frequent. It's tingling quite bad as when I type, I sometimes don't feel my fingers. It's almost every time on my right hand, mostly my index and middle finger.
I hope this is not something serious? (Such as in necessity of amputating my fingers :shock: )
 
rfcpatrick said:
Hi,
2. Why is low carb diet important to diabetics? If insulin is like what human body naturally produces, as long as diabetics inject proper amount of insulin, wouldn't it put them in a same position as normal people with normal bg? (Sorry if it sounds confusing). I mean normal people eat pasta, rice and all those starches regardless and still not diabetic. If diabetics eat them and give same amount of insulin as normal people usually release from their pancreas, wouldn't it be the same? With right amount of insulin, it sounds like diabetics can eat as much as carbs they would like?
Patrick
Hi Patrick,

In answer to question 2, a low carb diet is NOT important for a Type 1 diabetic, since as you have already reasoned, it can be covered by quick acting insulin. It is Type 2s who really benefit from going low carb and many on the forum can testify to this.

Here are some links to some really useful documents and books which will help to to get better control using carb counting and insulin adjustment .....

Get used to detailed carbohydrate counting.
Buy this excellent book (only about £10) that provides clear pictures of nearly every food you might need

1) Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting for People with Diabetes

(http://www.amazon.co.uk/gp/product/0956 ... 01_s00_i01)

2) Carb Counting & Insulin Adjustment:

An introduction to carbohydrate counting and insulin dose adjustment

https://shop.diabetes.org.uk/store/lite ... -book.aspx
- I believe this is the basis of the DAFNE (Dose Adjustment For Normal Eating) course which you should get enrolled on ... it will change your life with all the knowledge you will gain from this course

3) Adjusting your Insulin when results are too high or too low:
An excellent detailed document, with plenty of examples, to assist you in making required insulin adjustments. Download it and print it out so it is readily at hand after blood sugars have been made & recorded.

http://www.diabetes-scotland.org/ggc/do ... Change.pdf

Books you could purchase:

4) Using Insulin: Everything You Need for Success with Insulin
http://www.amazon.co.uk/Using-Insulin-E ... 973&sr=8-1

5) Type 1 Diabetes in Children, Adolescents and Young Adults.
http://www.amazon.co.uk/Diabetes-Childr ... 072&sr=1-3
Don't get put off by the title since the principles apply to all Type 1 diabetics

Record everything (BG, carbs, excercise etc)
One more critical point that I forgot to mention .. record, record .... record.
 
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