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Should i feel so tired?

richard67

Member
Messages
10
Location
essex
Type of diabetes
Type 1
Treatment type
Insulin
Hi my name is Richard and I am new here.I was diagnosed about 5 years ago but I stupidly did not really take it too seriously as I felt no actual symptoms of diabetes and decided to worry about it in the future.This decision came back to haunt me about 4 months ago when I started feeling extremely tired and started losing weight rapidly.Having lost 3 stones in a very short amount of time I went to the doctor who said it was diabetes related and sent me to the local hospital diabetes clinic.For about 6 weeks now I have been taking 4 injections from a pen per day - 3 x 8ml rapid release and 16ml of slow acting (this started lower but has been upped to this by diabetic clinic, who I am in contact with weekly).Also I have changed my diet accordingly.
My problem is that I have not improved at all.My energy levels are so low I literally struggle to get out of bed and do not manage to most days.I have been signed off work for 2 months but I am seeing no light at the end of the tunnel....I know it is relatively early days but with 3 children,my wife and my job I really need to start improving to some degree. My GP just says it will take time but surely I should feel at least some improvement? Any thoughts/ideas/experiences would be very welcome and sorry for the long first post! Many thanks,Richard
P.S. my blood sugars range from 12-16 in the morning and then anywhere between 15-23 the rest of the day...
 
Hi Richard,

No, you shouldn't be feeling so tired.

Your blood sugars are too high and you need to work on getting them down; there is a post for new members that should arrive soon describing the targets to aim for and how to do that; essentially you need to match the insulin you are taking with the food you are eating.

You will have a specific ratio of insulin to carbohydrate (the starting point for most people is 1 unit of fast acting insulin : 10 grams of carbohydrate). Mine is quite different from that and changes over the day (I become noticeably less insulin resistant, meaning I need to take less insulin, as the day goes on).

It will take you trial and error and blood testing strips to work this out.

You say that you are Type 1 but were diagnosed some time ago; do you mean you were initially thought to be Type 2?

I bet you haven't had this tested but I would also bet that you are vitamin B1 deficient and vitamin D deficient; ideally get tested for both to see but if your doctor won't do that start taking Thiamin (B1) and Vitamin D3 in fairly enthusiastic doses; B1 is water soluble and will get flushed out of your system if you take too much and vitamin D has a very low toxicity so don't worry about going over the RDA (unless you go crazily over it).

Here is a link to a good site with details of various supplements.

http://www.phlaunt.com/diabetes/20144672.php

I figure we are, as Type 1's, statistically likely to be deficient in at least vitamin B1 and vitamin D so why not supplement for those if there are no toxicity issues? Vitamin D should be in the form of D3. As you'll see it won't help with your diabetes but may have other benefits.

On vitamin B1 research at the University of Warwick showed that people with Type 1 and Type 2 diabetes have around 75 per cent lower levels of vitamin B1 than people without diabetes. Research has shown that thiamine (vitamin B1) can block the processes that lead to microvascular complications which include neuropathy, retinopathy and kidney disease; i.e. the hat-trick of complications that we worry about.

I also take Alpha Lipoic Acid (which we'd all be getting prescribed for us if we lived in Germany).

The other thing that should be tested on diagnosis and as part of an ongoing routine monitoring is your thyroid function; has that been tested? There can be a correlation between thyroid problems and auto-immune illnesses like Type 1 diabetes I think. Coeliac disease is another thing you should be checked for.

Try and get on a DAFNE course to help with insulin/carbohydrate management.

Once you've got these initial things done then you can move ahead with understanding and controlling your diabetes.

Some useful books I found were; Jenny Ruhl 'Blood Sugar 101' and Dr Bernstein's 'Diabetes Solution'.

Best

Dillinger
 
Hi Dillinger, thanks so much for the helpful reply - it is nice to know there is help around when I am struggling so much.I will ask my doctor for the tests you suggest and get the vitamins either way.To be honest I am overwhelmed by it all and struggle understanding the carbs counting thing!I am not helped by the fact that I feel so low I have very little appetite anyway although I do eat as much as I can.
Anyway thanks again for your advice.
Richard
 
Hi,

This is the new member's post -http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=39&t=26870

It is overwhelming and there is a huge amount to learn but you're going to be ok and you're going to get the hang of it.

Nothing that happens is 'magical' or inexplicable; it seems to me that often engineers and the very practical do best with diabetes as it is essentially a problem of managing a complex system according to some basic principles. But even the impractical and lazy (like me) can get the hang of it.

Best

Dillinger
 
Hi Richard and welcome to the forum :)

Here is the information which we give to new members (referred to by Dillinger) and I hope you will find it useful. Ask more questions and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

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 70,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

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

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.
 
