Thanks for explaining that. I am quite ignorant about type 1 I'm afraid. But that obviously makes sense and explains why the doctor would have been concerned. There must be others with more experience here who can offer advice.A HbA1C of 39 in a type 1 often raises questions as to whether the good result is achieved by running hypo more than anyone would want. Sounds like @Kerryannhogan (just like me) has a low HbA1C by putting up with a lot of hypos, which hide the nasty spikes & complications.
A HbA1C of 39 in a type 1 often raises questions as to whether the good result is achieved by running hypo more than anyone would want. Sounds like @Kerryannhogan (just like me) has a low HbA1C by putting up with a lot of hypos, which hide the nasty spikes & complications.
I haven't tried low carbing yet @Kerryannhogan , it's something I'm looking into. The low carb bit of the forum has lots of tips about doing it on a budget.
@mentat are you able to give any advice on insulin adjustment when going low carb? If I were to jump in both feet low carbing tomorrow is there anything I should be looking out for, could there be an impact on my ratios or basal rates? I'd be worried that removing all carbs would also remove my (already pretty flimsy) resilience against hypos so any tips would be much appreciated.
Yeah thanks for the heads upHi @Kerryannhogan Do bear in mind that some of the replies here are from Type 2s who may treat their diabetes with diet only.
Hi you have hit the nail on the head I'm having more hypos than anyone could imagine and I have horrible blood sugars after meals too! I think lantus doesn't suit me either but I'm going on a pump so my basal should be corrected soon, as for my meals I hardly eat much but when I do it has healthy carbs.. but just like you I'm considering the diet from the book... let me know how it goes for you !
A pump should help a lotOnce you get your basal right, then you can concentrate on any spikes if you're still having them. I think I suggested having your bolus earlier (sorry if I've got confused and that wasn't you).
For meals, I found it really helps to eat the same thing for a few days, and find a bolus dose that works for that meal, then you can move on and sort the other meals. Doing one segment of the day at a time is good because it can be overwhelming and stressful if your sugars are running mad all the time.
Hi @Kerryannhogan - I've been low carbing for about 2.5 years and found it's the best way to keep HbA1c low whilst avoiding hypos. I did have laser treatment for retinopathy at the end of the 90s but it has been stable ever since - there are no guarantees but it's not necessarily progressive.
They mainly come from vegetables and mostly with my evening meal, otherwise I get a few from berries, yoghurt, cream etc.it does seem that low carbing is the best way, what type of carbs do you eat can I ask?
Heyyeah we spoke before I started bolus insulin 20 mins before and they went fab but then hypo 2 hours after and then the rollercoaster begins haha! hopefully this pump will sort me right out... I know brown basmati rice with nuts in is so good for my blood levels, but they run so low after.. I think my dosages are far to high but I'm on such little doses! I have 5 units with every meal and I still hypo but then cause I overtreat it goes shockingly high
O gosh it sucks doesn't it? I agree with @azure , hopefully a pump will be really helpful (I have my heart set on one too).
Are you carb counting? Cos 5u with every meal sounds like maybe you aren't? I'd be amazed if everymeal had exactly the same amount of carbs in. It is a pain in the bum, but worth doing a bit of weighing so you can be confident you know the carb content of your favourite meals - you might find that you can drop a unit and maybe avoid the hypo later on?
Are there any patterns to your hypos? I find im most at risk of dropping in the morning when I'm most insulin sensitive, so I need to vary my ratios through the day. If you can spot patterns you might be able to figure out some sort of coping mechanism.
If you are going to low carb it might be worth discussing with your DSN. I just mention this because I have read that fast tightening of control can lead to worsening of retinopathy which then goes on to improve with the better control (it's just the sudden change can cause it to get worse before the improvement). So if you already have complications it is worth talking through any big changes with your diabetic team to avoid any sudden shocks.
its usually dinner/tea time i drop a lot but my night time insulin makes me hypo 2 hours after (lantus) and that's maybe 5 hours after my fast acting insulin so i doubt its that...
I can vouch for the stability of Tresiba/Degludec, only 1 injection a day and it lasts around 36 hours, it reduces night time hypos due to its stability, very flat profile. I was on this before I went onto the pump and recommend it.
I have been diagnosed 4 years and have had background retinopathy for the past 2 years, I believe my issues were bought about due to the time I was undiagnosed although I was very poorly for a week and onset very sudden I think I went a long time undetected, I read Bernsteins book and although adopt low carb pretty much 5 days a week I relax a little at weekends and will eat choc, have a glass of wine, but have stabilised my bg levels much more, at one point early on I was yo-ing a lot high and low, low carb has helped hugely, I have only recently had my eye test come back as normal. The book to me was a revelation in self management, and comforting also to be written by a type 1 who is now in his 80's living a complication free life.
Watch out for hidden carbs tho like milk, and protein also converts to sugar so you still need to inject some quick acting to cover it, there isn't necessarily a free lunch with lo carbing
Hi KristinAnother thing I like about Bernstein is to eat the same macros each day at different meal and keep bf VERY low carb.
I take twice the insulin in the morning for my smallest lowest carb meal of the day. I take 1/2 u it at 8. Wait 15 min and eat my avocado and celery
At noon I have 1/3 of my lunch eat the same amount of protein, 2 oz, and some veggies with avocado and at 3 I eat the other 2/3 but with a few more veg. 1/2 u it at each
At 6:30 I eat 3 oz protein, more veg and 2 handfuls salad greens and still 1/2 unit.
I'm very insulin resistant in the morning and far more sensitive as the day goes on.
Bernstaein helped me find my macros to insulin at each meal. I don't eat the same food, just the same macros. Random eating didn't work for me but it does for others. I think pumper will do much better random eating. The fat, fiber, protein and carbs all digest at different speeds and times and I could never match my insulin right so I'd rollercoaster.
Lastly, if I eat more than 3 oz protein at a meal I have to split my bolus and take 1/2 with the meal and 1/2 an hour or so later. So I prefer to spread it out throughout the day rather than have a large portion at once. It's tough when we eat out though. We don't eat out often though
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