# Hi there, newly diagnosed type 1.



## Pat91 (Jan 22, 2021)

Hello all, good evening I have just been diagnosed with type 1 a week ago, so a bit overwhelmed by it all still, but looking forward to gaining knowledge from you guys on the forum


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## Inka (Jan 22, 2021)

Welcome to the club you didn’t want to join @Type1Pat  from another Type 1. A Type 1 diagnosis is a huge thing to get your head round, but it does gradually get easier. Be kind to yourself and pace yourself.

How were you diagnosed? What insulins are you on? I’m on a pump now and have been for years, but before that was on injections. The good news is the tech we have now does make day to day life easier.


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## Pat91 (Jan 22, 2021)

Hi there, I was taken to hospital early hours of Thursday morning with DKA , my bloods were extremely high as I didn't know I had diabetes, my glucose was 36.9 and my ketones were 6.9, so extremely lucky I'm ok really, I'm currently on 10 units of Nova rapid 3 times a day and 26 units of lantus at night. It does sound a lot easier having a pump from what I have been reading.


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## trophywench (Jan 23, 2021)

Not easier!  No.  Different, Oh yes.  Insulin needs do not stay static for ages at a time whatever way we deliver it - needs adjustment every so often, as well as still needing to work out how many grams of carbohydrate in whatever we decide to eat, in order to give ourselves the right amount of fast acting insulin to counteract those carbs.   But, they haven't even as yet introduced you to that - it really is very early days for you.

So - my honest advice is to learn to walk before you try to run, because Diabetes is a marathon, not a sprint - and NEVER stop asking questions whatever they happen to be!


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## Inka (Jan 23, 2021)

Type1Pat said:


> Hi there, I was taken to hospital early hours of Thursday morning with DKA , my bloods were extremely high as I didn't know I had diabetes, my glucose was 36.9 and my ketones were 6.9, so extremely lucky I'm ok really, I'm currently on 10 units of Nova rapid 3 times a day and 26 units of lantus at night. It does sound a lot easier having a pump from what I have been reading.



Very scary for you! I hope you’re feeling better now you’re on insulin. I can’t remember how soon i felt better but it was pretty quick. I hadn’t realised how ill I’d been feeling. 

@trophywench is right that a pump isn’t easier. It still needs work and thought. I had mine after a number of years of injections.

Are your diabetes team keeping in close contact with you?


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## Pat91 (Jan 23, 2021)

Good morning all, were you able to get your pump on the NHS , and could this be something I'm offered in the future,  I have yet too hear from the specialist but they have said they will be in contact in due time,  I understand everyone is different so will require different readings but I woke with a reading of 8.3 glucose, had my 10 units of Nova rapid and for breakfast 2 boiled eggs and 2 wholemeal dry toast, do you think I'm on the right sort of track. Thank you.


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## rebrascora (Jan 23, 2021)

Hi and welcome from me too.
I am just coming up 2 years down the line with my diagnosis and it is amazing how much more confident I am with managing it now and I feel fitter and healthier than I have for 30 years, so there can be positives to it. You have been unfortunate to be diagnosed at such a difficult time in the NHS but it is great that you have found this forum, because peer support is hugely beneficial with diabetes and even in better times HCP support is not as intensive for adults as it is for children who are diagnosed, so you are left to do quite a lot of figuring stuff out yourself. I would have been totally lost without the advice and tips and general uplift I have received from the wonderful members here. 

I found that experimenting and testing lots (much more than they recommend) was key to learning how my body responded to food and insulin. Having the Freestyle Libre system makes that experimenting so much easier and I would definitely recommend you pushing for that to help you manage your diabetes if you haven't got it. One of the qualifying factors is testing 8 or more times a day. As regards pumps, they are mostly NHS funded but only a small percentage of people have them and you really need to learn how to manage things with MDI first. There is a lot of tweaking involved so you need to learn how your body responds first and some people simply will not qualify as they are very expensive. Personally, now that I have Libre I am very happy to continue with MDI but I know most people who get a pump love them and would not go back. You have a long way to go with learning to carb count and adjust your insulin doses with MDI first, so just take it one step at a time.

Just out of curiosity, was there any reason why you had dry toast? I am wondering if NHS staff have been emphasizing a low fat diet to you? Many of us find that more fat and less carbs makes our diabetes easier to manage but since you are currently on fixed units of NovoRapid you would need to be careful about reducing your carb intake. I don't think it would be unreasonable for you to have butter on your toast though unless you prefer it dry.


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## helli (Jan 23, 2021)

Welcome to the club @Type1Pat .
Sounds as if you had a traumatic diagnosis. The good thing is you now know what you are dealing with. Type 1 can be frustrating at times but other times I forget about it. I think of it like having a toddler who misbehaves sometimes but mostly is a sweetie.
There is a lot to learn such as adjusting your doses for food, exercise, illness, etc. Pumps make the adjustments easier but are useless if you don't understand the logic. Injections simplify this logic so are a great place to start. 
I injected for 12 years before pumping. I think more people seem to be getting pumps earlier now but I am glad to have had the time to learn the logic and for it to become second nature. Unfortunately, pumps can fail. It is rare but it happen. When it does, it is never at a great time, it is stressful and young you to return to injections. If that is not second nature, the stress of remembering what to do, how much to inject, etc is greater.
All of that said, Type 1 is not as much of a life changer now as it used to be. When I was diagnosed, I was told it should not stop me doing what I want. And it hasn't. Like it hasn't stopped Henry Slade playing rugby for England or Theresa May running the country.
Ask questions, air your frustrations, just chat. We have been where you are. And all still learning.


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## Pat91 (Jan 23, 2021)

Hi guys thank you for the warm welcome,  certainly have a lot to learn but sounds like I'm in good company, do you guys have 3 meals a day and what doses of insulin do you take, also any advice on meals to have and is snacking in-between meals good or bad. Not sure on the diet side of things yet hence the dry toast  , also do you recommend only checking before Meals and not after as I was advised to by NHS staff. Thank you .


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## Inka (Jan 23, 2021)

Type1Pat said:


> Good morning all, were you able to get your pump on the NHS , and could this be something I'm offered in the future,  I have yet too hear from the specialist but they have said they will be in contact in due time,  I understand everyone is different so will require different readings but I woke with a reading of 8.3 glucose, had my 10 units of Nova rapid and for breakfast 2 boiled eggs and 2 wholemeal dry toast, do you think I'm on the right sort of track. Thank you.



Yes, pumps are available on the NHS but you need to qualify for one. Then you need to have a certain level of ‘learning’ - eg you have to know how to carb count (count carbs and adjust your insulin to match). A pump doesn’t take over control of your diabetes - you still have to do that. It’s still work. The main benefit is the ability to match your basal insulin to your needs hour by hour.

*The important thing to remember is that the key to controlling Type 1 is insulin*. We don’t have to eat a special diet (but do need to think about what we’re about to eat and make sensible choices).

You’re on fixed dose of Novorapid at the moment so you’ll need to eat the same amounts of carbs for each meal. Hopefully you’ll soon be changed onto a more flexible regime. *Insulin is intimately connected with carbs*. In time you’ll know your meal ratios (how many carbs one unit of insulin will deal with), count the carbs in your meal and adjust your Novorapid dose to suit.

