# Diagnosed T1 yesterday; high readings



## pawprint91 (Jun 21, 2022)

Hello,

I was diagnosed as a T1 diabetic yesterday afternoon. Had a fair amount of weight loss, thirst, urination etc, that led me to the drs for a blood test. Apparently my hba1c (I think that's right) was 158. Got referred straight to diabetes team by drs yesterday afternoon. After a crash course with blood sugar monitors and injecting, I was sent home with it all. I have woken up feeling a bit overwhemed today with so much to take in and think about. 

I have been started off on background insulin twice a day and told to eat 'normally' for now. Before my first dose last night, my blood sugar was 31  (2 hours after evening meal of 2 chicken salad wraps). I felt okay health wise but was pretty concerned. This morning reading was 15. I have a call today with my diabetes team so hopefully they might be able to help with this. However, struggling to eat 'normally'(obviously knocked things like chocolate etc on the head for now) knowing that my readings are so high! Just wondering if anybody else has experience of this early on in their diagnosis?

Have been lurking on these forums this morning and last night - thank you so much to everyone for showing me how okay it is going to be in the end!


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## Bruce Stephens (Jun 21, 2022)

pawprint91 said:


> I felt okay health wise but was pretty concerned.


It's safer (short term) to be somewhat high than low, and there are apparently separate risks (separate from the risk of going too low) from lowering blood glucose too quickly. And 15 in the morning isn't too bad.


pawprint91 said:


> obviously knocked things like chocolate etc on the head for now


Well, skip the Mars bars and things, sure, but if you like chocolate there's no reason you can't have small quantities without worrying too much.


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## pawprint91 (Jun 21, 2022)

Bruce Stephens said:


> It's safer (short term) to be somewhat high than low, and there are apparently separate risks (separate from the risk of going too low) from lowering blood glucose too quickly. And 15 in the morning isn't too bad.
> 
> Well, skip the Mars bars and things, sure, but if you like chocolate there's no reason you can't have small quantities without worrying too much.


This is reassuring - thank you. Particularly with knowing that 15 is actually not awful!


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## Bruce Stephens (Jun 21, 2022)

pawprint91 said:


> Particularly with knowing that 15 is actually not awful!


As you've probably gathered, the goal is to stay 4-10 most of the time, but I'm sure many of us get to 15 now and again (but briefly, we hope). I did yesterday just before eating my evening meal. (Actually it looks like that happens quite often so I'll need to try and address that.)


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## pawprint91 (Jun 21, 2022)

Bruce Stephens said:


> As you've probably gathered, the goal is to stay 4-10 most of the time, but I'm sure many of us get to 15 now and again (but briefly, we hope). I did yesterday just before eating my evening meal. (Actually it looks like that happens quite often so I'll need to try and address that.)


I think I am so concerned as 15 is my lowest reading - but this time yesterday I hadn't had an official diagnosis (!) so need to keep reminding myself there is no quick 'fix' and the background insulin needs sometime to start working in my system etc.


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## Rob Oldfield (Jun 21, 2022)

pawprint91 said:


> I think I am so concerned as 15 is my lowest reading - but this time yesterday I hadn't had an official diagnosis (!) so need to keep reminding myself there is no quick 'fix' and the background insulin needs sometime to start working in my system etc.


You're quite right.  It'll take a bit of time to get your levels down and, as Bruce said, they won't want to lower them too quickly.  Over time things will calm down but ALL of us have periods where our levels just refuse to play nicely.  It's one of the things about diabetes that, sadly, we just need to get along with.  I'd be interested to hear how your meeting with the diabetes team goes later.  Is that the team from your GPs?


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## pawprint91 (Jun 21, 2022)

Rob Oldfield said:


> You're quite right.  It'll take a bit of time to get your levels down and, as Bruce said, they won't want to lower them too quickly.  Over time things will calm down but ALL of us have periods where our levels just refuse to play nicely.  It's one of the things about diabetes that, sadly, we just need to get along with.  I'd be interested to hear how your meeting with the diabetes team goes later.  Is that the team from your GPs?


Thank you. From what they said in the initial consultation type phone call, I suspect novorapid might be coming into play quicker than expected. It's the team from the hospital - I shall report back!


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## trophywench (Jun 21, 2022)

Hiya - welcome to the Club no-one ever wanted to join!

Background insulin twice a day - sounds like Levemir to me - is it?  Those of us that are fans of it (I'm one) have always said it's brill cos you can see what it's doing for you pdq (I reckon, within 12 ish hours)  However - it takes a couple of days to see fully what it does - I mean it's OK dropping by 16 when you start at 31 - but you wouldn't exactly want it to do that when you start at 15 !!!     now, would you?    

It won't though - it'll even itself out and you'll gradually see what happens ..... so no panic right at the moment please.

Plus at the mo it's more than likely your own insulin hasn't completely ceased and it does usually take time for all of it to grind to a halt.  Trouble is nobody can say what it will do or when it will decide to do it, just yet.

My first jab I felt like my whole body was just waking up, most peculiar.

Anyway - gradually you'll get yourself sorted out and be able to resume life as you previously knew it properly, so good luck and keep us posted please.


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## pawprint91 (Jun 21, 2022)

trophywench said:


> Hiya - welcome to the Club no-one ever wanted to join!
> 
> Background insulin twice a day - sounds like Levemir to me - is it?  Those of us that are fans of it (I'm one) have always said it's brill cos you can see what it's doing for you pdq (I reckon, within 12 ish hours)  However - it takes a couple of days to see fully what it does - I mean it's OK dropping by 16 when you start at 31 - but you wouldn't exactly want it to do that when you start at 15 !!!     now, would you?
> 
> ...


