My story, with lots of questions! New type 1

Type 1 and LADA New to Type 1 Diabetes
41

Thank you, Zoe. I'm still trying to figure out all this 'crap'. I'm sorry, that's my favorite word today.

My dad says I am playing with my chemistry set (lol).

I am terrified of Lantus in general, to be honest. Because I know once it's in there, it's in there, and I'm stuck with it for 24 hours. I feel like since I was eating relatively low carb but giving much more humalog than I was Lantus, that it will be okay to try 9u of Lantus and begin again with the I:C ratio... does that seem like sound logic to you?

I'm afraid sometimes I may not be very logical. I don't want a lapse in logic to have me laid out on the floor unconscious! Lol.

42

What Zoe said, plus I agree that one usually uses insulin to "correct" high blood glucose and one "treats" a low with glucose/food.

For example, if I wake up in the morning and my before-breakfast BG reading is 160 mg/dl, I prepare a single injection of Novolog which contains both a "bolus" for my breakfast carbs and a "correction" for the 160.

Please note: This is MY correction, do not copy it! I'm an insulin-resistant T2 so my insulin doses will be much higher than a T1's insulin doses, as a general rule.

Anyway, I do my correction by subtracting 100 (my target blood glucose) from 160, which leaves me with 60 mg/dl to correct, and then divide 60 by 8 (my correction factor is one unit of Novolog for each eight points mg/dl above my target of 100 mg/dl) which gives me a correction dose of 7.5 IU of Novolog.

If I'm having 15 grams of carbs for my breakfast, I divide that by 4 (my insulin:carb ratio is 1:4) which is 3.75 IU. I add together 7.5 (correction) and 3.75 (bolus) and get 11.25 IU total Novolog, which I will round up to 12 IU because I'm so very insulin resistant -- it would be OK to dip into the 90's anyway.

So that's how I calculate my insulin if I'm going to combine a bolus and a correction.

But what if it's been four hours since lunch, dinner in an unfamiliar restaurant won't be for an hour or two, and I test my BG and it's a bit high, say 180? If I know that I don't have any more Novolog on board (after four hours), I can just calculate a correction:

180 mg/dl - 100 mg/dl = 80 mg/dl

80 mg/dl / 8 (correction factor) = 10 IU of Novolog

I don't HAVE to eat yet, I can just go ahead and correct the hyperglycemia and wait until I know what I'm having for dinner and then, at the restaurant, bolus JUST for the meal when the time comes, say two hours after my correction.

What I would NOT want to do two hours after a correction is test again, and correct again because the Novolog from the previous correction is still being metabolized and if I corrected again I would "stack" the corrections and probably go hypo.

Clear as mud? ;o)

43

CDE does mean certified diabetes educator. Your clinic or hospital should have one, or know where there is one. They are popular, so if you don't care for what you hear, you should be able to compare with another.

Your diet and the food you take in is critical to the insulin that you need. You need to learn what a carb is, how to count them and dose according to your needs and meals. The nutritionist can help with that. Both have helped me considerably. Like many here, I like to have all the information that I could get. Be bold. Ask questions. This is a brand new lifestyle that you will carry for the balance of your being. Making the best of it equals a long and productive life.

Sometimes, it's good to be diabetic.

Be well

Brian Wittman

44

I don't use any of the electronic logs, and I'm a software engineer with twenty years in the biz. You'd think I would have written one by now, eh? I like the process of keeping a written log: circling things, putting stars next to things, writing little notes with lots of exclamation points, etc. It keeps me on track, keeps me honest, keeps me thinking, lets me flip back and see what happened yesterday or last week. Call me a Luddite, but I like the flexibility of my ever-evolving paper log (just an 8-1/2 by 5-1/2 spiral bound notebook of graph paper -- gotta love those graph lines for helping me keep it tidy and do my math calculations in orderly rows and columns.)

45

Thank you! I didn't realize I was supposed to have a team until I came on here. I'm making appointments with a nutritionist and a diabetes educator posthaste!

46

Thank you catlover! I've never really had much of a 'normal' kind of life, change has been my constant, so I'm sure I'll adjust to my new 'abnormal' pretty well. I'm very glad I found this forum, it's already been incredibly helpful :-)

47

Thank you Doris :-)

48

Thank you Marty! I ordered the books already, but I'll check to make sure they are the most current editions. I didn't think to look.

