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Questions from a new diabetic.

M

Migey

Member
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7
Hey guys.

I'm a newly diagnosed diabetic (type 1), and am fairly young, and I'm just beginning to adjust to all of this, and I have a lot of questions, large and small, which I'd really appreciate some help with!

Okay, first of all, as far as meal times are concerned: do they have to be regular? I'm on four insulin injections a day, one long-acting before bed, and three short-acting before meals. The long-acting one I'm supposed to take at roughly the same time every day, and I always try to. But will it make a difference if my short acting one is not at the same time every day? I often eat meals at different times on different days: not too drastically different, but often an hour or two hours difference from day to day. Will I need to adjust this, or will it cause me problems?

As far as snacks go, is it a problem if I take irregular, even large snacks, as long as they are not sugar/carb heavy? I had my dinner today, but at around 11 o clock I was quite hungry, so took a fairly decent sized meal again, but which should have totalled up to less then 10g of carb (eggs + two quorn sausages). Is doing this problematic, or can I freely snack on carb/sugar low things such as meat, eggs, dairy, etc?

I am still eating a fair bit of chocolate these days, but I am being very careful about it: usually its just a small bar with my lunch, and the bars I have have 25g of sugars in them, so i equate this to 2-3 units of my short-acting insulin. Since I'm accounting for it, is that a problem? Or should I be avoiding anything sweet out of principle? I'm struggling to work out how to manage my sweet cravings and if they are inherently a problem for me (as concerns my diabetes) even if I account for them with my insulin.

I've noticed something strange: heavily refined and/or processed foods with a lot of carbs in them seem to have a greater effect on my blood sugar then they should based on the carb content. For example, 250g of carbs in say, some spaghetti, will seem to balance out fairly well with roughly 25 units of my insulin. However, 160g of carbs in a pack of pre-processed tortellini will not seem to equate with 16 units of my insulin, and will raise my blood sugar higher then what I calculate it should. Is this simply because it's converting/releasing the sugars faster? Should I compensate with more insulin?

Random thing: do crisps have any strange interactions with blood sugar? I ask because when I recently had my very first hypo, this was because I (seemingly) overjudged my insulin when deciding to have a large pack of crisps after my lunch. My lunch contained exactly 27 grams of carbs (I assume eggs have no carb/sugar content, right?) and the crisps had 90g of carbs, so I took 12 units, and had the crisps just 5 minutes after my lunch. My BM was not particularly low before the lunch, but for some reason it was enough to drop me down to 2.8 and I had my first hypo (which isn't a bad thing in a way, now I know what to look out for). I can't work out why this happened: everything I ate with carbs in it had the nutritional values on the packet, so I should have been able to calculate my dose precisely?

I am aware that I am probably a terrible diabetic at the moment: I'm struggling to adjust to the changes in my lifestyle, and am desperately trying to learn and understand everything I need to know to live my life as normally as possible. Any help is greatly appreciated! Thanks!
 
Hi midgey,

I'm fairly new at this as well (nearly 9 months) and the first thing I was taught is not to be too hard on yourself, there is so much to take in. So I'm sure that you will get a lot of replies with a lot of info to.

One thing I learnt is you shouldn't be taking insulin with snacks such a crisps, also you will need more or less insulin with you activity levels, every time I walked to work I was having a hypo til I realised this but if I ate the same on a day off I was fine. I've just started reading a great book called think like a pancreas which i think is fantastic and was recommend this by fellow diabetics.
I also wanted to know how to help with my cravings of sugar and was advised by my dietician to have an options hot chocolate, and it works, however from my first chat with my diabetes nurse was everything in moderation. You know your own body and by the sounds. Of it I think your sound fantastically well. The carbs thing I'm still get the hang of and try and stick to a low gi carb as much as I can.

You doing great and I know a lot more info will be coming your way xx


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Differing the times you eat is no problem. You inject for the amount of carbs you eat I guess ? Also, there is no rule saying you have to have 3 meals and 3 injections. Obviously check with your nurse but some days I may eat 4 smaller meals, so I inject 4 times. Likewise, if I just have an omelette for lunch, no carbs so don't inject. Heather is quite correct too when she mentions exercise. If I take exercise, I usually take slightly less insulin before with meal as cardio will naturally lower my blood sugar levels.
As you say, you are recently diagnosed so it probably is better to try to eat regularly to begin with but the more experience you have, the more you read etc, the easier it becomes. When first diagnosed, diabetes controls your life ! Quite soon though, with knowledge and experience, you control the diabetes, not the other way around !
Good luck Migey ;-)
 
Just on the crisps thing (I'm type 2 so I don't know much about insulin dosing etc) are you absolutely SURE they contained 90g of carbs? That seems extraordinarily high - how many did you eat? I haven't eaten crisps since I was diagnosed but I'm almost certain that they're something like 20g per bag. Are you sure you weren't looking at the carbs per 100g thing, for example? (Most bags of crisps only weigh 25g or 30g).