It’s not hard to do - so don’t worry about that. You’ll pick it up easily when you’re shown. For now, keep good records of what you eat and your blood sugar results.

Be prepared for hypos. Often once your body is getting the insulin it needs, your own insulin-producing cells will recover a little and push some insulin of their own out. Test lots and be cautious.


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## Inka (Jan 23, 2021)

Put something on your toast for sure! Please don’t think certain foods are forbidden. All you’re going to be doing is learning to be your own pancreas and do the job that used to do - that is, injecting the appropriate amounts of insulin to control your blood sugar.

Don’t get confused by advice aimed at Type 2s. That’s a different condition.


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## Pat91 (Jan 23, 2021)

I have been reading quite a lot online, as  want to know as much as possible really, I have heard about the rule of 500?  Apparently I need 1 unit of insulin per 10g carbs, I have been finding that upon checking my blood sugar's before bed they are around 6.5 to 9, so because I'm on 26;units of lantus I'm having to have a sandwich before bed too last Me till morning, will I always be on a night time dose or is this something that i may over time be taken off. Thank you.


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## Pat91 (Jan 23, 2021)

Inka said:


> Put something on your toast for sure! Please don’t think certain foods are forbidden. All you’re going to be doing is learning to be your own pancreas and do the job that used to do - that is, injecting the appropriate amounts of insulin to control your blood sugar.
> 
> Don’t get confused by advice aimed at Type 2s. That’s a different condition.


Ok thank you, does type 1 and type 2 vary quite a lot in terms of diet then.


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## Inka (Jan 23, 2021)

Type1Pat said:


> I have been reading quite a lot online, as  want to know as much as possible really, I have heard about the rule of 500?  Apparently I need 1 unit of insulin per 10g carbs, I have been finding that upon checking my blood sugar's before bed they are around 6.5 to 9, so because I'm on 26;units of lantus I'm having to have a sandwich before bed too last Me till morning, will I always be on a night time dose or is this something that i may over time be taken off. Thank you.



Ok, the rule of 500 is more ‘advanced’ learning. Read as much as you want but that’s not something you need to know now.

The 1 unit to 10g carbs is a ratio, as I described above. It’s common to be started on that ratio but in reality ratios vary, person by person, meal by meal. So someone might have say a ratio of 1 unit to 8g for breakfast, 1 to 10g for lunch and 1 to 12g for evening meal. Those are just examples.


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## Pat91 (Jan 23, 2021)

Oh right I see, I will put that on the back burner for now then. In your opinion what blood sugar level would I need to be at before bed in order not to have to eat a snack, bearing in mind I'm still required the 26 units of Lantus.


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## Inka (Jan 23, 2021)

A good book often recommended here is _Type 1 Diabetes in Children Adolescents and Young Adults_ by Ragnar Hanas. Ignore the title - it’s informative for adults too. You don’t have to read it and take it in all in one go. It’s something you can dip into as needed.

Re bedtime - always be cautious. Next time you speak to your team, ask for a bedtime level to aim for. I used to aim for above 8 but your target might be different, especially as it’s early days ie it might be higher eg 10. If you’re concerned as to what’s happening overnight, then you can set an alarm to get up and test eg at 2am and see what’s happening.

The first weeks after diagnosis are hard as things change. It’s an information-gathering time as much as control - that is, testing lots, recording your meals, recording hypos or any issues.


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## rebrascora (Jan 23, 2021)

I've never heard of the rule of 500? What is that? 

As regards the bedtime snack, is that because without it you are dropping too low through the night and waking up hypo? If so, I wonder if your 26 units of Lantus is too much or alternatively whether injecting it in the morning might be a better option for you instead of at night as it has a peak of activity about 5 hours after injecting but many people need less insulin through the night so that peak can occur at a time when you need less and cause problems. You would need to discuss those options with your diabetes team. If your insulin dose is too high, you end up eating to match your insulin which can lead to weight gain, when your insulin should be adjusted to match your needs. 
Insulin usage is very individual so they start you off on a "conservative" best guess and then adjust it, which is why keeping good records of what you eat each day and your readings is so important. I would definitely recommend you test 2 hours after meals as well. The more I tested, the more I learned. I self funded extra test strips to get more data and then self funded Freestyle Libre until I got it on prescription because the more info you have about your levels the better you understand things and can control it more effectively. That is my opinion anyway.


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## Pat91 (Jan 23, 2021)

Thank you for the recommendation, will have to have a look,  I am logging all my levels plus what I'm eating. Think thats were I need the most guidance at bedtime as last night my readings were 6.9 before bed, so was worried it was too low, hence the sandwich. Will keep logging everything as you suggest and  hopefully I will get an  appointment with specialist  soon, thank you.


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## Pat91 (Jan 23, 2021)

rebrascora said:


> I've never heard of the rule of 500? What is that?
> 
> As regards the bedtime snack, is that because without it you are dropping too low through the night and waking up hypo? If so, I wonder if your 26 units of Lantus is too much or alternatively whether injecting it in the morning might be a better option for you instead of at night as it has a peak of activity about 5 hours after injecting but many people need less insulin through the night so that peak can occur at a time when you need less and cause problems. You would need to discuss those options with your diabetes team. If your insulin dose is too high, you end up eating to match your insulin which can lead to weight gain, when your insulin should be adjusted to match your needs.
> Insulin usage is very individual so they start you off on a "conservative" best guess and then adjust it, which is why keeping good records of what you eat each day and your readings is so important. I would definitely recommend you test 2 hours after meals as well. The more I tested, the more I learned. I self funded extra test strips to get more data and then self funded Freestyle Libre until I got it on prescription because the more info you have about your levels the better you understand things and can control it more effectively. That is my opinion anyway.


In terms of my readings in the night I'm not sure, as have not done any since leaving hospital, I just remember the nurse telling me to eat something before bed when I was in hospital as my sugars were in the 6s and she was worried they would dip to low over night, I don't feel confident not having at least a sandwich before bed if my sugars are under 9 ,could I be overeating at night if this is the case. The 26 units just seems a big dose so I worry I would be too low in the morning, would you recommend I check in the night to make sure I'm not too low maybe without the sandwich at bedtime ? Thank you.


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## Robin (Jan 23, 2021)

rebrascora said:


> I've never heard of the rule of 500? What is that?


I just had to look it up. 500 divided by your total daily dose is supposed to give you the figure in grams of how many carbs one insulin unit covers. It wouldn’t work for me AT ALL and not for you, either I suspect, as we take so little basal.


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## grovesy (Jan 23, 2021)

Have you not got a contact number for the Diabetic Nurse at the hospital?


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## Pat91 (Jan 23, 2021)

Type1Pat said:


> In terms of my readings in the night I'm not sure, as have not done any since leaving hospital, I just remember the nurse telling me to eat something before bed when I was in hospital as my sugars were in the 6s and she was worried they would dip to low over night, I don't feel confident not having at least a sandwich before bed if my sugars are under 9 ,could I be overeating at night if this is the case. The 26 units just seems a big dose so I worry I would be too low in the morning, would you recommend I check in the night to make sure I'm not too low maybe without the sandwich at bedtime ? Thank you.