Thank you for your lovely and reassuring message. Yes it is Levemir! My pre-lunch reading was only (!) 17, which after a breakfast and a snack for elevenses I was really happy with for now. Taking it one blood sugar reading/injection at a time right now!


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## trophywench (Jun 21, 2022)

You could spend some money on yourself and invest in a really good book about Type 1 Diabetes - despite the actual title, it's very informative and helpful for T1 people of all ages - I hardly fall into the categories in the title (being a great grandma but not quite as old as the Queen!) and is often used by the personnel at 'my' hospital D clinic to help explain things to all & sundry!






						Type 1 Diabetes in Children, Adolescents and Young Adults Seventh Edition: Amazon.co.uk: Ragnar Hanas: 9781859597989: Books
					

Buy Type 1 Diabetes in Children, Adolescents and Young Adults Seventh Edition Seventh by Ragnar Hanas (ISBN: 9781859597989) from Amazon's Book Store. Everyday low prices and free delivery on eligible orders.



					www.amazon.co.uk
				




Don't be tempted by apparently cheaper books which are older versions than the 7th edition, since there's no point in relying on out of date advice.

There's also 'Think Like a Pancreas' by Gary Scheiner (which has also been revised since I bought mine!)

Both written in English (USA English for the Gary one) rather than Medicalese.


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## pawprint91 (Jun 21, 2022)

Thank you, I will certainly have a look into those.


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## Inka (Jun 21, 2022)

pawprint91 said:


> Thank you. From what they said in the initial consultation type phone call, I suspect novorapid might be coming into play quicker than expected. It's the team from the hospital - I shall report back!



That’s good news! The Novorapid will help enormously. I was started on both insulins as soon as I was taken off the drip in hospital. Type 1s need a background insulin and also a bolus/fast/meal insulin. Once you’re sorted, you’ll be able to eat a pretty normal diet within reason. The main thing is you’ll now have to think lots more whereas before you could eat and not really think.

Pace yourself. It takes a while to get used to, but it will gradually get easier.


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## pawprint91 (Jun 22, 2022)

trophywench said:


> My first jab I felt like my whole body was just waking up, most peculiar.


I don't know whether it is pyschological or not, but last night and this morning I have almost felt born again? Feel more 'me' and happier than I have done in months! Not sure if it's due to feeling more positive following my conversation with the nurse or because my body finally has the insulin it needs (or because the sun is out) or a mix of all 3, but I genuinely feel so much better (and I didn't have to get up to pee in the night for the first time in ages!! Sorry if this is TMI ).


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## pawprint91 (Jun 22, 2022)

Good morning everyone!

Feeling so much happier today. Evening reading was 22 as opposed to 31, and morning reading was 11. Had a really positive conversation with my diabetic nurse yesterday afternoon. She's not starting me on novorapid immediately, but has increased my basal insulin from 8 to 9 am and pm. She has told me to begin to learn to 'carb count' - but just to get a feel to see what my blood sugar does when I eat certain foods, don't need to inject Novorapid just yet unless blood sugar remains high. She has told me to be sensible, but eat fairly normally, which is positive to hear. She has said if my blood sugar is still getting readings consistently over 14 to begin using 2 units of novorapid before meals from the weekend, and the following week if it is consistently over 12 to increase that to 3 units. (She's given me 2 weeks worth of advice as she's on holiday next week). Only thing I have a query about with this that you may be able to help me with is should I be increasing how often I check my blood sugar as I begin to record how the different carbs affect me? I was originally told to check it 4 times a day before meals - will I see a difference in blood sugar by lunch that relates to what I ate for breakfast as well as if I have a mid morning snack?

Thank you to everybody who replied yesterday, as I have said in my reply to @trophywench above - I feel like a new person today! Whether that's because I can now see a way forward and yesterday I just felt a bit scared and confused (don't get me wrong, that feeling has not completely gone away!), or because my body finally has the insulin it's been looking for for the past few months, I don't know. But I am feeling more positive today!


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## Rob Oldfield (Jun 22, 2022)

pawprint91 said:


> I don't know whether it is pyschological or not, but last night and this morning I have almost felt born again? Feel more 'me' and happier than I have done in months! Not sure if it's due to feeling more positive following my conversation with the nurse or because my body finally has the insulin it needs (or because the sun is out) or a mix of all 3, but I genuinely feel so much better (and I didn't have to get up to pee in the night for the first time in ages!! Sorry if this is TMI ).


Excellent news!  Glad to see it's been so positive for you.  I remember before I was diagnosed I also didn't get a full night's sleep for months and the weariness just kind of crept up.  Dozing off in the office was one of the things that led me to the Dr and diagnosis many years ago.


