T1 on insulin

[Debbie.Hodgson1]

Hello I was diagnosed with type 1 on Wednesday. Went to g.p and blood glucose 18.5 and high ketones in urine. Weight loss. Thirsty. Headaches. Sent me straight to hospital! Waiting for the bloods to confirm it’s definitely type 1.
Started insulin 10 units a day. This was put up to 14 a day on Friday but doesn’t seem to be going down? On waking it’s 11 or 12 and during the day 14-16.
Spoke to a dietitian and I’m having cereal for breakfast. And lunch and tea I’m doing 1/2 veg/salad 1/4 protein 1/4 carbs. I’ve stopped all snacks crisp/chocolate/biscuits instead I’m eating fruit and an odd yoghurt. I’m feel quite frightened of food now I actually feel a bit lost because this is all new to me and a complete shock! I have a telephone call on Wednesday with my nurse. I also have coeliac disease and fibromyalgia

 

[Daibell]

Hi. Are you on two insulins? Once your T1 is verified or even if not you should probably be on the Basal/Bolus regime. One, the Basal, will be one or two shots per day and the Bolus is for each mealtime. Over time your Basal will need to be tweaked to balance it and you will be taught carb-counting to adjust the Bolus shots for each meal. BTW NHS dieticians are best avoided. Having cereal for breakfast is not the best diet for us due to the carb content. Go for eggs and bacon etc in preference.

 

[Debbie.Hodgson1]

Hi. Are you on two insulins? Once your T1 is verified or even if not you should probably be on the Basal/Bolus regime. One, the Basal, will be one or two shots per day and the Bolus is for each mealtime. Over time your Basal will need to be tweaked to balance it and you will be taught carb-counting to adjust the Bolus shots for each meal. BTW NHS dieticians are best avoided. Having cereal for breakfast is not the best diet for us due to the carb content. Go for eggs and bacon etc in preference.

Hi I’m currently only taking the one shot in a morning. Have the bolus in the fridge ready but my nurse said she doesn’t want me to start that yet. I did wonder about the cereal. I’ll try the eggs instead.

 

[In Response]

@Debbie.Hodgson1 fear of food is not good. I recommend encouraging your nurse to get you on the bolus as soon as possible.
I have had T1 for over 15 years and maintain good levels (and weight) whilst eating what I want when I want.
Insulin is the tool you need to enable this. You do not have type 2 so it is not necessary to restrict your diet to low carb.
If you restrict your diet at the moment you will not be able to give your nurse the data she needs to help determine your insulin dose for a “normal” diet.
.I don’t want to scare you but don’t be too afraid of higher levels (low double figures) when you are first diagnosed. Reducing your levels too fast can result in damage to your eyes.

This may all sound a bit daunting at the moment but it is early days and will take some time getting used to. Once you are, diabetes should not stand in your way.

 

[Debbie.Hodgson1]

@Debbie.Hodgson1 fear of food is not good. I recommend encouraging your nurse to get you on the bolus as soon as possible.
I have had T1 for over 15 years and maintain good levels (and weight) whilst eating what I want when I want.
Insulin is the tool you need to enable this. You do not have type 2 so it is not necessary to restrict your diet to low carb.
If you restrict your diet at the moment you will not be able to give your nurse the data she needs to help determine your insulin dose for a “normal” diet.
.I don’t want to scare you but don’t be too afraid of higher levels (low double figures) when you are first diagnosed. Reducing your levels too fast can result in damage to your eyes.

This may all sound a bit daunting at the moment but it is early days and will take some time getting used to. Once you are, diabetes should not stand in your way.

Thank you. I will talk with my nurse on Wednesday. I understand what you are saying about not low carb. I have spent the last few days explaining to friends and family I don’t have type 2 and type 1 is very different as in I can eat pretty much anything with in reason. Because I’m not yet on the bolus I’m a little scared to eat too much and send my numbers even higher

 

[Antje77]

Started insulin 10 units a day. This was put up to 14 a day on Friday but doesn’t seem to be going down? On waking it’s 11 or 12 and during the day 14-16.

It takes time and patience to find the right dose. The only way to find it is trial and error, and the amount of insulin we need is highly personal.
So for safety reasons, you start out at a lowish dose and slowly titrate up to find the right dose for you.

