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Recently diagnosed Type 1 at 63

Alison54321 said:
I think we have to allow @JAT1 to make her own decisions about what to eat.
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Yes, of course. I just wanted to point out that she has choices. There is carb counting as generally taught by the NHS, there is low carb as advocated by a growing number of enthusiasts, and then there is strict low carb as taught by Dr Bernstein. There are keto diets that allow fruit, and others that see fruit as dangerous.

Personally I don't think the very low carb diet I am following is healthy from the point of view of nutrition, and it has not succeeded in lowering my bg to the non-diabetic levels I'd like. However for me elevated bg is so dangerous, I feel obliged to follow a diet that is not ideal in order to keep it as low as possible.
 
PatsyB said:
I never realised a person could get type 1 when older always thought it was only found in the young but am glad all is getting sorted for you
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A lot of GPs don't know this either. I have just tried to explain it to mine. I hope she believed me!
 

It could be that you are bolusing too much but it could also be that you are bolusing too early. Also, you're maybe experiencing the inaptly named "honeymoon" period, where your beta cells start making insulin again for a while - it can really throw calculations out.

Timing is very personal and needs to be customised for each individual.

For example, I tend to bolus about 20 to 30 mins before a meal, in order to give the insulin time to distribute around my body so that it meets the glucose from carbs headon instead of playing catch up. But I'll adjust the timing depending on the type of food (less time for a low GI food), and whether I'm trending up or down (more time if I'm trending up or am at a highish level already, less time if I'm trending down and am at a low level).

With you hypoing before the end of a meal, it might be that, and I'm just speculating here, (a) you were already trending down at a low level so the insulin aggravates the low before the carbs get on board, in which case fruit at the start is an excellent idea to nudge it up before the insulin hits peak action, or (b) the beta cells are doing their honeymoon thing so you've got a double whammy of insulin from your pancreas and the injected insulin, and it all kicks in before the carbs catch up, or (c) you maybe just need less pre-bolus time than others do - it varies widely between individuals.

If your dsn hasn't mentioned it yet, look into cgm, like libre. Unlike strips, whuch just give a tiny snapshot, cgm gives a continuous trace showing how insulin and food are working together across time. We're dealing with a situation which operates over time, so actually being able to see it moving in more or less real time makes things much easier.

For example, in the pic below, at the left hand side at around 18:00 I can see the blue dots trending down, I knew that I'd be eating about 75 g, and I'd need about 9u for that, so I pre-bolused for what I thought would be about 20 mins, but the meal took a little longer to prepare than expected, about 30 mins, so there's a dip down towards 4 but the meal was finished off with a nice bit of dark chocolate cheesecake which would raise again, the sugar being buffered by the fat in the cheesecake and the barley in the Scotch broth, so I end up with a nice dip and rise instead of a spike.

Just being able to see how certain combinations of food and timing interplay makes it a lot easier. If course, T1 being T1 it still throws some random fliers, but I ain't showing those graphs, lol...

 
I cut fruit down majorly compared to my before diabetes days. My goal is max 3/day because I noticed that over that and BG will spike. As far as making my own decisions about what to eat - I used to be totally ruled by appetite. I was normal weight back then. Whatever appetite said, I did, asap. Now something overrules that - fear of the consequences of high BG.
 
My GP had diagnosed me as T2 due to age, but the Endo, based on a fasting blood test, said I am T1. GP was shocked out of his tree. The 8 hour fast was so difficult. 7 hours prior to the test, I stuffed myself to the point of pain and then slept til test time all because of the fear of hypo. My GP (not sure if I will ever go back to him again) has been wrong more than once. He prescribed meds which I took because I trusted him and then my liver started to give out alarming, critical reads. The liver specialist said it was the meds that were the cause of this, my liver is fine as long as I don't take meds, and that GPs prescribe too much.
 
Scott, that graph looks complicated. I'm working to eat nearly the same every day so that I have a better picture of what to expect. I don't want a gadget stuck into me all the time and besides they cost money (hate spending). I'm ok with pricking my finger. I bolus just before eating (after cooking) and want the amount of insulin to remain the same. Mostly for simplicity. I find carb counting to be inexact even though I have a scale and don't want the math of calculating doses. My endo never said anything about calculating doses anyway but then she also endorses 50% of food intake to be starch !
 
JAT1 said:
I'm working to eat nearly the same every day so that I have a better picture of what to expect
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Sounds as if you would get on well with Dr Bernstein: http://www.diabetes-book.com/laws-small-numbers/
He is said to be the greatest expert on insulin use. You can get his up to date advice by listening to his monthly Teleseminars. There are always lots of questions on insulin.
 
I am not sure about "greatest expert on insulin use" as he seems to advocate avoiding it as much as possible.
 
JAT1 said:
Now something overrules that - fear of the consequences of high BG.
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It's certainly good to have a healthy respect for complications, but it is also good to keep matters in perspective, otherwise it can become overwhelming.

Many T1s who develop complications will be the first to admit that a major driver of it was them "burning out": not bothering to take insulin, bg in the high teens and 20s for weeks, months.

My take on it is that I'll do a fair bit to keep in a tidy 4 to 7 range, but if I make a mistake, an occasional flier to 12 or 15 for a few hours isn't that big a deal in the wider scheme of things and is likely to have little or no impact on risk. That is a different situation entirely to the peeps running in the 20s.