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## Rob Oldfield (Jun 22, 2022)

pawprint91 said:


> Good morning everyone!
> 
> Feeling so much happier today. Evening reading was 22 as opposed to 31, and morning reading was 11. Had a really positive conversation with my diabetic nurse yesterday afternoon. She's not starting me on novorapid immediately, but has increased my basal insulin from 8 to 9 am and pm. She has told me to begin to learn to 'carb count' - but just to get a feel to see what my blood sugar does when I eat certain foods, don't need to inject Novorapid just yet unless blood sugar remains high. She has told me to be sensible, but eat fairly normally, which is positive to hear. She has said if my blood sugar is still getting readings consistently over 14 to begin using 2 units of novorapid before meals from the weekend, and the following week if it is consistently over 12 to increase that to 3 units. (She's given me 2 weeks worth of advice as she's on holiday next week). Only thing I have a query about with this that you may be able to help me with is should I be increasing how often I check my blood sugar as I begin to record how the different carbs affect me? I was originally told to check it 4 times a day before meals - will I see a difference in blood sugar by lunch that relates to what I ate for breakfast as well as if I have a mid morning snack?
> 
> Thank you to everybody who replied yesterday, as I have said in my reply to @trophywench above - I feel like a new person today! Whether that's because I can now see a way forward and yesterday I just felt a bit scared and confused (don't get me wrong, that feeling has not completely gone away!), or because my body finally has the insulin it's been looking for for the past few months, I don't know. But I am feeling more positive today!


On post meal testing I believe the standard advice is to test two hours later.  There are exceptions but that, as a generality, should have given both the carb in the meal and any Novorapid taken time to take effect.  Note that the time to kick in differs for different insulins but Novorapid is supposed to start having an effect after 10 or 20 minutes.

Has any more organised training on how to carb count been mentioned?  Many places run schemes such as DAFNE (dose adjustment for normal eating).

Other questions are whether you're going to be put on the lists to be given an insulin pump and any form of continuous glucose monitoring?  Both of those are where T1 technology is heading.


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## pawprint91 (Jun 22, 2022)

Rob Oldfield said:


> On post meal testing I believe the standard advice is to test two hours later.  There are exceptions but that, as a generality, should have given both the carb in the meal and any Novorapid taken time to take effect.  Note that the time to kick in differs for different insulins but Novorapid is supposed to start having an effect after 10 or 20 minutes.
> 
> Has any more organised training on how to carb count been mentioned?  Many places run schemes such as DAFNE (dose adjustment for normal eating).
> 
> Other questions are whether you're going to be put on the lists to be given an insulin pump and any form of continuous glucose monitoring?  Both of those are where T1 technology is heading.


Thank you for the advice 

Nurse told me to download a few apps and use these to begin to learn/recognise carbs that are in the foods I would normally eat at home - only had a look this morning but bloody hell, I can't believe how many carbs are in some things. Obviously you wouldn't be going mad with eating carbs, but is there a limit a diabetic can have in a day? However, no novorapid in relation to this yet, only 2/3 units if readings remain high. I didn't write this part down, but I'm sure she said in the end when I'm confidnt with carb counting etc 1 unit of insulin (novorapid) is needed for every 10g of carbs? Have I made this up? I wouldn't be surprised if it differs from person to person. She has also booked me on a course at the hospital in August, I didn't catch the name but it could well be the one you have mentioned!

No mention of an insulin pump yet, but she did say I would be able to get a Freestyle Libre device - she said due to me being a teacher it will be invaluable to me in terms of checking blood sugars etc and not stressing when teaching.


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## Robin (Jun 22, 2022)

pawprint91 said:


> Thank you for the advice
> 
> Nurse told me to download a few apps and use these to begin to learn/recognise carbs that are in the foods I would normally eat at home - only had a look this morning but bloody hell, I can't believe how many carbs are in some things. Obviously you wouldn't be going mad with eating carbs, but is there a limit a diabetic can have in a day? However, no novorapid in relation to this yet, only 2/3 units if readings remain high. I didn't write this part down, but I'm sure she said in the end when I'm confidnt with carb counting etc 1 unit of insulin (novorapid) is needed for every 10g of carbs? Have I made this up? I wouldn't be surprised if it differs from person to person. She has also booked me on a course at the hospital in August, I didn't catch the name but it could well be the one you have mentioned!
> 
> No mention of an insulin pump yet, but she did say I would be able to get a Freestyle Libre device - she said due to me being a teacher it will be invaluable to me in terms of checking blood sugars etc and not stressing when teaching.


There’s no limit to the number of carbs you can have, once you’re matching your insulin doses. However, many of us find it's easier to have a well balanced meal, with a mix of fats and proteins with the carb, because it best matches the action of the insulin.
A ratio of 1 unit insulin to 10 carbs is what most people are started off with, and it’s a good starting place. Mine is basically that, but I need more at breakfast, some people find they need different ratios at different times of day, depending when they exercise etc. You’ll find out what suits you once you get going.
Hopefully you’ll get a Libre fairly soon, it’s certainly been a game changer for me. Most people have to wait to be considered for a pump. If you’re doing well with injections, you won’t be offered one, as they are a scarce resource and are given to people most in need if they are struggling to maintain levels with injections. Also, a pump or any of its component parts, (like the cannula that inserts under the skin) can fail, and you need to have injecting down to an automatic process and know what you’re doing, in case you have to revert back to it in a crisis.


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## trophywench (Jun 22, 2022)

Testing before each meal is the first step, assuming you have 3 meals a day, with 5 'ish' hours between those meals.

The '2hrs after' mantra for Type 2 diabetes not using insulin does NOT apply to you and me.  It is not 200% essential to avoid post meal rises because fast acting insulin does not 'just stop' working after 2 hours - in fact by now in my relationship with it (24 years) it's 'ramping up' for the first 45mins-1 hour then consistently effective for the next 2 hours, then slides downwards fairly gradually for the next hour -ish.  I reckon approx 4.5 hrs in total.  It kicks in pdq for me so if I was out for a meal and jabbed it all in before my starter, which deliberately wasn't carby, say prawn cocktail, because I had ordered fish and chips for my main which was carby (ie the batter and the spuds) - I'd be hypo before my main arrived and have to start drinking someone's fullfat coke .....   DO be careful!