 

[Debbie.Hodgson1]

It takes time and patience to find the right dose. The only way to find it is trial and error, and the amount of insulin we need is highly personal.
So for safety reasons, you start out at a lowish dose and slowly titrate up to find the right dose for you.

thank you

 

[Jaylee]

Hello I was diagnosed with type 1 on Wednesday. Went to g.p and blood glucose 18.5 and high ketones in urine. Weight loss. Thirsty. Headaches. Sent me straight to hospital! Waiting for the bloods to confirm it’s definitely type 1.
Started insulin 10 units a day. This was put up to 14 a day on Friday but doesn’t seem to be going down? On waking it’s 11 or 12 and during the day 14-16.
Spoke to a dietitian and I’m having cereal for breakfast. And lunch and tea I’m doing 1/2 veg/salad 1/4 protein 1/4 carbs. I’ve stopped all snacks crisp/chocolate/biscuits instead I’m eating fruit and an odd yoghurt. I’m feel quite frightened of food now I actually feel a bit lost because this is all new to me and a complete shock! I have a telephone call on Wednesday with my nurse. I also have coeliac disease and fibromyalgia

Hi @Debbie.Hodgson1 ,

Welcome to the forum. & the diverse individuality of the condition that is why we all happen to be here..

Firstly, axiety over food is not a positive way forward. It is a good idea to lower your BGs over a period of time in order to "acclimatise" to getting back within healthy range. As mentioned above, there can be possible issues with the eyes doing a "short sharp shock."

However, the insulin you are taking should be dealing with your fasting BG levels it's not really designed for your meals.
The bolus prescribed sitting in your fridge? You should be talking with your nurse about using it.
Keep a diary of what you've eaten & your BG levels which will help your HCPs to help you.

Bests wishes, & let us know how you get on with the determining test results..

 

[Debbie.Hodgson1]

Hi @Debbie.Hodgson1 ,

Welcome to the forum. & the diverse individuality of the condition that is why we all happen to be here..

Firstly, axiety over food is not a positive way forward. It is a good idea to lower your BGs over a period of time in order to "acclimatise" to getting back within healthy range. As mentioned above, there can be possible issues with the eyes doing a "short sharp shock."

However, the insulin you are taking should be dealing with your fasting BG levels it's not really designed for your meals.
The bolus prescribed sitting in your fridge? You should be talking with your nurse about using it.
Keep a diary of what you've eaten & your BG levels which will help your HCPs to help you.

Bests wishes, & let us know how you get on with the determining test results..

Morning my nurse has told me I am not to start my novarapid yet? She said we need to just use this one insulin in a morning for now but did not say why. I will ask her when I ring her tomorrow. Thank you

 

[KK123]

Hi @Debbie.Hodgson1, I agree in that you do not need to immediately change your diet or go very low carb at this stage if ever and if you do it could mask the data. The aim when first diagnosed as a type 1 is to obtain the data whilst on a 'normal for you' diet, that way they can judge how much insulin you may need per amount of carbs and help you to get to a position where you can adjust your own insulin to what you choose to eat. Personally I think it's a good idea at this stage to cut out random bags of crisps or those snack type things you may eat in between meals as that does make it harder to manage your insulin use at this time. I would stick to the mantra of 3 meals a day (if that is your current norm), leaving at least 4 hours between meals. This gives the insulin you take per meal time to work without a 20 carb bag of crisps, et al messing up your insulin requirements between meals and making it harder to determine whether the meals or the snacks have contributed to high or low levels.

Once you are in a position to understand how it all works (or at least is supposed to), and what your insulin to carb ratio is, and how your favourite meals affect your levels and all the rest, then you can decide upon a dietary strategy. Some type 1s may choose very low carb, others may choose medium carb and others may go higher. The point is it is your choice and you do not have to go LCHF as a matter of course. With type 1s (generally as we are all different) the theory is that you actually can eat what you want provided you are able to match the insulin to it in a manner that keeps you stable glucose wise and stable and healthy in every other aspect, ie weight. That can be hard to do of course so adjustments along the way can be made, for example a person struggling to manage their levels may decide to go low carb. Remember that what we are missing is a hormone, and that hormone needs replacing (insulin). It's more complicated than just that as our hormones all work in tangent with each other so one that is missing/faulty can affect the others. There is no 'take x amount of insulin for x amount of carbs' as so many other factors come into it. Having said that though, it is used as a starting point and as a guide to working out what works for you otherwise we'd have no clue, hence my suggestion not to rush into a particular diet but to take it slowly until you know and have seen enough to decide for yourself.

