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Really... no chocolate??? at all...?

Discussion in 'Type 1 Diabetes' started by Esther1411, Oct 24, 2011.

  1. Esther1411

    Esther1411 Type 1 · Active Member

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    I have recently changed to MDI's and was kinda wondering if this means that I could have the occasional treat? I did have a tiny finger of home made with canderel chocolate cake yesterday as a desert, and had an extra two units of Novorapid before my meal in anticipation of my intended "fall from the chocolate wagon" and all seemed well. This morning my BG is back up over 10 (from averaging around 8.8 for the last three days) and am feeling pretty rough (and stupid!) Do we think this is connected - I know I have a lot to learn, any comments, tips or advice welcome :roll:
     
  2. Fallenstar

    Fallenstar · Well-Known Member

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    Hi Esther

    If you are dose adjusting for carbs eaten then you should be able to have chocolate if you want it. You should be able to have anything you want within reason if you have had a insulin unit dose worked out for your grams of carbohydrate.
    Have a word with your DSN about this, if they have not helped you with this then ask to go on the DAFNE course, you will cover all you need to know about adjusting your Bolus to whatever you want to eat...and as always it is a matter of testing and tweaking but you will get there.

    don't despair you can have a bit of Chocie if you fancy it...all is not lost at sea :lol:
     
  3. Esther1411

    Esther1411 Type 1 · Active Member

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    Thank you Fallenstar,
    I have been put forward for a course I think is called IMAGE but that was only just over a week ago and have heard nothing as yet. I'm a bit confused actually and have tried today to call the diabetic centre today but have not heard back yet. I was told to use 7 -5-7 units of rapid with meals as a guide and 10 units of levemir. I was also told to use 1 unit of rapid for 10g of carbs so am not really sure which I should be doing as from what i understand two small pieces of granary bread would be 20gs of carbs so should I then be taking only two units of rapid??
    So you don't think the cake put up my BG this morning then?
     
  4. Cheryl

    Cheryl · Well-Known Member

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    You have to respond to your body's reaction to carb based foods, particularly fatty ones as these will be absorbed more slowly than others so are more difficult to handle with carb counting on MDI. Learn your insulin to carb ratio & the carb values of the food that you are going to eat then you can pretty much eat what you like within reason. Keep treats to mealtimes so you can up your insulin dose to match it. You did the right thing, but maybe underestimated the amount of carb in the cake. It always amazes me just how much sugar many pre-packaged foods contain, e.g. a muffin from Costa or Starbucks could have over 50 grammes of sugar in it! Some pre pack Chinese stir fry sauces ate 35%+ sugar!!

    Ask to see a dietician to discuss carb counting & find out about DAFNE (Dose Adjustment For Normal Eating), hopefully you can get on a course, though I understand that waiting times can be long.

    Some people on insulin find that they can eat pretty much anything and adjust their mealtime insulin to fit; others find that low carb is the only way to maintain decent control.

    Get online too, some diabetes & weightoss websites have food databases that you can search for free & give you the carb values of foods. The best way to manage is to educate yourself, but you're here asking questions, so you know that :D

    Chin up, it's tough staying on top of MDI, but there's loads if help here. And don't be afraid to demand the attention of as many different HCPs as you think can help you; mist of them know that a healthy diabetic niw is a cheaper diabetic to the NHS in the long term.
     
  5. phoenix

    phoenix Type 1 · Expert

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  6. Fallenstar

    Fallenstar · Well-Known Member

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    There are so many variables as to why an individuals results are slightly higher/lower, even on a personnel level and speaking from experience, that we are not privy to .So it is hard to say really. It could have been the cake, but there are so many reasons during the night that we may have a reading that is out of line when we wake.
    Dawn Phenomena , which is a boost of Cortisol released by the Adrenal glands at about 4/5 AM to get us up and ready for the day. Sometimes there will be variations in these levels which will effect BG results all independent of what we have eaten the night before.
    Maybe we have had a more active /restless nights sleep, nightmares ,dreams all these things effect hormone levels which effect BG during the night by a few units....all out of our control. The liver releases Glucose also ,sometimes more,sometimes less,it depends what we have done the day before, this will raise BG even if we starve our selves of food. If you have exercised hard during the previous day you may get a drop during the early hours of the morning as your muscles replenish their selves with Glucose. All variables.
    Let alone night time Hypo's :shock: but after these you will probably be very high, well up into top double figures. I don't consider 10 too bad, some will, but that is just me. It would not alarm me as a "few" one off's ,even higher. They happen I'm afraid, that is the nature of the beast and sometimes it is nigh impossible to pin point what it is.
    If it carries on rising and stay's at 10 then you will need to test,adjust accordingly with the help of your team...and some good people on here. I'm not the best at advising adjustments for other people.