And for 20 -odd years people on forums have been saying 'Novo-not so-rapid'  to me.  (Well how bloomin quick do you want it?     )   I'm not going to guess how quick it will kick in for you - just saying, is all!

To begin with, you're trying to get your basal insulin dose as near 'right' as you can.  Please do start studying the carb content of whatever you eat as soon as possible, cos it's something we all absolutely do have to do.  Start getting used to what X amount of Y food, looks like in your real life - aaah, so if I use one of these dishes to have my breakfast cereal in, and put up to this line of cornflakes, then add milk up to that line, It will be Z grams of carb.  If I use this serving spoon for mash, 2 spoons of it will be ~grams.

It's OK saying 'an egg sized spud = 10g' but as I commented in 1972, they haven't told me though, who laid that egg - a wren, a hen or an ostrich?   Aaaarrgghh.

You'll get there!


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## pawprint91 (Jun 22, 2022)

Robin said:


> There’s no limit to the number of carbs you can have, once you’re matching your insulin doses. However, many of us find it's easier to have a well balanced meal, with a mix of fats and proteins with the carb, because it best matches the action of the insulin.
> A ratio of 1 unit insulin to 10 carbs is what most people are started off with, and it’s a good starting place. Mine is basically that, but I need more at breakfast, some people find they need different ratios at different times of day, depending when they exercise etc. You’ll find out what suits you once you get going.
> Hopefully you’ll get a Libre fairly soon, it’s certainly been a game changer for me. Most people have to wait to be considered for a pump. If you’re doing well with injections, you won’t be offered one, as they are a scarce resource and are given to people most in need if they are struggling to maintain levels with injections. Also, a pump or any of its component parts, (like the cannula that inserts under the skin) can fail, and you need to have injecting down to an automatic process and know what you’re doing, in case you have to revert back to it in a crisis.


 Thank you. I'm not sure how I feel about insulin pumps; I think I'd be happier sticking to injections to be honest! Sorry if this is a silly question, but does it hurt to put your libre on, and does it ever get knocked about?


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## pawprint91 (Jun 22, 2022)

trophywench said:


> Testing before each meal is the first step, assuming you have 3 meals a day, with 5 'ish' hours between those meals.
> 
> The '2hrs after' mantra for Type 2 diabetes not using insulin does NOT apply to you and me.  It is not 200% essential to avoid post meal rises because fast acting insulin does not 'just stop' working after 2 hours - in fact by now in my relationship with it (24 years) it's 'ramping up' for the first 45mins-1 hour then consistently effective for the next 2 hours, then slides downwards fairly gradually for the next hour -ish.  I reckon approx 4.5 hrs in total.  It kicks in pdq for me so if I was out for a meal and jabbed it all in before my starter, which deliberately wasn't carby, say prawn cocktail, because I had ordered fish and chips for my main which was carby (ie the batter and the spuds) - I'd be hypo before my main arrived and have to start drinking someone's fullfat coke .....   DO be careful!
> 
> ...


 I have a bigger gap between lunch and dinner (probably more like 7 hours - but with snacks!) - would it be worth doing an extra afternoon test?

I'm keen to start learning the carbs, I want to be really good at it  but I know it is a long journey.

Eating out is one of my biggest questions I think - it's something I really enjoy doing. How truly feasible is it? Do you have to split up your novorapid injections throughout your meal? Sorry if this is a silly question, just desperate from advice from anyone, and someone as experienced as yourself with managing type 1 is a source of great knowledge and hope for me!


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## trophywench (Jun 22, 2022)

It depends on both your hospital (ie the keenness of the consultants and nurses to get people on pumps) and also the CCG (who don't all like spending their money by any means!) as to whether or when a pump is on the cards.  Your first task in every case is to try and find out what your body does in most situations.  As we don't come across the entire gamut of likely situations very quickly - it takes time!

Right now - the one you're in is a 'one off' - since you will never ever again in your entire life, be newly diagnosed!    

Take your time.


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## Rob Oldfield (Jun 22, 2022)

pawprint91 said:


> Thank you. I'm not sure how I feel about insulin pumps; I think I'd be happier sticking to injections to be honest! Sorry if this is a silly question, but does it hurt to put your libre on, and does it ever get knocked about?


No silly questions here.  For me - a tiny impact when putting it on - not even worth saying 'ouch' for, and they can get knocked but it's rare. Think I've lost one from knocking against a door frame in about four years of use.


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## Robin (Jun 22, 2022)

pawprint91 said:


> Thank you. I'm not sure how I feel about insulin pumps; I think I'd be happier sticking to injections to be honest! Sorry if this is a silly question, but does it hurt to put your libre on, and does it ever get knocked about?


No, it doesn’t hurt, I’d say it feels like someone brushed past you in a tight space, more of a tap than a scratch. People do lose their Libres by knocking them on door frames etc, and one of mine once just worked loose towards the end of the two weeks. I overtape it with a bit of micropore tape for the first couple of days, some people use tegaderm and you can buy specially designed straps from places like Amazon and Etsy. Other folk find they cling like a limpet with no problem, it probably depends what sort of skin you’ve got!


