Newly Diagnosed Type 1

@Lottie1993type1

Hello Lottie and welcome to the forum

Here is the advice we give to new members and I hope you will find it useful. Ask as many questions as you like 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 130,000 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

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 Lottie - yes we have loads of advice! Welcome to our gang.

Try not to get too anxious or scared it's all manageable with the right approach. Post up questions on anything that's troubling you.

You'll have to experiment a bit, we are all different. You're on 2 injections a day - so mixed insulin like Novomix or Humalog Mix I'm guessing???

For me, eating similar amounts of carbs, at similar times helps me to predict what my BG levels are doing (or will be doing 2 hrs later) in comparison to my insulin. I find this easier on work days than at weekends.

If you're asking about snacks, take a look at the thread just started here...............

http://www.diabetes.co.uk/forum/threads/snacks.73222/#post-792542

Most people usually get the opportunity to move to different insulin regimes after a while, this can offer more flexibility. I have decllined at the moment as mixed insulin seems to be working for me - although I get a spike once a week or so when I get things wrong.

If you've read @daisy1 's post above then you are already aware that the body is capable of turning almost everything you eat into sugar. However, carbohydrates are by far your worst enemy so all the things you've come to like over the past years like rice, pasta, bread and potato you should at least think about cutting down on.

Some people manage to pretty much eradicate carbs from their diets, others like me opt for a moderate intake of about 150g per day. If you start loooking at the labels on things you'll probably be surprised how quickly the carbs add up.

BTW, when you eventually see an NHS diebetician you will find that the advice you are given will be contrary to the general aproach of most of the people on this forum.

have you been given clear instructions/ongoing help on how to adjust your doses to get your BG right?
lower carb, normal protein with higher fats are good snacks when your BG is up .. now that they have removed the warning on dietary cholesterol, an egg is perfect as part of a snack... fat and protein doesn't spike much and burns slower and lasts during the night
http://www.diabetes.org.uk/Guide-to-diabetes/Teens/Help-and-support/We-can-help/Careline/


you may have lost weight and be skinny prediagnosis...you will probably put on weight in the next month, now that your body is working better.. it may take a few months for your 'body image' to catch up, if you aren't looking forward to getting some healthy flesh back on....don't panic a lot find carb control is what diabetes is all about with BG and weight. peer group weight fashion changes, it use to be size 16 marilyn monroe,

Hi Lottie and welcome to the forum.

Keep a detailed bg diary so that you can show it to your DSN and they will advise you on adjusting your insulin doses, but as Urbanracer says they may change you over to a basal/bolus insulin regime once you've got use to injections, if your hungry before bed try eating something like a babybel and a piece of ham that should take the edge off your hunger until the morning.

Lottie1993type1 said:

I have just been told to take my doses as advised, (Novomix) before breakfast and tea. My nurse said my doses will change and I will probably be having 3 instant acting injections before each meal and one longer acting injection before bed...

I am keeping a diary of what my BG is, & I see my nurse next Monday.

Is it normal to be fretting this much??

Click to expand...

That is basal/bolus often referred to as MDI (Multiple Daily Injections).

http://www.diabetes.co.uk/insulin/basal-bolus.html


Good luck.

Lottie1993type1 said:

I have just been told to take my doses as advised, (Novomix) before breakfast and tea.

Is it normal to be fretting this much??

Click to expand...

Yes it's normal. You're 22 years old and you've recently been told that you have a very serious 'condition'. But you will learn to live with it, and as I wrote above, it is a manageable condition. You can control your diabetes, it doesn't have to control you. You just have to look after yourself a bit better than others do.

There's no reason that you cannot carry on doing whatever it was that you were planning to do with the next 60+ years of your life, unless of course it was breaking the world record for eating sugar straight out of the bag.

And don't rush at trying to get everything right straight away, take small steps.

Lottie1993type1 said:

I have just been told to take my doses as advised, (Novomix) before breakfast and tea. My nurse said my doses will change and I will probably be having 3 instant acting injections before each meal and one longer acting injection before bed...

I am keeping a diary of what my BG is, & I see my nurse next Monday.

Is it normal to be fretting this much??

Click to expand...

I'd say it's very normal to be fretting this much..studies show it may even take 3-12mths to get back to the normal you.
I'm only T2 and a mature, AKA old 60 but it freaked me out for a couple of months

as advised is you continue with this dose till you see your DR again?
I would watch the carbs when I'm high and "eat to my meter" eg. if high 2 hr after lunch I would reduce my carb at tomorrows lunch, till it's all sorted
a food and BG diary will show what is happening to your DR

HI and welcome. Yes, keep the carbs down and have protein and fats as needed to keep you feeling full (plus veg and fruit as needed). You are currently on a mixed insulin regime which is good to start with and the nurse may suggest changes. She has already said you will shortly be changed over to the Basal/Bolus regime which I'm on. It gives you total control as you adjust the rapid insulin to match what you are eating at each meal. It does involve a few more injections but worth it for full control. Don't worry as you are going down the right route.

You may also 'honeymoon' like I have done for 6 months and your blood sugars will stabilise in the main without much worry about getting the insulin doses as accurate. Good luck and long live the honeymoon period!

Welcome to the club! I know I'm probably going to buck the trend a little here in how I manage myself.
I was diagnosed type 1 about 6 months ago and am now 25. I went to the GP for a UTI but my urine had a lot of sugar and trace ketones which led the nurse to check my blood glucose - 29! - and the rest, as they say, is history. I initially started on the twice daily injections but that does rely on you eating a similar amount of food, particularly carbs/sugars, at similar times each day.
I am a veterinarian so every day is different and I definitely don't have a normal or routine eating schedule so I quickly found the basal-bolus system suited me better - 1 injection of long acting insulin to give you a general background amount of insulin. And then multiple injections throughout the day after meals.
I know I am lucky that my job and profession means I already have a fairly good understanding of diabetes. When I am explaining it to clients I say something along the following lines: you eat food, it is broken down in your stomach and intestines into individual building blocks, namely protein, fats and sugars (carbohydrates are broken down to sugars). Sugars are the main thing we are focussing on with diabetes, and these are absorbed into your blood through your intestines. Your blood will deliver that sugar all around the body to your organs and tissues, but for the sugar to make the jump from blood to tissues and cells, it needs insulin to get out - insulin opens the door that allows sugar to get to where it needs to go. Normally your pancreas would make this insulin as it was needed but our pancreas's have given up in that area which is why we inject.
I try my best to eat healthy, and avoid high sugar things where I can, but I don't let the diabetes rule my life. It is what it is, it is important that you manage it, but the main thing is you can manage it, and in doing so you can have a normal happy life.
I still have a hot chocolate or a piece of cake or a snack, and then I inject with the short-acting insulin so that the sugars from that food can leave my blood and go where they need to go (and in doing so keep my sugar levels within the normal range). It has taken me several months to know how much insulin to take with different foods and I am constantly learning. It helps to write things down because how you react to the insulin is very individual - what your blood sugar was before eating, what you ate, how much insulin you took, were you resting or active, what your blood sugar was 2 hours later. For me, if I'm still a bit high 2 hours later, I inject a little more insulin and check again in an hour. What you are doing at the time as well will affect your insulin requirements - if I am about to slob out on the sofa I take a little more short-acting insulin. If I am about to exercise or run errands (generally busy and active), I'll take less.
It is a big change and sometimes you may feel overwhelmed, but you've got us on here, and you don't need to rush to do everything at once. It's not going to happen overnight, like I sad, I've taken months to get my routine sorted. But diabetes is not the boss, and you can definitely manage it