# Caught unguarded



## Purls of Wisdom (Apr 27, 2022)

I have recently been diagnosed. Type unconfirmed. It came as a shock to say the least. I did not know anything about it. Partly cos of needle phobia. Learning bit by bit but not enough. Being very hard on myself when it comes to meal times and more so too much information on the net and little support. Too early I have been told. I am acutely stuck with what to eat, how much a day and in week. I need urgent guidance before I starve myself to nothing. Please help. 
Thanking you in advance.


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## EmmaL76 (Apr 27, 2022)

Hi, there are so many of us that can totally relate to how your feeling. I am at the absolute top end of being hard on myself and punishing myself for what I see as my failures. This resulted in chronic food restriction ( I was slim on diagnosis) and this has continued for 1.5 years. Result, depression, extreme weight loss no energy and living in a zombie like state. This is absolutely not the path you want to go down. Please hear me when I say starvation is not the answer. Also as your diagnosis is unclear you could potentially be masking the real issue by severe food restriction. I am in this position now, my diagnosis is still unconfirmed but I have terrible anxiety around eating. There are many sustainable ways to be diabetic and not starve and although I am not the best person to advise in this, I’m sure many will be along to help. Do you know what your hba1c was on diagnosis? And what the general feeling of your gp is regarding your type?


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## Windy (Apr 27, 2022)

Hi, please don't starve yourself, you need to eat still. What sort of food do you eat normally? Are you looking to lose weight? Do you have any diet restrictions, like vegetarianism that you also need to think about? Dependant on what you want from your diet, make a plan.
There's book recommendations here, some of which are recipe books to give you meal ideas. Or on the main Diabetes UK site, there are recipes too.
My plan was to lose weight, so I eat 1500 calories a day so that I can do that. If you don't need to lose weight, then you'd need to find out what calories you need to eat each day to maintain your weight, but be mindful of foods that will put your blood glucose up. So I'd probably start by not eating biscuits/crisps/sweets/chocolate, or having them infrequently as a treat, and work from there. Think of the other things that you eat, ie eggs, meat, fish, vegetables etc and plan meals around them. There's lots of different diets that people eat, low carb, medium carb, veggie, vegan etc, you need to find out what works for you, there's no one right answer.
But please eat. 
Sarah


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## Inka (Apr 27, 2022)

Welcome @Purls of Wisdom  You mention a needle phobia - are you on any medication for the diabetes? Can you explain a little more about your diagnosis?


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## Tdm (Apr 27, 2022)

Low carb veg to try...avocados, low carbs, high cals. Pak choi is low carb, as is rocket. Boiled eggs are a useful snack.Some soya sauages are low carb but check as some high. I snack on babybel for a no call boost and no suagar jelly is a bit of a treat..if you whisk melted no sugar jelly with double cream it makes a vey nice high cal desert though possibly not something that is healthy long term but good for morale. Its horrible at first but it does get better as you go up the learning curve...believe me, it does get better! The worst is waiting for diagnosis ...such releif when i realised it was 'only' type 1. Still haven't put the weiht back on despite trying so buying a new set of clothes now...diabetes made me slim  wish it could make me young again too.
But remember, it gets easier


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## Cherrelle DUK (Apr 27, 2022)

Hi Purls of Wisdom, welcome to the forum.

It’s natural to be concerned when first diagnosed, especially as you don’t know your type yet. I think I ate two tablespoons of porridge the first day I was diagnosed as I was scared senseless due to not having the right info and worried I’d implode!

Knowing what to eat and when is a process which we’ve all been through so please try not to be so hard on yourself as you’ll get there in time.

Could you tell us more about how you came to be diagnosed and is there any way you could give them a nudge to confirm your type?

It might help to have a look at the info on our main site such as ideas on what to eat which I found useful regardless of type.









						Living with diabetes
					

Living with diabetes is difficult. There are so many factors to consider and it can be stressful knowing what's best, but you shouldn’t need to put your life on hold. Here you'll find lots of information to help you live well with your condition. From advice about treatments and what to eat, to...




					www.diabetes.org.uk
				




We’re here to support you every step of the way so feel free to give us a call on 0345 123 2399 to talk through any concerns you may have and be sure to have a read through the forum for some insights and ask as many questions as needs be .


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## Purls of Wisdom (Apr 27, 2022)

EmmaL76 said:


> Hi, there are so many of us that can totally relate to how your feeling. I am at the absolute top end of being hard on myself and punishing myself for what I see as my failures. This resulted in chronic food restriction ( I was slim on diagnosis) and this has continued for 1.5 years. Result, depression, extreme weight loss no energy and living in a zombie like state. This is absolutely not the path you want to go down. Please hear me when I say starvation is not the answer. Also as your diagnosis is unclear you could potentially be masking the real issue by severe food restriction. I am in this position now, my diagnosis is still unconfirmed but I have terrible anxiety around eating. There are many sustainable ways to be diabetic and not starve and although I am not the best person to advise in this, I’m sure many will be along to help. Do you know what your hba1c was on diagnosis? And what the general feeling of your gp is regarding your type?


Thank you reaching out. I only got diagnosed on 11th April. Rushed to the Hospital. Spent 9 days there. Upon admission my sugar levels were over 30. Ketones were borderline 1.3 and HbA1c of 99. First it was thought to be Type 1. I was suggested insulin. That was my major undoing.  I have never been too heavy for my age and height. Lost more weight now. My summery from the hospital is suggesting that it is most likely to be type 2 or LADA. Type 1.5? Not confirmed yet. No idea regarding BP or cholesterol. I test 4 times a day and take NoveRapid x3 and Lantas before bed. Gliclazide 2x2 daily. Could not tolerate Metformin so stopped by the consultant. Coming back to food, I have been given too many mixed messages. I can eat brown bread. Then I can't eat brown bread. Only Bran or Oats for breakfast. Eggs? High in cholesterol. Small clementines? Too sweet. Do not be eat Almonds, too fatty. Go easy on tomatoes. No pasta. Only brown. Less potatoes. Milk and cheese? Can not eat bananas everyday. Must be small. 2 rich tea everyday are too many. I am allowed digestives. Portion control. Only eat half of what I used to. Being vegetarian, there is not much left which I can eat guilt free. When feel hungry, one must eat, I was told. But eat what and how much?  I have already come to my tethers end. Worried, hungry, confused and angry at myself. All I want for some one is to guide me, which item I can eat and how many times a week. Such as 3 eggs, 3 small bananas a week. How many apples or tomatoes? Can I finish my meal with a piece of fruit? 2 slices of whole meal bread a day. Can I eat rice krispies or Corn flakes or pop corn? Blue or green cap milk. I hardly take any as it is. A dash in my tea and little amount in cereal. Salt or butter? How to count carbs and calorie control? The list is endless.
I also suffer from depression and anxiety and am on meds for life. Battled Breast cancer in 2016. I am originally an Indian female with strong will power, principled and aim for perfection, not a positive trait to have, I hasten to add. I cook and prefer to eat home cooked meals. So, I know there are choices out there as long as I ve the knowledge and understanding. 
I am sure you can understand my desperation, confusion and frustration. I am so grateful that I ve found this platform. Thanks. Stay safe and healthy!


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## Purls of Wisdom (Apr 27, 2022)

Cherrelle DUK said:


> Hi Purls of Wisdom, welcome to the forum.
> 
> It’s natural to be concerned when first diagnosed, especially as you don’t know your type yet. I think I ate two tablespoons of porridge the first day I was diagnosed as I was scared senseless due to not having the right info and worried I’d implode!
> 
> ...


Thanks. This forum is something I needed badly. I know now that I have support of real people who are either in the same boat as myself or been thru it. Thanking you all with much appreciation.


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## Leadinglights (Apr 27, 2022)

I can see your confusion about what to eat as there are many ways that people manage their diabetes and it is a matter of finding the way that suits you and that to a large extent depends on not just the diabetic type you are but what medications people take. This is why you will see a variety of different ways people manage their blood glucose levels.
In theory people who take insulin will have a different dietary regime they follow and even then it will depend on what their insulin regime is what they will need to do diet wise.
If they are adjusting their insulin dose to compensate for the amount of carbs they eat, in theory they can have a normal diet just like any non diabetic, however if they are told what dose of insulin to take then they would need to eat a fixed amount of carbs for that insulin.
There is a lot to learn and get your head around at the start.
The people who are Type 2 who are dietary managed with or without oral meds will often choose to go a low carb route which would mean they would not have potatoes, bread, rice, pasta, cereals, tropical fruits as well as cakes, biscuits, and sugary drinks. Many people adopt the principal of eating to their monitor as everybody is different and one size definitely does not fit all.
I hope this helps clarify the varied information you see.


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## harbottle (Apr 27, 2022)

Eggs are OK - the liver won't make cholesterol if dietary cholesterol is consumed (Unless you have a condition that means it doesn't do this.)


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## Leadinglights (Apr 27, 2022)

Hopefully some people who take insulin will be along to comment on your insulin regime and dispel some of the myths about what you can and can't have. 
I assume you have a blood glucose monitor as you should be testing frequently to avoid hypos. you have not mentioned what levels to are getting. 
Being vegetarian should present no problem, there are several people here who are.
It sounds as if you haven't been given much support for your diabetic clinic. 
Often when people go onto insulin then they do not need to take the gliclazide as it can be counter productive but others may know more about that.


