# Hello!



## Azura (Aug 9, 2018)

I'm new to the forum, was diagnosed with type 1 about 3 years ago, but am still struggling with diabetes management. I am hoping to get my diabetes in order and hopefully get some help for the mental health problems that have come as a result of my diagnosis.


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## Martin Canty (Aug 9, 2018)

Welcome @Azura , plenty of useful advice & help here..... Feel free to ask any questions


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## Matt Cycle (Aug 9, 2018)

Hi Azura and welcome to the forum   Sorry to hear of your mental health issues related to your diagnosis.  Have you discussed it and had any help/advice/guidance from your diabetes team?


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## Azura (Aug 9, 2018)

Matt Cycle said:


> Hi Azura and welcome to the forum   Sorry to hear of your mental health issues related to your diagnosis.  Have you discussed it and had any help/advice/guidance from your diabetes team?



I only recently had to acknowledge the need for me to go to therapy, so I guess I haven't been too honest with my diabetes team about that. But I'm doing some CBT at the moment, and even though the changes have been small, they've been having a positive impact on my life so far! It's been a bit frustrating managing the diabetes, though. I have absolutely no control over it sometimes!


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## Matt Cycle (Aug 9, 2018)

Azura said:


> I only recently had to acknowledge the need for me to go to therapy, so I guess I haven't been too honest with my diabetes team about that. But I'm doing some CBT at the moment, and even though the changes have been small, they've been having a positive impact on my life so far! It's been a bit frustrating managing the diabetes, though. I have absolutely no control over it sometimes!



That's good with the positive impact it's having.  Yes, T1 can be very difficult.  I think you were the same age as me when I was diagnosed and I still get frustrated with it now after all these years but have learned to live with that and I just try and do my best in managing it and don't ignore it (you can't really!) but focus on the many positive things in my life.


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## trophywench (Aug 10, 2018)

Hi Azura_ - _I bet the vast bulk of us had some mental health issues purely from the diagnosis of T1 - or rather when we actually started to consider its management every day.  It takes time - it's a form of grieving - but it was over 30 years post diagnosis that anyone at all ever explained that to me - and Oh how I wished I'd known that at the time!

There's a thing called 'The 5 stages of grief' that plots the course of the grief process that most people normally need to go through in order to come out the other end still intact - and yep, I still recognise every step.  Don't try to rush it though and don't try to squash it down except briefly, just make sure you let it out when you get in a safe place.

Now - that ruddy diabetes!

Go back to square one and pretend you've only just found out you are T1 and buy yourself a book with the stunning title 'Type One diabetes in babies, children and teenagers' by Ragnar Hanas.  It applies equally to 20, 30 or 50 year old T1s and because it's written in plain English intended for the parents of those kids - and the kids themselves when they're old enough to understand - it's not too 'medical textbook' like.

And ask, ask, ask again about anything at all you are having trouble with - because someone on here will know what worked for them when that happened.


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## Diabetes UK (Aug 10, 2018)

Hi Azura, welcome to the forum. Glad to hear that the CBT is having a positive impact, even just small changes are steps in the right direction. Feel free to ask any questions or vent any frustrations, there will usually be someone to answer or share their advice and support, and plenty of members who understand the difficulties of getting a diagnosis of type 1.


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## Deleted member 18634 (Aug 10, 2018)

Hi Azura and welcome, it's great that you've started to reach out and engage with your diabetes just by joining the forum. I spent A LONG time in denial and struggling to come to terms with my diabetes so I fully get how hard it can be. It's fantastic that you're getting CBT and I hope this helps, it certainly did with me. 

Diabetes is a pain to manage at the best of times, let alone when you're struggling with your head but you're doing all the right things. Please don't be afraid to reach out when you need to. Doctors, nurses and specialist teams are all there to help you at the end of the day.