We all have to find our own way but I think that sometimes the balance and fear of risks can drive people to a stage where quality of life is substantially reduced.

I disagree with Bernstein. I eat out a fair bit, and my venue and menu choices would be heavily restricted were I to go the Bernstein way.

With modern insulins, metering methods, understanding of insulin time patterns, there's a much, much wider choice of foods which can be eaten safely and stay in range, which he would rule out.

It is understandable that newly dx'd will have fears about complications, and it can seem attractive when Bernstein offers his "Diabetes Solution": that's what I'm after, says the newbie, a solution!

But when the solution involves more or less ruling out an entire food group?

Don't get me wrong here, I'm not suggesting we all start eating 16 inch stuffed crust pizza and a few doughnuts. I've certainly ruled out a few foods because they just don't work for me. It's a question of how far do you take it. I think taking it to the Bernstein extent of 30g per day is just too far to still have any semblance of a full life.

He just doesn't seem to understand the concept of eating modestly.
 
Diakat said:
I am not sure about "greatest expert on insulin use" as he seems to advocate avoiding it as much as possible.
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He persuades his patients (T1 and T2) to eat a diet comprising <30g carbs daily (or less if they are children or small) from low carb foods, divided between 6g carbs at breakfast and 12 at lunch and dinner. If that is not enough to give them what he considers to be completely normal bgs he may prescribe them Glucophage, and then on to insulin. The overriding aim is always normal bgs.
 
Putting T1s on glucophage instead of insulin is not good practice.
 
Scott-C said:
It is understandable that newly dx'd will have fears about complications, and it can seem attractive when Bernstein offers his "Diabetes Solution": that's what I'm after, says the newbie, a solution!
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No-one is obliged to adopt one option for coping with diabetes and then stick with that for life. I am not yet on insulin, but if/when I start it I think I would prefer to follow Dr B's Laws of small numbers until I got the hang of things and then, perhaps, risk adding a few more carbs. I read on this Forum about people new to insulin floundering about with their bgs yo-yoing and it sounds really distressing.
 
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Diakat said:
Putting T1s on glucophage instead of insulin is not good practice.
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Dr B treats T2s as well as T1s. How he treats his patients is based on an exhaustive examination. I really don't think anyone challenges his expertise, just his priorities. You could find out as much as me and much more simply by going to his site. Or even buy his book - IMO it's well worth it.
 
Hi @JAT1 ,

A warm welcome to the forum & the T1 "club."

Just take it all in bite sized chunks. Start from the reference of what you already know regarding your diet recommended by your HCPs.
Understand how your meds work with it. Then tweak as appropriate to your needs...

Don't try racing whilst the "L plates" are still attached.

Though I adopt a different aproach to @Scott-C I would suggest grabbing the book "think like a pancreas." & ask questions with other insulin users.. Using insulin is like good comedy......... Timing.


Then, we look forward to discussing any issues that may arrise with your proposed future action.
Till then? Please, just keep reading.
 
Alexandra100 said:
and much more simply by going to his site
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Yikes, Alexandra, as you pointed out yesterday his site has been hacked!

Don't know if it's been fixed yet, but when I had a look yesterday, it was redirecting to a site called cnhv, and a bit of googling suggests it downloads a bit of malware called CoinHive Montero Mining which seems to do some weird stuff like taking over yr computer to do some even weirder stuff with a bitcoin-like electronic currency called Montero.

Although I disagree with the dude, I hope he and his hosting people have got the hack sorted out, those people are vermin.

If people check out his site, what we were getting yesterday was a page saying, "proof of work required", history shows a redirect to cnhv, none of which is good.
 
Jaylee said:
Please, just keep reading.
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@Jaylee if I read much more my eyes will drop out! Not sure if you mean diabetes literature in general or Forum posts in particular, but I read them all obsessively. Messages from DiaTribe, Diabetes in Control, Dr B, Diabetes UK etc etc land daily in my email inbox, and they all get scanned and often read.

But in principle I thoroughly agree. It shocks me that many people new to the Forum seem content to get all their information here. Views and tips from those at the coal face are invaluable, but IMO not enough.
 
Alexandra100 said:
No-one is obliged to adopt one option for coping with diabetes and then stick with that for life
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The issue which many of us have with Bernstein is that he presents his solution as the one and only option and, at numerous points in his book, implicitly and explicitly, offers a view that anyone not following his dictates is an idiot.

I accept totally that lchf has a place in both T2 and T1 management, more so with T2, less so with T1, but still a place for it.

But what irks a lot of a people is that with T1, the message is being really badly sold.

Telling people they "must" do this is not even remotely persuasive.

Most people kick against being told to do something.

But that hasn't stopped Tim Noakes, who, for reasons I fail to understand, got involved in a minor twitter incident over appropriate hypo treatments, and ended up coming out with this sanctimonious rubbish, which pi***d off a lot of T1s who might otherwise have been prepared to listen. He, as someone who actively plugged carb loading for athletes for decades, and then changed his mind, is now telling T1s they are stupid if they eat more than 50g a day, because he is right and they are wrong. Not persuasive, at all.

 
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