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## trophywench (Jun 22, 2022)

Yep - what they both said about the Libre the bathroom door in our motorhome is a sod for it.  A right mixture of being narrower than a house door, on an angle, and not being made out of anything very substantial paired with an old mare who leaves it too late to walk calmly into the bathroom and take a comfortable seat before she has an accident!  Why? - because I'm far too busy interfering in other people's lives, obviously!

_Edit_
Oh, I meant to say 'chatting with mates' .......


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## trophywench (Jun 22, 2022)

Oh, and I defo don't jab for dessert before my main.  How would I know beforehand whether I might fancy sticky toffee pudding and custard or  creme brulee when I haven't even yet seen someone else's one being waitered past our table?   Even if it's a fixed meal - don't jab before the plate's in front of you - you never know what might be on the plate - you well overestimate the size, the thickness of the pastry/batter, the size of the Yorkshire or whatever .......


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## Bruce Stephens (Jun 22, 2022)

pawprint91 said:


> Sorry if this is a silly question, but does it hurt to put your libre on, and does it ever get knocked about?


I think I disagree slightly with other comments, and yes, it can hurt a little when you apply it. Not much, and sometimes I barely feel it at all. And (obviously) I consider it worthwhile (I've been using them for a few years now).

It's certainly possible to knock the thing. It's held by glue, in my experience quite securely (but some people seem to have skin that it doesn't stick to quite so strongly), but it's certainly possible to knock the thing off if you're not reasonably careful.


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## Rob Oldfield (Jun 22, 2022)

pawprint91 said:


> I have a bigger gap between lunch and dinner (probably more like 7 hours - but with snacks!) - would it be worth doing an extra afternoon test?
> 
> I'm keen to start learning the carbs, I want to be really good at it  but I know it is a long journey.
> 
> Eating out is one of my biggest questions I think - it's something I really enjoy doing. How truly feasible is it? Do you have to split up your novorapid injections throughout your meal? Sorry if this is a silly question, just desperate from advice from anyone, and someone as experienced as yourself with managing type 1 is a source of great knowledge and hope for me!



On the eating out question, it's definitely feasible.  Some of the apps will give an estimate of the amount of carb in a particular meal.  Obviously the exact number will be dependent on ingredients used and the amount on the plate - which you've got control of if you're cooking at home but not if eating out.  You also will - over time - just develop an eye for it and be able to estimate carb on the fly.  It's also one of the situations where a Libre/Pump combo really kicks in - for example post meal you grab a reading from the Libre and see that your level has gone through the roof (because you underestimated the carb in that sticky toffee pudding?), and the pump then allows you to give a correction dose with a couple of button presses.


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## trophywench (Jun 22, 2022)

@Rob Oldfield - Not unusual for me to do that whatever - I always omit to remember they'll have put sugar in the custard and i no longer enjoy it.  Wish I'd asked for a dollop of vanilla ice cream with it now ......


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## Bruce Stephens (Jun 22, 2022)

pawprint91 said:


> Eating out is one of my biggest questions I think - it's something I really enjoy doing. How truly feasible is it?


Very.


pawprint91 said:


> Do you have to split up your novorapid injections throughout your meal?


Not usually. Novorapid has its peak a bit less than an hour after injection (I think) and is active over about 4 hours or so. Usually that's fine, so you can just inject once (when the food's actually started arriving). If you have a long meal (like a tasting menu, for example) maybe you'd inject twice. Some foods (like pizza) can be awkward and can take a long time to digest, and in those cases maybe split the dose (so have part of it a couple of hours after eating).

Or just accept that eating out isn't that common, so make a best effort with a single injection and don't worry too much about a spike afterwards. Control is much more a long term thing rather that something we're going to get right all of the time. Sometimes it's worth just enjoying the food and occasion.


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## pawprint91 (Jun 22, 2022)

Bruce Stephens said:


> Not usually. Novorapid has its peak a bit less than an hour after injection (I think) and is active over about 4 hours or so. Usually that's fine, so you can just inject once (when the food's actually started arriving). If you have a long meal (like a tasting menu, for example) maybe you'd inject twice. Some foods (like pizza) can be awkward and can take a long time to digest, and in those cases maybe split the dose (so have part of it a couple of hours after eating).


 Would you just pop to the loo to give yourself your injection? Sorry if this is a private question, just thinking about the practicalities of it all! (I wouldn't imagine we're going to start derobing at the table to get the needle in ).

Thank you so much everyone for all your answers and help!


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## Bruce Stephens (Jun 22, 2022)

pawprint91 said:


> I wouldn't imagine we're going to start derobing at the table to get the needle in


I inject into my arm or stomach at the table. Female clothing might make injecting into the stomach awkward, I agree, but commonly there's some suitable part of the body exposed that you can use.


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## Bruce Stephens (Jun 22, 2022)

Bruce Stephens said:


> I inject into my arm or stomach at the table.


And if I need to roll up a sleeve, I'll just do that.


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## pawprint91 (Jun 22, 2022)

Bruce Stephens said:


> I inject into my arm or stomach at the table. Female clothing might make injecting into the stomach awkward, I agree, but commonly there's some suitable part of the body exposed that you can use.


Do you ever feel self conscious doing so? It is crazy for me to think I must have been in a restaurant where people have done this and I just wouldn't have noticed/been aware so possibly not obvious.