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## Azura (Aug 10, 2018)

Emma Diabetes UK said:


> Hi Azura and welcome, it's great that you've started to reach out and engage with your diabetes just by joining the forum. I spent A LONG time in denial and struggling to come to terms with my diabetes so I fully get how hard it can be. It's fantastic that you're getting CBT and I hope this helps, it certainly did with me.
> 
> Diabetes is a pain to manage at the best of times, let alone when you're struggling with your head but you're doing all the right things. Please don't be afraid to reach out when you need to. Doctors, nurses and specialist teams are all there to help you at the end of the day.



It's so nice to see people reach out to each other here, I wish I'd had the courage to do this earlier. But hey, baby steps, right? My friends have been very supportive, but in the end I am the only one who can implement changes. My main struggle is a ridiculously high Hba1c, and the time the insulin takes before working. It's very strange, none of my doctors or specialist teams could identify any lumps, yet half of the time my insulin takes over 2 hours to begin lowering my blood glucose levels... It makes it very difficult to gauge how much to inject for meals and correction. 

I'm finally discussing switching to a pump with my team, though. Hopefully that will change the irregularity of the situation. But any help with this problem is welcome until that point!


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## Azura (Aug 10, 2018)

Hannah DUK said:


> Hi Azura, welcome to the forum. Glad to hear that the CBT is having a positive impact, even just small changes are steps in the right direction. Feel free to ask any questions or vent any frustrations, there will usually be someone to answer or share their advice and support, and plenty of members who understand the difficulties of getting a diagnosis of type 1.



CBT is something I really should have tried ages ago! Sadly it took a major breakdown and hospitalisation for DKA to make me realise I couldn't force myself into my old and careless lifestyle without consequences. Now I have to take even just daily tasks slow, and while it can be frustrating to feel like my potential has been reduced so much, I'm seeing positive changes! I might have a long way to go, but my friends are luckily here to get my excited when I complete even the smallest task.


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## trophywench (Aug 11, 2018)

Have you ever done a basal insulin test, to see if the dosage and timing of that is as right as it can be?  We have to do this anyway a fair bit when pumping - and definitely 'quite a lot' in the first few months after getting one in order to get to know how much insulin our bodies actually need - but it's mega helpful for MDI users too.

https://www.diabetes-support.org.uk/info/?page_id=120


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## Pumper_Sue (Aug 11, 2018)

Azura said:


> My main struggle is a ridiculously high Hba1c, and the time the insulin takes before working. It's very strange, none of my doctors or specialist teams could identify any lumps, yet half of the time my insulin takes over 2 hours to begin lowering my blood glucose levels... It makes it very difficult to gauge how much to inject for meals and correction.


Hello and welcome to the forum.
As @trophywench says have you tested your basal(background insulin)? If you are not having enough basal then your bolus will have double the work to do. Once you have your basal sorted check your carb ratio. Do make sure you only make one change at a time otherwise you wont have a clue what's worked or hasn't.

Take one day at a time and remember Rome wasn't built in a day. The best strategy I ever learnt was to treat my blood sugar reading as just that and nothing else. So if higher than expected or wanted then a correction given same if low, snack eaten then move on don't dwell on things (life's far to short  )


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## SB2015 (Aug 12, 2018)

Azura said:


> CBT is something I really should have tried ages ago! Sadly it took a major breakdown and hospitalisation for DKA to make me realise I couldn't force myself into my old and careless lifestyle without consequences. Now I have to take even just daily tasks slow, and while it can be frustrating to feel like my potential has been reduced so much, I'm seeing positive changes! I might have a long way to go, but my friends are luckily here to get my excited when I complete even the smallest task.


Hi Azura, and welcome to the forum.  Glad you have found us.

I also struggled with the day to day grind of managing my diabetes, and then waited too long before I was honest about this and took too long to ask for help.  Glad that you have access to CBT and that it is already having an impact.  Although it may seem like tiny steps and small impact I found that the strategies are long lasting especially when I remember to practice the strategies.  They not only help me with my attitude towards my diabetes they also had a positive impact on other aspects of life.

