Type 1 So much conflicting information!

Foulksey said:

Hi all,

This is my first post - was diagnosed Type 1 in Feb 2016. Feel a bit like its worse now a year later though as should be used to it by now!? I'm sure I'm not the only one who feels like this though.

Anyway, my question is - if you just jab your finger before each meal and before bed you are aiming for between 4 and 7 (ish). So the numbers in my book are not too bad, a bit high sometimes. However, I have the Freestyle Libre that shows my highs (sometimes very) in between the meals. So, my the daily graph on my Libre machine is up and down like a rollercoaster - is that ok? My dietician says I should eat what I like and just control it with insulin - surely then if you eat something sweeter you will still go up when you have eaten? To not move on the graph would mean putting more insulin in and then you risk a hypo!?

I'm supposed to be at the stage where I inject insulin to meet what I am eating but I find it all so scary (and as someone else said every jab of the finger is like taking another test!) that I am reluctant to stray from the same range of meals week in week out.

Help please?

Click to expand...

First of all, you should give yourself some slack - diabetes isn't linear and neither is your blood glucose, it's always going to be a bit up and down. Just like life

You can eat almost anything when on a basal/bolus regime or insulin pump; but obviously within reason... There are many tips and tricks to keeping your BG flat even when eating the "less than ideal" types of food and one of my favourites being to "pre-bolus"; which means to take your bolus insulin in advance of your meal, where the timings are relevant to the glycemic load and fat content of what you're eating. You'll find a wealth of info in this book, which I'd recommend you purchase and read cover to cover. I'm, not endorsing it, or selling it to you, but what you can learn from this wee book can improve your diabetes management dramatically:

https://www.amazon.co.uk/d/cka/Thin...naging-Diabetes-Insulin-Completely/0738215147

I certainly don't graze on celery and lettuce between meals and I have a fairly respectable HbA1c and general BG control. I'd say I follow a diet and lifestyle that's fairly close to that of a non-diabetic. It just takes a little pre-planning at times and implementation of some nifty tricks

I could have written this myself, I know exactly what you mean! I have recently started using a Freestyle Libre and whilst I was just logging finger pricking results before meals, bed etc my readings looked fine! Now when I read the Libre my levels are all over the place in between meals!! I don't have any answers but just wanted to let you know you're not the only one!

Hi @Foulksey, yes I am pretty much eating what I like please let me know how you get on! I'd love yo hear from someone in a similar position to me

Foulksey said:

Hi all,

This is my first post - I was diagnosed Type 1 in Feb 2016. I do feel a bit like I am coping with it worse now, a year later, as I should be used to it by now shouldn't I!? I'm sure I'm not the only one who feels like this though.

Anyway, my question is - if I was just jabbing my finger before each meal and before bed, aiming for between 4 and 7 (ish) the numbers in my book are not too bad, a bit high sometimes. However, I also have the Freestyle Libre that shows my highs (sometimes very) in between the meals. So, my daily graph via my Libre machine is up and down like a rollercoaster - is that ok?

My dietician says I should eat what I like and just control it with insulin - surely then if you eat something sweeter you will still go up when you have eaten? To not move on the graph would mean putting more insulin in and then you risk a hypo!?

I'm supposed to be at the stage where I inject insulin to meet what I am eating but I find it all so scary (and as someone else said every jab of the finger is like taking another test!) that I am reluctant to stray from the same range of meals week in week out.

Help please?

Click to expand...

Bolusing more in advance can reduce any spoke after eating - often amazingly so. The book Think Like A Pancreas is fantastic for helping. I still refer to it even though I've had Type 1 for more than 20 years. If you choose to,do this, move your bolus very gradually 5 mins more in advance at a time until you find the sweet spot (which may vary for different meals).

What are you worried about regarding carb counting and adjusting your insulin according to what you're about to eat? It's not as scary as it sounds, and you'll soon learn what works for,you. If you don't a,ready have one, ask for a half unit pen as it gives you mor flexibility with doses.

I've had it for over 30 yrs. And what I do is test in AM, before meals, bedtime. On my meter I average between 80 and 115 usually. If it's 80 I've had more lows. I don't mess with postpradials, no CGM. The most useful thing about those I think would be waking a kid up when they're low by ringing a cell phone. But as I understand it the Libre won't do that like Dexcom does, so I'd avoid that one. I quit doing A1Cs quite awhile ago because they were always about the same (6.2-6.5). I bought a kit last month at it was 6.5. I never used to carb count until recently and I usually eyeball the meals.

Foulksey said:

My dietician says I should eat what I like and just control it with insulin - surely then if you eat something sweeter you will still go up when you have eaten? To not move on the graph would mean putting more insulin in and then you risk a hypo!?

Click to expand...

