sorry-lots of questions!

[samantha13]

hi everyone, am really sorry but have so many questions and i'm hoping i can get some answers here :? I've just 1month ago been diagnosed as insulin dependant diabetic. i take 8units levimer at night and 3,4 and 6 units novorapid with meals. I work night duty 2 nights per week and have an 'extra meal' at midnight on these nights and i take 3units with it. I'm a healthy weight and have a bmi of 24. I walk 1hr five days per week. my blood sugars are on average 6.5 fasting 9.0 before lunch, 8.0 before dinner and 12.0 before bed. I don't feel i can personally eat any less. Common sense tells me i need more insulin but i'm not sure how to go about increasing it.

Also when I was diagnosed the nurse told me i should eat things with 10grams sugar or less but i find this nearly impossible and am unsure if thats per product or per 100grams?

I also eat quite a lot of fruit, maybe 5pieces a day but have heard this may not be suitable for diabetic diet?

If anyone could help me out i'd be more than grateful as i do not see the diabetic team for 2months and would like to have better readings by then if poss

 

[IanD]

Welcome, Samantha, to the club no-one wants to join.

Sue or Ken will be along soon to post a page of general advice. I, & many other diabetics, have found it beneficial to drastically reduce all carbohydrates. This advice came from a T1 diabetic.

Dare I ask you age? As you have only recently been diagnosed, you are likely to have some residual pancreas function, & may not be fully T1.

I recommend avoiding all products containg sugar. You don't need them, & they don't do you any good. I snack on nuts & cheese. I don't need sugar for energy - I can play tennis at club standard all afternoon without tiring, & without bananas & energy drinks. While playing, energy from fat reserves keeps my BG around 7, whereas if I am resting, it would drop to about 5.

I don't get hungry, & my BMI is maintained at about 25.

 

[cugila]

We sure are Ian. Friday is always a day for a lie in........ :wink:

So, Samantha........here is That advice which should hopefully answer some of your questions and help you on your route to good control of your diabetes.

Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.

As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!
If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l........(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l.....( Type 2)

2hrs after meals....... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Ken / Sue.

 

[daisy1]

So on Friday while the cat's away the mice will play :lol: I once had to write that 50 times in the days when you had lines for bad behaviour :wink:

 

[samantha13]

thanks for your advice, i really appreciate it! This forum has been a lifesaver. in answer to your earlier question i'm 26. apparently developed my diabetes from an auto immune disorder.

one more quick question- if i have a meal and check bs 2-3hrs post and it's still high ie 10-12ish should i at this stage inject more insulin or do i wait until the next meal? also if on the extremely rare occasion :wink: i allowed myself something like a bar of choc can i inject a few units to cover this?

I understand these questions are possibly very frustrating to you but i am new to this and still overwhelmed :? so i apologise in advance lol

 

[noblehead]

one more quick question- if i have a meal and check bs 2-3hrs post and it's still high ie 10-12ish should i at this stage inject more insulin or do i wait until the next meal? also if on the extremely rare occasion :wink: i allowed myself something like a bar of choc can i inject a few units to cover this?

At 2-3 hours post meal your novorapid will still be working and could still be lowering your blood glucose, novorapid is active in the body for up to 4=5 hours after injecting. Correcting high bg between meals can cause pre-meal hypo's, so the DAFNE approach is to correct a high reading at your next meal time, this would mean including a correction dose with your normal insulin dose for that meal. Typically 1 unit of novorapid will lower bg by 2-3mmol, so if your pre-meal bg reading was 12, you would include 2 extra units of insulin on top of the dose you are taking for the carbs in that meal, this should be sufficient to bring your bg back to normal levels.

The DAFNE approach (Dose adjustment for normal eating) I mentioned above is a carb counting course for type 1 diabetics, it teaches you to count the carbs in your meal correctly and so match this with your insulin (insulin/carb ratio). Most people find that their ratio is different throughout the day, so you may need more insulin to match your carbs at breakfast than you do for your evening meal, or vise versa, during the course you will establish your own ratio with the help of the course co-ordinators. Ask your diabetes nurse about the DAFNE course and enroll on this at the first opportunity, and hopefully your post-meal highs will become less frequent.

As for the chocolate bar, try eating this after your main meals and include a extra unit or two of insulin depending on the carb content of the bar.

Best wishes

Nigel

 

[samantha13]

thanks for the advice, you have been a great help. i will definately be asking about DAFNE it sounds like a great program