As others have said a basal rate test can help to check that the background insulin is correct, then you can sort out the bolus insulin.  This is easier to do with a pump as you have so much more variability over 24 hours.  Let us know how you get on with discussions regarding the pump.


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## SB2015 (Aug 12, 2018)

Ps
The Support that I found on here had a big impact as well. 
 People who live with D day-to-day and know what it is like.

Keep asking and keep in touch.


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## Azura (Aug 13, 2018)

Pumper_Sue said:


> Hello and welcome to the forum.
> As @trophywench says have you tested your basal(background insulin)? If you are not having enough basal then your bolus will have double the work to do. Once you have your basal sorted check your carb ratio. Do make sure you only make one change at a time otherwise you wont have a clue what's worked or hasn't.
> 
> Take one day at a time and remember Rome wasn't built in a day. The best strategy I ever learnt was to treat my blood sugar reading as just that and nothing else. So if higher than expected or wanted then a correction given same if low, snack eaten then move on don't dwell on things (life's far to short  )



@trophywench  I have been doing the test for the past 2 days, and so far it seems that my basal insulin is correct. Should I keep testing for this week and then move on to the carb ratio?


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## Azura (Aug 13, 2018)

SB2015 said:


> Hi Azura, and welcome to the forum.  Glad you have found us.
> 
> I also struggled with the day to day grind of managing my diabetes, and then waited too long before I was honest about this and took too long to ask for help.  Glad that you have access to CBT and that it is already having an impact.  Although it may seem like tiny steps and small impact I found that the strategies are long lasting especially when I remember to practice the strategies.  They not only help me with my attitude towards my diabetes they also had a positive impact on other aspects of life.
> 
> As others have said a basal rate test can help to check that the background insulin is correct, then you can sort out the bolus insulin.  This is easier to do with a pump as you have so much more variability over 24 hours.  Let us know how you get on with discussions regarding the pump.



I am honestly so glad I'm on the forum now. I have to keep reminding myself that the tiny steps matter and that their impact will show in the long run, and I think by just spending more time on here for advice is going to be another positive change in my life. Sadly my hospital appointment has been moved to about a month and a half from today, so until then I will just have to do my utmost best to lower my Hba1c.


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## HOBIE (Aug 13, 2018)

Hi Azura & welcome, Well done for joining a good forum. It is a ------- thing at times but keep at it & you will feel the benefit


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## Pumper_Sue (Aug 13, 2018)

Azura said:


> @trophywench  I have been doing the test for the past 2 days, and so far it seems that my basal insulin is correct. Should I keep testing for this week and then move on to the carb ratio?


As long as you have a 24 hour profile to see how your levels are that's fine so no need to continue all week. That's being a glutton for punishment 

So next question is how long before a meal do you bolus? Most people find 15 - 20 mins before eating is ideal as this gives the insulin time to start working before the food hits the blood sugars.
If you are doing this then start by testing your carb ratio. Many people find they need different ratios for different times of the day.
Try very hard not to correct so you can see exactly what is happening. General rule is if you hypo or spike to high within two hours then it's a ratio problem.


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## Azura (Aug 13, 2018)

Pumper_Sue said:


> As long as you have a 24 hour profile to see how your levels are that's fine so no need to continue all week. That's being a glutton for punishment
> 
> So next question is how long before a meal do you bolus? Most people find 15 - 20 mins before eating is ideal as this gives the insulin time to start working before the food hits the blood sugars.
> If you are doing this then start by testing your carb ratio. Many people find they need different ratios for different times of the day.
> Try very hard not to correct so you can see exactly what is happening. General rule is if you hypo or spike to high within two hours then it's a ratio problem.



Ah, I didn't know that! I will try the 15 minute thing first, and if the blood sugars are still giving me problems I'll move on to testing my carb ratio. Thank you so much for the tip!


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## SB2015 (Aug 13, 2018)

As well as timing the bolus, and gradually adjusting that, another thing I find really helps my levels is to do something for 15 minutes after every meal.  We go for a walk, or I do the clearing, or I do some ironing, ...  I just don’t sit down.


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