In fact ... It was bugging me so I've just looked it up. A bag of Walkers Cheese & Onion crisps, weighing 33g, is 50g carbs/100g, therefore a single bag is about 16g carbs. No wonder you went hypo!


Type 2 on Metformin, diagnosed Jan 2013, ultra low carber, Hba1C at diagnosis 8% (11mmol), now between 5 and 6 mmol. 20kg lost so far :)
 
Answer your questions by each paragraph.

On basal/bolus you can miss a meal should you choose or eat earlier or later, there's no set times and this is why its a better insulin regime over the twice daily fixed doses. As your newly diagnosed I would wait until you get to grips with diabetes and more importantly carb counting before you consider any changes to your meal times.

If you snack between meals then this can lead to weight gain, if however your weight is fine then it shouldn't be a problem. Protein based snacks can still effect bg, I know from my own experience my bg can go up if I eat protein between meals.

I would limit the chocolate to a treat once or twice a week rather than eat it everyday, if you buy dark chocolate with a cocoa content of 85% you will find they are much lower in carbs and won't impact on bg as much.

The more processed a food is the more likely it will raise bg outside our bg target range, try and cook from scratch if you can and weigh your food out, recommend you get a good set of digital scales and a carb counting book, try and purchase a book on the glycemic index which will be extremely useful.

Eggs are virtually carb free, I'm assuming you ate a large family size pack of crisps as a standard 30-40g packet of crisps contains around 15-20g of carbs, what you sometimes find if a meal contains a lot of fat it can delay the absorption of your food and the insulin peaks before the meal is digested, not saying this is the case here and its maybe a case that you miscalculated the carbs in your food and give too much insulin.

Your not a terrible diabetic at all and your just learning like everyone else, it doesn't matter how long someone has had diabetes we never stop learning, try and read up as much as possible on diabetes and ask to get on a carb counting course once your 6 months down the road, the book Think Like a Pancreas which Heather mentions is an excellent read.
 
Finzi said:
In fact ... It was bugging me so I've just looked it up. A bag of Walkers Cheese & Onion crisps, weighing 33g, is 50g carbs/100g, therefore a single bag is about 16g carbs. No wonder you went hypo!
Click to expand...

Noblehead was correct: it was a 150g of Walkers Sensations crisps! 60g of carbs per 100, so 90 for 150.

Additionally, Noblehead, roughly how mucgh of an effect do protein based snacks have on you? Even say, plain meat with literally 0g of carbs in it?

So more heavily processed foods do actually raise my bm far further then they should based on their carb content?

And about the chocolate: is there really any problem with it as long as I count it in my insulin dose and have it right after lunch?

My weight is fine by the way! If anything, I'm skinnier then I should be I believe (something like 53 kg, and am 5.9 ft)

Finally, a new question. How much physical activity will I have to do before it affects my blood sugar? For example, will a 30 minute walk (on flat ground) make a difference? How about a 20 minute bike ride at a fairly average speed? Will these have a large affect on me?

Sorry for all the questions, and if I don't completely understand the answers sometimes. I will look into that Think Like a Pancreas book!

Thanks for the help! :)

Edit: Forgot something! How do artifical sweeteners (aspartame, for example) work with BM levels? For example, I have a bottle of diet coke in front of me that claims to have 0g of sugars in it. Will it have an effect on my blood sugar?
 
Hi. Answering your last question, sweeteners will have no effect on blood sugar so ignore them when calculating. BTW, if your weight is OK then you don't need to worry too much about your carb intake as long as it is matched to the insulin and vice versa. It's when people have weight gain with insulin that they need to take more care with carb intake.
 
Diet coke has no effect on me, and yes any activity will have an effect, I walk everywhere on a flat surface, you will get to know your own body, I feel like I've spent 35 years getting to know what my body can do, and yet now it's like starting all over again getting to know how it copes with everything, sorry I can't help more xx


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Exercise will affect different people in different ways ! As Heather said, you'll soon get to know what exercise will do to your blood glucose readings. Much will depend on intensity, time of day, length and type of workout. Test prior, I make sure I'm at least 7. Test after, and compare. Good luck !
 
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