T1- newly diagnosed Day 6 on insulin

In Response said:

Hi @Alex1911 and welcome to the club.

It is always a shock to be diagnosed with a chronic condition with a lot to take on board but things do get better.
I strongly recommend chasing up with the consultant for a follow up. It sounds as you are on fixed dose but that should change to make things more flexible for you.

It is not surprising you have some questions to ask - keep them coming. But to start with I will provide my answers to your first lot.
Please bear in mind we are all different and I have no medical qualifications ... just nearly 20 years of experience of Type 1

- how come my fingers hurt so much now when pricking them and it was fine at the start
I don't know why your fingers hurt but you may want to look at your technique. Unfortunately, we are never taught how to prick our fingers but there are some tips
- make sure you have the lancet depth adjusted so it is just deep enough to get some blood but not too long. Most lancet devices will have a small dial to adjust the depth
- avoid pricking the middle of the padded area of your finger. it is better to prick to the edge of this area as you will not be pressing there when you do things like type.
- "rotate" your fingers - change the finger you prick regularly. I came up with a "finger schedule" to help me remember to change fingers. I use different hands for odd and even dates and then allocate a time of day for each finger. For example, the little finger on my left hand takes all pricks between waking and lunch on 1st/3rd/5th/7th/... of the month.
- Libre is great BUT you need to understand its limitations. I would recommend finger pricking at least once a day to check the Libre is close.

- I also feel like if I have a bruise where I have been injecting the last 2 times despite changing locations every time
You may have injected into a blood vessel which causes a little bruising.
The advice used to be to pinch a bit of fat and inject into that. This advice changed when needles got shorter but as someone without much fat (and as an active gym going you may be the same), I still find it better to pinch and inject into that part.

- what happened if I am below 8 before a meal? E:g 6, how much would 10 gr of carbs brings me up to?
Unfortunately, we are all different and food is different.
The best way to work out what affect 10g of carbs would have on YOU is to try it. When your levels are stable and you have no bolus insulin (NovoRapid) on board (so more than 4 hours after your last injection), eat 10g (or 5g if you want) of fast acting carbs such as Dextrose tablets. Measure your levels again after about 30 minutes.

- should I take Levemir before bed if I am about 5-6- will it drop me too low during the night
YES,
The idea is that the Basal insulin should keep your levels stable.
You should not stop taking this but you may want to have a little bit of carbs (e.g, half a biscuit) to bring your levels up before going to sleep in case they fall during the night.


- how can I wake up with sugar levels greater than when I went to bed: and no I did not raid the fridge in the middle of the night
This is due to something called Dawn Phenomenon.
If you use the Search function at the top right of the page, you will find many many threads on this topic.
Basically, our helpful liver dumps a load of sugar into our blood at the start of the day to give us energy to get going.
Anyone with a healthy pancreas will release insulin to counteract the sugar. Anyone with a defective pancreas will see a ris ein blood sugar levels.

- why do I still have pins and needles even when I am within range, same with the blurry vision
It will take some time for our bodies to adjust to lower levels, especially if you have been at higher levels for some time.
The recommendation is to reduce levels slowly as a fast change could affect small blood vessels such as those in out eyes.
It is not advised to buy expensive glasses during this period as our eyes usually stabilise but a pair of cheap ready readers may help.

- I travel a lot internationally for work: what's the logistics now snd also eat out quite often: how do I manage that?
No problem. I travel a lot internationally (just booked my first long haul since the start of the pandemic).
Take everything you need diabetes-wise in your hand luggage
Carry twice as much as you think you may need
Request a letter from your consultant (GPs tend to charge for this) to say you must carry diabetes equipment with you at all times including needles. It is rare that this is requested but useful to keep with your passport.


- should I have a ketone reader? My highest has been 15
Yes, you should have a ketone meter ... and ketone strips on repeat prescription

- what about going back to the gym?
Yes. You will need to learn how your body reacts to exercise (another example about how we are all different) so take your meter and hypo treatment with you and take it easy to start with.
I go to the gym a few times every week and cycle and hike and climb and ...

- would my sugar levels be impacted by illness or even my menstrual cycle?
Yes. Typically, both will see your levels rising a bit.
You should ask about "Sick Day Rules" when you see or talk to your consultant or DSN.

I appreciate that is a lot of information. Don't expect to understand everything about diabetes on day 1, Or ever.
Don't expect perfection - there are too many things which can affect our levels.
But, diabetes should not stop you doing what you want - it hasn't stopped me and I have given it a few challenges over the years.

Click to expand...

In Response said:

Hi @Alex1911 and welcome to the club.

