Hello,

I am completely new to this, only being diagnosed with Type 1 diabetes and insulin-dependant last week.
I visited my doctor after losing around 3.5 stone in weight for no reason just over a few months, excessive thirst, blurred vision and so on. She completed a blood test and the next day she rushed me into A&E as my potassium as 6point something (apparantly heart attack level) and was started on insulin the day after.

Anyway, to cut the story short, I am now injecting NovoR**** insulin 3 times a day, and Levemir over night. I have had my dose changed a few times by my diabetic nurse, and I am now on a 6,6,8 (Novor****) and a 14 (Levemir) dose.

However, we are rather confused as to what to look for in food.
On the back of each product at the moment I'm looking at Carbohydrates and of which sugars. I assume both of these need to be low, if so, what is advisable? I realise fruit and vegetables are important.
I tried to do some research but couldn't really find anything useful.

My glucose levels have been all over the shop, as low as 3.4 and as high as 16.9 - though they seem to be settling a little.

Any information would be greatly appreciated.

Many thanks.

Well, it's good that your are being medically taken care of now. One tip I have on reading labels; I was taught this 18 years ago when I was diagnosed; is that if sugar is listed in the first four ingredients of the package, then the product has a lot of sugar in it. I was told to avoid those type of foods unless I wanted them as a treat, which in turn would be more insulin. Remember that it can be listed as fructose, corn syrup, etc., also. I basically try to stay away from anything that is white. For example, white bread, pasta or rice. I basically try to eat wheat pasta,wheat bread and brown rice. Sometimes though I do eat the other but have to use more insulin for that. Your basically going to have to get to know your body with this disease now. You can follow the basic guidelines, but you'll know what your body can take and can't. Good Luck and Stay Healthy!!

Thank you for your reply.

I am going to be completely thick here, so please excuse me!

On the back of pre-packed foods here in the UK, we have a nutrition table something like:

http://www.onlineservers.org/nutrition.GIF

Which things should I be avoiding, or figures I should be looking at keeping under per pack?

Thanks!

Okay, I think I know what you're asking. You said you were on 6,6,8 for Novolog, is that correct? Does that mean you take 6 units for breakfast and lunch and then 8 at dinner? Do you have a meal plan right now? What you can do is call your doctor and ask them what your meal time ratio is. That means how many carbs do you eat for 1 unit of insulin. If your ratio is 15 carbs for 1 unit then you would take 1 unit of Novolog for one serving or 4 units for the whole pack.

When my daughter was first diagnosed I didn't understand the ratios and thought she had to eat the same amount of carbs at each meal. Now we understand that she can vary the amount of carbs she eats, as long as she knows what the ratio is. She keeps a pencil and paper next to her at dinner and writes down everything she eats. One piece of bread, 17 carbs; 1/2 cup mashed potatoes, 20 carbs; etc., etc. When we get the total we divide that by her ratio number to know how much Novolog to take. Your doctor can tell you what your ratio number is. That number may change many times though but if you know what they decided to start you at then that should help you a lot.

You should be looking at the total number of carbohydrates in anything you eat. Some carbs are absorbed quicker than others but being newly diagnosed, you have a lot to get used to so learning about that can come a little later. Right now you just need to know the total number of carbs and your insulin ratio.

Is that what you needed to know?

Hi there.
Many thanks for your reply.

Yes, my r**** insulin is a 6 before breakfast, 6 before lunch and currently 8 units before dinner. Then a 14 for my slow release night insulin.

Luckily I'm speaking to my diabetic nurse today where she takes the results I've recorded of all my blood glucose results, so I'll certainly ask her about this 'ratio' - it makes sense!
I have just ordered the OneTouch UltraSmart meter, so this will be helpful with recording amount of carbs and a clear analysis of each result - much better than my current.

Thanks for the information once again.

Regards,

My daughter uses the One Touch UltraSmart also, she really likes how easy it is and how it keeps track of everything.

I'm sure that today they will go over a lot of things with you and you will get a better understanding of how to treat this. It does take some time. It's very overwhelming at first and it's a lot of information to absorb. It really does start to all fall into place though and things will make sense in no time. At this appointment they will probably go over food labels with you and show you what to look for.

Good luck and let us know how you make out.

Thanks for your reply Linda.
I got the OneTouch ultra smart today - very nice indeed!
However, the change in reading was 6.2 on the onetouch and on my old meter 5.7 - so quite a difference, not sure if this is normal. I saw something on their site about a percentage difference. I don't know whether it's meant to be more accurate though...

I spoke to my nurse and she's upped my insulin again, so I'm now on a 6, 6, 10, 14. She said not to worry too much about diet yet, as I have to visit her again next month. She said to cut out obvious things such as cakes, chocolate, biscuits and obvious sugary things, but she said as this is all so new, not to worry too much about carbs etc.