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## ianf0ster (Apr 27, 2022)

Hi @Purls of Wisdom  At least you are vegetarian rather than vegan - they really have a hard time cutting down on carbs.
Whether on Insulin and Glic or not you can eat as much cheese and as many eggs as you want (because you aren't trying to lose weight). Though I have never eaten more than 400gms of cheese in a day, or more than 7 eggs in a day.. Avocados and Olives are also great for getting more calories without adding carbs. Tree nuts are also OK (carb wise) for the majority of Type 2's , but cashews can be a problem for some (like me).


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## Windy (Apr 27, 2022)

I'm also vegetarian. I have quorn (sausages/pieces/mince), seitan, tofu, TVP/soya, cheese, nuts and eggs for protein, and make veggie curries and chillis, eat roasted cauliflower and broccoli, hummus, omelettes, soup, guacamole, cauliflower cheese, spag bolognaise etc. There's a fair amount that you can have, I know there's loads of conflicting information, but you can find lots to eat. I hope you find a way through it all, it does get easier, honestly.


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## Purls of Wisdom (Apr 28, 2022)

Cherrelle DUK said:


> Hi Purls of Wisdom, welcome to the forum.
> 
> It’s natural to be concerned when first diagnosed, especially as you don’t know your type yet. I think I ate two tablespoons of porridge the first day I was diagnosed as I was scared senseless due to not having the right info and worried I’d implode!
> 
> ...


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## Purls of Wisdom (Apr 28, 2022)

The Surgery explained that they won't get results for the test done at the hospital. I am positive that 4 vials of blood was taken so that GP can have most recent results. 
Seriously speaking, I could do without this uncertainty. Thanking you. X


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## everydayupsanddowns (Apr 29, 2022)

Purls of Wisdom said:


> The Surgery explained that they won't get results for the test done at the hospital. I am positive that 4 vials of blood was taken so that GP can have most recent results.
> Seriously speaking, I could do without this uncertainty. Thanking you. X



Ah @Purls of Wisdom ! Sorry to hear what a confusing and frustrating time you have been having 

Depending on which tests are being done (possibly for autoantibodies and cPeptide), not all labs carry them out, so your samples may have had to be sent away - which can mean the results take longer to get back unfortunately.

Sounds like you have been reading advice on a wide range of diabetes management strategies, hoping to find ‘the way’. It would be so much simpler if diabetes operated like this, but it is a frustratingly fickle character, and along with having all manner of types and subtypes, even two people with notionally the same diagnosis could have success (or less so) by following exactly the same diet sheet. Because they are different people, with different gut biomes, genetic make-up, predispositions, reactions to foods, not to mention tastes and preferences. 

There isn’t one single approach that will work for everyone. But actually, what works for someone else isn’t all that important - what really matters is what works for YOU!

Think of your diabetes diagnosis as an ongoing adventure of personal discovery and experimentation. Your blood glucose meter is your compass, and other‘s suggestions (whether forum folks or medical professionals) are your guidebooks and tour guides.

In short… Since you have background and mealtime insulin, in theory you can eat absolutely any amount of anything you want (however healthy or unhealthy that may be). You simply need to find the correct balance of dose and timing to match the carbs/sugars in whatever it is, so that the speed of the digestion of the food matches the action of the insulin, and your BG levels stay in range.

But on your voyage of personal discovery you will find various ’neighbourhoods’ that you don’t get on with, and popular sights and ‘attractions’ that leave you cold. Some foods simply won’t behave nicely for you, or will produce erratic results such that any potential enjoyment they may have provided is ruined by the BG chaos that ensues - no matter hard you try. Other meals or foods will be a real challenge, but the view from the summit will be so breathtaking you will be prepared to put the effort in to get there. 

”Can you eat that?“ I can’t tell you... But I know you can use your BG meter to find out


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## Jacen017 (Apr 29, 2022)

Purls of Wisdom said:


> I have recently been diagnosed. Type unconfirmed. It came as a shock to say the least. I did not know anything about it. Partly cos of needle phobia. Learning bit by bit but not enough. Being very hard on myself when it comes to meal times and more so too much information on the net and little support. Too early I have been told. I am acutely stuck with what to eat, how much a day and in week. I need urgent guidance before I starve myself to nothing. Please help.
> Thanking you in advance.


Hi Purls Of Wisdom,

I don't have much advice on the types of food to eat as I'm currently matching my insulin to my meals and managing to have a normal diet without to much difficulty but I totally remember that panic and constant hunger! 

 As others suggest, the best thing is to test your blood glucose levels before a meal and then again 2 hours after the first bite to see what sort of impact that meal has had on you and you can start to get an idea of what you can tolerate.  If I remember correctly you're looking for a rise of no more than 2-3 mmol. (Someone please correct me if I'm giving the wrong advice)

What I can help you with is the Needle Phobia that you mentioned.  I also suffer from Needle Phobia and that for me was the worst part of being diagnosed with diabetes.  

It was taking me almost 2 hours to prick my finger or inject at first and then as soon as I had managed to do it I had to start trying again so I could get the blood to test again after 2 hours!  I had several times where I would faint with the needle in my stomach.

What I found helped me in the end was to take the needle out of the lancing device and prick myself manually - it's more painful but gives me a feeling of control that I couldn't get using the device as intended.

For injections - I found that bouncing the needle gently on the stomach whilst taking deep breaths would cause it to just slip in almost accidentally.  

I've also now purchased a device called TickleFlex which is absolutely brilliant, you slip it over the tip of your insulin pen and it hides the needle.  It has little rubber arms that tickle the skin and distract so you don't feel the needle going in and at the same time it gathers the skin up onto the needle.  It fits fine over my Novorapid pen but does not fit on my Toujeo pen properly.

I hope you're doing ok, it does all start to get better even though it feels like it never will at the start.


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## Purls of Wisdom (May 2, 2022)

everydayupsanddowns said:


> Ah @Purls of Wisdom ! Sorry to hear what a confusing and frustrating time you have been having
> 
> Depending on which tests are being done (possibly for autoantibodies and cPeptide), not all labs carry them out, so your samples may have had to be sent away - which can mean the results take longer to get back unfortunately.
> 
> ...


How and where I can learn the correct balancing of dose and timing to match the carbs/sugars? Who is going to teach me? I won't ask when or how long cos I must learn to be patient and calm. Thanks.


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## Purls of Wisdom (May 2, 2022)

Does that mean pricking my finger 4 times more? 


Jacen017 said:


> Hi Purls Of Wisdom,
> 
> I don't have much advice on the types of food to eat as I'm currently matching my insulin to my meals and managing to have a normal diet without to much difficulty but I totally remember that panic and constant hunger!
> 
> ...


Does that mean I ve to prick my finger 4 times more daily?


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## everydayupsanddowns (May 2, 2022)

Purls of Wisdom said:


> How and where I can learn the correct balancing of dose and timing to match the carbs/sugars? Who is going to teach me? I won't ask when or how long cos I must learn to be patient and calm. Thanks.



Some of that will depend on which type of diabetes you end up having, and whether you continue to use mealtime and background insulins (also known as basal:bolus or multiple daily injections). 

For T1 and LADA/T1.5 there are online or in-person courses like DAFNE or Bertie (other local variants exist) which teach you about the interactions between insulin, carbs, alcohol, exercise, stress, temperature, illness and a host of other variables. And how to understand, interpret and use your BG meter results to help inform your decisions, doses and choices. 

Essentially it’s an ongoing process of adjusting your background (basal) dose so that it just holds your BG levels steady when you don’t eat, then adjusting your insulin:carbohydrate ratio so that by calculating or estimating the amount of total carbohydrate in any meal or snack you can get an insulin dose that should match. 

It sounds a lot more complex written down as a summary that it is in practice, and soon enough you’ll be able to guesstimate the carbs in any plate of food from 50 yards. 

Good luck, and let us know how things go


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## Jacen017 (May 2, 2022)

Purls of Wisdom said:


> Does that mean pricking my finger 4 times more?
> 
> Does that mean I ve to prick my finger 4 times more daily?


If you want to see what sort of impact the food you are eating is having on you then yes, you would need to test before and 2 hours after.

You can always start just testing one meal and see how you get on.  It's never going to be a one size fits all situation, you need to find what works for you.

As you are using Novorapid 3 times a day I'm assuming that you are using it with each meal?  I believe you would either need to be adjusting your food to match the carbs covered by a set dose or adjusting your dose to match the carbs you are eating.  

For example, I inject 1 Unit of Novorapid for every 10g of carbs I'm going to be eating but that ratio is different for different people.  Try to speak with your DSN about carb counting.


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## Purls of Wisdom (May 2, 2022)

Does that mean pricking my finger 4 times more?


Jacen017 said:


> Hi Purls Of Wisdom,
> 
> I don't have much advice on the types of food to eat as I'm currently matching my insulin to my meals and managing to have a normal diet without to much difficulty but I totally remember that panic and constant hunger!
> 
> ...


Does that mean I ve to prick my finger 4 times more daily?


everydayupsanddowns said:


> Some of that will depend on which type of diabetes you end up having, and whether you continue to use mealtime and background insulins (also known as basal:bolus or multiple daily injections).
> 
> For T1 and LADA/T1.5 there are online or in-person courses like DAFNE or Bertie (other local variants exist) which teach you about the interactions between insulin, carbs, alcohol, exercise, stress, temperature, illness and a host of other variables. And how to understand, interpret and use your BG meter results to help inform your decisions, doses and choices.
> 
> ...


Sounds impossible task to comprehend at present. Where are those courses available from?


