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Some advice please

T

Tjroberts3

Member
Messages
8
Type of diabetes
Type 1
Treatment type
Insulin
Hello all. Apologies in advance if this ends up being quite long. I’ve been T1 for 10 1/2 years now (almost 30 years old) and I feel like I’m stuck!
Had my ups and downs with HCPs over the years, and have been out of touch for a while, but regularly seeing Diabetes Nurse at my GP for the last year, as well as recently a “Specialist Diabetes Nurse” for covers several surgeries. These have both been helping but I feel like I’ve reached the limits of their usefulness.
A1C was 73 most recent, and has been over 70 for too long now. Specialist recently put me on Tresiba, but I’m not sure to what effect.
I carb count but my rations definitely aren’t right. Levels aren’t below the suggested 9 two hours after a meal, but they are 3 hours after HOWEVER then they just keep falling. So I’m wondering if my Tresiba is too high - 58 units a day (which I know is very high). It was 60 but I’ve dropped it 2 units and I’m considering dropping it further - could high background insulin be what’s continuously pulling my levels down??
I’ve been using the Freestyle Libre for several months which is what is causing me to question things now - the data is excellent but I’m not sure how to fix it!
I definitely experience the dawn phenomenon- a term I only learnt from these forums (despite discussing it with the nurse months ago, which resulted in the change to Tresiba).
I intend to make contact with the specialist diabetes department at local hospital again for the first time in years, as I need to speak to someone who actually understands the Libre data I think, and can help me (but they’re a nightmare to get hold of or book appointments).
So any thoughts or advice would be appreciated, although I recognise this is probably a bit of a ramble.
One last thing is I’ve been toying with a low carb diet for sometime now. I see plenty of talk about it for T2 on this forum and diabetes UK website, but have any T1s tried it and found it helpful?
 
Hi @Tjroberts3 ,

Firstly i notice from your profile your prescribed medication is "Novorapid, Tresiba, & Metformin."

Here is a link on a how to basal testing. https://mysugr.com/basal-rate-testing/

Your prescription of Metformin indicates you have a level of insulin resistance, (which is how it works by lowering the IR.)
So don't be worried about the amount of basal being used in comparison to other folk. But by all means check it & make sure its working for you. (It's the foundation of which to set everything up on.)

I'm a relatively lowish carber. But. i wouldn't advise anyone starting with the diet side of it until understanding how the meds work..

Edited to add a tag of a guy who knows his Libre stuff, that may help chop sense into it for you too.. @Scott-C
 
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Tjroberts3 said:
I’ve been toying with a low carb diet for sometime now. I see plenty of talk about it for T2 on this forum and diabetes UK website, but have any T1s tried it and found it helpful?
Click to expand...
Have you read Dr Bernstein's classic book "Diabetes Solution"? He is himself T1, has survived to the age of 83 and is the acknowledged authority on insulin use. You can read extracts from his book and also watch informative short videos here:

http://www.diabetes-book.com/read-online-diabetes-solution/

You might also like to read this article from the Diatribe site:

"Low Carb vs. High Carb - My Surprising 24-day Diabetes Diet Battle
11/2/15 - ADAM'S CORNER

diet-battle.png
By Adam

Twitter summary: What I learned from doubling my carb intake: the same average blood sugar, but four times as much hypoglycemia, more work, stress, & danger.

As a teenager, I ate a high carb diet that included lots of Goldfish crackers, white sandwich bread, pasta, and white potatoes. It was tasty, but it put my blood sugars on a wild roller coaster every single day. Things turned around in college when I learned about nutrition, got on CGM, and spent time with health conscious friends. I soon realized that eating less than 30 grams of carbs at one time was a complete gamechanger. I’ve stuck with that approach ever since.

But is this lower carb method actually better for my blood sugars, or have I just been fooling myself? To find out, I took on a somewhat terrifying self-tracking experiment:"

You can read the rest of Adam's article here:
https://diatribe.org/low-carb-vs-high-carb-my-surprising-24-day-diabetes-diet-battle
 
With the utmost respect @Alexandra100 , (I'm taking my moderator "cloak" off here.)

You are profiled as "pre-pre-diabetic". are you an insulin dependant.? it's unclear...
 