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## Rob Oldfield (Jun 22, 2022)

pawprint91 said:


> Do you ever feel self conscious doing so? It is crazy for me to think I must have been in a restaurant where people have done this and I just wouldn't have noticed/been aware so possibly not obvious.


No.  I tended to do it though trousers and into thigh (and thus below table level).  Chance of anyone non diabetic really noticing what's going on is really pretty much zero.  (Edit.... And if they do, then really there's nothing there for anyone to get upset about.)


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## Bruce Stephens (Jun 22, 2022)

pawprint91 said:


> Do you ever feel self conscious doing so? It is crazy for me to think I must have been in a restaurant where people have done this and I just wouldn't have noticed/been aware so possibly not obvious.


It doesn't really take enough time to be self conscious. It's 15 seconds or so, so I just do it, as though I've done it thousands of times before and it's completely routine and normal. Remember that ignoring such things is the normal British thing to do, and almost everyone will, if they notice at all.


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## pawprint91 (Jun 22, 2022)

Bruce Stephens said:


> It doesn't really take enough time to be self conscious. It's 15 seconds or so, so I just do it, as though I've done it thousands of times before and it's completely routine and normal. Remember that ignoring such things is the normal British thing to do, and almost everyone will, if they notice at all.


I can currently count on 1 hand the number of injections I have given myself, so I think I need to remember how routine for me it will become - thank you!


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## everydayupsanddowns (Jun 24, 2022)

pawprint91 said:


> I can currently count on 1 hand the number of injections I have given myself, so I think I need to remember how routine for me it will become - thank you!



Injecting at a table is easy, especially if you’re wearing something that allows access to midriff. In the beginning you might want to position yourself with your back to the majority of diners… but as others have said it is all over and done so quickly, often below table level, and the equipment is discreet enough that in all my 30 years the one person who has ever actually noticed me jabbing at a table waved their blood glucose meter at me across the room 

The trickier ones I felt were crouched down by the side of the pavement… but yes, I’ve done that too 

Enjoy your meals out! It won’t be long before you can fairly accurately eyeball the carbs on a plate of food from 50 yards


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## pawprint91 (Jun 25, 2022)

everydayupsanddowns said:


> Enjoy your meals out! It won’t be long before you can fairly accurately eyeball the carbs on a plate of food from 50 yards


Thank you! That day feels a long way off, but today is only day 4 of learning to carb count, so ... small steps!


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## Zoombie (Jun 25, 2022)

I find the Carbs and Cals app helpful. I’m on a pump now but when I was on mdi I used to inject into my thigh when eating out.


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## Windy (Jun 25, 2022)

everydayupsanddowns said:


> one person who has ever actually noticed me jabbing at a table waved their blood glucose meter at me across the room


Is this like the secret handshake that the Masons have, but for T1s?

I've only noticed once that someone was injecting their insulin, and that was at work when I was talking to her. She was chatting away, then hoiked up her t shirt a bit, jabbed her stomach, and kept talking. I said "Diabetes?" and she laughed and I said I was T2, and that was about it. I wouldn't bat an eyelid if someone injected in a restaurant, and probably wouldn't even notice tbh.

@pawprint91 - I've got a copy of Pocket Carbs and Cals that I bought and haven't really used.
I can send you if you PM me your address. Not offended if you don't want it, or if you don't want to send your address. It always pays to be cautious online. I don't want any money for it, it's going to the charity shop otherwise, or back on the bookshelf to gather dust! @everydayupsanddowns - please let me know if this isn't allowed (I mean the offer of the book rather than dusty bookshelves)


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## pawprint91 (Jun 25, 2022)

Windy said:


> Is this like the secret handshake that the Masons have, but for T1s?
> 
> I've only noticed once that someone was injecting their insulin, and that was at work when I was talking to her. She was chatting away, then hoiked up her t shirt a bit, jabbed her stomach, and kept talking. I said "Diabetes?" and she laughed and I said I was T2, and that was about it. I wouldn't bat an eyelid if someone injected in a restaurant, and probably wouldn't even notice tbh.
> 
> ...


That's so kind of you! I have the app (paid for version), so not sure if I would need the book too?


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## Windy (Jun 25, 2022)

pawprint91 said:


> That's so kind of you! I have the app (paid for version), so not sure if I would need the book too?


If you've got the app, you shouldn't need the book too, and the app's easier to carry!  Sarah


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## pawprint91 (Jun 25, 2022)

Can anybody offer any further advice on my readings? (Diabetes helpine not open at the weekend!!)

Basically, today and yesterday, my readings have gone right down before meals (in the 6-8 range). Whilst this is surely positive, I'm only on basal insulin at the moment - would you say this is normal? This is my 5th day on basal insulin. I guess my body could still be producing some of it's own insulin too, which I guess might be helping. My only high (teen numbers) reading has been before bed, and that is because I am probably only doing it 2-3 hours after eating, the others are all before a meal when it has been at least 5 hours after a main meal (with maybe only one snack). I'm just a bit confused as to when I would end up needing novorapid if these are my readings without it. I know we're all different but just wondering if anybody could offer any insight!


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## Bruce Stephens (Jun 25, 2022)

pawprint91 said:


> I guess my body could still be producing some of it's own insulin too, which I guess might be helping.


That would be my guess. An alternative might be that your basal dose is too high (ideally with the right basal dose we stay close to level).


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## pawprint91 (Jun 25, 2022)

Bruce Stephens said:


> An alternative might be that your basal dose is too high (ideally with the right basal dose we stay close to level).