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## trophywench (May 2, 2022)

If you have Type 1 diabetes, the hospital clinic will arrange this for you.  If you don't have Type 1, you won't be offered such a course, but in any case it isn't rocket science, just a bit of maths involved is all and we can assist you if you ask. 

Testing your BG via a fingerprick shouldn't actually hurt.  Try reading this





__





						Painless Pricks
					

Managing blood glucose levels for type 2 diabetes. Learning how to achieve long term control by testing and diet.




					loraldiabetes.blogspot.com


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## everydayupsanddowns (May 2, 2022)

Purls of Wisdom said:


> Does that mean I ve to prick my finger 4 times more daily?



Clinical trial data shows that more frequent BG monitoring is associated with better outcomes. Typically it is found to be helpful to check your levels before each meal (to help adjust your dose) and before bed (for safety). There may be additional times where it’s helpful to check, eg if you think you might be experiencing hypoglycaemia or for the legal DVLA driving requirements. 

If you find fingerstick monitoring difficult because of your needle phobia you may be able to access isCGM (Libre) or rtCGM (eg Dexcom) where blood samples are needed far less frequently. 

A lot of this will become clearer when your exact diagnosis is confirmed, so try not to get stressed about it in the mean time.


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## Leadinglights (May 2, 2022)

I'm not sure testing before you eat and after 2 hours is appropriate if you are injecting insulin as the body is going to be responding differently than a Type 2 with diet management where they do want to be finding out the effect of meals.
Hopefully some Type 1 or folk taking insulin can clarify.


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## rayray119 (May 2, 2022)

Leadinglights said:


> I'm not sure testing before you eat and after 2 hours is appropriate if you are injecting insulin as the body is going to be responding differently than a Type 2 with diet management where they do want to be finding out the effect of meals.
> Hopefully some Type 1 or folk taking insulin can clarify.


But you might get an idea on how you're timings are and wether it might be a good idea to eat somthing.  That's why j do it.


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## rayray119 (May 2, 2022)

Purls of Wisdom said:


> I have recently been diagnosed. Type unconfirmed. It came as a shock to say the least. I did not know anything about it. Partly cos of needle phobia. Learning bit by bit but not enough. Being very hard on myself when it comes to meal times and more so too much information on the net and little support. Too early I have been told. I am acutely stuck with what to eat, how much a day and in week. I need urgent guidance before I starve myself to nothing. Please help.
> Thanking you in advance.


Just to encourage you I too had an extreme fear of needles before being diagnosed to put I got really worked up before getting any vaccines or blood tests done and need to close my eyes while these being done so when they told me i would need to be injecting myself several times a day I was freaked out.   Now I've been injecting myself seal times a day for about 7 months  I no longer have this fear and it even feels normal at points


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## Purls of Wisdom (May 2, 2022)

Jacen017 said:


> Hi Purls Of Wisdom,
> 
> I don't have much advice on the types of food to eat as I'm currently matching my insulin to my meals and managing to have a normal diet without to much difficulty but I totally remember that panic and constant hunger!
> 
> ...


I took your kind advice and tested BG before and 2 hours after the meals. What a carry on. Before lunch I tested 10.7 and 2 hours later, it jumped to 14.3. Pre dinner reading was 8.5 and 2 hours later it was 14.9. Surprised, shocked and horrified, I am more baffled.


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## Leadinglights (May 2, 2022)

Purls of Wisdom said:


> I took your kind advice and tested BG before and 2 hours after the meals. What a carry on. Before lunch I tested 10.7 and 2 hours later, it jumped to 14.3. Pre dinner reading was 8.5 and 2 hours later it was 14.9. Surprised, shocked and horrified, I am more baffled.


IF that was something that somebody got who is Type 2 but not taking insulin then most definitely the meal was too carb heavy but for somebody taking insulin then it is more likely that the insulin dose is not enough to cope with the amount of carbs or the timing of the dose need adjusting. But I suspect you are not yet in a position to be changing things with out advice either from your DSN or some of the very helpful people here who are familiar with insulin regimes and what to expect.


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## trophywench (May 2, 2022)

Well if you are Type 1 - that's perfectly fine.  Target for us is 'back to normal before next meal' which you are, in fact you were below !   If Type 2 - not utterly fantastic but by no means a complete disaster.

Please - press for proper identification of which type of diabetes you have!


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## Ditto (May 3, 2022)

Hello and welcome.


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## helli (May 3, 2022)

Jacen017 said:


> If you want to see what sort of impact the food you are eating is having on you then yes, you would need to test before and 2 hours after.


This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.


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## trophywench (May 3, 2022)

helli said:


> This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.


YES!!!!!


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## Jacen017 (May 3, 2022)

helli said:


> This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.


Thanks for correcting me 

I got into the habit of doing it early days and just never stopped.


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## Irisaria (May 4, 2022)

helli said:


> This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.


This is interesting!  Does that mean ignore any spikes during the 4 hours so long as the BG reading drops to the 'correct' level after 4 hours or so?


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## helli (May 4, 2022)

Irisaria said:


> This is interesting!  Does that mean ignore any spikes during the 4 hours so long as the BG reading drops to the 'correct' level after 4 hours or so?


I would not change the dose if my levels returned after 4 hours. 
I am lucky to have a CGM so I can see when the spikes occur and have adjusted the pre-bolus time so the peak of the insulin potency closer matches the peak of carb digestion. 

But if your levels return to "normal" after. 4 hours, your dose is correct. 
And, in my opinion, short spikes should not be a concern. Remember, people without diabetes can see spikes up to 10mmol/l


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## leonS (May 4, 2022)

With what is a high level of ketones with a high BG you are almost certain to be type 1. T2s can not produce ketones except under very specific conditions such as a serious prolonged infection. Even with this ketones are rare in T2.

There is no treatment for T1 other than insulin. Insulin must be injected several times each day. NICE say that a T1 should do a finger prick blood test AT LEAST four times a day.

I would accept the offer of insulin and press to have your treatment under the care of a specialist clinic. They can help wjth setting up initial values for your treatment - a skill that few GPs have.


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## Irisaria (May 4, 2022)

helli said:


> I would not change the dose if my levels returned after 4 hours.
> I am lucky to have a CGM so I can see when the spikes occur and have adjusted the pre-bolus time so the peak of the insulin potency closer matches the peak of carb digestion.
> 
> But if your levels return to "normal" after. 4 hours, your dose is correct.
> And, in my opinion, short spikes should not be a concern. Remember, people without diabetes can see spikes up to 10mmol/l


Thank you, that makes a lot of sense!


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## trophywench (May 4, 2022)

It's being far too high and staying high for hours on end, frequently, to worry about.

Occasional excursions, even into the stratosphere, are OK as long as you enjoyed whatever caused it!


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## rayray119 (May 7, 2022)

helli said:


> This is advice for type 2. With Type 1 (or type 2 treated with basal/bolus insulin) we are dependent on the speed of our "fast" acting insulin which will continue working for 4 hours so testing after 2 hours is unnecessary and misleading.


I wouldn't say it's completely misleading while not in my case anyway. I actually do find those in-between checks helpful to provide certain identify certain things. But everyone's different.


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## Lucyr (May 8, 2022)

leonS said:


> With what is a high level of ketones with a high BG you are almost certain to be type 1. T2s can not produce ketones except under very specific conditions such as a serious prolonged infection. Even with this ketones are rare in T2


This is not true. T2 can produce ketones for many reasons without a serious infection. Some T2 don’t produce much of their own insulin and can produce ketones if not injecting enough insulin, some get ketones as a side effect of certain medications, can get ketones from dehydration, from a low carb diet, there are many causes.


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## Irisaria (May 10, 2022)

Actually I agree with you rayray119.  I often check before going out for a walk for example to make sure I won't hypo while out.


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## Mrs Mimoo (May 15, 2022)

I eat lots of asian foods and I found that paneer and curry sauces were ok but rice and breads etc. were a no go area. so I have curry with cauliflower rice and no bread and it's almost as good and low carb. Konjak rice is ok too.


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## Lih (May 15, 2022)

Purls of Wisdom said:


> Thank you reaching out. I only got diagnosed on 11th April. Rushed to the Hospital. Spent 9 days there. Upon admission my sugar levels were over 30. Ketones were borderline 1.3 and HbA1c of 99. First it was thought to be Type 1. I was suggested insulin. That was my major undoing.  I have never been too heavy for my age and height. Lost more weight now. My summery from the hospital is suggesting that it is most likely to be type 2 or LADA. Type 1.5? Not confirmed yet. No idea regarding BP or cholesterol. I test 4 times a day and take NoveRapid x3 and Lantas before bed. Gliclazide 2x2 daily. Could not tolerate Metformin so stopped by the consultant. Coming back to food, I have been given too many mixed messages. I can eat brown bread. Then I can't eat brown bread. Only Bran or Oats for breakfast. Eggs? High in cholesterol. Small clementines? Too sweet. Do not be eat Almonds, too fatty. Go easy on tomatoes. No pasta. Only brown. Less potatoes. Milk and cheese? Can not eat bananas everyday. Must be small. 2 rich tea everyday are too many. I am allowed digestives. Portion control. Only eat half of what I used to. Being vegetarian, there is not much left which I can eat guilt free. When feel hungry, one must eat, I was told. But eat what and how much?  I have already come to my tethers end. Worried, hungry, confused and angry at myself. All I want for some one is to guide me, which item I can eat and how many times a week. Such as 3 eggs, 3 small bananas a week. How many apples or tomatoes? Can I finish my meal with a piece of fruit? 2 slices of whole meal bread a day. Can I eat rice krispies or Corn flakes or pop corn? Blue or green cap milk. I hardly take any as it is. A dash in my tea and little amount in cereal. Salt or butter? How to count carbs and calorie control? The list is endless.
> I also suffer from depression and anxiety and am on meds for life. Battled Breast cancer in 2016. I am originally an Indian female with strong will power, principled and aim for perfection, not a positive trait to have, I hasten to add. I cook and prefer to eat home cooked meals. So, I know there are choices out there as long as I ve the knowledge and understanding.
> I am sure you can understand my desperation, confusion and frustration. I am so grateful that I ve found this platform. Thanks. Stay safe and healthy!