The rule of 500 is something I read were by you add all your units up for 24 hours then divide 500 by the total of your insulin, that then gives you roughly how much insulin per unit you need for every 10g of carbs. Think that is right anyway


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## Pat91 (Jan 23, 2021)

grovesy said:


> Have you not got a contact number for the Diabetic Nurse at the hospital?


Hi there yes I have a number i did ring them earlier in the week as i was having a hypo, they said just to log everything and call back sometime next week to see my readings.


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## Inka (Jan 23, 2021)

@Type1Pat Definitely don’t worry that having a sandwich at bedtime is over-eating! But I do recommend setting an alarm to test around 2am. Apart from reassuring you, it would be useful info to give your team.


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## Pat91 (Jan 23, 2021)

Inka said:


> @Type1Pat Definitely don’t worry that having a sandwich at bedtime is over-eating! But I do recommend setting an alarm to test around 2am. Apart from reassuring you, it would be useful info to give your team.


Thank you, if I went to bed without a sandwich and my readings before bed were say in the 6s or 7s do you think my blood sugar would be low in morning with the Lantus 26 units.


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## Inka (Jan 23, 2021)

Type1Pat said:


> Thank you, if I went to bed without a sandwich and my readings before bed were say in the 6s or 7s do you think my blood sugar would be low in morning with the Lantus 26 units.



I couldn’t say @Type1Pat but I would advise that you *don’t* go to bed below 8 as an absolute minimum at the moment. 

Your Lantus dose might be adjusted, you might even be given a different basal insulin, but you should be wary of hypos *particularly* at night. When on injections, I had a bedtime snack routinely.


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## Pat91 (Jan 23, 2021)

Inka said:


> I couldn’t say @Type1Pat but I would advise that you *don’t* go to bed below 8 as an absolute minimum at the moment.
> 
> Your Lantus dose might be adjusted, you might even be given a different basal insulin, but you should be wary of hypos *particularly* at night. When on injections, I had a bedtime snack routinely.


Ok brilliant, thank you for your help will carry on as I am for now, just done my readings again before lunch and they are at 5.8 so that's not bad is it.


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## Inka (Jan 23, 2021)

5.8 is an excellent reading   In the early days, it’s better to bring your blood sugar down gradually and it’s better to avoid hypos. You and your team can refine things later as things settle. It’s often said that a Type 1 is a marathon not a sprint, and that’s very true.


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## rebrascora (Jan 23, 2021)

Robin said:


> I just had to look it up. 500 divided by your total daily dose is supposed to give you the figure in grams of how many carbs one insulin unit covers. It wouldn’t work for me AT ALL and not for you, either I suspect, as we take so little basal.


Yes, you are right, it absolutely would not work for me either Robin!

@Type1Pat 
As regards how many meals and snacks a day, that again is an individual thing. I usually manage on just 2 meals a day and sometimes only 1 with perhaps a chunk of cheese or some nuts in between as a snack. Once you learn to carb count then that will allow you to eat whenever you want to and adjust your insulin dose to match the carbs you eat..... this is the benefit of the basal/bolus insulin regime.... it allows you so much more flexibility.  I imagine at the moment, they have probably just told you to eat normally... whatever that is, so that they can figure out your ratios and adjust your doses and particularly get your basal dose correct as that is the key to managing diabetes well.


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## Pat91 (Jan 23, 2021)

rebrascora said:


> Yes, you are right, it absolutely would not work for me either Robin!
> 
> @Type1Pat
> As regards how many meals and snacks a day, that again is an individual thing. I usually manage on just 2 meals a day and sometimes only 1 with perhaps a chunk of cheese or some nuts in between as a snack. Once you learn to carb count then that will allow you to eat whenever you want to and adjust your insulin dose to match the carbs you eat..... this is the benefit of the basal/bolus insulin regime.... it allows you so much more flexibility.  I imagine at the moment, they have probably just told you to eat normally... whatever that is, so that they can figure out your ratios and adjust your doses and particularly get your basal dose correct as that is the key to managing diabetes well.


Yes exactly that, just have to eat regularly as such and log everything readings  and what not. I did tweak my insulin a bit as the nurse advised me to lower my daytime dose but I found my sugars creeping up so went back onto my original 10 units of Nova instead of 8.


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## helli (Jan 23, 2021)

Once you get used to carb counting and dosing your fast acting insulin according to how many grams of carbs you eat, you will be able to eat as often as you want. I am a grazer so eat snacks between most meals. Thankfully, I am also very active so don't have to worry about my weight.
But the diet advice for Type 1 is eat as often as you would without diabetes.

Your night time insulin is different. It lasts about 24 hours. The aim of it is to keep your blood sugar level when you do not eat. So, on the correct dose, if you went to bed at 6.9, you should wake around the same number. There are a few things that could affect that but I won't confuse you, now.

As for dry toast, it is how I always eat my toast and have done since I was a child. To me, there is nothing worse than toast that's gone soggy due to the butter melted on it. But then, I'm weird.

I say "nothing worse" then remembered Brussel sprouts. And swede. And ...


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## Pat91 (Jan 23, 2021)

helli said:


> Once you get used to carb counting and dosing your fast acting insulin according to how many grams of carbs you eat, you will be able to eat as often as you want. I am a grazer so eat snacks between most meals. Thankfully, I am also very active so don't have to worry about my weight.
> But the diet advice for Type 1 is eat as often as you would without diabetes.
> 
> Your night time insulin is different. It lasts about 24 hours. The aim of it is to keep your blood sugar level when you do not eat. So, on the correct dose, if you went to bed at 6.9, you should wake around the same number. There are a few things that could affect that but I won't confuse you, now.
> ...


Do you guys recommend carbs with every meal or is it ok too just have a salad and tuna for lunch, yes I must say I prefer dry toast with eggs but I'm afraid I do like butter with marmite on toast , I wasn't eating before bed in hospital tho and I was on more Lantus,  could  this be because I'm more active now, thank you .


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## helli (Jan 23, 2021)

Type1Pat said:


> Do you guys recommend carbs with every meal or is it ok too just have a salad and tuna for lunch


Once you are counting carbs, you can have as many or few carbs as you want in a meal as you would calculate your insulin dose accordingly. So a tuna salad would be fine.
However, whilst you are on fixed insulin doses, I would be very wary of doing so as you could hypo.
If you give this as an example of a typical lunch next time you talk to the diabetes nurse, it may encourage her to allow you to carb count. 

And thank you for making me feel less weird with my dry toast preference. Although I would still not add butter with Marmite.


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## Pat91 (Jan 23, 2021)

Does blood sugar increase when we are sleeping or can it only decrease as long as we are not eating directly before bed.


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## helli (Jan 23, 2021)

Our livers drip glucose into our blood stream 24 hours a day. If we take no insulin, our blood sugars would rise overnight.
The slow acting insulin, Lantus, mops up this glucose and stops the rise.
If you have no insulin, there is no reason for blood sugars to fall.

As I mentioned previously, there are other things which could impact our blood sugars but this is what I was taught at first and it helped me understand. So I am trying to keep it simple.
Carbs in food plus glucose from our livers are the two main things which affect our blood sugars.