:) Thanks again.

Sounds like your numbers are pretty good for being newly diagnosed. It's a lot of information to take in at once and a lot of work but it does get easier. From what I've read in your posts, it sounds like you've got a good attitude about everything and will do great. How old are you, if you don't mind me asking? Sounds like you're an adult from your posts. I am surprised that they're not too concerned with your diet right now. By the time you have your next appointment you'll be a month and a half into this. I would think you should be counting carbs by then. I would suggest you read as much as you can before your next appointment. Also write down whatever questions you have so you can ask them when you go. Good luck to you. Sounds like you're off to a great start!

Hi Linda. Thanks again for your reply. :)

I was also quite shocked they weren't too concerned regarding diet, but I think they're just trying to get me used to injecting.
Generally my levels are between 3.9 and anywhere up to 14.5.

I assume when it comes to 'counting' carbs there will be no 'set' insulin dose except that of an evening as doses will be dependant on the amount of carbs. Is this how it works with you daughter?

This has just been something I've took in my stride. I haven't (yet (TM!)) felt depressed or angry about it, it's something I, and an awful lot of others have to get used to and a way of life. It's better than the alternative!!!

:)

Dan,

Good for you about taking it in stride. That's fantastic and if you feel this way now, after being newly diagnosed, then you're doing great! You're right about the alternatives and even when you think about the advances they've made just in the past few years you realize how lucky you are to have this now and not 10 years ago. The new insulins are wonderful and let you vary your diet. The home meters give you better control. Used to be that diabetics could only test their urine with a dipstick and that didn't give them a number, just told them if the sugar was high. They never knew how high or how low.

Yes, you're right, your dose at meals will vary with how much you eat and you'll be adjusting that yourself but they will show you how to do it. I'm sure they'll be talking to you about that at one of your next appointments. And yes, the night dose will stay the same but your doctor may fine tune that if needed. He/she will see patterns in your blood sugar log book and may adjust the night dose accordingly. My daughter has been on the same night dose of 11 units for about 3 months now and it's changed probably 4 times since her diagnosis just over a year ago.

You really seem like you have such a great attitude. That will help you so much. My daughter also has a good attitude. She's 13 and for her it's never been a big deal. I think the biggest problem she has is when she's fallen asleep on the sofa and still has one more shot to take for the day. It's pretty hard to wake her up and she won't let me give her the shot so what we have is a cranky, tired teen trying to give herself a shot. Not a pretty site! Other than that, it's just become something she does.

Take care,
Linda

Hi again Linda.
Hope you're okay.

How old was your daughter when she was diagnoised and what type of symptoms did she - or did you spot?
I just had excessive weight loss for no apparant reason (a total of 3.5stone loss in weight), excessive thirst and blurred vision. It took me a long while to get to the Dr's as I *had* (past tense now!) a major fear of needles and couldn't face the thought of a blood test.
However now, I've had so many needles whilst I was in hospital I'm okay with it now, and the home injecting isn't much of an issue!!!

I've been trying the Diabetic chocolate as I'm a complete choc'o'holic and it's actually not too bad to my delight!

You are defintiely right, 10 years ago i'm sure it was a different story indeed, and at least with myself, and your daughter being quite young, who knows what'll be available in 10 years time.
I read somewhere and made me realise, "you control the diabetes, it doesn't control you" - and I think that's so true. It's not going to stop me, and I'm sure it won't stop your daughter as you mentioned her positive attitude, in doing anything with my life. Sure, there's some major lifestyle changes I need to adapt to - but it's not a death sentence.

I found it rather shocking doing research on the Internet about the complications associated with diabetes, and I had that acidosis thingy (not sure of the spelling) when it's too high for too long in hospital, so hopefully that's sorted now since the insulin has started. True to my Diabetic nurses' word - I have put on 0.5stone so at least I'm getting back up to the weight I should be for my height.

Did your daughter go through any fase of "Why me" or anger/depression with it? I've read in so many places this is common, however I don't seem to have (yet) gone through this, and I don't feel that I will.

I completely sympathise with you and your daughter, I have also got to about 11PM at night and fell asleep and been awoken to be told I need to do my last shot of the day. It's not the nicest 'wake up' sentence - so I definitely understand!

Has your daughter had any 'serious' hypos yet, i.e. where you've had to inject her with a Glugagen injection?

It's good to see you've taken so much interest and time giving information to others from your daughter's illness.

Good luck to you both!

Dan.