Hi. Have you had any guidance on how much insulin to take per gram of carbohydrates? I've been type 1 for 42 years and I have to count carbohydrates so I know how much insulin to take each mealtime.I'm here if you want to ask anything


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## Purls of Wisdom (May 16, 2022)

Mrs Mimoo said:


> I eat lots of asian foods and I found that paneer and curry sauces were ok but rice and breads etc. were a no go area. so I have curry with cauliflower rice and no bread and it's almost as good and low carb. Konjak rice is ok too.


How do you carb count when it comes to home cooked curries? I have come to this conclusion that I can't eat 2 slices of brown bread or 2 wholemeal chapattis. No problem in making various low carb veg dishes but carb counting is a bit tricky. Any suggestions are welcome.


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## Purls of Wisdom (May 16, 2022)

Lih said:


> Hi. Have you had any guidance on how much insulin to take per gram of carbohydrates? I've been type 1 for 42 years and I have to count carbohydrates so I know how much insulin to take each mealtime.I'm here if you want to ask anything


I have only had one meeting with the dietitian and the nurse. Still on set insulin but counting carbs. Keeping a food diary. Type of Diabetes is not known yet. I have forgotten how many carbs I could eat in a day. So, I am only consuming around 100 carbs. Too many? My relationship with food is very rocky these days. I wish I could feel a little bit more relaxed and less anxious when it comes to food. Thanks.


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## Lucyr (May 16, 2022)

Purls of Wisdom said:


> How do you carb count when it comes to home cooked curries? I have come to this conclusion that I can't eat 2 slices of brown bread or 2 wholemeal chapattis. No problem in making various low carb veg dishes but carb counting is a bit tricky. Any suggestions are welcome.


I calculate the carbs in the whole dish and then divide it by how many portions it is serving to find the carbs in my portion


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## ianf0ster (May 16, 2022)

Where it's difficult to count the carbs directly, just experiment with what you think/feel will be OK and check with your BG meter that it actually was OK. After several tests of similar dishes you get experienced enough not to make any major mistakes.


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## Inka (May 16, 2022)

Purls of Wisdom said:


> How do you carb count when it comes to home cooked curries? I have come to this conclusion that I can't eat 2 slices of brown bread or 2 wholemeal chapattis. No problem in making various low carb veg dishes but carb counting is a bit tricky. Any suggestions are welcome.



Count the carbs in the main carby thing eg. rice, then look at any sauce or sides. If there’s small amounts of carbs in each side dish, but I’m having a few side dishes, then I consider them all together and add on 5/10/whatever grams of carbs.

If you’re on fixed doses of insulin, you shouldn’t reduce your carbs without support else you risk a hypo. You should be having fixed amounts of carbs for each meal to go with your fixed doses of insulin. That is, you can’t make up missing carbs later in the day, you need to work with your insulin for each meal.


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## Leadinglights (May 16, 2022)

Purls of Wisdom said:


> I have only had one meeting with the dietitian and the nurse. Still on set insulin but counting carbs. Keeping a food diary. Type of Diabetes is not known yet. I have forgotten how many carbs I could eat in a day. So, I am only consuming around 100 carbs. Too many? My relationship with food is very rocky these days. I wish I could feel a little bit more relaxed and less anxious when it comes to food. Thanks.


Surely if you are on fixed dose of insulin you need to be quite careful of the amount of carbs in each meal otherwise you are risking being hypo or having a big spike. If you can't remember then ask your DSN for a reminder.


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## Purls of Wisdom (May 16, 2022)

Leadinglights said:


> Surely if you are on fixed dose of insulin you need to be quite careful of the amount of carbs in each meal otherwise you are risking being hypo or having a big spike. If you can't remember then ask your DSN for a reminder.


I just did. Thanks.


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## Purls of Wisdom (May 16, 2022)

Inka said:


> Count the carbs in the main carby thing eg. rice, then look at any sauce or sides. If there’s small amounts of carbs in each side dish, but I’m having a few side dishes, then I consider them all together and add on 5/10/whatever grams of carbs.
> 
> If you’re on fixed doses of insulin, you shouldn’t reduce your carbs without support else you risk a hypo. You should be having fixed amounts of carbs for each meal to go with your fixed doses of insulin. That is, you can’t make up missing carbs later in the day, you need to work with your insulin for each meal.


Thank you for clearing it for me. I ve emailed my DSN. Roughly how many carbs are needed to deal with 3u and 4 u of Novorapid? Lack of knowledge and understanding is making me more anxious.


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## Purls of Wisdom (May 16, 2022)

Lucyr said:


> I calculate the carbs in the whole dish and then divide it by how many portions it is serving to find the carbs in my portion


I did that when I made soup the other night but homemade lentils and veg curries is either tricky or I am trying too hard?


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## Purls of Wisdom (May 16, 2022)

Jacen017 said:


> If you want to see what sort of impact the food you are eating is having on you then yes, you would need to test before and 2 hours after.
> 
> You can always start just testing one meal and see how you get on.  It's never going to be a one size fits all situation, you need to find what works for you.
> 
> ...


You are God sent. Now the proverbial penny has dropped. Thanks. If carbs are little over 1:10 ratio? For example, 33 carbs and 3u of Novorapid?


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## Jacen017 (May 16, 2022)

Purls of Wisdom said:


> You are God sent. Now the proverbial penny has dropped. Thanks. If carbs are little over 1:10 ratio? For example, 33 carbs and 3u of Novorapid?


Yes 

Keep in mind that the ratios are different for different people however.


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## rayray119 (May 16, 2022)

Purls of Wisdom said:


> You are God sent. Now the proverbial penny has dropped. Thanks. If carbs are little over 1:10 ratio? For example, 33 carbs and 3u of Novorapid?


Thats just a starting point they tend to try people on and even if it turns out to be right amount for now it won't always be. Needs change over time.


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## Purls of Wisdom (May 16, 2022)

Understood. Thanks. Knowing this much will do for now.


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## Inka (May 16, 2022)

Purls of Wisdom said:


> Thank you for clearing it for me. I ve emailed my DSN. Roughly how many carbs are needed to deal with 3u and 4 u of Novorapid? Lack of knowledge and understanding is making me more anxious.



It completely depends on the individual and their situation. When you were given your fixed doses of Novorapid, you should have been given a carb amount for each meal eg Lunch - 3 units of Novorapid, 40g carbs or whatever, evening meal 4 units, 50g carbs or whatever. *My figures there are just an example - do not follow them! *


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## Purls of Wisdom (May 16, 2022)

Purls of Wisdom said:


> You are God sent. Now the proverbial penny has dropped. Thanks. If carbs are little over 1:10 ratio? For example, 33 carbs and 3u of Novorapid?





Purls of Wisdom said:


> Understood. Thanks. Knowing this much will do for now.





Purls of Wisdom said:


> You are God sent. Now the proverbial penny has dropped. Thanks. If carbs are little over 1:10 ratio? For example, 33 carbs and 3u of Novorapid?


What about mid morning and mid afternoon snack? Usually it is either a piece of fruit or small amount of unsalted peanuts / seeds.


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## rayray119 (May 16, 2022)

Inka said:


> It completely depends on the individual and their situation. When you were given your fixed doses of Novorapid, you should have been given a carb amount for each meal eg Lunch - 3 units of Novorapid, 40g carbs or whatever, evening meal 4 units, 50g carbs or whatever. *My figures there are just an example - do not follow them! *


its looks not everyone is unfounmtly unforttly(and s when i started on set doses I was just told to limit it for now and would to taught how to it depending on what i'm eating afterwards)  bit awkward at the time i just ate a salad a salad for lunch and injected 6 units of novorapid(i know would  better know but being only a week in and that point I didn't) not sure how it if would worked diffinatty if i was diagnosed in the hospital i actually go to.


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## rayray119 (May 16, 2022)

Purls of Wisdom said:


> What about mid morning and mid afternoon snack? Usually it is either a piece of fruit or small amount of unsalted peanuts / seeds.


is reason you're having this to try and keep your blood sugar up?(just asking to so people can advice you proberrly)


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## Purls of Wisdom (May 16, 2022)

Inka said:


> It completely depends on the individual and their situation. When you were given your fixed doses of Novorapid, you should have been given a carb amount for each meal eg Lunch - 3 units of Novorapid, 40g carbs or whatever, evening meal 4 units, 50g carbs or whatever. *My figures there are just an example - do not follow them! *


I know the seriousness of this ailment hence being cautious. Won't do anything if unsure. All your comments are giving me the basics which I can build upon. Thanks.


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## Purls of Wisdom (May 16, 2022)

I know exactly how one would ve felt initially. I am just lucky that I reached out and seeked help and guidance. 
I was given a lump sum number of carbs which I fail to recall now. 1:10 ratio is the best calculation stratagy I have heard in 5 weeks. I am happy to know this much at this stage. I know things will change and so are the numbers and suggestions. 
Can not thank my stars enough.