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## Pat91 (Jan 23, 2021)

helli said:


> Our livers drip glucose into our blood stream 24 hours a day. If we take no insulin, our blood sugars would rise overnight.
> The slow acting insulin, Lantus, mops up this glucose and stops the rise.
> If you have no insulin, there is no reason for blood sugars to fall.
> 
> ...


Oh I see ok that helps a lot thank you, going back on your previous comment you were right, because I had very little carbs but still had my 10 units of Nova, I had a hypo 1 HR 20 mins after lunch,no noticed the symptoms and treated quickly with 3 jelly babies and 2 digestives, scary how fast it happens tho.


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## Deleted member 25429 (Jan 24, 2021)

I was diagnosed with type 1 18 months ago at the age of 53. I like you went into DKA it’s scary and overwhelming. At first I was worried about going low when I was asleep now that my insulin is fairly stable I can go to bed at 5 and not worry about hypos . My advice would be test test and test some more gives you more confidence . It shows you how you react to different foods . For example beef is difficult but I am fine with a slice of seeded bread . We are all different and need different amounts of insulin . Without this forum I would not have the control I have


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## trophywench (Jan 24, 2021)

Sure it's the beef and not what you eat with it?  Beef is protein, Nil carbs.  Roast spuds Boiled spuds Yorkshire Pud and the gravy all contain a decent amount of carbs, before you even start adding any accompanying veg.


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## everydayupsanddowns (Jan 25, 2021)

Welcome to the forum @Type1Pat

Wow! It sounds like you’ve done a tonne of learning already! That inquisitive spirit will serve you well in the weeks and months ahead, but as you’ve discovered sometimes the more you learn, the more you realise there is to find out!

Things will be different in the short term, while you are finding your feet. But I get the feeling that you are capable of switching to a more flexible self-initiated intensive insulin therapy fairly early as you are asking all the right questions, so do push your clinic for that and get them to hand over some of the responsibility.

*To recap:*
The 500 rule is a basic rule of thumb for establishing doses based on your Total Daily Dose, which is often recommended to split 50:50 between basal and bolus. But it’s more a guideline than a rule and needs to be adapted. Plus the fact that your TDD may not yet be right, and your basal:bolus split could be 60:40 40:60 or somewhere in between. See also the 350 rule or the 400 rule... which are the same thing but give different results!

There are also ‘rules’ for insulin sensitivity (100... 150...) but again these are only helpful as starting points for you to tweak/adjust.

*Plus*
You aren’t currently carb counting, so it’s all a bit academic! 

*Fixed doses*
While you are on fixed doses, you need to keep eating fairly consistent amounts of carb for each meal to ‘balance’ the insulin. This might be slightly different at different times of day (you may need fewer carbs in the morning, and more later in the day to balance the same dose). If your BG is in range before eating and your insulin and carbs balance your BG should be back to where it started by 4-5 hours after you injected/ate.

Insulin acts for a loooooong time, and that’s one reason why some HCPs are nervy of people checking BG between meals... because the number might be high, but you might already have enough ‘insulin on board’ to bring it down by the next meal.

*Basal insulin*
Your basal (or background) insulin should *only* hold your BG steady when you are not eating and don’t have rapid insulin acting. In time you will discover how to check and adjust this on an ongoing basis (because your insulin needs will rise and fall through the year), but for now the simplest benchmark is overnight. Eat your evening meal around 6pm so that it is out of the way by bedtime. Then your waking level should be roughly the same as your bedtime level. And you should *not* need to snack to make that happen. If you are worried set an alarm for 2-3am and check again then. Your BG is likely to be lowest around this time.

Well done on a cracking start! And do consider getting that Ragnar Hanas book or  Think Like a Pancreas’ by Gary Scheiner


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## Pat91 (Jan 25, 2021)

Freddie1966 said:


> I was diagnosed with type 1 18 months ago at the age of 53. I like you went into DKA it’s scary and overwhelming. At first I was worried about going low when I was asleep now that my insulin is fairly stable I can go to bed at 5 and not worry about hypos . My advice would be test test and test some more gives you more confidence . It shows you how you react to different foods . For example beef is difficult but I am fine with a slice of seeded bread . We are all different and need different amounts of insulin . Without this forum I would not have the control I have





everydayupsanddowns said:


> Welcome to the forum @Type1Pat
> 
> Wow! It sounds like you’ve done a tonne of learning already! That inquisitive spirit will serve you well in the weeks and months ahead, but as you’ve discovered sometimes the more you learn, the more you realise there is to find out!
> 
> ...


Hi there and good morning everyone, thank you for the kind words and advice it is very much appreciated, I have been eating before bed normally a sandwich, last night I checked my BG at 9pm after having my dinner at 5pm. At 6.7  I just had 1 digestive instead of the sandwich and set my alarm for 1.15am my levels were 4.6 to my relief, so in theory could I repeat this every night a d be confident my readings will stay around the same at night as. When I woke this morning they were still 4.6. had my Weetabix and 10 units of Nova, checked at 10am , so 2hrs 30 mins after breakfast and my readings were 9.1, is this ok as long as my levels are back down by lunch ? Thank you.


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## rebrascora (Jan 25, 2021)

Absolutely.... sounds like you have it cracked! With the Freestyle Libre system. We have a range of between 3.9 and 10.0 and we are looking to stay within that range 75% of the time. Obviously, with just a few finger pricks, you don't really know what your levels are doing the rest of the time, whereas with the Libre it is sampling your levels every few minutes, so you get a much better view of your whole BG profile over 24 hours but from the readings you are getting so far, you are doing really great!!


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## Pat91 (Jan 25, 2021)

rebrascora said:


> Absolutely.... sounds like you have it cracked! With the Freestyle Libre system. We have a range of between 3.9 and 10.0 and we are looking to stay within that range 75% of the time. Obviously, with just a few finger pricks, you don't really know what your levels are doing the rest of the time, whereas with the Libre it is sampling your levels every few minutes, so you get a much better view of your whole BG profile over 24 hours but from the readings you are getting so far, you are doing really great!!


Hi there, thank you for the feedback, that's a relief to know I'm on the right track, how long were you on injections before you switched to libre ? Thanks.


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## rebrascora (Jan 25, 2021)

I started on insulin in March 2019 and whilst I was given the initial nod for Libre on prescription in Feb 2020, it didn't happen due to Covid because training was put on hold. Eventually I decided to self fund the LIbre in June ( no training required when self funding) and did that for 3.5 months (expensive but so worth it) before actually getting it on prescription in October. Learning to interpret the information and not be too hasty in responding to it is very important with Libre as it does provide a lot of info and getting it on prescription is a postcode lottery and depends if you fit NICE criteria and some consultants are keener than others to utilize their "allowance" or so it feels to me. I started testing much more frequently and could demonstrate to my consultant from my BG app on my phone how I was using that extra data along with a food diary to improve my results and that convinced him to offer the Libre on prescription... I went into the appointment armed with a lot of points as to why I wanted it and it would be helpful and I fully expected that I would need to fight my corner quite hard for it and possibly be refused but he could see that I had a good grasp of what I was doing and not over reacting to information from finger pricks and he agreed without me having to put forward my case to any extent. I was over the moon when I left the appointment, but it took another 8 months to actually get them on prescription, so you have to be prepared to be a patient and even then a bit of badgering doesn't go amiss. In the current climate with the NHS, things are generally progressing much slower and that is understandable, so you may have to get used to finger pricking for a while longer yet.... or self fund... but do be aware that some people have struggled to get it on prescription once they have started self funding.... which shouldn't happen, but has to at least a couple of forum members. Mine had been agreed in principle so I had nothing to lose in self funding (short term) after that (other than the money of course.... which started off as some birthday money and then I dug into some savings because I didn't want to be without it after that). 