It is always a shock to be diagnosed with a chronic condition with a lot to take on board but things do get better.
I strongly recommend chasing up with the consultant for a follow up. It sounds as you are on fixed dose but that should change to make things more flexible for you.

It is not surprising you have some questions to ask - keep them coming. But to start with I will provide my answers to your first lot.
Please bear in mind we are all different and I have no medical qualifications ... just nearly 20 years of experience of Type 1

- how come my fingers hurt so much now when pricking them and it was fine at the start
I don't know why your fingers hurt but you may want to look at your technique. Unfortunately, we are never taught how to prick our fingers but there are some tips
- make sure you have the lancet depth adjusted so it is just deep enough to get some blood but not too long. Most lancet devices will have a small dial to adjust the depth
- avoid pricking the middle of the padded area of your finger. it is better to prick to the edge of this area as you will not be pressing there when you do things like type.
- "rotate" your fingers - change the finger you prick regularly. I came up with a "finger schedule" to help me remember to change fingers. I use different hands for odd and even dates and then allocate a time of day for each finger. For example, the little finger on my left hand takes all pricks between waking and lunch on 1st/3rd/5th/7th/... of the month.
- Libre is great BUT you need to understand its limitations. I would recommend finger pricking at least once a day to check the Libre is close.

- I also feel like if I have a bruise where I have been injecting the last 2 times despite changing locations every time
You may have injected into a blood vessel which causes a little bruising.
The advice used to be to pinch a bit of fat and inject into that. This advice changed when needles got shorter but as someone without much fat (and as an active gym going you may be the same), I still find it better to pinch and inject into that part.

- what happened if I am below 8 before a meal? E:g 6, how much would 10 gr of carbs brings me up to?
Unfortunately, we are all different and food is different.
The best way to work out what affect 10g of carbs would have on YOU is to try it. When your levels are stable and you have no bolus insulin (NovoRapid) on board (so more than 4 hours after your last injection), eat 10g (or 5g if you want) of fast acting carbs such as Dextrose tablets. Measure your levels again after about 30 minutes.

- should I take Levemir before bed if I am about 5-6- will it drop me too low during the night
YES,
The idea is that the Basal insulin should keep your levels stable.
You should not stop taking this but you may want to have a little bit of carbs (e.g, half a biscuit) to bring your levels up before going to sleep in case they fall during the night.


- how can I wake up with sugar levels greater than when I went to bed: and no I did not raid the fridge in the middle of the night
This is due to something called Dawn Phenomenon.
If you use the Search function at the top right of the page, you will find many many threads on this topic.
Basically, our helpful liver dumps a load of sugar into our blood at the start of the day to give us energy to get going.
Anyone with a healthy pancreas will release insulin to counteract the sugar. Anyone with a defective pancreas will see a ris ein blood sugar levels.

- why do I still have pins and needles even when I am within range, same with the blurry vision
It will take some time for our bodies to adjust to lower levels, especially if you have been at higher levels for some time.
The recommendation is to reduce levels slowly as a fast change could affect small blood vessels such as those in out eyes.
It is not advised to buy expensive glasses during this period as our eyes usually stabilise but a pair of cheap ready readers may help.

- I travel a lot internationally for work: what's the logistics now snd also eat out quite often: how do I manage that?
No problem. I travel a lot internationally (just booked my first long haul since the start of the pandemic).
Take everything you need diabetes-wise in your hand luggage
Carry twice as much as you think you may need
Request a letter from your consultant (GPs tend to charge for this) to say you must carry diabetes equipment with you at all times including needles. It is rare that this is requested but useful to keep with your passport.


- should I have a ketone reader? My highest has been 15
Yes, you should have a ketone meter ... and ketone strips on repeat prescription

- what about going back to the gym?
Yes. You will need to learn how your body reacts to exercise (another example about how we are all different) so take your meter and hypo treatment with you and take it easy to start with.
I go to the gym a few times every week and cycle and hike and climb and ...

- would my sugar levels be impacted by illness or even my menstrual cycle?
Yes. Typically, both will see your levels rising a bit.
You should ask about "Sick Day Rules" when you see or talk to your consultant or DSN.

I appreciate that is a lot of information. Don't expect to understand everything about diabetes on day 1, Or ever.
Don't expect perfection - there are too many things which can affect our levels.
But, diabetes should not stop you doing what you want - it hasn't stopped me and I have given it a few challenges over the years.

Click to expand...

Mrs HJG said:

Forgot to say - if your HbA1c was really high, you might find your eyesight gets a lot worse before it gets better - I wasn't warned and was reliant on a huge magnifying glass to even see the TV over Christmas and was off work/couldn't drive until the end of January because it took time for everything to settle. Hopefully you will just get a bit of fuzziness, but hopefully being forewarned will stop the panic I had.

Click to expand...