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Newly Diagnosed Type1, Lowering Apidra Because Of Low Carbs And Hypos.

Discussion in 'Type 1 Diabetes' started by Chris33 2, Sep 15, 2018.

  1. Chris33 2

    Chris33 2 Type 1 · Newbie

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    Hi all

    I was diagnosed with type1 about 3 months ago and was put on slow release Lantus-24 units at breakfast and 3 X Apidra a day -12 units. Since then I reduced my dose to 22 Lantus and 10 Apidra, later on about 4 weeks ago the nurse had told me to take 18 Lantus and then 9,7 and then 8 units of Apidra during the day.

    All was going fine to begin with, but the last few weeks I've been having hypos even more frequently, thing is im not a very orderly person and eating at certain times just does not work with me,...plus i don't have as much of an appetite these days so my carb intake is quite low.
    I don't drive..I cycle everywhere and always have done, but going out on my bike is starting to scare me as im having these hypos all the time and im finding myself drinking orange juice because they just come on from no where...

    The question is, how can i manage this better?..I've had to start lowering my Apidra because im scared...Please help!

    Chris.
     
  2. Deleted Account

    Deleted Account · Guest

    It might be time to start carb counting and adjusting your fast acting insulin according to what you eat rather than trying to eat to your insulin dose.
    Google "bertie online" and you should find a useful online course which explains about carb counting.
    The great advantage of this is the flexibility it gives you: eat what you want when you want.
     
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  3. Circuspony

    Circuspony Type 1 · Well-Known Member

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    Cycling will be increasing your insulin sensitivity. I struggle with hypos if I have fast acting insulin on board when doing exercise too. Have you told this to the diabetes team? They should be helping you adjust your doses to when you eat, what you eat and your exercise pattern.
     
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  4. LooperCat

    LooperCat Type 1 · Expert

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    Hi Chris, welcome! Tagging @daisy1 for the welcome blurb...

    The benefit of the basal/bolus regime that you’re on is that you don’t have to eat at regular times, but it’s crucial to make sure that your basal Lantus dose and timing is right. Looks to me like it might be a little high, still. It should keep you running steady, and then you top up with bolus/Apidra when you eat. Google “basal rate testing” to get some guidance on that - you fast in small blocks and monitor your levels and then adjust your Lantus in response. Carb counting is also an important skill to learn.

    Because you’re so newly diagnosed, your pancreas may still be “honeymooning” and chuck out a bit of insulin when you least want it. That’ll go with time, but it does make things difficult in the early days :(
     
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  5. daisy1

    daisy1 Type 2 · Legend
    Retired Moderator

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    @Chris33 2

    Hello Chris and welcome to the Forum :) Here is the Basic Information 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 well over 235,000 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

    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.

    Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

    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.
    Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

    • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

    • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
     
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  6. SamJB

    SamJB Type 1 · Well-Known Member

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    As mentione,d you need to start carb counting, which is where you match your insulin dose to the amount of carbs you are eating.

    The more frequent hypos you are experiencing are down to something ironically called the Honeymoon Period. This is where you pancreas' islet cells kick in again, before being killed off completely. So you should expect more frequent hypos and your Lantus dose to be adjusted downward in this period. So long as you always carry your BG meter and some fast acting carbs, you'll be ok.
     
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  7. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @Chris33 2, from my experience as a diabetic on insulin, not as professional advice or opinion.
    As @SamJB suggests you may be going through the honeymoon period which may go on for ? 12 months +/-.
    It is surprising that your nurse did not mention this to you. I think of it as the injected insulin giving what remaining insulin-producing cells there are a rest and those cells then start to respond at least partially to rises in BSLs.
    So you have internal plus external insulin supply. It is tricky because you do not know how much insulin your body is producing plus regular exercise increases the sensitivity of both external insulin and internally insulin.
    The priority then is to avoid hypos.
    Going low carb increases your risk of hypos in the situation you are in. I would personally call it a big, crazy risk.
    I gather low carb is described as consuming under about 120 to 130 g of carbs per day.
    Is there anything wrong with discussing with your nurse a diet of even 140 g + carbs per day?
    Of course if you are still growing, so say, up to age 20, low carb diets are NOT recommended anyway.
    Nor is Intermittent Fasting.
    And on low carb diets professionals have stressed the need to ensure sufficient essential food, minerals and vitamins are eaten.

    Best Wishes and live safely !!
     
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