Newly Diagnosed type 1

[DannyMilbourne]

Hey guys hope you're all well, I have been newly diagnosed on Saturday with type 1 diabetes.
I'm still so overwhelmed by all the information given to me and I'm struggling, basically I have a Tresibo pen I take in the morning then I have a NovoRapid pen I take before each meal 3 times a day.
I enjoy a snack and a cup of tea just before I go to bed and my question is do I have to have another shot of Insulin with these as there will obviously be some sugar in them?
Many thanks

 

[sleepster]

Hi @DannyMilbourne, welcome. I hope you aren't feeling too overwhelmed I wish I had some encouraging words for you, maybe try not to attempt to understand it all now, just take it one day at a time and come back here and ask any questions you have. Everyone else here is knowledgeable and supportive and there's no such thing as a silly question
To help answer your question...
Are you on fixed doses of novorapid or are you counting the carbs in your meals?
Are you injecting for other snacks?
What snack are you having/wanting to have before bed?
Finally how is your blood glucose before bed?
I think the best thing to do would be to ask your diabetes specialist nurse (DSN) for their advice, particularly if your BG is still running high.
I would say if the snack is like 1 biscuit and you aren't having sugar in your cup of tea then you're probably ok not injecting for the time being. If your snack is 2 slices of toast with jam and a cuppa with 3 sugars then that's a different story. If you haven't been told how to adjust your doses or what to do for snacks then for now you might be best not snacking or having something low carb, like some nuts or cheese.
Many moons ago (like 20 years ago ) I was told if a snack was under 20g of carbs I didn't need to bolus for it but advice may be very different now.
Hope that helps a bit.

 

[RoughcutAU]

G’day! Welcome to the club nobody asked to join! It can be overwhelming at first but day by day you get the hang of it (a few curveballs aside). I was diagnosed August last year and still very much learning what does amd doesn’t spike my Blood Glucose Levels. Lots of experiments and don’t be hard on yourself when you make a mistake. You’re best friend is your meter and checking levels before and after different foods will help (before it all changes 3 months later ) I joke.. alittle. Feel free to PM if you have any questions you feel silly about - i know i did but no question is silly.

 

[becca59]

Welcome @DannyMilbourne Perhaps dispense with the snack for now, until you have more knowledge of what happens whilst asleep. If you snack without insulin you could be going high, making control harder to manage the following morning. But if taking insulin you risk going low. It is very early days. Lots to learn and overnight is not the best time. Perhaps have more at tea time if you think you may be hungry. If you are not actually hungry and it is just habit, ask yourself does my body really need food lying in it whilst asleep.

 

[Daibell]

Hi and welcome. It's a judgement really. If I have a snack of, say, 30 gm or less I won't inject more Novo as it's not worth doing. Be careful with injecting more Bolus before sleep in case you get it wrong and risk a hypo. As another poster saked, are you on fixed Novo doses or adjusting for the carbs in each meal? Many medics start you on a fixed dose and leave it for months before they explain carb-counting your dose at each meal. Ensure that you start carb-counting soon if not already.

 

[DannyMilbourne]

Hey guys, sorry for the late response.

Basically I am on fixed doses, I have 10 units of Tresiba in the morning and I'm on 6 units Novorapid before every meal.

My snack is usually like a couple of biscuits and my tea usually has 2 sugars in it, it's all just so overwhelming and I don't know what to do haha.
Many thanks guys for all your replies so far

 

[RoughcutAU]

It’s ALOT to take it which is part of the reason early in they put you on fixed doses. Gives you time to wrap your head around it all/learn.

To specifically answer your question - when you are carb counting your sugary tea and biscuits would generally require a bolus dose. The “bonus” of being T1D on insulin means you can eat basically anything you want you just need to dose appropriately.

The added “bonus” is i found that because I’m a “simple” creature I changed my snacking habits because in most cases I couldn’t be assed bolusing for a snack. IE I have tea or coffee with no sugar and one biscuit then I don’t have to stab myself. (Note this works for me not everyone).

 

[DannyMilbourne]

@RoughcutAU I'm not sure how to properly reply here so I'll give this a go

Ahh okay I got you, I did wonder why everyone wasn't on fixed dose lol thank you for clearing that up

Right okay I'm with you and that's good to know I can eat what I want still but I was just panicking that the dose they told me to take wouldn't be enough, I'm scared to dose more/less than what they've told me to lol

It's hard cause I've done the same routine for about 10 years now, snack and tea before bed and it's so hard to change...does it all depend on my BS levels? Like if its still normal then I can carry on without dosing? Appreciate your help.

 

[EllieM]

Hi @DannyMilbourne and welcome to the forums

Right okay I'm with you and that's good to know I can eat what I want still but I was just panicking that the dose they told me to take wouldn't be enough, I'm scared to dose more/less than what they've told me to lol

It may well not be enough, since your team don't yet know how much insulin you need. I would argue that that doesn't matter, as your blood sugar results, whether low or high, will provide the information you and they need to find out how much insulin you need. (And unfortunately people's insulin needs can change with time, and exercise, and illness and stress and ...)

My recommendation would be to keep a good diary of what you eat to go with your blood sugar results. How often are you talking to your team? Hopefully very often, as you'll need help with altering your doses.

Good luck.

 

[DannyMilbourne]

Hi @EllieM and thank you

Right okay I understand, so it will more than likely change again soon?

I've been writing down what my results have been and what I've been eating for lunch and dinner etc shall I keep doing it that way?