Anyway, hope that info helps.


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## helli (Jan 25, 2021)

Type1Pat said:


> Hi there, thank you for the feedback, that's a relief to know I'm on the right track, how long were you on injections before you switched to libre ? Thanks.


Libre is not an alternative to injections. 
Libre is a glucose monitor - some see it as an alternative to finger pricking although I still prick my finger a few times a day. 
As @rebrascora mentioned, it allows you to see what happens to your blood sugars all the time rather than just the moments in time when you prick your finger. It does this by taking a measurement every 5 minutes and showing the blood sugar roller coaster on a graph. 
Availability of these on prescription does not seem to be related to how long you have had diabetes but more related to what your postcode is. There are some NICE guidelines such as how many times per day you test. I would recommend asking about these when you next talk to your diabetes nurse.  

The alternative to injections are insulin pumps. 
Again it varies how quickly after diagnosis you may get one of these but they are pretty expensive so it is more down to the need rather than the duration.


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## trophywench (Jan 25, 2021)

Errr - Libre is simply not all that accurate for me - I would never trust it to base my treatment on.

It can be a full 2.0 different to my BG reported by my meter.  It will report that I am mid 3s and therefore hypo, when by actual BG is sitting comfortably in the high 4s and sometimes, low to middle 5s.  What it does help with though, is seeing trends more easily so eg how long it took for your BG to increase to 9.1, how long it stays at that level, how long it takes it to get back to around 5 thereafter.  Then we have to fathom out whether we need an adjustment to our bolus for brekkie, or whether we need extra basal insulin working at that time of day.  These are not primary school calculations, they are at least A level ones if not university degree level ones.  And you have only started at Nursery school very recently .........

There is no quick fix for most things - not a permanent fix anyway (but there are often quicker things we can do as a temporary measure)  so model yourself on the tortoise instead of the hare.  Slow but sure usually gets us there quicker in the finish - because we learn to understand why and how on the way and can use that info to apply to the next prob.


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## helli (Jan 25, 2021)

trophywench said:


> Errr - Libre is simply not all that accurate for me - I would never trust it to base my treatment on.


There have been many discussions on this and I realise how hard it is to plough through the many threads to find it again. 

Some people are just not compatible with Libre, some people are not like the Factory Man they use for the factory calibration (there are ways around this), some sensors have problems (Abbott will replace them) and there are limitations with all CGMs including Libre (less accurate during the first 24 hours, less accurate when high and low, readings are about 15 minutes behind "reality") but bearing this in mind, I am confident with bolusing from my sensor but not correcting highs and lows. 

Furthermore, Libre 2 has just been released and is said to be more accurate. 

Some of this is education (I learnt about the limitations from social media rather than any formal training) and some of this is personal preference. 
But as one of the main criteria is reducing the number of finger pricks, NICE seem to be of the opinion it is accurate enough.


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## grovesy (Jan 25, 2021)

helli said:


> There have been many discussions on this and I realise how hard it is to plough through the many threads to find it again.
> 
> Some people are just not compatible with Libre, some people are not like the Factory Man they use for the factory calibration (there are ways around this), some sensors have problems (Abbott will replace them) and there are limitations with all CGMs including Libre (less accurate during the first 24 hours, less accurate when high and low, readings are about 15 minutes behind "reality") but bearing this in mind, I am confident with bolusing from my sensor but not correcting highs and lows.
> 
> ...


I like your thinking we are not all like the Factory Man.


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## Inka (Jan 25, 2021)

Type1Pat said:


> Hi there and good morning everyone, thank you for the kind words and advice it is very much appreciated, I have been eating before bed normally a sandwich, last night I checked my BG at 9pm after having my dinner at 5pm. At 6.7  I just had 1 digestive instead of the sandwich and set my alarm for 1.15am my levels were 4.6 to my relief, so in theory could I repeat this every night a d be confident my readings will stay around the same at night as. When I woke this morning they were still 4.6. had my Weetabix and 10 units of Nova, checked at 10am , so 2hrs 30 mins after breakfast and my readings were 9.1, is this ok as long as my levels are back down by lunch ? Thank you.



Hi again @Type1Pat For me personally, 4.6 would be slightly too low for nighttime, particularly if I was on injections. I’d rather go through the night on a 6 or around there. Even now I have a pump and can have a more individual basal rate, I would still eat a tiny amount of carbs if I was in the 4s during the night. Perhaps you could go with 1 and a half digestives at bedtime and see how that works?

Yes, I think your 9.1 was very good after breakfast. You seem to be doing very well


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## Inka (Jan 25, 2021)

Interesting @trophywench My consultant isn’t that impressed with the accuracy of the Libre either and said, like you, it was best to see patterns. I like to keep pretty tight control and she said that the Libre wouldn’t be ideal for that as it’s results weren’t that accurate. Hearing that and realising I’d probably end up finger-pricking anyway, I was put off.


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## trophywench (Jan 25, 2021)

I'm definitely not either - nor Factory Woman.

Remains to be seen whether Libre 2 is more accurate.


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## rebrascora (Jan 25, 2021)

My most recent sensor has not been nearly as accurate as all my previous ones which I felt very comfortable to bolus and correct from but this last one has knocked my confidence a little and I did wonder if they had "changed" the "factory man" used to calibrate it. (Maybe he is off sick with Covid!!) It has given me "LO" readings (which I have never had before) when I have been mid 3s to low 4s (and no compression issues) so I am inclined to think it is just a less that great sensor. Hopefully my next ones will be better. The current one was actually a replacement from Abbott rather than a prescription one.... maybe hot off the press. It is still giving me reasonable readings most of the time but I feel much more inclined to check it more frequently than I have with previous sensors which I maybe only checked 2-3 times during the 14 day period if I felt the reading wasn't compatible with how I felt.

@Type1Pat Apologies, I didn't pick up that yopu were confusing Libre with a pump. I was assuming you meant how long after starting on insulin ie diagnosis.... my introduction to diabetes was slightly different to yours in that I was initially assumed to be Type 2 so I went through the routine of strict low carb diet and oral meds for a few weeks before starting on insulin, so I kind of associate insulin with the beginning of my Type 1 diagnosis rather than when my diabetes symptoms first occurred and therefore I didn't pick up on the nuance of your question and misunderstanding.


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## grovesy (Jan 25, 2021)

trophywench said:


> I'm definitely not either - nor Factory Woman.
> 
> Remains to be seen whether Libre 2 is more accurate.


Well I will starting my first Libre 2 at the end of the week.


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## helli (Jan 25, 2021)

grovesy said:


> Well I will starting my first Libre 2 at the end of the week.


Please post your experience. 
I am looking forward to getting mine - my DSN has said she has written to my GP to get my prescription changed but speed and efficiency are not their string points so I think it will be a while before I get my hands on one.
My current Libre failed this morning so I had to report it to Abbott. They are sending a replacement. I hoped I could convince them to send a Libre 2 but they only replace like for like. 