    The DAFNE will really help you and as Cheryl has said chase the care you deserve and are entitled to , it is all new to you just yet but you will get there so don't worry :D

    Let us know how you go on, and welcome! :D
     
  7. jopar

    jopar · Well-Known Member

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    I've got a feeling that the IMAGE course is Esthers clinic version of DAFNE...

    As said MDI is all about learning all the many different factors that effects control, that require dose adjustment of our insulin...

    Phoenix link is a good start for carb counting information..

    I also suggest a book called Using Insulin by John Walsh.. this will give you the information to work out things such as Carb/insulin ratio's, corrections, working out how long your quick acting is impacting on your BG's, how to test to see if your basal (background insulin) is correct and a lot more info..
     
  8. Fallenstar

    Fallenstar · Well-Known Member

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    I thought the IMAGE course was for prevention of Type 2 Diabetes???? you need to ask your DSN for the DAFNE course :D
     
  9. AndyS

    AndyS Type 1 · Well-Known Member

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    HI Esther,

    The BDEC link Phoenix posted is an excellent resource until you can get on a formal course.

    There are a couple of things that you need to get figured out really.
    1) What does 1U of insulin do to your blood sugar
    2) What does 1CP (~10G Carbs) do to your blood sugar.

    Once you have those two it becomes pretty easy maths to figure it all out. One thing to bear in mind is that sometimes the ratios between CP and Insulin change depending on your activity levels, time of year, time of day, illness.. phase of the moon (laugh now, who knows what they may yet find :p)

    Anyways the thing is if your yummy cake is home made (or even if it isn't) you can still work it all out. The thing with the home cooking is to check the total carbohydrate content for ALL the ingredients, you want total Carb, not just the sugar.
    So for a chocolate cate you will probably need to count:
    - Sugar (obviously)
    - Flour
    - Cocoa (check the Carb content per 100g, you may be surprised)
    - Milk
    I know there are other things like Eggs, Butter etc but they don't count :)
    One thing to bear in mind with the artificial sweeteners is that they are not actually Zero Carb, just VERY VERY low. Check the packaging, they often are the same gram for gram, the only difference is you usually use a tenth or less compared to regular sugar, though often you need to tweak the recipe to compensate for the bulk and using flour means you don't really win.

    One thing I did was to work through all my various recipies and make note in my book for the total carb for the whole thing and then an approximate carb value for a "typical" portion. I also did this for many of my wifes recipies so now she can just cook and then check the scribbles I made and let me know.

    The key thing is that with MDI you can have pretty much what you would like as long as you can count it accurately enough and dose for it. You just need to learn how count it all and also to wait and ignore the intermediate highs and trust that levels will come down as expected.
    For example, today before I left work I was 9.5, which was a surprise as I espexted to be around 6. When I got home I was 6.5. I put this down to the fact that lunch included some home made soup and home made whole grain bread that I know is quite a low GI.
    The temptation can be to "chase your sugars" where you end up correcting for a high blood sugar that is not actually a real high.

    Good luck and make sure to enjoy the chocolate. My dietician told me that choloclate, and other such treats, are also a VERY important food group because there is no point living healthy and for ever if you are miserable ;)

    /A
     
  10. Esther1411

    Esther1411 Type 1 · Active Member

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    Thank you everyone for you advice - all very helpful.

    I think IMAGE (Insulin Management and Adjustment Group Education) may well be my clinic's version of the Dafne course, although I have heard them talking about that too, maybe I can do both! I have been told the waiting list is around two months, so just before Christmas, then I'd like to think I could be sorted by then so I may well be back on here driving you guys mad!
    I did go and do the BDEC- online course (thank you) and found it very helpful and would recommend the 2/3 hours it takes to anyone in a similar position to myself i.e. newly diagnosed and slightly confused.
    Thanks again for your time guys - and wishing everyone a happy day and nice numbers!!
     
  11. moonstone

    moonstone · Well-Known Member

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    One day you too will eat chocolate whenever you want to :) not long now. There's so much to get your head around to start off with that it's best just to get the basics sorted, but you will be able, one day, to work out how to eat whatever you want. I eat whatever I want, whenever I want, but for my first year I honeymooned, so there was no way to match insulin to carbs - so for a whole year I had to go without anything nice at all and I had to eat quite minimal carbs. Not a very happy bunny at the time.
     
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