Hi. Yes, do check the Basal balance. One way is to fast for a good few hours and see if your BS goes up or down. If it goes up you need to increase the Basal and vice versa. If you have some excess weight and hence IR then you may need to reduce your daily carb intake. When on insulin you can't eat as many carbs as you like otherwise weight goes on. If this happens then you have a vicious circle of IR and ever increasing insulin shots.
 
Jaylee said:
With the utmost respect @Alexandra100 , (I'm taking my moderator "cloak" off here.)

You are profiled as "pre-pre-diabetic". are you an insulin dependant.? it's unclear...
Click to expand...
Sorry, I keep meaning to write a signature, but never find the time, too busy preparing all those low carb meals and testing testing testing. My worst A1c in the summer of 2017 was 41 (hence the pre-pre-diabetic label) and more recently it was 37, but even eating extremely low carb I can't get my home testing numbers anywhere near normal. I suspect I am actually pre-LADA and producing very little insulin, because I am thin to the point of disappearing and my bgs are unpredictable and don't respond to low carb in the way that T2s' numbers seem to do. I'd love to try basal insulin, but there is no way anyone (with the exception of Dr Bernstein) is going to prescribe that for me given my A1c results. I did very well to persuade my GP to give me Metformin, but that hasn't made much difference so far, another clue that my problem is insulin insufficiency rather than resistance.
 
@Alexandra100 . So is the answer to the question, no you're not insulin dependent?
Are there no tests to give you a definitive diagnosis.
 
Alexandra100 said:
Sorry, I keep meaning to write a signature, but never find the time, too busy preparing all those low carb meals and testing testing testing. My worst A1c in the summer of 2017 was 41 (hence the pre-pre-diabetic label) and more recently it was 37, but even eating extremely low carb I can't get my home testing numbers anywhere near normal. I suspect I am actually pre-LADA and producing very little insulin, because I am thin to the point of disappearing and my bgs are unpredictable and don't respond to low carb in the way that T2s' numbers seem to do. I'd love to try basal insulin, but there is no way anyone (with the exception of Dr Bernstein) is going to prescribe that for me given my A1c results. I did very well to persuade my GP to give me Metformin, but that hasn't made much difference so far, another clue that my problem is insulin insufficiency rather than resistance.
Click to expand...

Appreciated, with respect. your own health status needs to be addressed accordingly. Your own personal achievement is commendable. (sincerely.)
But... Need i go on with regards to the the OP's personal condition..? Please start your own topic if you have concerns regarding where you personally stand on a diagnosis..

Kind regards.

J>
 
therower said:
@Alexandra100 . So is the answer to the question, no you're not insulin dependent?
Are there no tests to give you a definitive diagnosis.
Click to expand...
As I said, I can't be insulin dependant because no-one will prescribe it for me. Similarly, no-one will send me for a GAD or C-peptide test unless / until my A1c result worsens enough to put me into at least the pre-diabetic category. I'm only on this thread because the OP was wondering about the value of a low carb diet for T1s and I knew that Dr B and Adam of Diatribe both endorse this, in their different ways. I have absolutely no advice to give about insulin from my own personal perspective.
 
Alexandra100 said:
As I said, I can't be insulin dependant because no-one will prescribe it for me. Similarly, no-one will send me for a GAD or C-peptide test unless / until my A1c result worsens enough to put me into at least the pre-diabetic category. I'm only on this thread because the OP was wondering about the value of a low carb diet for T1s and I knew that Dr B and Adam of Diatribe both endorse this, in their different ways. I have absolutely no advice to give about insulin from my own personal perspective.
Click to expand...
Then from my own perspective (& other IDs.) don't give advice to IDs.
However, i personally have no issue of the carb count advised on a specific carb count equirory.. carb count help from anyone experienced is always gratefully received. :)
 
Jaylee said:
Then from my own perspective (& other IDs.) don't give advice to IDs.
However, i personally have no issue of the carb count advised on a specific carb count equirory.. carb count help from anyone experienced is always gratefully received. :)
Click to expand...
If you re-read my one contribution to this thread, you will see that I simply referred the OP to two writers whose T1 credentials are impeccable. I can't see why I would need to be insulin dependent to do that.
 
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