Sorry, long way of saying I am looking forward to reading other's experience of Libre 2. 
Maybe I can experience your improved accuracy vicariously.


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## Pat91 (Jan 25, 2021)

helli said:


> Libre is not an alternative to injections.
> Libre is a glucose monitor - some see it as an alternative to finger pricking although I still prick my finger a few times a day.
> As @rebrascora mentioned, it allows you to see what happens to your blood sugars all the time rather than just the moments in time when you prick your finger. It does this by taking a measurement every 5 minutes and showing the blood sugar roller coaster on a graph.
> Availability of these on prescription does not seem to be related to how long you have had diabetes but more related to what your postcode is. There are some NICE guidelines such as how many times per day you test. I would recommend asking about these when you next talk to your diabetes nurse.
> ...





Inka said:


> Hi again @Type1Pat For me personally, 4.6 would be slightly too low for nighttime, particularly if I was on injections. I’d rather go through the night on a 6 or around there. Even now I have a pump and can have a more individual basal rate, I would still eat a tiny amount of carbs if I was in the 4s during the night. Perhaps you could go with 1 and a half digestives at bedtime and see how that works?
> 
> Yes, I think your 9.1 was very good after breakfast. You seem to be doing very well


Hello again, yes I was a bit weary myself of the low reading will probably have more biscuits like you say before bed, have been speaking to my diabetic nurse contact and he has taken me down from 10 Nova to 8 as I have been too low before my next meal, he has also advised me to slightly adjust my insulin dose by 1 or 2 units if I'm having a bigger portion of carbs. Have also been told if I'm having no carbs with my meal to not have any Nova. My question is do we still need insulin to break down foods with no carbs ? Thanks again.


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## Pat91 (Jan 25, 2021)

rebrascora said:


> My most recent sensor has not been nearly as accurate as all my previous ones which I felt very comfortable to bolus and correct from but this last one has knocked my confidence a little and I did wonder if they had "changed" the "factory man" used to calibrate it. (Maybe he is off sick with Covid!!) It has given me "LO" readings (which I have never had before) when I have been mid 3s to low 4s (and no compression issues) so I am inclined to think it is just a less that great sensor. Hopefully my next ones will be better. The current one was actually a replacement from Abbott rather than a prescription one.... maybe hot off the press. It is still giving me reasonable readings most of the time but I feel much more inclined to check it more frequently than I have with previous sensors which I maybe only checked 2-3 times during the 14 day period if I felt the reading wasn't compatible with how I felt.
> 
> @Type1Pat Apologies, I didn't pick up that yopu were confusing Libre with a pump. I was assuming you meant how long after starting on insulin ie diagnosis.... my introduction to diabetes was slightly different to yours in that I was initially assumed to be Type 2 so I went through the routine of strict low carb diet and oral meds for a few weeks before starting on insulin, so I kind of associate insulin with the beginning of my Type 1 diagnosis rather than when my diabetes symptoms first occurred and therefore I didn't pick up on the nuance of your question and misunderstanding.


Hi there, that's ok it doesn't take much to confuse me at the minute to be fair .


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## rebrascora (Jan 25, 2021)

Type1Pat said:


> My question is do we still need insulin to break down foods with no carbs ? Thanks again.


In the absence of carbs, approx 40% of protein and 10% of fat will be broken down into glucose which will then hit the blood stream. If you take a boiled egg which is almost equal parts fat and protein with about 7g of each in a large egg. 40% of that 7g of protein is about 3g and 10% of the 7g fat breaks down to 0.7g carbs, so about 3.7g carbs from the protein and fat in one egg. Say you have 2 eggs, that is about 7g carbs. Add in a bit of salad for and you might get to 10-15g carbs which means that you are not going to be a long way out when you get to your next meal if you don't inject any bolus insulin. If you do that meal a few times and find you are getting reasonably consistently high readings at your next meal time, then you could perhaps experiment with 1-2 units of insulin for a 2 egg salad and see how that goes. Or do a similar calculation for Tuna or ham if that is your preference with a salad. With fat, you would have to eat an awful lot of fat for the 10% conversion to make a significant difference to your overall BG so mostly we ignore that and just calculate the protein. Do bear in mind that meat and fish and eggs are predominantly water though, so whilst an egg might be 60g in weight only 7g of those are actually protein and it will be the same with tuna and slices of ham or beef etc, so don't make the mistake of weighing the egg or the meat and just taking 40% of that. You have to look up the protein content of that meat or fish and then work out how many grams of protein are in your 3 slices of ham of half a tin of tuna and then work out 40% of that.... 
Hope that makes sense. It can all get a bit complicated which is why sometimes having regular carb portions with every meal is sometimes easier. 

On the other hand, I like to make life as complicated as possible and follow a low carb way of eating, so most of my meals do not contain a main source of carbs. You get used to judging protein, just like you would carbs after a while. The advantage is that if I get it wrong I am not going to get it hugely wrong because it might be the difference between just 2 or 3 units of bolus insulin with a meal, so I can never make a big mistake. I often use just 4 or 5 units of bolus insulin in a day eating like this, so any hypos are not really serious ones and if I go high, it is not hugely high.


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## Pat91 (Jan 25, 2021)

rebrascora said:


> In the absence of carbs, approx 40% of protein and 10% of fat will be broken down into glucose which will then hit the blood stream. If you take a boiled egg which is almost equal parts fat and protein with about 7g of each in a large egg. 40% of that 7g of protein is about 3g and 10% of the 7g fat breaks down to 0.7g carbs, so about 3.7g carbs from the protein and fat in one egg. Say you have 2 eggs, that is about 7g carbs. Add in a bit of salad for and you might get to 10-15g carbs which means that you are not going to be a long way out when you get to your next meal if you don't inject any bolus insulin. If you do that meal a few times and find you are getting reasonably consistently high readings at your next meal time, then you could perhaps experiment with 1-2 units of insulin for a 2 egg salad and see how that goes. Or do a similar calculation for Tuna or ham if that is your preference with a salad. With fat, you would have to eat an awful lot of fat for the 10% conversion to make a significant difference to your overall BG so mostly we ignore that and just calculate the protein. Do bear in mind that meat and fish and eggs are predominantly water though, so whilst an egg might be 60g in weight only 7g of those are actually protein and it will be the same with tuna and slices of ham or beef etc, so don't make the mistake of weighing the egg or the meat and just taking 40% of that. You have to look up the protein content of that meat or fish and then work out how many grams of protein are in your 3 slices of ham of half a tin of tuna and then work out 40% of that....
> Hope that makes sense. It can all get a bit complicated which is why sometimes having regular carb portions with every meal is sometimes easier.
> 
> On the other hand, I like to make life as complicated as possible and follow a low carb way of eating, so most of my meals do not contain a main source of carbs. You get used to judging protein, just like you would carbs after a while. The advantage is that if I get it wrong I am not going to get it hugely wrong because it might be the difference between just 2 or 3 units of bolus insulin with a meal, so I can never make a big mistake. I often use just 4 or 5 units of bolus insulin in a day eating like this, so any hypos are not really serious ones and if I go high, it is not hug
> ...


