Hello
This is the first time I am posting here. I am 21 year old engineering student who was diagnosed as type 1 diabetes 2 weeks ago. I was DKA by the time I reached the hospital. I am now on multiple injection therapy (3 rapid acting (Humalog) before meals, and one long acting (Lantus) before dinner). I was already underweight (50 Kg with 170cm height) and the onset of diabetes made me lose about 9 KGs and made me dangerously underweight. I feel fine after insulin therapy and am gaining weight (about 45 KGs now).
I take 12U of lantus every night, 12U of Humalog in the morning and afternoon, and 11U of Humalog at night. I am still learning how to control my BGs. I am currently on CGM that my doctor put (Freestlye Libre. Works for 14 days and only they can extract its measurements during hospital visits). I asked the clinic if they could give me the data but they refused to do so and only gave me the graphs. Also, they gave me no way to know the CGM reading without visiting the hospital (Librelink is not available in India). So I found another way (Glimp) to extract data from the sensor and I am using it daily to track my BGs. My blood sugars averaged at around 205 mg/dL for the first few days. It significantly improved and my average today is 121 mg/dL with the highest reading today being 161 mg/dL. It is sad that after the 14 day period, I cannot afford a CGM and have to go back to testing with strips. The convenience and data given by CGM is unparalleled and I will miss it. I have been taking a walk after every meal (about 12000 steps per day).
I am hungry all the time and I’m eating a lot of food. The doctor said it is because of the insulin. My carb intake is also relatively high , standing at 260g per day (All good carbs and low G.I food, though). The only high G.I food that I believe I’m having is the mix of brown and white rice in the afternoon. It is actually the staple food in my country and it is difficult to avoid. I plan to switch completely to brown rice, however.
My C-Peptide test gave a fasting C-Peptide level of 0.16 ng/ml. Do I have a chance of having a honeymoon phase? Does niacinamide help in preserving beta cell function for the first 2 years? (I found multiple studies saying that it does but my doctor isn’t convinced).
What should be my target BG levels for the first few months?
The injection with pens sometimes hurt and cause bleeding. Any tips to prevent this?
Apart from the questions I asked… Is there any advice that any experienced type 1 diabetic can offer regarding T1D management?
Sorry for the long post.
EDIT (29 May 2017): I originally posted this this about 2 months ago. I have learned so much about managing type 1 in these two months and TUD helped me a lot with it. My BG control improved significantly. My BG now rarely exceeds 140 mg/dL and averages at around 109. My BG management app estimates my A1C as 5.7%. Thank you so much for your support.
The only effect of niacinamide I’m aware of that is beneficial for most or many diabetics (but quite possibly not at your age) is to lower triglycerides and raise HDL cholesterol. At therapeutic doses, it works quite well for that purpose, but has some major annoying side effects (flush, severe hive-like skin blotching for an hour or more, etc.). It can also significantly raise BGs. On the other hand, I’ve been taking it for the last year and am in a deep and extended honeymoon myself! So, not sure.
As for the rest, welcome to the community! I know it’s not where most of us want to end up, but if you have to have a chronic disease, Type 1 diabetes isn’t the worst to have. We can treat effectively. I also can’t afford a CGM, and it is great technology. Hopefully the future will make it more affordable for the rest of us. So am I right in thinking your doctors have you on a fixed dose of Humalog, rather than carb-counting and using it as a bolus insulin to cover carbs? If so, you should get better at BG control (although yours is pretty good it sounds like so far) when you start using the rapid-acting for adjustments and bolus rather than as a fixed amount that forces you to eat on schedule.
And don’t worry about long posts! We do that a lot and really well around here
Hello & welcome! I’m sorry you’ve been dx’d with T1D but you’ve found a great community of educated, experienced & caring people, who will help you. I don’t think i can offer much since i was dx’d in Jan 2016, but here are some things that helped me.
I wrote everything down in a notebook: time of day, BG reading, what i ate, number of carbs, etc. i wanted to have a sense of how my foods affected the readings. With your technical expertise & all those apps out there, you can make your own reports. I started testing every hour or two at first just out of curiosity.
I basically ate the same things every day: steel-cut oatmeal & an egg for breakfast and a huge salad w veggies, chicken & balsamic vinegar for lunch & dinner. I did that for probably 10 months in an effort to stabilize the readings. The oatmeal fling didn’t last as i watched what it did to my readings. Let’s not even discuss the Corn Flakes fiasco LOL You will learn the better foods for you & the ones you would rather avoid.
I tested very frequently. I didn’t have a CGM so i did it the low-tech way LOL & was on injections. My endo called that a low-tech pump!
Over time, i was able to branch out with new (old) foods, checking carbs religiously & so far, so good. I went through the frustrations of being so “high maintenance.” I mean, who has time for all this?! But with effort & good record-keeping, i feel more settled. This community has helped a lot & i’m fairly new to it.
One thing everyone will tell you: YOU CAN DO THIS!! You can live a healthy, long, complication-free life with T1D. Do what you’re doing & check back for all the much better responses you will get from the veterans in this community.
P.s. i found that certain sites for injections were better than others. Pinching a little skin could help & also waiting for alcohol to dry (if you wipe first) & injecting slowly. I found that the back of my arms, hips, middle of stomach & one thigh were better sites.
Thank you for the reply. Type 1 Diabetes is definitely not the worst. It has its bright side: It motivates you to eat and live healthier.