Hi Dan,

My daughter was 12 when she was diagnosed. Her and I went to visit relatives in another state right after Christmas last year and she had her first noticeable symptoms on the airplane. She was so thirsty and said the soda tasted wonderful. Then she was at the bathroom over and over. I kept telling her to stop drinking but she said it tasted too good. She had lost weight before that but she always wore baggy clothes so I didn't really notice. By the following day she started to feel tired and just kind of out of it. There were so many viruses going around that I thought she was just coming down with something. She didn't really seem sick though, she still wanted to do things but got tired very quickly. By New Year's Day we had to take her to the emergency room because she was vomiting and having severe stomach cramps. The nurse immediately knew what was wrong. She tested her blood sugar and it was over 700. She was in ketoacidosis and her potassium level was extremely low. I remember you said you had the same problem with your potassium level and the acidosis thingy (lol). She was also very dehydrated and had lost more weight than I realized. So they admitted her and she fell into a deep sleep and stayed that way until late the next day. They woke her up every hour or so to check her but it wasn't easy to wake her up. But they said as long as she could wake up then it was okay and to just let her sleep. By the end of the next day she was so much better but she stayed in the hospital for 5 days to get her stable and used to the injections.

I was kind of freaked by everything because I knew very little about diabetes and everything they told me was too much to listen to at the time. It wasn't until we got home and made an appointment with a diabetes educator and nutritionist that we got a better feel for what was going on. I'm still learning and so is she, which is why I like to read the message boards. Lots of info on here. She was never really upset by the whole thing. She said she feels good having gotten over her fear of needles. Kind of like you said, after everything in the hospital, it's really no big deal anymore. She doesn't mind the carb counting and has gotten really good at it. She can pretty much look at a plate of food and know how many carbs are in it. Drinks are harder, you never know how much sugar they use so she just avoids sweetened drinks. But no, she never had any of the "why me's" or anything like that. People often told me that she must be depressed and not showing it but I know that's not the case. They do say that sometimes you get to a point where you've just had it with everything and don't want to deal with it but I can't see her getting like that. That's just not her. But if she does ever get down about it then we'll deal with that when it happens.

How long were you in the hospital? It's kind of surreal isn't it? They are telling you all these things but it's hard to process.

As for her having any hypo's. None. They say that with these insulin regimines that the lows are rare. I hope that's the case. We keep a glucogon at school and one at home though, just in case. She tends to run a bit low regularly at midday so she always has a snack at that time. From what I understand, nighttime was always a scary time for diabetics with the old insulins but the new basal insulins tend to keep you pretty steady. Are you testing in the middle of the night once in awhile to see how your blood sugar is? If not then it may not be a bad idea to do that once or twice before your next appointment. I've heard from other people on this board that if you do have a severe low in the middle of the night that you will usually wake up very quickly right before it happens. I believe your body tries to rush sugar into your system to counteract it, which makes you wake up very suddenly. If that should ever happen and you do wake up like that then don't ignore it. Check your blood sugar and/or have a glucose tab. Our doctor never told us about that though, I only read about that on these boards. And I've been meaning to ask the doctor about it but I forgot. Guess I should write that down!

Do you live at home? How are your parents doing with all this? I'm sure it's a big adjustment for everyone!

The complications are very scary but they keep telling us that with good control they are much less likely to happen. And with frequent checkups it's easier to keep on top of things and they check for problems each time you have a visit. There are so many type 1's who have had this for years and years with no complications and the medical advances are fantastic so we'll just keep thinking positively! :-)

Good luck to you too Dan! Keep that attitude and you'll do great!

Hi again Linda. :)

I guess really the people I have to thank for getting me to do a Doctor was my work colleagues and family. I would say, before Christmas, probably around November'ish I started losing weight dramatically. It was just falling off me and in the end as I mentioned a total of 3.5stone (3.5 stone = 49 pound).
I was also drinking dramatically, but mine went on for quite a while whilst it sounds like your daughters was pretty quick. My 'excessive' thirst probably started before Christmas, and I was literally drinking perhaps 6 litres of water a day.

My colleagues were so concerned and wanted to get me to a Doctor many times they were even on the phone trying to find out my Doctor's surgery telephone number to which I had to hang up before they got the doc!