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## rebrascora (Jan 25, 2021)

An apple is about 15 g carbs depending upon size and type so likely to take your levels up by about 4.5mmols as a rough approximation. So that might take you up form 5 to 9.5 by 2 hours later but it depends upon when you last injected your bolus insulin for the previous meal as to how much is still active in your system and might also take up some of the carbs from the apple. So there might be 2 units of insulin still active in your system when you eat the apple and you end up something like 4.5 before the next meal or there is no active insulin left and you end up in the 9s. Understanding how much insulin may still active in your system is an individual thing which depends on the insulin used and your absorption rate etc and how active you are at that time or if you were very active earlier, which will make you much more responsive to the insulin.... so lots of factors to take intop consideration and only trial and error and lots of documenting food and readings will show you how your body works.  
If I am in the 4s I usually just have a single prune and that acts like about 5g carbs, so will take me up into the 5s but then I don't use 8 or 10 units of bolus insulin with a meal, just 2 or 3 so it is very unlikely there will be much left over to send me hypo unless I do a lot of exercise.

No one can really tell you, just your own body and your BG meter, which is where more frequent testing (or Libre) can be so helpful in learning how it works.


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## grovesy (Jan 25, 2021)

helli said:


> Please post your experience.
> I am looking forward to getting mine - my DSN has said she has written to my GP to get my prescription changed but speed and efficiency are not their string points so I think it will be a while before I get my hands on one.
> My current Libre failed this morning so I had to report it to Abbott. They are sending a replacement. I hoped I could convince them to send a Libre 2 but they only replace like for like.
> 
> ...


I have 4 in the wardrobe, I ordered early as we have been having problems with the post here since Xmas. Though the order came in usal time as they come tracked. The replacement reader came quickly too!


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## Pat91 (Jan 25, 2021)

rebrascora said:


> An apple is about 15 g carbs depending upon size and type so likely to take your levels up by about 4.5mmols as a rough approximation. So that might take you up form 5 to 9.5 by 2 hours later but it depends upon when you last injected your bolus insulin for the previous meal as to how much is still active in your system and might also take up some of the carbs from the apple. So there might be 2 units of insulin still active in your system when you eat the apple and you end up something like 4.5 before the next meal or there is no active insulin left and you end up in the 9s. Understanding how much insulin may still active in your system is an individual thing which depends on the insulin used and your absorption rate etc and how active you are at that time or if you were very active earlier, which will make you much more responsive to the insulin.... so lots of factors to take intop consideration and only trial and error and lots of documenting food and readings will show you how your body works.
> If I am in the 4s I usually just have a single prune and that acts like about 5g carbs, so will take me up into the 5s but then I don't use 8 or 10 units of bolus insulin with a meal, just 2 or 3 so it is very unlikely there will be much left over to send me hypo unless I do a lot of exercise.
> 
> No one can really tell you, just your own body and your BG meter, which is where more frequent testing (or Libre) can be so helpful in learning how it works.


Right ok I see will keep on experimenting and logging my bloods and diet, thank you


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## Inka (Jan 25, 2021)

Type1Pat said:


> Hello again, yes I was a bit weary myself of the low reading will probably have more biscuits like you say before bed, have been speaking to my diabetic nurse contact and he has taken me down from 10 Nova to 8 as I have been too low before my next meal, he has also advised me to slightly adjust my insulin dose by 1 or 2 units if I'm having a bigger portion of carbs. Have also been told if I'm having no carbs with my meal to not have any Nova. My question is do we still need insulin to break down foods with no carbs ? Thanks again.



Yes, protein turns to glucose too, especially if you don’t eat any carbs with it eg if I have a salmon fillet, green veg and a baked potato, I only need to count the carbs in the potato and can use my normal meal ratio. The salmon is ‘free’ (ie I don’t have to count it) as is the green veg. However, if I were to have the salmon with a green salad and no countable carbs, I’d have to take into account the protein in the salmon and the small amount of carbs in the lettuce too, which I could ignore in a normal meal.

It’s much easier and more predictable to have some carbs with each meal. Avoiding carbs doesn’t make it easy - just work in a different way. It also messes with insulin sensitivity, which is another reason I eat a reasonable amount of carbs.

It’s so very, very easy to start seeing food as the enemy. It’s not. You can just eat a normal healthy diet - all that’s changed is you have to think more before you eat and be your own pancreas.


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## helli (Jan 25, 2021)

@Inka and @rebrascora (and others), I think we. have to remember that @Type1Pat is on fixed insulin doses and not carb counting at the moment. 
The information about protein impact is valid but is it relevant (and not confusing) for someone newly diagnosed on fixed dosage?

My advice in this situation would be to avoid low carb meals until you have learnt about carb counting and dose adjustment. 
If low carb meals are common, ask your DSN about carb counting. 

Then we can move on to glucogenesis (apologies for the spelling ... it is probably not correct).


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## Pat91 (Jan 25, 2021)

Inka said:


> Yes, protein turns to glucose too, especially if you don’t eat any carbs with it eg if I have a salmon fillet, green veg and a baked potato, I only need to count the carbs in the potato and can use my normal meal ratio. The salmon is ‘free’ (ie I don’t have to count it) as is the green veg. However, if I were to have the salmon with a green salad and no countable carbs, I’d have to take into account the protein in the salmon and the small amount of carbs in the lettuce too, which I could ignore in a normal meal.
> 
> It’s much easier and more predictable to have some carbs with each meal. Avoiding carbs doesn’t make it easy - just work in a different way. It also messes with insulin sensitivity, which is another reason I eat a reasonable amount of carbs.
> 
> It’s so very, very easy to start seeing food as the enemy. It’s not. You can just eat a normal healthy diet - all that’s changed is you have to think more before you eat and be your own pancreas





helli said:


> @Inka and @rebrascora (and others), I think we. have to remember that @Type1Pat is on fixed insulin doses and not carb counting at the moment.
> The information about protein impact is valid but is it relevant (and not confusing) for someone newly diagnosed on fixed dosage?
> 
> My advice in this situation would be to avoid low carb meals until you have learnt about carb counting and dose adjustment.
> ...


I did not know this, how come, you don't have to take into account the fibre when  eating carbs but you do when there are no carbs .


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## Pat91 (Jan 25, 2021)

helli said:


> @Inka and @rebrascora (and others), I think we. have to remember that @Type1Pat is on fixed insulin doses and not carb counting at the moment.
> The information about protein impact is valid but is it relevant (and not confusing) for someone newly diagnosed on fixed dosage?
> 
> My advice in this situation would be to avoid low carb meals until you have learnt about carb counting and dose adjustment.
> ...


To be honest I do consume carbs with most meals anyway. And I look forward to learning more from you guys on here.


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## Deleted member 25429 (Jan 25, 2021)

trophywench said:


> Sure it's the beef and not what you eat with it?  Beef is protein, Nil carbs.  Roast spuds Boiled spuds Yorkshire Pud and the gravy all contain a decent amount of carbs, before you even start adding any accompanying veg.