Dillinger said:
Hi,

This is the new member's post -http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=39&t=26870

It is overwhelming and there is a huge amount to learn but you're going to be ok and you're going to get the hang of it.

Nothing that happens is 'magical' or inexplicable; it seems to me that often engineers and the very practical do best with diabetes as it is essentially a problem of managing a complex system according to some basic principles. But even the impractical and lazy (like me) can get the hang of it.

Best

Dillinger

That's funny, I'm an engineer and that's exactly how I look at it, a complex bioprocess control problem with lots of feedback loops.

One book you ddn't mention was "think like a pancreas" by Gary Scheiner which I've found very useful.

Do you have a reference for the vitamin B and D levels, I'd be interested to have a read of it.

Thanks

Dave
 
Hi Richard, My name is Jim. This is the first time ive posted on this forum for some time, ive been trying to unpick all the problems i have been through over the last 5 years. I think I have made some sense of it now.
Have you been experiencing any psychological stress? or been through an operation, illness, crime etc?
Are you experiencing any mood changes; tearfulness, irritability?
Have you had trouble sleeping, excess sleeping?
loss of libido, erectile function?
You mention weight loss, does this include muscle wasting/weakness (thigh muscles shrinking)?
 
Hi

It is also natural to feel **** with depression after diagnosis and your whole life turned upside down. I literally cried myself to sleep for 6 weeks after T1 diagnosis.

However, your levels aten't helping. You are still way yo high and this will be impacting on tiredness and lethargy.

Tbh you need to ask your healthcare people to get you on a DAFNE course asap, so that you can learn how to adjust doses yourself. At this stage you really should have lower levels.

Are you being looked after by a consultant ir gp? You need a consultant.

Have your healthcare people given you any advice on how to adjust your insulin at all for foods?

If not under a consultant.. Ask straight away for an urgent referral to see one, as you really should not be still above 10 with your readings at this stage...
 
Hi thank you all so much for your replies ,I really appreciate your time and help.

Dillinger and Daisy1 - thanks for the link and post - there is some good stuff there for me.

Jim - thanks for your reply ,well no I have not been through any stress,operation,illness or crime.I can sleep fir hours and hours sometimes yet hardly at all at others.I am quite tearful and irritable which I put down to the fact I am so tired and seeing no light at the end if the tunnel.
As for the weightloss yes it does include muscle wastage .I have lost a large amount of fat and muscle(my Gp says this is because my body has been living off its reserves due to diabetes ) and am now really quite weak, struggling to do many things that were easy 5 months ago.I am still seeing no improvement and am actually still losing weight.I am at my wits end now sadly.

Donnellysdogs - thank you too for taking the time to reply.I am under a diabetic clinic run by nurses at my local hospital referred by my GP.To be honest all they do is put up my insulin dose each time I tell them there is no improvement.I have a consultant appointment in 7th January which I am attaching a lot of hope to right now.
My readings today so far are 10.9 this morning and 18.1 at lunchtime with my new dose of 10ml fast acting x3 and 20ml of slow release x1.Just to add I am completely off my food although I am trying to eat as much as I can and I am suffering from stomach pain which my GP says is IBS
 
Your levels are way too high. Thats why you feel tired and loosing weight. Do you carb count? i think you should increase your insulin both slow and fast acting? Do you experience any hypos?
 
Hi ewelina , no I do not carb count.The diabetic nurse said the first priority was to get the blood sugars down with insulin and then we would move on to carb counting but obviously they are not coming down.
I do not ever experience hypos - my readings are just allways high. Thanks for your reply. Richard
 
Perhaps you should give a carb counting a go. Its not very difficult and you could match insulin to what you eat. You obviously need more insulin as your levels are very high. When you get your levels down you will start feeling much better straight away.
 
Richard...
i would in your shors increase your basal by another 1 unit every 3 days until all your levels get to under 10.

Basically if you are taking 10 unit of long acting insulin morning and or night up this to 11 morning etc.... And or night...

Do this for 2 days .. Monitor.. Record and see what results are....

Then change as necessary.

You must get your blood results diown.... You will not feel better until they are down under 10 on a daily basis.

You need to be able to carb count. Especially with xmas coming up...this is a minimum for all type 1's... And type 2's!!

I am a headstrong girlie.. So believe that you got to take charge of your own wellbeing...you may not be this head strong.. So I apologise if I am a bit OTT!!


You will be feeling better when youncan get your levels beteen 4 n 8, but you donappear to havemedical persons that are a bit slow at achieving this...
 
How do dsns/consultants expect people to control levels on fixed doses and no knowledge of carb counting, irritates the **** outa me.