As a total newbie, this would be my guess, too. Don't feel comfortable adjusting my own doses 5 days in, guessing I should be okay for the rest of today and tomorrow before I can call a nurse on Monday. (Hoping so, anyway!)


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## Lucyr (Jun 25, 2022)

If your readings are normal, just enjoy it whilst it lasts! Keep testing to keep an eye on your levels though


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## Mrs Mimoo (Jun 25, 2022)

pawprint91 said:


> Thank you for the advice
> 
> Nurse told me to download a few apps and use these to begin to learn/recognise carbs that are in the foods I would normally eat at home - only had a look this morning but bloody hell, I can't believe how many carbs are in some things. Obviously you wouldn't be going mad with eating carbs, but is there a limit a diabetic can have in a day? However, no novorapid in relation to this yet, only 2/3 units if readings remain high. I didn't write this part down, but I'm sure she said in the end when I'm confidnt with carb counting etc 1 unit of insulin (novorapid) is needed for every 10g of carbs? Have I made this up? I wouldn't be surprised if it differs from person to person. She has also booked me on a course at the hospital in August, I didn't catch the name but it could well be the one you have mentioned!
> 
> No mention of an insulin pump yet, but she did say I would be able to get a Freestyle Libre device - she said due to me being a teacher it will be invaluable to me in terms of checking blood sugars etc and not stressing when teaching.


there are many apps but I like the free myfitnesspal although it has annoying ads which I ignore


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## Mrs Mimoo (Jun 25, 2022)

Windy said:


> If you've got the app, you shouldn't need the book too, and the app's easier to carry!  Sarah


Hi Windy which app to you recommned for carbs and cals?


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## Windy (Jun 25, 2022)

Mrs Mimoo said:


> Hi Windy which app to you recommned for carbs and cals?


Hi Mrs Mimoo, I'm afraid I'm a bit of a luddite and don't use an app at all, unless you count Libreoffice Calc, which is an open source version of excel where I've set up a spreadsheet and have googled each food item one by one, or scoured the back of the food packet for the nutrition information and recorded it on the spreadsheet.


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## Lucyr (Jun 25, 2022)

I find nutracheck the best, app only with annual payment is cheapest. Myfitnesspal is free but more American whereas nutracheck is uk based. You can do a free trial to try it.


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## Inka (Jun 25, 2022)

pawprint91 said:


> As a total newbie, this would be my guess, too. Don't feel comfortable adjusting my own doses 5 days in, guessing I should be okay for the rest of today and tomorrow before I can call a nurse on Monday. (Hoping so, anyway!)



A good guess INO. This is why I think it’s daft to give a Type 1 only basal insulin. You either get ok blood sugar but spike too high when you eat, or youre given too much basal because it’s having to cover your food due to lack of bolus/fast insulin. It’s better to have a small amount of basal plus small amounts of bolus rather than just basal alone. They have different jobs.


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## Rob Oldfield (Jun 26, 2022)

Windy said:


> Hi Mrs Mimoo, I'm afraid I'm a bit of a luddite and don't use an app at all, unless you count Libreoffice Calc, which is an open source version of excel where I've set up a spreadsheet and have googled each food item one by one, or scoured the back of the food packet for the nutrition information and recorded it on the spreadsheet.


That's exactly what I've done!


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## everydayupsanddowns (Jun 26, 2022)

Windy said:


> Is this like the secret handshake that the Masons have, but for T1s?



Haha! Exactly that


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## pawprint91 (Jun 26, 2022)

Inka said:


> A good guess INO. This is why I think it’s daft to give a Type 1 only basal insulin. You either get ok blood sugar but spike too high when you eat, or youre given too much basal because it’s having to cover your food due to lack of bolus/fast insulin. It’s better to have a small amount of basal plus small amounts of bolus rather than just basal alone. They have different jobs.


Hopefully I'll be evened out somehow soon!


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## pawprint91 (Jun 27, 2022)

Hello all,

A week in, and I am feeling overall positive, but still overwhelmed and with a different question every day ... so I'm now just treating this thread as my newbie question thread, thank you so much to everyone who's helped me already on my new journey over this past week! 

Today's question ... should injectoins 'hurt', or does this mean I've done it wrong? The first few times I honestly didn't feel a thing, but the past coupke of nights it has stung a little when I've put the needle in and then been a bit tender for a while afterwards. I'm wondering why this is. I can only inject into my thigh at the moment due to weightloss pre-diagnosis. Does it mean I'm hitting a muscle or something and therefore making a mistake, or have I just got a bit more confident and started jabbing harder? As ever, any advice greatly appreciated!


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## everydayupsanddowns (Jun 27, 2022)

pawprint91 said:


> Today's question ... should injectoins 'hurt', or does this mean I've done it wrong? The first few times I honestly didn't feel a thing, but the past coupke of nights it has stung a little when I've put the needle in and then been a bit tender for a while afterwards. I'm wondering why this is. I can only inject into my thigh at the moment due to weightloss pre-diagnosis. Does it mean I'm hitting a muscle or something and therefore making a mistake, or have I just got a bit more confident and started jabbing harder? As ever, any advice greatly appreciated!



Over the years I think I got used to various different levels of sensation from injections. Some barely noticeable, and others really quite sore!

Quite a lot of it (rightly or wrongly!) I used to put down to different points on the skin - eg if I just happened to put the needle right on a hair follicle, or it nicked through a nerve or capillary I figured there would be more for my body to complain about? I have read some forum members suggesting that they gently touch the needle on the skin in a couple of places and choose the one where they feel it less.