Unfortunately it is the beef don’t eat potatoes or Yorkshire’s . Had it with a salad . Every time I eat it I have to inject an hour after eating it and even then I what I call a significant rise in my sugar levels. I do tend to stick to a veggie diet but don’t eat potatoes, pasta or rice


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## everydayupsanddowns (Jan 25, 2021)

helli said:


> Sorry, long way of saying I am looking forward to reading other's experience of Libre 2.



I’ve got one on at the moment. Gathering info to give it a bit of a write-up.


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## nonethewiser (Jan 25, 2021)

Freddie1966 said:


> Unfortunately it is the beef don’t eat potatoes or Yorkshire’s . Had it with a salad . Every time I eat it I have to inject an hour after eating it and even then I what I call a significant rise in my sugar levels. I do tend to stick to a veggie diet but don’t eat potatoes, pasta or rice



Ain't that odd, thought I was only one who did same, don't have issue with chicken lamb pork for sunday roast only beef requires extended bolus.


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## trophywench (Jan 25, 2021)

@Type1Pat - where did you get that about fibre from?  Can't see that anyone here has mentioned it at all.

Here in the UK - and most of Europe - carb measurements automatically exclude fibre. 

Only in the USA (as far as I know) do you first need to deduct the fibre content from the total carb figure.  And amounts in recipes are expressed as 'cups' - always found this hilarious as all my mom's were different sizes, as mine always have been - and these days nobody hardly gets married so probably won't have even received a tea set off a neighbour of their mother which they keep at the back of a cupboard 'just in case' Mrs Bloggs turns up, as an unsolicited extra wedding present!


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## Deleted member 25429 (Jan 25, 2021)

nonethewiser said:


> Ain't that odd, thought I was only one who did same, don't have issue with chicken lamb pork for sunday roast only beef requires extended





nonethewiser said:


> Ain't that odd, thought I was only one who did same, don't have issue with chicken lamb pork for sunday roast only beef requires extended bolus.


I’m glad I’m not the only one


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## helli (Jan 25, 2021)

Type1Pat said:


> I did not know this, how come, you don't have to take into account the fibre when  eating carbs but you do when there are no carbs .


I think, when you write “fibre”. You mean “protein”.
The reason why you don’t need to worry about protein when you eat carbs but do need to consider it when you eat no carbs is that the body needs glucose. Normally, our body gets glucose from carbs. If it has not carbs, it can break down the protein you eat instead. This is called something like glucogenisis.
 If you eat carbs, the body knows not to break down the protein into glucose so you don’t need to worry about dosing insulin for the protein.

Incidentally, technically, fibre is a carbohydrate. However, the body cannot digest fibre so it does not absorbs the glucose from fibre.
Thankfully, in the UK, food labels have subtracted the fibre from the carbs so we don’t have to.
It is useful to know this if we use recipes from the internet which may have been sourced from American where the fibre (or “fibre”) is included in the carb content on food labels.


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## helli (Jan 25, 2021)

trophywench said:


> And amounts in recipes are expressed as 'cups' - always found this hilarious as all my mom's were different sizes,


Cups as measurement for recipes are fantastic.
Just like teaspoons and tablespoons there is a definition of the size of a cup and you can buy cup measures.

Scooping out a cup of flour rather than weighing it is time saving and easy.
The Americans know what they are talking about with baking recipes that measure with cups and spoons.


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## Pat91 (Jan 26, 2021)

helli said:


> I think, when you write “fibre”. You mean “protein”.
> The reason why you don’t need to worry about protein when you eat carbs but do need to consider it when you eat no carbs is that the body needs glucose. Normally, our body gets glucose from carbs. If it has not carbs, it can break down the protein you eat instead. This is called something like glucogenisis.
> If you eat carbs, the body knows not to break down the protein into glucose so you don’t need to worry about dosing insulin for the protein.
> 
> ...


Thank you for that, our bodies are amazing really aren't they.


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## Pat91 (Jan 26, 2021)

Benny G said:


> @Type1Pat, One week into insulin therapy: Well done.
> You have taken a decisive step coming to a forum and dipping your toe into the big pool. There's much to learn, but don't worry there's plenty of time to splash around.
> You have been started on fixed doses of insulin to take each day, this will help bring your daily glucose levels down to a more normal range, and help you regain the weight you lost before diagnosis.
> I don't think anyone has mentioned 'diabetic honeymoon' yet:
> ...





Benny G said:


> @Type1Pat, One week into insulin therapy: Well done.
> You have taken a decisive step coming to a forum and dipping your toe into the big pool. There's much to learn, but don't worry there's plenty of time to splash around.
> You have been started on fixed doses of insulin to take each day, this will help bring your daily glucose levels down to a more normal range, and help you regain the weight you lost before diagnosis.
> I don't think anyone has mentioned 'diabetic honeymoon' yet:
> ...


Thanks mate.


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## Deleted member 25429 (Jan 26, 2021)

helli said:


> I think, when you write “fibre”. You mean “protein”.
> The reason why you don’t need to worry about protein when you eat carbs but do need to consider it when you eat no carbs is that the body needs glucose. Normally, our body gets glucose from carbs. If it has not carbs, it can break down the protein you eat instead. This is called something like glucogenisis.
> If you eat carbs, the body knows not to break down the protein into glucose so you don’t need to worry about dosing insulin for the protein.
> 
> ...


Thanks for this really explains a lot appreciate it


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## stillgoing (Jan 30, 2021)

In the old days we used to count calories. All food has some calories. all those calories end up in your blood as glucose. The lantus insulin is meant to deal with all this background processing. The fast acting insulin deals with the spikes caused by eating carb.

It was too difficult for most people to count calories. Its bad enough counting carb but it helps in control.

The insulin reacts with the glucose in the blood stream so that it can enter the cells and be used as energy. If the cells cannot get energy from a glucose supply they get it by breaking down your body fat. This process causes ketones. If you have surplus glucose the body turns it into fat ready for later use. Can be very easy to gain weight when eating with insulin. 

The rate all this happens is different for everybody so you have been started on an average wet finger in the air levels.
After a while the DSN will be able to refine them and then you will learn to do it too.

Try not to run. I was on fixed rate for 54 years. I have now moved to a varied rate and playing with the numbers. Take your time. Lots of conflicting information and (mostly) all right. A very individual condition


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## Inka (Jan 30, 2021)

I’ve never counted calories nor am I fat. Insulin doesn’t make you fat nor do carbs - unless, of course, someone is over-eating and making poor food choices. Then it’s the excess and the poor choices that cause the fat *not* the insulin.

There are far too many people with Type 1 with eating disorders, and I know how easy it is to fall into that hole without realising.

Just to be clear @Type1Pat Eating a normal diet and taking your insulin will NOT make you fat. I eat cereal, bread, pasta, desserts sometimes, chocolate, etc etc and I am most definitely not fat! My BMI is around 20 and I’m slim and wiry. I’ve had almost 30 years of insulin and it’s not made me fat - not now nor in the past. My weight has remained stable and I believe my weight now is the same as it would have been if I’d never developed Type 1.


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## stillgoing (Jan 30, 2021)

sorry inka. Didn't mean to imply that the insulin makes you fat. As you rightly say that is the excess food. However when on fixed insulin you can end up eating to the insulin to prevent hypos. You then end up eating too much rather than cutting the insulin down. The balance is the amount you eat to the insulin to the amount of energy you need.


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