Not sure what you mean here but even non-diabetics will experience a rise in postprandial bg levels, but as already explained getting your bolus timing right so that your QA insulin is working as your food begins to digest is a must @Foulksey , you'll learn all this and more when your book arrives

Ooo feb 2016! Same as me

Yer you will often rise a bit after eating, thats where the GI comes in handy. Low GI meals I go for 10-20 mins pre bolus (i like it to dip a bit on the CGM before the food rises it) and my personal goals are never getting more than a 7.8 spike. This is often the case with a few annoying meals hitting 8, and once on holiday hitting 11 (which put me in a very nice mood).

These are tight goals but I had a spare transmitter and sensor (one week left of life on the G5) so My partner wore it for the week. She spiked to 7.8 a few times with meals so that was my aiming point. Annoyingly it hit 7.8 and then proceeded to come down and level off nicely - envious

I recommend Think like a pancreas, I was told to read t by numerous people, and while most topics are often spoke of on the forum there was plenty left to scrub up on.

Hi @Foulksey . Have you been educated on how to carb count? A dedicated program.

Foulksey said:

Hi all,

This is my first post - I was diagnosed Type 1 in Feb 2016. I do feel a bit like I am coping with it worse now, a year later, as I should be used to it by now shouldn't I!? I'm sure I'm not the only one who feels like this though.

Anyway, my question is - if I was just jabbing my finger before each meal and before bed, aiming for between 4 and 7 (ish) the numbers in my book are not too bad, a bit high sometimes. However, I also have the Freestyle Libre that shows my highs (sometimes very) in between the meals. So, my daily graph via my Libre machine is up and down like a rollercoaster - is that ok?

My dietician says I should eat what I like and just control it with insulin - surely then if you eat something sweeter you will still go up when you have eaten? To not move on the graph would mean putting more insulin in and then you risk a hypo!?

I'm supposed to be at the stage where I inject insulin to meet what I am eating but I find it all so scary (and as someone else said every jab of the finger is like taking another test!) that I am reluctant to stray from the same range of meals week in week out.

Help please?

Click to expand...

Hi. You may want to find a new dietician or do without one. When on insulin you can't eat what you like unless you want to add weight and start to become insulin resistance and risk more hypos thru larger blood sugar swings.

Foulksey said:

My dietician says I should eat what I like and just control it with insulin - surely then if you eat something sweeter you will still go up when you have eaten? To not move on the graph would mean putting more insulin in and then you risk a hypo!?

Click to expand...

The aim isn't not to go up. The only person with a blood sugar line that doesn't move is a dead person. Everyone, diabetic or not, will get a rise in blood sugar after eating.

The aim should be to keep blood sugar in a similar range to that of a non diabetic. It's worth noting that non diabetes can spike up to 11, that'll be rare, but possible and normal in a non diabetic after eating something sweet.

If your blood sugars moving loads when you haven't eaten the first move should be to have a look at your basal dose with a bit of basal testing. The job of basal insulin is to keep you stable when not eating or bolusing, you shouldn't really move much more than 2mmol up or down if you fast for 6 hours with the right basal dose - https://mysugr.com/basal-rate-testing/

Then remember that the timing of your bolus can be crucial to help ensure the insulin is actually in on target and working when the food goes in.

Different foods can start effecting blood sugar at different times. A high fat meal might not let the carbs start to impact on blood sugar for 4/5 hours. This is known as the pizza effect.

Things other than food will impact on blood sugar: dawn phenomenon; stress; exercise; illness; lack of sleep; hormones, they'll all make the line move. Because you are a living breathing human.

Daibell said:

Hi. You may want to find a new dietician or do without one. When on insulin you can't eat what you like unless you want to add weight and start to become insulin resistance and risk more hypos thru larger blood sugar swings.

Click to expand...

BINGO

Hi,

Oh I have been here and like you only noticed these spikes after getting the Libre. One way I manage mine is with this routine:
1. If my bloods are below 7 before a meal I inject my rapid straight before a meal.
2. If my bloods are between 7 and 10 then I'll inject my rapid acting 15 minutes before eating.
3. If they are anything higher than 10 I'll inject 30 minutes before eating.

It does take some advanced planning but it's definitely helping me with my post meal spikes.

If you aren't already doing so I would cross reference your Freestyle Libre readings with a manual finger prick. I have posted and seen many posts of inaccuracies with this device. I have found the Feeestyle tracks well for me on FBG, but during the day can be up to 2 mmol out; this has lead to me finger pricking more often with 2 manual testers through anxiety. As a non insulin Type 2 for me it is not a big deal, but this does concern me from an accuracy stand point.

One good thing, the official Freestyle App for me has never read lower than a manual test (apart from when using the unofficial App, which often puts in hypo numbers). I suppose if you are able to spot a trend and saw that the official App, tracked say 1.5 mmol above where you really are the device is still useful (I have assumed your device is out, maybe it's just how it reacts with me).