When I was admitted in the hospital, I was initially given Humalog Mix. But it wasn’t optimal and I reached mid 400 BG levels on that. By the time I got discharged from the hospital, they switched me over to Basal-Bolus regime with a starting dose of 8U of rapid acting insulin thrice a day, and 8U of long acting insulin once. The doctor told me to adjust it on my own, and told me that he was “sure that I can figure it out.” My current BG levels are a result of my carb counting and adjustment of insulin doses. The doctor just reviews my changes and gives suggestions if necessary. I calculated my I:C ratio and insulin sensitivity and I did give a few correction shots earlier, when I went high in the evening (thanks to the CGM). I am still calibrating my insulin dose calculations - it might take a while to get it right. I had 3 hypos till now. Once when I took a hot bath just after lantus, which caused it to get absorbed faster. Once when I got my insulin dose wrong (took 1U extra), and once when my correction dose topped with my dinner bolus. One of them happened while I was awake and I quickly corrected it before it gave me symptoms (CGM again), and the other two in my sleep (I didn’t know until I saw the CGM data).
I’m trying. Might take a while to calibrate everything and get better at carb counting.
Thank you for the response. It does feel good to be part of tudiabetes. I do note down everything (Food, BG readings, Insulin readings, and even injection sites) on an app called Diabetes: M. I am still learning carb counting now and I’m eating same things everyday just like you. I will start experimenting with new foods soon. I’m gonna have to change to the low tech pump soon.
That is helpful advice. Never tried injecting into hips and arms. Will try and post result here. Thank you.
Welcome, @spacepirate! Two books many of us find helpful are Think Like a Pancreas by Gary Scheiner and Using Insulin by John Walsh. Both talk about carb counting, bolus timing, exercise, and avoiding lows and highs.
Welcome to the club noone wants to join. Best thing is to check bg lots, and eat to your meter. Everyone is different and truly YDMV (your diabetes may vary). Low carb high fat is popular right now and works for me, but it’s not for everyone. Don’t let the disease control your life. It’s just one more thing to live with and make you… unique. It’s good that you found tudiabetes.org! Great resource!
Welcome and I’m glad you found your way here. I learned so much from the members of this community when I was diagnosed T1 just over 2 yrs ago (at the age of 54). I hope you do as well.
You’ve received great suggestions so far. A few thoughts:
Be your own best advocate
Ask questions often
Trust your instincts
Take time to smile and laugh
And … something I still work on everyday…don’t be too hard on yourself if
your numbers go haywire. There is always tomorrow!
Thank you for the reply! It is quite rare that people get T1D at the age of 54. But I guess you were lucky. I’d love to postpone my onset from 21 to 54!
First of all, I congratulate you on learning good basic diabetes skills: carb counting, keeping a log, and frequently measuring your blood glucose. While I love all the modern diabetes technology, improving your knowledge of how insulin, food, and exercise impact your blood sugar levels form the foundation for good diabetes control.
I encourage you to buy a food scale. It is the best way to accurately calculate grams of carbohydrates, the main food component that drives post meal blood glucose (BG). Using the food weight combined with an app like Calorie King will help you to accurately carb count.
Another simple technique that is often overlooked and undervalued is finding a pre-bolus time customized to your metabolism. A pre-bolus time is that time between taking your insulin dose and when you start to eat. Many people and doctors try to simplify that to a standard 15 minutes. The trick is to better match your insulin action profile to your food action curve.
You can personally experiment with pre-bolus times by checking your BG at the time you dose, write it down, and then delay eating while systematically checking your glucose level every ten to fifteen minutes (record the time and BG number) until you note a pronounced drop. Only do this when you can devote full attention to it while you keep emergency glucose nearby and your meal ready to eat. Pre-bolusing makes a huge difference in post-meal blood sugar. Discover your unique pre-bolus times and you will be well on your way to better control. Your ideal pre-bolus time is probably different at different times of the day. Many of us observe a longer pre-bolus time is needed in the morning versus later in the day.
I was diagnosed at a little older age than you, at 30. You can do this. Your best weapon is your acquired knowledge about your diabetes, a good attitude, and persistence. Diabetes is a long-game. You need to let go of your failures and fully embrace your successes. Pace yourself. Learn a little each day and it will add up to an impressive collection of knowledge that will serve you well.
Finally, I have found participating here has contributed immensely to my success with diabetes. I’ve learned valuable techniques that doctors never mention. Of course you need to listen to your doctors but they don’t know everything. You are now living with diabetes 24 hours every day and that counts for a lot. Interacting in a peer support group like TuD will help you in many ways you don’t now realize.
You’d be amazed! I developed T1 at 40, many of the long-term members here developed Type 1 in adulthood as well. My feeling is about half our community here (at least those with Type 1) got sick in childhood, while about half got sick as adults. Fortunately, we have good tools to deal with Type 1 now compared to what my grandmother and great-grandmother (also Type 1) had
I was diagnosed Type 1 in May of 2016 at the age of 61. It is such a life changer and a lot to learn. I am supposed to be looking forward to retirement and enjoying life. Now I have to concentrate on learning all about diabetes.
I agree, that sucks. When you look forward for so many years to begin a new chapter in retirement, no one dreams of dealing with diabetes. One thing I can tell you, however, is that the more you learn about diabetes and how to manage it, the smaller chunk of your life it will consume. I know it doesn’t seem that way, especially in the first few years. But, with a little bit of luck and some hard work, you can restore most of that retirement dream. Good luck! Feel free to pose questions here. Many of us have lots of experience in dealing with the diabetes beast.
Terry,
Thanks for the positive response. I have been reading a lot on this site for several months, I have learned a lot. I seem to learn something every time I am on here. I have recently added the mysugr app to my phone and it is helping me keep a closer eye on things. This is a very big learning experience.
I totally agree. I had been waiting for about 15-25 minutes after taking Humalog before eating. As I turned to better food choices with more dietary fibers and low G.I, this waiting time resulted in a hypo 20 mins after the meal. I started waiting less than 5 minutes and I got a nice, fairly flat line.
Already ordered one online!
Absolutely. I learned a lot of valuable information from these forums.
