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Question...

M

Mad76

Well-Known Member
Messages
319
Location
London
Type of diabetes
Type 1
Treatment type
Insulin
Hi there,

Newly diagnosed, so really unsure about certain things ...

I'm on novorapid 3 times a day before meals. And lantus at night. So far whenever I check bg before bed it's around 5. My nurse and consultant said to avoid a hypo overnight have a snack before bed.

But as someone already overweight I feel this is a recipe for disaster !! I've already gained 4 kg since diagnosis. This constant eating is getting me down..but I'm too worried of hypo etc If I dont ?


Any experience s or advise ??
 
How new? Things take a bit of getting used to - the balance of insulin and food. It's worth discussing concerns with your nurse/consultant - they may be able to help suggest tweaks to your insulin regime.

With their help, you should be working towards adjusting your insulin doses to match what you eat (less food = less insulin required) and what you're doing (more exercise = less insulin required), and if you want to lose weight, you can then safely play with those three factors.

But experience counts for a lot, and if you're freshly diagnosed, you'll be learning quickly what works and what doesn't.
 
Welcome to the team @Mad76.

NovoRapid and Lantus is a common combination.
A couple of questions:
- Do you carb count or do you have fixed NovoRapid doses?
- what is your BG when you wake?

If you need to eat to maintain your BG, your doses may be too high as the idea of the Lantus dose is to maintain a stable BG throughout the time when you do not eat.
We cannot advise on actual doses but if you eat before sleeping (without any NovoRapid) and wake at around 5mmol/l, you could consider reducing your Lantus by a notch and not eating.

It is common for medical advice for newly diagnosed people with type 1 to be very conservative to minimise hypos.
 
evilclive said:
How new? Things take a bit of getting used to - the balance of insulin and food. It's worth discussing concerns with your nurse/consultant - they may be able to help suggest tweaks to your insulin regime.

With their help, you should be working towards adjusting your insulin doses to match what you eat (less food = less insulin required) and what you're doing (more exercise = less insulin required), and if you want to lose weight, you can then safely play with those three factors.

But experience counts for a lot, and if you're freshly diagnosed, you'll be learning quickly what works and what doesn't.
Click to expand...

Thanks for your reply. I was diagnosed about 3 weeks ago. Started on 6 units novorapid each meal. I've been taught how to adjust it. I've bugged the nurse and met her weekly. Shes probably sick of me but I still dont feel confident adjusting doses without asking. If that makes sense? Anyway no more nurse apps, I'm going to try to do it myself. Bought the carbs and cals book . Am trying to adjust according to that so on about 3 units per meal according to what I eat. But they told me not to reduce the lantus from 10 units. I will have full check up.in 3 months .
Maybe they'll tell me to adjust it then

Is it common to keep lantus the same at first ???
 
Hi and welcome @Mad76 :)

When diagnosed we are started off on small units and a standard insulin/carb ratio, it's a starting point. From diagnosis you are simply settling into a routine with testing and injecting, the key is to recording your results and doses so you can start to see patterns and therefore have ammunition with which to either make the adjustments yourself or to take to your nurse and ask for advice with. Diaconnect is a phone app and is useful as you can email the results direct to your nurse.

In regards to adjustments, it is normal to adjust your background insulin if you feel you are running too low, so it makes no difference when, however when adjusting insulin only change one thing at a time, if you start adjusting your carb/insulin ratio and background insulin at the same time you are complicating things, so do one thing alone and leave it 3-4 days to see how the adjustment affects your levels.

The process is slowly slowly with adjusting, don't rush any decisions or indeed make them if you are unsure, speak to your nurse, also they are used to ALOT of questions early on so you're not being a pain, it's perfectly normal they are there to help you.

Getting knowledgeable is the key, don't worry about weight gain, your body is still recovering from the diagnosis, so go easy on yourself, get a copy of 'Think like a pancreas' written by a type 1 and become an expert, also try the online Bertie course which helps with carb counting https://www.bertieonline.org.uk/
 
Don't worry too much about the weight gain at the moment. Pretty soon you will learn to adjust the insulin to match the food you eat and then you won't be eating just to feed the insulin, and finding that you are eating when you're not remotely peckish.

Follow the link in @Juicyj's post - it's a useful course. Also there are book available that are geared to T1's - Think Like a Pancreas and Using Insulin are the two that come instantly to mind. Both helpful and instructive. Using Insulin is perhaps a bit more technical and detailed than Think Like a Pancreas. Certainly the Bertie course is a first stop though.
 
Agree with above. Work to nurses advise for the moment. They are just looking for balance. They will look to adjust your lantus and snatch that supper away from you before you know it XD
 
Did you lose weight in the run up to diagnosis? Many of us do and in the first few months on insulin there is some gain - your body now works properly so starts to replenish the lost fat reserves.
 
Circuspony said:
Did you lose weight in the run up to diagnosis? Many of us do and in the first few months on insulin there is some gain - your body now works properly so starts to replenish the lost fat reserves.
Click to expand...
Yes I did . I've always been really overweight. Never really got below 14 stones ... anyway I was finally on weight watchers and put the weight loss down to that . Clearly not !! So by the time I was hospitalised I was under 12 stones. For the first time ever. But since I started insulin and all this eating I've put on 4kg. I'm worried I'll spiral back now. The nurse said the same as you guys dont focus on weight now. Focus on sugar levels. But I am worried tbh ..
 
Interesting the nurse wanted to keep your Lantus at 10 for 3 months. My nurse slashed mine from 10-5 after the first two weeks. Not that you should do that of course. Just interesting how different Nurses do things differently.
 
Hi @Mad76 I know the initial weight loss can seem great, but its a false economy, as mentioned above your simply gaining some of what you lost, the most important thing is getting your levels sorted and keeping them stable, so ideally avoiding hypos as much as possible and of course hypers, stable levels will help stabilise your weight and make it easier to lose weight too, hence why the priority is glucose control.

As I said take it easy on yourself, things will start to level out and your body needs time to recover.
 
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