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## Purls of Wisdom (May 16, 2022)

rayray119 said:


> is reason you're having this to try and keep your blood sugar up?(just asking to so people can advice you proberrly)


No, I just follow the pattern I had pre diagnosis and as advised by the dietitian. Now this brings to my next point - am I supposed to keep my pre diabetes eating pattern? So that they can set the insulin dose or should stick to the 1:10 rule with set doses? Mind boggling stuff, if you ask me.


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## rayray119 (May 16, 2022)

Purls of Wisdom said:


> No, I just follow the pattern I had pre diagnosis and as advised by the dietitian. Now this brings to my next point - am I supposed to keep my pre diabetes eating pattern? So that they can set the insulin dose or should stick to the 1:10 rule with set doses? Mind boggling stuff, if you ask me.


This is something you're team should really be advising you on we can't tell you what radtio you should try.  Have you heard an hospital appointment yet if not push for one.


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## rayray119 (May 16, 2022)

Purls of Wisdom said:


> Mind boggling stuff, if you ask me.



Yep that's diabetes for you I felt very overwhelmed at 8 months ago and still do sometimes.    We all know what it's like so you're not alone.


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## Lucyr (May 16, 2022)

When I snack I use the same carbohydrate ratio method as i use for meals. If you’re not using a ratio yet then snacking will probably send you a bit high as fixed doses will be covering your meals not your snacks.


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## rayray119 (May 16, 2022)

Oh yes that's another thing when dianosiged I asked if I should take it for snacks and they said not for snacks just meals so unless I was trying keep my blood sugars up. I didn't have carb stnacks


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## Inka (May 16, 2022)

Purls of Wisdom said:


> No, I just follow the pattern I had pre diagnosis and as advised by the dietitian. Now this brings to my next point - am I supposed to keep my pre diabetes eating pattern? So that they can set the insulin dose or should stick to the 1:10 rule with set doses? Mind boggling stuff, if you ask me.



Ignore the 1:10 ‘rule’ - because it’s not a rule! Some people are started on 1:20, some 1:25, some 1:4, etc. It depends on many factors and you should follow the advice of your nurse not go for 1:10.


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## Inka (May 16, 2022)

Purls of Wisdom said:


> What about mid morning and mid afternoon snack? Usually it is either a piece of fruit or small amount of unsalted peanuts / seeds.



On fixed doses, you’d only have a carby snack if your blood sugar needed pushing up a little or if you were going to take exercise.

You can eat non-carby snacks or snacks with very minimal carbs.


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## Purls of Wisdom (May 16, 2022)

rayray119 said:


> This is something you're team should really be advising you on we can't tell you what radtio you should try.  Have you heard an hospital appointment yet if not push for one.


Things are moving very slowly for my liking. The consultant met up with the team to discuss my case on Friday. Not a word to me. Today I have also discovered that the contact number I ve been given to contact DSN is wrong. I used the number before, how can it be wrong today? I am not frustrated with out a reason. Stressful times as it is.


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## Purls of Wisdom (May 16, 2022)

Inka said:


> On fixed doses, you’d only have a carby snack if your blood sugar needed pushing up a little or if you were going to take exercise.
> 
> You can eat non-carby snacks or snacks with very minimal carbs.


Thank God. At least I got that right.


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## Inka (May 16, 2022)

Purls of Wisdom said:


> Thank God. At least I got that right.


 
You’re doing fine  It really is hard at first but you’re involved, interested and asking sensible questions.


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## Purls of Wisdom (May 16, 2022)

Inka said:


> You’re doing fine  It really is hard at first but you’re involved, interested and asking sensible questions.


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## Purls of Wisdom (May 16, 2022)

Everyone is mentioning "pushing the BG numbers up". What should be the numbers when I know to take an extra small carby snack? I look at the Libre2 readings within the green belt and know things are OK and no action is required. Correct or not, I ain't sure.


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## Jacen017 (May 16, 2022)

Inka said:


> Ignore the 1:10 ‘rule’ - because it’s not a rule! Some people are started on 1:20, some 1:25, some 1:4, etc. It depends on many factors and you should follow the advice of your nurse not go for 1:10.


This exactly!  Different people have different ratios, you need to check with your DSN to see where you should start.


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## Purls of Wisdom (May 16, 2022)

Jacen017 said:


> This exactly!  Different people have different ratios, you need to check with your DSN to see where you should start.


Thank you for keeping me right.


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## Jacen017 (May 17, 2022)




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## Purls of Wisdom (May 17, 2022)

Jacen017 said:


> View attachment 21026


Cheered me up, thanks.


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## trophywench (May 17, 2022)

I haven't seen that one before either!


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## Proud to be erratic (May 18, 2022)

Purls of Wisdom said:


> Everyone is mentioning "pushing the BG numbers up". What should be the numbers when I know to take an extra small carby snack?


When you are low, but not hypo. My D is possibly a bit different, since I have no panc'y and is described as brittle - can change very quickly. So my Libre alarm is set at 5.6 and when that sounds I scan. If the trend arrow is horizontal I take a small snack of 5 or 6 gms carbs, eg 1/2 hobnob biscuit, 1 finger of kit kat, 1x Nairns oat biscuits, some twiglets. I don't finger prick at this time, I know what the approx difference is between actual BG and Libre interstitial; my intent is solely to nudge my BG away from a possible 4.

If the trend arrow is up and the alarm is a momentary wobble I do nothing.

If the trend arrow is diagonally down I might take up to 10 gms to stop the downward trend and check 10 mins later.

If the trend arrow is vertically down, still only 10 gms, but made up of 1x jelly baby, ie a high GI nudge and 1x Nairns - no chocolate, ie no kitkat - to ensure the fat content isn't slowing down the carb response. Again scan to check the downward trend is being slowed and preferably stopped. If not slowed, I drink 10 gm lucozade or high carb orange juice (I don't like coke). I am now blatantly guarding against a hypo. 

In May I've had no low glucose events and just briefly touched 3.9. Only 1 modest low glucose event in April.  


Purls of Wisdom said:


> I look at the Libre2 readings within the green belt and know things are OK and no action is required. Correct or not, I ain't sure.


In my opinion correct. If you can stay in the green you are doing extremely well. If you stray from time to time above 10, in my opinion again you are doing very well.

Yesterday I was out with my daugter-in-law and granddaughter (who I've not seen for almost 3 yrs). We had a simple cafe lunch, and I had a small latte and a packaged sandwich, total 44 gm carbs. I took 4.5 units of insulin, my normal midday ratio of 10:1. My scan after 30 mins showed increase; after 45 mins high alarm above 10, 1hr I was at 15 and still going up. It was as if I'd forgotten to bolus - but I'd not forgotten, 2x witnesses and a NovaEcho pen confirming my dose and timing! I now took a further 5 units of bolus BUT very alert to the possibility of suddenly crashing. The trend reversed, at one stage the fall was quite Rapid, but with care I responded with medium GI snacks, including an 18gm Nakd bar taken in 1/3rds and I never got below 5. I don't know why my original bolus was so slow to kick in; I was concerned but not panicking. For a while my D was dictating to me ... rather than me keeping it controlled. But I did keep it managed, with a lot of effort and constant monitoring. I choose not to tell my daughter-in-law until later, I didn't want to share my anxiety, partly because she'd then worry, keep quizzing me and that would start to stress me - introducing another BG factor! But potentially a risky strategy, not sharing my challenge of that moment. Overall a satisfactory result, albeit with a large spike on my Libre graph.

How many pancakes on the roof.... or Purple with hatless aliens!!


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## Proud to be erratic (May 18, 2022)

Purls of Wisdom said:


> I did that when I made soup the other night but homemade lentils and veg curries is either tricky or I am trying too hard?


Is there rice involved with those curries?

Because we don't eat rice every day, sometimes not even every week, rice frequently doesn't give me a consistent BG response. You will know there are so many types of rice and if Tilda packaging is to be believed each type can have some variation in its carb content per 100gms uncooked. However the method of cooking also alters the cooked carb content per 100gns. If its washed then a portion of the uncooked carbs from the starch is washed away. If its cooked with an exact amount of water per 100gms and all of that cooking water is absorbed then the cooked carb content will be different from that same rice cooked in an excess of water and some drained away (with some carbs from starch released by cooking.

So, and I know this will be inappropriate for you, when we buy pre-cooked rice in its 'sealed' bag (there are various suppliers including Tilda) I've found the declared carb content on the packaging does work for me. But even Tilda dry rice declares different carb content for that dry rice after their cooking method, from what seems at first look to be the same sort of rice in a pre-cooked bag. It's not just DM that is confusing!


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## Purls of Wisdom (May 18, 2022)

Proud to be erratic said:


> When you are low, but not hypo. My D is possibly a bit different, since I have no panc'y and is described as brittle - can change very quickly. So my Libre alarm is set at 5.6 and when that sounds I scan. If the trend arrow is horizontal I take a small snack of 5 or 6 gms carbs, eg 1/2 hobnob biscuit, 1 finger of kit kat, 1x Nairns oat biscuits, some twiglets. I don't finger prick at this time, I know what the approx difference is between actual BG and Libre interstitial; my intent is solely to nudge my BG away from a possible 4.
> 
> If the trend arrow is up and the alarm is a momentary wobble I do nothing.
> 
> ...