Some areas or zones did seem to have thinner coverage than others. What needle length are you using? I used to use 8mm back in the day, but I think 4mm are more common these days, which should be easier to avoid muscle layers even where areas are quite lean?

So e needles also just seemed worse than others. I was a naughty re-user of needles, and could certainly tell the difference between 2 supposedly identical ones. But no good after a coulple of goes when blunt either! (and you really shouldn’t reuse them etc etc).

Your suggestion about increased confidence is a good one too!


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## pawprint91 (Jun 27, 2022)

everydayupsanddowns said:


> Some areas or zones did seem to have thinner coverage than others. What needle length are you using? I used to use 8mm back in the day, but I think 4mm are more common these days, which should be easier to avoid muscle layers even where areas are quite lean?
> 
> So e needles also just seemed worse than others. I was a naughty re-user of needles, and could certainly tell the difference between 2 supposedly identical ones. But no good after a coulple of goes when blunt either! (and you really shouldn’t reuse them etc etc).
> 
> Your suggestion about increased confidence is a good one too!


Thank you for your reply  I am indeed using 4mm needles. Is it normal to bruise? Have just noticed my thighs are covered in them 

Also, whuch angle should you/were you taught to inject at? The nurse I saw on the day of my diagnosis told me a 45 degree angle, but the tutorial on the diabetes uk website says a 90 degree one. (My dad is a retired nurse, and he also says 90 degrees), what are your thoughts? Edit: I've just googled this, I think she told me 45 degrees because of my weightloss issue!


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## Inka (Jun 27, 2022)

@pawprint91 I get lots of bruises when I inject. I think some people just do. I’ve had Type 1 almost 30 years and I inject carefully, but I still get bruises. It’s possibly to do with people’s build as well. 

If I hit a painful spot, I don’t inject there, I move on. Some places do seem ultra-sensitive. Usually moving a few millimetres sorts it. And yes, I inject at 90 degrees and usually pinch up.


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## everydayupsanddowns (Jun 27, 2022)

I’m not sure there’s enough length on a 4mm to go in at an angle?!


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## Bruce Stephens (Jun 27, 2022)

everydayupsanddowns said:


> I’m not sure there’s enough length on a 4mm to go in at an angle?!


Which might increase the chances of bruises, I guess (if the insulin is going only just under the skin, I could imagine that causing more irritation and inflammation).


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## iharding (Jun 28, 2022)

@pawprint91 if you touch the skin gently with the needle tip you can often tell if there's a nerve under the surface which is going to hurt if you break the skin. 
As for injection sites, we're all different. Anywhere around my abdomen stings when the needle goes in, stays sore afterwards, and usually results in a bruise. Arms can also be painful. As a result, I nearly always inject into legs.


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## rebrascora (Jun 28, 2022)

There are areas of my abdomen which are really no bother at all and I don't feel a thing and other areas which are really sensitive. Just above my belly button is one of the nice numb spots but of course the temptation is to use those areas more which isn't good, so I generally just rotate and accept that some will hurt and just get on with it. My buttocks where I inject my morning Levemir are the same. The underhung part is much less sensitive than the main backwards facing bulbous part. Thighs, right at the top is less sensitive than main front and side, but if you touch a nerve, yes it will be more painful however since you can't see them, it's just the luck of the draw. I do sometimes use the technique of touching the needle tip gently to my skin to find a less painful spot and then push it through.... or let the weight of the pen (Love the Novopen Echo for that as it is a nice solid weighty pen) take it in. The bruising is caused by nicking a fine capillary. No big deal and again, no way to avoid, just the luck of the draw. It is the stinging when I inject the insulin which I find most difficult to understand. Sometimes it doesn't sting at all and other times it really makes me wince. If I am really unlucky I get a triple whammy of hit a nerve and a capillary with the needle and it stings when I inject the insulin, but occasionally I get triple lucky and don't experience any discomfort or bruising at all. You take the rough with the smooth. 

You might find your thighs better if you inject into them with semi straight legs rather than bent because the muscles are taut when the legs are bent so perhaps make the nerves and capillaries a little more stretched and vulnerable. With the modern 4mm needles I think you would have to be quite emaciated to hit muscle in the recommended areas and I think the 45degree angle was generally advised for older longer needles. You can of course pinch up a bit of flesh on your tummy to inject into or your thighs for that matter.... harder to pinch and inject your bum unless you are a contortionist but most people have a decent covering on their bot.


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## trophywench (Jun 29, 2022)

Have to say, in areas where I could 'pinch an inch' such as literally my midriff bulge and some parts of my belly - I found it much less painful to actually stretch the skin to make it taut before jabbing.  Also if a bead of insulin on the pointy end to touch the bead to the skin to remove it, then jab on a dry bit away from where the bead was.


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## trophywench (Jun 29, 2022)

everydayupsanddowns said:


> I’m not sure there’s enough length on a 4mm to go in at an angle?!


I think the outer casing of the bit with the thread to screw it to the pen, would be much more likely to cause a bruise, frankly.


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## nonethewiser (Jun 29, 2022)

trophywench said:


> I think the outer casing of the bit with the thread to screw it to the pen, would be much more likely to cause a bruise, frankly.



Never angled needle for long time, not even with 6mm ones. Maybe did with 8mm just forget now.


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