Edited to add; the reason she has not put you on novarapid (for meals) may be that she is trying to work out your basal requirements first, it does take a while to fathom out what you require right now as a newly diagnosed type 1. I was on one insulin, then both, then back to one, then none for a short while then back to two, all over a period of 6 months. x

 

[KK123]

Hi. Are you on two insulins? Once your T1 is verified or even if not you should probably be on the Basal/Bolus regime. One, the Basal, will be one or two shots per day and the Bolus is for each mealtime. Over time your Basal will need to be tweaked to balance it and you will be taught carb-counting to adjust the Bolus shots for each meal. BTW NHS dieticians are best avoided. Having cereal for breakfast is not the best diet for us due to the carb content. Go for eggs and bacon etc in preference.

Hi Daibell, that depends on the individual. I sometimes eat porridge, take 2 units of insulin for it and am absolutely fine. It may not be the 'best diet' if it's sending your levels soaring or is making it impossible to bring them down without a barrel load of insulin or affecting you in some other way such as making you insulin resistant. I do not think type 1s have to cut out every carb in the manner some type 2s have to.

 

[Hertfordshiremum]

Morning my nurse has told me I am not to start my novarapid yet? She said we need to just use this one insulin in a morning for now but did not say why. I will ask her when I ring her tomorrow. Thank you

I was told the same thing initially I don’t understand why they do this. I suspect they think basal only will be fine as they seem to think things happen gradually, not always so! It was only when I pointed out I was eating very little and virtually no carbs and how was I supposed to sustain this that they changed their tune. Offer to eat something with carbs you would like to eat. In my case a small porridge for breakfast and record results every hour, if you are spiking badly she will probably change her mind. Although I would point out I soon learnt I just can’t eat porridge anymore.

 

[NicoleC1971]

The OP needs to set up correct dosing for carbs (a starter regime is normally 1 unit of fast acting for every 10g) though this varies based on your body weight, PMT status or just what you ate with those carbs so it is an art as well as a numerical equation! Some bg meters help you out by calculating the dose for you based on current bg, exercises status etc. (Bolus wizard).
I agree with the nurse that it is critical to get the basal right though and actually helpful not to eat carbs for a day just to see what happens so do keep a record.
I would not recommend tweaking things too much without the nurse's help so as to avoid hypos.
On carbs for type 1 (just my view)
The Dexcom (checks my sugar every 5 minutes) tells me that it is hard to get out in front of a carb induced spike and that's why I keep them low so that dosing errors may are also be low. I've gotten use to the low carb life and yes I could weigh out my food but I can't be bothered and prefer to eat liberal amounts of other foods that are much more nutritious!

 

[Daibell]

Hi again. My nurse started me on just the Basal but when I gave her my recorded BS readings she added the Bolus within a month as she could see my BS control was not good without the Bolus so see what your readings are like and discuss with her. I have to disagree to some extent with the comments about T1s being able to eat carbs fairly freely compared with T2s. Yes it's OK if you don't gain weight but as for non-diabetics if you have too many carbs you will probably gain weight so see what works for you.

 

[Hertfordshiremum]

Hi again. My nurse started me on just the Basal but when I gave her my recorded BS readings she added the Bolus within a month as she could see my BS control was not good without the Bolus so see what your readings are like and discuss with her. I have to disagree to some extent with the comments about T1s being able to eat carbs fairly freely compared with T2s. Yes it's OK if you don't gain weight but as for non-diabetics if you have too many carbs you will probably gain weight so see what works for you.

I agree I am Type 1 and can hardly eat any carbs as I spike so badly and increasing insulin gives me a hypo later. Not worth the awful rollercoaster that follows and lasts hours.