...and I have no such knowledge or coping mechanisms. In my little head, if the trend is horizontal that means all is well and nothing to do or worry about. What I do forget is the same horizontal line can fall down as well and fairly quickly. My boundaries are set by the DSN. Lastly I am still pricking my finger to check if the reading is correct, if not then different by how many points despite having Libre2 .  When can I safely stop jabbing my poor fingertips? Thank you.


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## Purls of Wisdom (May 18, 2022)

Proud to be erratic said:


> Is there rice involved with those curries?
> 
> Because we don't eat rice every day, sometimes not even every week, rice frequently doesn't give me a consistent BG response. You will know there are so many types of rice and if Tilda packaging is to be believed each type can have some variation in its carb content per 100gms uncooked. However the method of cooking also alters the cooked carb content per 100gns. If its washed then a portion of the uncooked carbs from the starch is washed away. If its cooked with an exact amount of water per 100gms and all of that cooking water is absorbed then the cooked carb content will be different from that same rice cooked in an excess of water and some drained away (with some carbs from starch released by cooking.
> 
> So, and I know this will be inappropriate for you, when we buy pre-cooked rice in its 'sealed' bag (there are various suppliers including Tilda) I've found the declared carb content on the packaging does work for me. But even Tilda dry rice declares different carb content for that dry rice after their cooking method, from what seems at first look to be the same sort of rice in a pre-cooked bag. It's not just DM that is confusing!


True. I know rice is a big no no. Although Basmati has lowest GI levels. Usually have plain boiled rice with curries. I have bought, not tried yet, wholemeal short grain rice advised by a vegan nephew.  It still has 75g of Carbs per 100gm.


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## Proud to be erratic (May 18, 2022)

Purls of Wisdom said:


> ...and I have no such knowledge or coping mechanisms. In my little head, if the trend is horizontal that means all is well and nothing to do or worry about.


Correct, for your present circumstances: pending formal diagnosis; no training; not carb counting.


Purls of Wisdom said:


> What I do forget is the same horizontal line can fall down as well and fairly quickly.


For me and I think most other people the strength and merit of Libre is less about the numerical reading and more about the trend arrow. So it's better if you try to get in the habit of consciously looking at the arrow and note the trend. In the future you will be taking corrective action based on the trend.


Purls of Wisdom said:


> My boundaries are set by the DSN.


Noted.


Purls of Wisdom said:


> Lastly I am still pricking my finger to check if the reading is correct, if not then different by how many points despite having Libre2 .


If different by +2, ie Libre 6.5 and actual 4.5 then accept the Libre reading, even though you know its a bit higher; nevertheless all fine until Libre reaches 10 or even 11. At Libre 11 actual will be approx 9. Don't bother finger pricking

If different by -2, ie Libre 4.0 but actual =6, again accept the libre reading knowing in your mind or your log notes that actual is 6 and accept Libre to about 8, when actual will be approx 10. Again don't bother finger pricking.


Purls of Wisdom said:


> When can I safely stop jabbing my poor fingertips? Thank you.


When you are in range, ie actual approx 5-10 no real reason to finger prick. If you want to be reassured that Libre is still broadly OK, then finger prick once daily. But this isn't really essential; it's just for your own peace of mind.

When Libre shows very low or you feel hypo finger prick to verify you are hypo and then treat the hypo. Wait 15 mins and finger prick again.

When Libre seems ridiculous, perhaps ultra low and stuck at that or very high and stuck at that, then you need to abandon that sensor and finger prick until the replacement sensor is up and running. Phone or email Abott and seek a replacement.

Currently, because of your fixed doses, you are getting 3 things out of Libre: confidence and experience in wearing the sensor; alarms to help you prevent a hypo; and awareness of what your body is doing in response to different foods and various types of activity or exercise.

There is a 4th thing you could get: confidence to carry out small experiments. You've experienced a hypo; you know its not nice, but you've also found out it's manageable and you don't automatically die! You've been hyper and found out that is also not pleasant; it led to your diagnosis and when you took a post prandial bolus you learnt going a bit high is also manageable. It's your body and your diabetes and you could consider trying different foods and adjusting your bolus by a unit or 2;  or by taking a 1 or 2 unit correction when you are at or near actual 10+. This may still feel very new to you, but about 5 weeks on from the first diagnosis and it would be appropriate to loosen the strings keeping you tied to your DSN. You also know that members in this forum do respond to a cry for help, so you are far from alone in this challenge.

We were discussing rice: if you were to cook yourself a portion of plain boiled rice the carbs and cals book says this would be 85gm carbs per 100 gm when dry & uncooked, but 31gm carbs per 100gm portion. Try a modest 70 gm cooked portion, which would be a touch over 20 gms of carbs and take 2 extra units of bolus to cover those extra carbs. This would be guessing a carb to insulin tatio of 10:1, which as an experiment would be very reasonable. Monitor on your Libre to watch what happens by taking a reading immediately before the meal and then at hourly intervals. No need to finger prick, just watch for the trend and make deductions as appropriate. Repeat this experiment 3 or 4 times to confirm your first try was representative of each time you might eat rice. 

I think you'll feel greatly emboldened by taking these initial steps.


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## rayray119 (May 18, 2022)

I have different advice for the libre Vs finger prick. I wouldn't be accepting the libre reading if finger prick was was 2 out so people think that's fine I don't (and also others) and cause  problems (a lot also say this isn't okay don't so I think it's depends on what you're comfortable with.


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## Proud to be erratic (May 19, 2022)

rayray119 said:


> I have different advice for the libre Vs finger prick. I wouldn't be accepting the libre reading if finger prick was was 2 out so people think that's fine I don't (and also others) and cause  problems (a lot also say this isn't okay don't so I think it's depends on what you're comfortable with.


Well, you don't have a lot of choice in the matter. If you phone Abbott asking them to replace the sensor because the differential (in steady state) is 2 - you might be lucky or, as happened to me a while ago, they point out that there is a manufacturer's tolerance for discrepancy with both the sensor and the meter. At the upper end of the range a differential of 2 is within tolerance.

In practice I frequently have sensors showing a differential of up to 2 and manage this; its a nuisance, but manageable. At one point I wondered if my meter was badly inaccurate. But I tested my actual BG on all 3 meters that I own as well as the meter at my GP's Surgery and there was a surprisingly good correlation.


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## Mrs Mimoo (May 21, 2022)

Purls of Wisdom said:


> How do you carb count when it comes to home cooked curries? I have come to this conclusion that I can't eat 2 slices of brown bread or 2 wholemeal chapattis. No problem in making various low carb veg dishes but carb counting is a bit tricky. Any suggestions are welcome.


In my case I count carbs and try to stick to 50g a day but a n injector I think you may be different. 

I would weigh out the protein = e.g. 200g of Paneer is about 300cals and low in carbs. 200g of chicken is aobut 200 cals 2g carbs.
Dry fry spices - a dried chili, good shake of turmeric, pinch cumin thumb or fresh ginger and a pinch of powdered coriandar seeds. can also add curry leaves, and other spices to taste
Put slug of olive oil in. Sweat 1 onion. season salt and pepper. 2g carbs.
Add your protein and cook till browned .

Add a tin of tomatoes for a tomato curry, or some coconut cream and almond flour for a crreamy curry. That's my go to... it's about 400 cals per person and maybe 13g of carbs? its more if you add double cream.

I serve with 'slimrice' made of konjak or cauliflower rice. I never touch breads chapatis or naan or popadom.


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## helli (May 21, 2022)

Proud to be erratic said:


> Yesterday I was out with my daugter-in-law and granddaughter (who I've not seen for almost 3 yrs). We had a simple cafe lunch, and I had a small latte and a packaged sandwich, total 44 gm carbs. I took 4.5 units of insulin, my normal midday ratio of 10:1. My scan after 30 mins showed increase; after 45 mins high alarm above 10, 1hr I was at 15 and still going up. It was as if I'd forgotten to bolus - but I'd not forgotten, 2x witnesses and a NovaEcho pen confirming my dose and timing! I now took a further 5 units of bolus BUT very alert to the possibility of suddenly crashing. The trend reversed, at one stage the fall was quite Rapid, but with care I responded with medium GI snacks, including an 18gm Nakd bar taken in 1/3rds and I never got below 5. I don't know why my original bolus was so slow to kick in; I was concerned but not panicking. For a while my D was dictating to me ... rather than me keeping it controlled. But I did keep it managed, with a lot of effort and constant monitoring. I choose not to tell my daughter-in-law until later, I didn't want to share my anxiety, partly because she'd then worry, keep quizzing me and that would start to stress me - introducing another BG factor! But potentially a risky strategy, not sharing my challenge of that moment. Overall a satisfactory result, albeit with a large spike on my Libre graph.


I do not understand why you took 5 units as your correction dose.
It is incredibly dangerous to guess such high doses.
My insulin to carb ratio is less than 1:10 (as yours maybe while you are in the honeymoon period) and my correction would be half of what you took.

Correct dosing is much much more than the number of units of insulin, it is also the timing. This is the reason why it is not advisable to correct until 4 hours after doing - you still have fast acting insulin working.

As others have said, you must talk to your DSN (I appreciate it is difficult to get through to them. Maybe you need to contact your GP surgery and request the number again) and get the dose and correction they recommen rather than using the 10:1 ratio and guessing the correction.

If you really feel the need to correct a high, do NOT rely on the number on Libre. The sensors have been calibrated to be accurate in “normal range”. The can be very inaccurate when levels are over 10mmol/l.

It sounds as if you are trying to micromanage your levels. Libre are great but they can lead to obsession of staying in range. Unless you are feeling unwell, it may help to restrict your Libre scans.