Erm I haven't really spoke to anybody yet, I got diagnosed on Saturday and I got discharged from hospital yesterday but I haven't spoken to anybody since I've been out, I've only spent 30 mins with a diabetic nurse on Monday in hospital, that's literally it lol

 

[EllieM]

Hi @EllieM and thank you

Right okay I understand, so it will more than likely change again soon?

I've been writing down what my results have been and what I've been eating for lunch and dinner etc shall I keep doing it that way?

Erm I haven't really spoke to anybody yet, I got diagnosed on Saturday and I got discharged from hospital yesterday but I haven't spoken to anybody since I've been out, I've only spent 30 mins with a diabetic nurse on Monday in hospital, that's literally it lol

I'm pretty sure they'll have started you on some sort of "standard" dose, possibly influenced by your weight. If they haven't given you any instructions on how much to eat then the dose may definitely change, they don't know whether you are on 0 carbs a day or on 1000g.

Your records sound fine to me.

Most T1s go on to a basal/bolus regime (unless on an insulin pump, but that is another story). The basal (tresiba in your case) is meant to keep your blood sugar level when you don't eat. The bolus (novorapid for you) is used to balance the carbs when you eat and (sometimes) to correct your levels is they are too high. Long term you'll get a carb ratio of say 1 unit of insulin to 10g of carbs (this is a common starting amount but can vary massively between people) and be able to adjust your dose to what you are eating. You'll also get a correction ratio of how much insulin to take if your blood sugar is too high.

How were you diagnosed? Was your blood sugar very high? Diabetic ketoacidosis?

But you should have a contact number or email of a diabetic nurse so you can discuss your levels. If you have no one to call maybe try ringing your GP to find out who is supposed to be contacting you. (I am a little out of practice with UK systems as was diagnosed over 50 years ago and left the UK in 1999).

 

[DannyMilbourne]

Okay that's fine, yeah they literally said nothing about food they just gave me them set dose numbers and said carb counting will come soon lol

Right okay I follow you, that seems pretty straight forward but I bet its far from that amazing how you know so much just like that

I remember hearing that word ketoacidosis, I went to the docs feeling generally unwell and my sugars were at 36 and my ketones was at 3.1 so sent me to hospital

I do have a number on my discharge letter I think, I will have a look tomorrow, if not then I will give my gp a call, I just don't to get any of it wrong and it's stressing me out

 

[EllieM]

I just don't to get any of it wrong and it's stressing me out

The only getting it wrong you can really do at this stage is to go back to hospital from ketoacidosis (hopefully very unlikely since you are now on insulin) or from extreme hypoglycemia (low blood sugar, hypo for short).

Did they talk to you about hypos at all? (Basically, it's the nature of being on insulin for your blood sugar to go too low sometimes, which you treat with something sugary, glucose is the fastest to act. As long as you recognise the symptoms this isn't much of an issue, just take sugar, wait till you feel better, and carry on,. But if you ignore a hypo then your insulin can make you go too low, leading to confusion and worst case a coma. It's worth always having something sweet with you when out and about, or by your bed at night, just so that you can treat any hypos.

Sorry, don't want to give you information overload, but any insulin user needs to know about hypos. Am guessing your blood sugars are probably still running high though, and hypos are only an issue when you go down below 4mmol/L But it's a legal requirement in the UK to do a blood test before you drive, just because it's so dangerous if you have a hypo behind the wheel.

Once again, good luck.

 

[iwilltouchyourcat]

Okay that's fine, yeah they literally said nothing about food they just gave me them set dose numbers and said carb counting will come soon lol

Right okay I follow you, that seems pretty straight forward but I bet its far from that amazing how you know so much just like that

I remember hearing that word ketoacidosis, I went to the docs feeling generally unwell and my sugars were at 36 and my ketones was at 3.1 so sent me to hospital

I do have a number on my discharge letter I think, I will have a look tomorrow, if not then I will give my gp a call, I just don't to get any of it wrong and it's stressing me out

Hiya and welcome to the club no one wants to join! I got diagnosed in a similar way to you, felt generally rubbish, partner frogmarched me to gp who found I had similar levels to yours and packed me off to a&e with dka and I was on a drip for 8 or so hours. Then blood tests confirmed type 1/LADA. It’s all a big shock and a steep learning curve but keep a close eye on your blood sugar, see what certain foods and activities (including stress!) do to your blood sugar and take it from there. And pester your diabetes team- it’s what they’re there for! I hope things calm down for you and you’ll find a lot of support here. Good luck!

 

[DannyMilbourne]

@EllieM ah okay that's good to know thank you

They did talk to me about hypos but I've heard that before so I was already in the know about it, luckily haven't had one yet, my BS levels haven't dropped below 10 since I've been diagnosed, they recommended it be between 4-7 mmol, I've not been nowhere near that lol just done another test before my lunch as I slept in over breakfast and it was 15.4

 

[DannyMilbourne]

@iwilltouchyourcat hiya and thank you haha
Oh no really? That sounds literally exactly the same as me then, I was thinking about phoning my gp or someone just to talk lol, yes I will do I'm writing literally everything down from activities etc so fingers crossed I'm getting there haha.
Thank you

 

[EllieM]

I've not been nowhere near that lol just done another test before my lunch as I slept in over breakfast and it was 15.4

There are good reasons to decrease your bgs slowly back to normal (avoidance of severe hypos plus sudden bg drops aren't great for your eyes).