Sent from the Diabetes Forum App
 
Dont worry about dsn's etc.. Rhereisagoodonli ecourese from Bournemouth hospital.. Bdec e learning... Google it.. And do the course... It doesnt take long.

Take a starting point that you need 1 unit of insulin for every 10 grams of carbs you eat..
Then we canho from there,..

You are fine. You will be fine..... You just need a little help now.... But you will get there...
 
There is a good on line course.. Bdec carbs elearning... Google it .

Sordy my typing erratic in previous post....
 
Hello Richard

There's an awful lot to managing insulin and managing food so that the two play ball with each other ok....

There are 2 ways to get your blood sugar levels to lower.... one way is to increase the insulin and the other way is to decrease the amount of carbohydrate that you are eating in your food. Carbohydrate in food has the biggest impact on blood glucose levels.

As you are not sure what you are doing with the insulin, your safest bet is to just to reduce the carbohydrate in the food you are eating. As your blood sugar levels are very high which is why you don't feel well, try reducing the carb by 30-40%

What exactly are you eating in your meals every day? only you are going to have to start to read the sides of the tins and packets of food that you buy to see how much carbohydrate is in them.

Monday morning as your sugar levels are high .... instead of eating cereal for breakfast, try having just 1 slice of toast... Cereal is approx. 30-40g carb per portion whereas 1 slice of toast will be about 17g carb. This should enable your blood sugar levels to be a bit lower by mid morning and be ok by before lunch..... You might start to feel a bit hypo but if this happens you can eat something with sugar in it like lucozade or a cup of tea with 2 tsp sugar. If you reduce the carb content for all your meals and test your blood sugar levels every 2.5hrs during the day, you should hopefully start to see some improvement so write down all the food that you are eating working out the carb content, write down your blood glucose levels and write down the amount of insulin you are injecting and then tell all this to the DSN at your hospital and get them to give you some help with everything.

The website donnellydogs has mentioned called BDEC gives diabetics guidance on how to adjust their bolus insulin using insulin to carbohydrate ratios I:C. (google BDEC diabetes) Join up and learn the art of using ratios..
DUK has also done an excellent guide as well all about carbohydrate counting and the link can be downloaded as a pdf https://shop.diabetes.org.uk/store/lite ... -book.aspx


Hope you feel better soon - you will do once your blood sugar levels start to be better controlled

All the best and hope you will let us all know how things are going for you..
 
ElyDave said:
That's funny, I'm an engineer and that's exactly how I look at it, a complex bioprocess control problem with lots of feedback loops.

One book you ddn't mention was "think like a pancreas" by Gary Scheiner which I've found very useful.

Do you have a reference for the vitamin B and D levels, I'd be interested to have a read of it.

Thanks

Dave

Hi Dave,

The Scheiner book is good - I agree that that should go on the reading list.

As to the vitamin stuff here are a couple of links; if you google diabetes + the respective vitamins you'll find quite a lot of information.

Vitamin D - as a preventative measure for Type 1 http://www.ncbi.nlm.nih.gov/pubmed/11705562 (this is why I give my children vitamin d3 supplements)

Vitamin B1 - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376872/

I think the vitamin stuff won't make massive immediate changes but I think of it as a way of bettering our odds a bit; and that's no bad thing when we are playing the long game with diabetes.

Best

Dillinger
 
hi Richard its Jim again.I see you are having trouble controlling your sugars.

Its possible your symptoms are due to HIGH CORTISOL....this is a very damaging state.
if I were you and the docs were failing to give clear answers... insist on a '24 hour urine cortisol test' sadly it is exactly what it sounds like ...you collect all your urine for 24 hours and the doc checks the level of cortisol.
CORTISOL is a catabolic steroid it splits protein and amino acids to create .... you guest it SUGAR this is why those in stress have trouble controlling sugar... also you could ask for a testosterone test. this is an anabolic steroid. the magic is the HOMEOSTATIC balance between cortisol creating sugar and testosterone using the sugar to build new body parts. including brain. i have been transformed by this. [btw i'm 53... its important to ask GP for the exact number you achieved in the test and the normal range into which they believe an adult male should fall as used by your hospital... so mine was '3' in a range 6.7 to 28 I needed suplimentation!!]

Richard i am not a doctor or medically trained in any way. all my info has come from a truly horrendous 4 years and a great deal of reading where the NHS has totally failed me... i will tell my full story soon ... it has shocked me. The advice i give you is given in good faith. i'm afraid you may have to take control of your health from your doctor! time to become the EXPERT PATIENT
 
Sorry its Jim again...my moto...never short of something to say !
May I ask your age?
I note you say you have no symptoms other than high sugars, what is your diagnosis? Sorry if I missed it somewhere!
 
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