Finally, remember you have Type 1/LADA, not type 2. There are no foods which are no nos. I regularly eat rice without getting hung up on GIs. Some people with Type 1 may find they struggle with it but we are all different. If you enjoy rice, once you know *your* ratios, dose accordingly and you may be surprised.
I strongly recommend avoiding the concept of food that is “bad” for your diabetes. This can lead to mental health issues around your relationship with food and diabetes.


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## Purls of Wisdom (May 21, 2022)

After speaking to the dietitian, I have started eating somewhat normal portions. Having more hyper levels since then. Also keeping an eye on the ketones. I ve only been told to increase 1unit of NovoRapid if pre meal reading is over 10. I had to do it at lunch time today. Being cautious and pricking finger if BG levels are higher than they should be. Taking notes for Tuesday's phone consultation with DSN.
P.S. the alert alarms have been working on and off!


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## Jacen017 (May 21, 2022)

Purls of Wisdom said:


> After speaking to the dietitian, I have started eating somewhat normal portions. Having more hyper levels since then. Also keeping an eye on the ketones. I ve only been told to increase 1unit of NovoRapid if pre meal reading is over 10. I had to do it at lunch time today. Being cautious and pricking finger if BG levels are higher than they should be. Taking notes for Tuesday's phone consultation with DSN.
> P.S. the alert alarms have been working on and off!


My alarms turn off intermittently but always reconnect after about 30 mins.  It usually doesn't cause any problems with alerting me.


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## Proud to be erratic (May 21, 2022)

Hello @helli, 

Thank you for your comments, but I'm mildly bemused and wondering if you have 2 postings muddled together in your response - or perhaps you are partly replying to me and partly to @Purls of Wisdom.


helli said:


> I do not understand why you took 5 units as your correction dose.
> It is incredibly dangerous to guess such high doses.


I did not guess. My normal correction ratio is 1:2 and when I'm above 10, certainly 12, I have found I need an even stronger correction ratio, which I deliberately choose to be cautious about, conscious that I was probably stacking the 2nd correction on top of the original lunch bolus. However I was at 15 and rising; intent on curtailing that high with a target of 6 in mind. Arguably I could have settled for 4.5 rather than 5 units, but with BG rising I was not going to settle for a half-way house. So, definitely not a guess, but a measured response and (as I said) very alert to going too low later on.


helli said:


> My insulin to carb ratio is less than 1:10 (as yours maybe while you are in the honeymoon period) and my correction would be half of what you took.


I'm T3c, after a total pancreatectomy and have no honeymoon period. 

My insulin to carb ratio is 1:10 at lunchtime and evenings and I took a bolus of 4.5 units against my 44gm carbs. There was no need for a correction in that bolus and, in this instance I applied no reduction factor for activity. Had I been at home and gardening I might well have reduced by 50%; but I was waiting at a Hospital for an indeterminate period and assessed (rightly or wrongly) that I wasn't going to be particularly active and might even need to be taking a taxi back to our Rail Station. So, while you could be right (in hindsight) that a reduced correction would have got a better result, at that time I made a judgement and I probably would make the same judgement again tomorrow. I'm determined to not get back onto the high/low/high roller coaster and Libre used diligently helped me avert that scenario.


helli said:


> Correct dosing is much much more than the number of units of insulin, it is also the timing.


I am acutely aware that timing is key to this whole process and frequently work out, after the event, that the timing hasn't worked so well. Alas, if only my body would be more consistent in its timing of response to insulin !!! If only the variations were just because of the time of day, the weather, how active I've been, what my actual BG was at time of dosing, my frame of mind - then I can incorporate those factors and do better, but there seem to be so many more imponderables ......


helli said:


> This is the reason why it is not advisable to correct until 4 hours after doing - you still have fast acting insulin working.


Perhaps. If I was 6 months into my diagnosis, you would probably be right. But after 26+ months and the benefit of Libre I am happy with my decision to stack. I always knew that was a risk, but I was not prepared to wait 4 hrs and potentially get into the 20s. I've been there in the past and not going to go there again if I can do otherwise.


helli said:


> As others have said, you must talk to your DSN (I appreciate it is difficult to get through to them. Maybe you need to contact your GP surgery and request the number again) and get the dose and correction they recommen rather than using the 10:1 ratio and guessing the correction.


If this remark is directed to me, then it makes no sense to me!


helli said:


> If you really feel the need to correct a high, do NOT rely on the number on Libre. The sensors have been calibrated to be accurate in “normal range”. The can be very inaccurate when levels are over 10mmol/l.


I totally agree. You might recall that on more than one occasion I have quoted to others your points about the limitations of Libre. You have assumed that I never finger-pricked throughout this post lunch climb (because I was trying to keep a longish narrative a bit shorter).  


helli said:


> It sounds as if you are trying to micromanage your levels. Libre are great but they can lead to obsession of staying in range. Unless you are feeling unwell, it may help to restrict your Libre scans.


If this advice is for me, then it is inappropriate. I'm content with my strategy for managing my DM. I'm not obsessed about staying in range, but I'm not going to knowingly sit back and do nothing when I'm at 15 and climbing.


helli said:


> Finally, remember you have Type 1/LADA, not type 2.


Presumably you are intending this for @Purls of Wisdom .


helli said:


> There are no foods which are no nos. I regularly eat rice without getting hung up on GIs.


I've tried reading back and can't find a reference to Glycaemic Index (GI) in this particular thread - but this is posting #90 so perhaps there is an observation elsewhere that I've missed.


helli said:


> Some people with Type 1 may find they struggle with it but we are all different. If you enjoy rice, once you know *your* ratios, dose accordingly and you may be surprised.
> I strongly recommend avoiding the concept of food that is “bad” for your diabetes. This can lead to mental health issues around your relationship with food and diabetesm.


These last 2 paras are clearly not intended for me. Since @Purls of Wisdom is currently on fixed bolus and does not yet know her ratios - I was gently trying to encourage her into a small experiment and thus allow herself to include rice in her diet in the future.

I completely agree with your last 2 sentences. But I do empathise with Purls of Wisdom's predicament feeling, at that time, pretty abandoned by Specialist support. and awaiting formal diagnosis.


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## Purls of Wisdom (May 22, 2022)

Hello there! I posted a couple of days ago that I ve started taking full portions at lunch and dinner time as suggested by the Dietitian and it has opened up a proverbial can of worms. 2 days on, my BG levels have been spiking most of the time. The Libre 2 alert alarms are going crazy. At times it is as high as 15.2. Been doing finger pricking to confirm. I do not have set ratio yet. The readings after full portion of home cooked meals are going to dictate the same. Still not adjusting the insulin doses. So, all this talk about increasing or decreasing insulin sounds alien to me. I wonder if those spikes are due to 30g carbs per meal? I am very strict when it comes to snacking etc. Seriously beyond my limited understanding whether these hypers are going to cause further harm or is it OK to let things be the way they are. The Dietitian knows about it so why worry? During the night BG levels stay in range. All wise words are welcome. Thanks. X


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## Purls of Wisdom (May 22, 2022)

Thank you Roland, for your deep understanding of this matter. Since my BG levels rise comparatively high many times a day, I am critically looking at my carbs Intake, so I ate 96g of plain boiled Basmati rice with little curried red kidney beans, sliced aubergine and olives at lunch time. The alarm has alerted me more than 3 times. It appears to me that may be I need to cut the wholemeal carbs down. Then what to eat? I do feel hungry in between meals and also know that it will encourage snacking. Pls suggest food ideas which are carbs free and filling. Thanks.


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## rayray119 (May 22, 2022)

Purls of Wisdom said:


> Hello there! I posted a couple of days ago that I ve started taking full portions at lunch and dinner time as suggested by the Dietitian and it has opened up a proverbial can of worms. 2 days on, my BG levels have been spiking most of the time. The Libre 2 alert alarms are going crazy. At times it is as high as 15.2. Been doing finger pricking to confirm. I do not have set ratio yet. The readings after full portion of home cooked meals are going to dictate the same. Still not adjusting the insulin doses. So, all this talk about increasing or decreasing insulin sounds alien to me. I wonder if those spikes are due to 30g carbs per meal? I am very strict when it comes to snacking etc. Seriously beyond my limited understanding whether these hypers are going to cause further harm or is it OK to let things be the way they are. The Dietitian knows about it so why worry? During the night BG levels stay in range. All wise words are welcome. Thanks. X


is it coming back down?


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## Leadinglights (May 22, 2022)

Purls of Wisdom said:


> Thank you Roland, for your deep understanding of this matter. Since my BG levels rise comparatively high many times a day, I am critically looking at my carbs Intake, so I ate 96g of plain boiled Basmati rice with little curried red kidney beans, sliced aubergine and olives at lunch time. The alarm has alerted me more than 3 times. It appears to me that may be I need to cut the wholemeal carbs down. Then what to eat? I do feel hungry in between meals and also know that it will encourage snacking. Pls suggest food ideas which are carbs free and filling. Thanks.


The problem may be you are having two high carb foods in one meal, rice and kidney beans and without being able to adjust your insulin accordingly. 
Are you vegetarian? if not then some meat or fish, or eggs or halloumi go well with curried foods. Any green veg, broccoli, green beans, mangetout, spinach, or coleslaw.