In the end, I think I also came to the conclusion that I did need to go. My potassium was 6point something, I'm really not sure whether that is high or low, all they said it's at a danger level of heartattack hence me being hospitalised. I also had ketoacidosis (that was the word I was looking for on my last post - thanks!) and was shocked to eventually read when I got out of hospital what that actually is. Very worrying.
I'm sure you've heard about the NHS (national health service) here in Britain, but my Doctors and nurses were absolutely brilliant, unfortunately it was such a busy evening I was admitted that I spent the night in A&E on a trolley not a bed (i.e. no pillows) and wasn't allowed to drink/eat for 23hrs, so going from drinking all those litres to nothing it was difficult!
The next day my levels must've come down and then I was admitted to a ward for a while. I was having a joke around with the nurses etc and they realised how against I was being hospitalised and staying another night. So, they did everything in their power (they were so lovely!) to get me to see the diabetic clinic nurse the same day. They put me in the day ward, to which I didn't even get in there before they got me an hr long appointment in the clinic which I was able to go home straight from there.
My Diabetic nurse has been fantastic, she is on holiday from work (not gone abroad though) for 2 weeks, so she's been dealing with me from home, every few days I have to phone her and give her the latest glucose results.
I was in hospital just for a total of 2 days, the thing was even though my glucose was extremely high and the potassium and ketoacidosis I felt absolutely fine. They were so shocked and saying I should be feeling all these different things, but I felt absolutely fine. As they didn't tell me what I was in for until I was being discharged, I was really questioning why I had a place in A&E and I felt fine, and others were extremely ill and still waiting!

Unfortunately with circumstances in the last week, and other family members being hospitalised I've missed certain meals, though I've tried to do everything possible to just do a few units of insulin and have snacks until I got home to eat something properly. It's been a really bad couple of weeks but things can only get better!!!

I do live at home, and my parents have been very good, and the rest of my family. It is a definite shell-shock and a major change, but it's something we're gradually getting used to.

Has your daughter ever considered using an insulin pump? Many people have mentioned this to me, but I'm not sure about it. I'm fine with the insulin pens.

I think I've been pretty close to a 'hypo' - I'm not sure what the level is that you'd go unconcious but I've been as low as 3.4, at which point I was extremely shaky and getting blurry vision and felt like I was somewhere else - people were speaking to me, but it's like they weren't there. However, I took immediate action and it turned out fine!

Dan.

Wow Dan, sounds like you were lucky that you finally went in to the hospital. I know how easy it is to put something off, especially if you're not feeling sick! That's a lot of weight that you lost. My daughter lost about 20 lbs but like I said, I didn't really think that much of it. I knew she had lost a little weight but I was shocked to find it was 20 lbs!

Sorry to hear about what you've been going through with other family members being in the hospital! Sounds like you have a lot to deal with right now. I hope it all works out okay and just make sure you take care of yourself!

We've discussed an insulin pump with the doctors. Her doctors said we'd have to wait at least 6 months before using one. They wanted to be sure she was comfortable with injections and carb counting first. After the 6 months, she was very comfortable with everything and didn't want to change. So for now, we leave things as they are but I think the topic of a pump will come up again, in time. Especially if her control doesn't stay in a good range. At that point we'll probably discuss it further.

Like you, she's also had some lows where she's felt shakey and knew she needed to eat but she's never had the blurred vision or felt disoriented. I don't know what a 3.4 works out to but I'm thinking it's in the 50's somewhere. That's pretty low. She usually starts to feel weird at about 75 (4.3 or so) and will treat that. I don't know at what point she would pass out, I hope I never find out!

Linda

Hiya. :) Hope you're both doing okay.

I'm not sure what the levels we have here in the UK (i.e. 3.4 equate to in what you use), but it is certainly low.
The problem is at the moment it's hard to know whether I really am using the right amount of insulin, as I've got 'set' amounts before each meal.

On my next visit I hope she'll get me counting carbs and using a ratio so I know I'm not doing too much or too little. My levels the last couple of days have been brilliant, all in the 'normal' range except 1.

I'm very undecided on the insulin pump, but this is all totally new and for the time being what I'm using will be fine. I've just read so many good things about the pumps in the fact you don't have to eat at the same sort of times and so on...

Dan.

Dan,

One thing that may help you with your insulin amounts is the 500 Rule. This is from a book called The Pocket Pancreas and I've found it to be helpful. It's a small inexpensive book, I think I paid about 5$ for it. The 500 rule is that you add up your total units of insulin for the day (fast acting and slow) and divide 500 by that number. I believe you said you were taking 36 units for the day so 500/36 would be about 14 units. That means you take 1 unit of insulin at meals for every 14 grams of carbs that you eat. It's a general guideline and only works with the insulin regimine that you use, it won't work if you use regular insulin (which you don't).

So, maybe from that you can get an idea of how many carbs you should be eating at your meals. If you take 6 units for breakfast, then that's about 84 carbs and you probably want to stay around that amount.

I know you haven't really talked to the nurse about this yet but it may just help you get through the next few weeks a little better. I may not be explaining this very well. If you do a ****** search on "500 Rule diabetes" then I'm sure you can find something that explains it a bit better.

Hope that helps.