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## Purls of Wisdom (May 22, 2022)

Eventually. For a short while, before rising again specially after meals. For example - on Friday, I woke up to 
7.2 had breakfast at 10:00. 
11.50 it rose to 13.4. 
At 12:45, it further rose to 13.8.
Had nothing to eat. 
Pre Lunch 11.1 time 1:30
15.0 at 4:00
10.7 at 7:10
Pre dinner 5.7 @ 8:00pm
Bedtime 11.6

On Saturday Post breakfast it spiked between14.3 and 15.4. Glucose meter reading was not much different. 

Pre lunch 11.6
Stay around 8.8 till dinner.
 Spiked to 13.4 and to14.9
Went to sleep after 10u of Lantus.
Ketones remained 0.0 and 0.1.

Similar numbers today. 7.9
Post breakfast it rose to 14.9 ketones 0.2
Pre lunch was 10.1

Had a couple of alerts. Readings between 9.3 to 14.9.


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## Purls of Wisdom (May 22, 2022)

Leadinglights said:


> The problem may be you are having two high carb foods in one meal, rice and kidney beans and without being able to adjust your insulin accordingly.
> Are you vegetarian? if not then some meat or fish, or eggs or halloumi go well with curried foods. Any green veg, broccoli, green beans, mangetout, spinach, or coleslaw.


Thanks leadinglights. I think so too. Usually it is 2 wholemeal chapattis with fresh veg curry or 2 slices of brown seeded bread with light cheese slice, cucumber and a medium tomato, mostly carb free.


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## Purls of Wisdom (May 22, 2022)

Keeping your advice and mine observation in mind, had 1 slice of seeded brown bread with boiled eggs and a slice of cheese. Finished tonight's dinner with a small apple. Hoping for less alerts.


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## Lucyr (May 22, 2022)

I think what you need to bear in mind is that it’s normal for blood sugar to rise between meals. Once you are adjusting doses and able to bolus more in advance of the meal you can reduce them somewhat but you won’t eliminate them. 

If the high alarm is bothering you, switch it off or set it to a higher value. You aren’t acting on the high readings for corrections at the moment so it isn’t really of any benefit to you to have them going off.


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## Purls of Wisdom (May 23, 2022)

Thanks Lucyr.


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## Purls of Wisdom (May 23, 2022)

Leadinglights said:


> The problem may be you are having two high carb foods in one meal, rice and kidney beans and without being able to adjust your insulin accordingly.
> Are you vegetarian? if not then some meat or fish, or eggs or halloumi go well with curried foods. Any green veg, broccoli, green beans, mangetout, spinach, or coleslaw.


Please consider me completely naive, I understand that carbs make the BG levels spike. So, a DM individual should try not to eat wheat, bread, rice or pasta. The wholemeal options are equally bad. Can someone on this forum, please explain what exactly do they eat and suggest me what to eat as a vegetarian? Just salad and veg? Limited amount of fruit? Water? It is possible to survive for a couple of meal times, but for the rest of the life? I shudder to think. 

One theory goes like this that little or no carbs and the other hand, one will be able to eat everything, within limit of course, once insulin dosage is corrected. I really do not understand what to believe or who? Feeling at loss and physically sick, not knowing what to eat guiltfree. 

I must appear as a most annoying person who simply fail to understand the basics of Diabetes and follow instructions. 
I do not know what I would ve done without your continuous support. Thanks. 

P. S. Anyone from India and vegetarian? Please reach out.


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## rayray119 (May 23, 2022)

Purls of Wisdom said:


> I must appear as a most annoying person who simply fail to understand the basics of Diabetes and follow instructions.
> I do not know what I would ve done without your continuous support. Thanks.


no-one fully understands diabetes due to the fact it just likes to misbehalf sometimes. don't be too hard on yourself you were only diagnosed a few weeks back right?.  I'm about 8 and half months in(which is still considered fairly newly diagnosed i believe) and even though i taught myself a lot in that and have lernt from others here and other support networks. I still make mistakes)


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## Purls of Wisdom (May 23, 2022)

rayray119 said:


> no-one fully understands diabetes due to the fact it just likes to misbehalf sometimes. don't be too hard on yourself you were only diagnosed a few weeks back right?.  I'm about 8 and half months in(which is still considered fairly newly diagnosed i believe) and even though i taught myself a lot in that and have lernt from others here and other support networks. I still make mistakes)


Thanks for your words of encouragement. Much needed today and always.


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## Inka (May 23, 2022)

@Purls of Wisdom You missed out the last bit of the sentence, which is extremely important: *“….without being able to adjust your insulin accordingly”.*

That’s why you have to watch your carbs now. On fixed doses of insulin, the amount of mealtime insulin will only cover a certain amount of carbs, so you have to fit your food (carbs) to your insulin. Once you can adjust your mealtime insulin, you’ll be able to fit your insulin to your food, which gives more freedom with meal choices.


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## Leadinglights (May 23, 2022)

Purls of Wisdom said:


> Please consider me completely naive, I understand that carbs make the BG levels spike. So, a DM individual should try not to eat wheat, bread, rice or pasta. The wholemeal options are equally bad. Can someone on this forum, please explain what exactly do they eat and suggest me what to eat as a vegetarian? Just salad and veg? Limited amount of fruit? Water? It is possible to survive for a couple of meal times, but for the rest of the life? I shudder to think.
> 
> One theory goes like this that little or no carbs and the other hand, one will be able to eat everything, within limit of course, once insulin dosage is corrected. I really do not understand what to believe or who? Feeling at loss and physically sick, not knowing what to eat guiltfree.
> 
> ...


There are quite a lot of substitutions you can make, cauliflower, butternut squash and chick pea is one of my favourite combination for a curry, you could use paneer, mushrooms, courgette, green beans, aubergine. Somebody suggested using an omelette instead of naan or chapati. 
You can get plenty of flavour from herbs and spices and avoid too many prepared sauces.
I agree it is just a bit harder if you don't eat meat or fish but still plenty of things you can have. Search for low carb or keto veggie recipes and there are loads on the internet.


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## Purls of Wisdom (May 23, 2022)

Inka said:


> @Purls of Wisdom You missed out the last bit of the sentence, which is extremely important: *“….without being able to adjust your insulin accordingly”.*
> 
> That’s why you have to watch your carbs now. On fixed doses of insulin, the amount of mealtime insulin will only cover a certain amount of carbs, so you have to fit your food (carbs) to your insulin. Once you can adjust your mealtime insulin, you’ll be able to fit your insulin to your food, which gives more freedom with meal choices.


Your views on low carb diet or bare minimum carbs diet?


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## Leadinglights (May 23, 2022)

Purls of Wisdom said:


> Your views on low carb diet or bare minimum carbs diet?


Unless you are able to adjust your insulin I would think it quite dangerous to be having bare minimum carbs as you should be having the amount per meal that your DSN advised for your fixed insulin dose.
Once you are adjusting insulin then some people find eating normally is easier to manage their blood glucose that if they go low carb as they then would  have to take account of proteins. 
Hopefully you will have opinions from those taking insulin.


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## Inka (May 23, 2022)

Purls of Wisdom said:


> Your views on low carb diet or bare minimum carbs diet?



You’re on fixed doses of insulin: you need to eat enough carbs for that insulin. If you don’t, you run the risk of a nasty hypo.

Once you’re adjusting your mealtime insulin, you can choose a diet that suits you as an individual.


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## Purls of Wisdom (May 24, 2022)

Leadinglights said:


> Unless you are able to adjust your insulin I would think it quite dangerous to be having bare minimum carbs as you should be having the amount per meal that your DSN advised for your fixed insulin dose.
> Once you are adjusting insulin then some people find eating normally is easier to manage their blood glucose that if they go low carb as they then would  have to take account of proteins.
> Hopefully you will have opinions from those taking insulin.


No such amount has been ever mentioned or the ratio. Either things are moving extremely slowly or my mind is on an override.


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## Leadinglights (May 24, 2022)

Purls of Wisdom said:


> No such amount has been ever mentioned or the ratio. Either things are moving extremely slowly or my mind is on an override.


I think you should ask what amount of carbs you should be aiming at per meal for your insulin dose otherwise you risk not having enough or having too many for that particular dose of insulin.
Also ask about carb counting and adjusting your dose according to what you are having. Has anyone mentioned the on-line BERTIE course for carb counting or DAFNE or your local equivalents.


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## trophywench (May 24, 2022)

I don't think anyone has mentioned them for the simple fact that not even a fully proven T1 gets DAFNE or equivalent instantly - used to be offered after 6 months ish pre pandemic but Heaven knows 'when' now.


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## Purls of Wisdom (May 27, 2022)

trophywench said:


> I don't think anyone has mentioned them for the simple fact that not even a fully proven T1 gets DAFNE or equivalent instantly - used to be offered after 6 months ish pre pandemic but Heaven knows 'when' now.


Completely agree.


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## helli (May 27, 2022)

trophywench said:


> I don't think anyone has mentioned them for the simple fact that not even a fully proven T1 gets DAFNE or equivalent instantly - used to be offered after 6 months ish pre pandemic but Heaven knows 'when' now.


6 months after diagnosis for some CCGs. It was 12 years after diagnosis for me. 
I was given an insulin to carb ratio by a locum endocrinologist I met once about a year after diagnosis. As an engineer, I am comfortable analysing numbers so tweaked my dose accordingly.


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## Jacen017 (May 27, 2022)

I've got my DAFNE equivalent course next week so it's about 6 months here.


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## rayray119 (May 27, 2022)

I had to be asked to referred here still no letter.


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## trophywench (May 31, 2022)

Well of course 50 years ago there was no such thing - hence I'd been diagnosed about 30 years when I got mine!  Everything comes to she who waits ....... !


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