49

Hey there~ from a nurse and CDE perspective it sounds like you have a great attitude and perspective on YOUR diabetes. I wanted to share how I explain Lantus. Your liver works just fine and is constantly dumping small amounts of glucose into your blood (more during stressful times and less if you have alcohol in your blood). So the purpose of the Lantus is to move
the sugar out of your blood into your body’s cells that your liver is putting in. If you get your lantus dose close to accurate you should be able to go 24 hrs without eating and your sugar (in theory) should stay relatively level. As you’ll learn and have read sugar management is very artsy! Any basal
insulin is a good thing and once you have a better
understanding of the importance of timing of the different
insulins it will be less scary. Keep educating yourself!!

50

Your welcome. That's good advice about having a Gluacon Kit around u and teaching otgher's how to use it if they find u unchonis. I've used them lots in my 38 years with Type 1. I have my husband trained on them. Also my daughters and my 5 year old g-daughter. Just incase! LOL!

51

Just to provide a little different view, I live alone so don't bother with glucogon. The only severe low I had was when I first started and did something both daring and dumb. But even that, where I was unconscious, my liver kicked in and brought me out of it which is a natural process and I was able to treat myself with glucose tabs.

Some people are subject to more and more severe lows, but I'd guess most of us rarely if ever have one we can't handle ourselves.

52

I've meant to pop in here, I agree with a lot of the diabetes advice. I wouldn't worry about working out "for" weight loss? I would worry about working out to be stronger, happier and fitter in general.

Regardless of what level you start at, if you can stick with it for 5 months, that's a great accomplishment and you should keep it up!! I've lost a bunch of weight w/ T1 but I've been at it since like 2006, maybe 2005, I'm a little bit fuzzy since, unlike LG, I ***loathe*** logging of any sort. Blathering on message boards yes, logging, no.

53

I know it's hard to stay optimistic after being diagnosed but I promise you that it will get better. I was diagnosed as a kid and I remember it taking a lot of trial and error before my dosages were ironed out. With time, you will be able to make adjustments and your sugars will be more controlled. Once your sugars are more controlled then your symptoms should start to dissipate. I had many of the same symptoms pre-diagnosis and they eventually went away. I look back at pictures and see that I also went through a phase of gaining weight before losing it at a rapid pace. It's just the body freaking out I guess. Remember that your body is going through a lot right now so be patient and let yourself heal.

In terms of diet, there isn't one single "diabetic diet." With type 1 you can pretty much eat whatever you want as long as you count the carbs and give the appropriate amount of insulin. Personally, I eat a vegan diet for reasons unrelated to diabetes and it works just fine for me. You mentioned that you are concerned about some of your numbers from your blood work and my advice would be to try out a vegan diet for awhile to see if it helps. Eating whole foods (unrefined grains, sugars, veggies, seeds, beans, etc) does miracles on healing the body. Sorry, I don't mean to push a vegan diet so hard! I find that if you eat a balanced diet and exercise often then you shouldn't have too many problems keeping your blood sugars under control.

I hope this helps and I hope you start to feel better soon. Hang in there!

54

Palimonvet- I enjoy reading about your experiences and treatment. Your story is very helpful. I read fast, so you can't be too long-winded for me! More information is always better, in my book.

I like the way you describe diabetes to your friends, very succinct. I think I may borrow that. Unfortunately, I have some friends that will need an additional tutorial on what insulin and blood glucose are, and what roles they play. I'm a very matter-of-fact (but hopefully warm!) person, but that hasn't helped much with people's reactions. Ah, well, it's only a minor annoyance.

You and I are like-minded when it comes to research. I'm pretty adept at sifting through info and categorizing it appropriately, and always check sources. I like reading scientific journals and studies as well. I'm trying to focus on the big picture and get my knowledge base up to par first, but I'm sure I'll dig in to all the detailed info in the not-so-distant future. Please post anything you find interesting or helpful, I'd certainly read it!

55

Super_sally- I spent many years eating a low carb (low/no refined carbs, mostly low GI/GL foods), higher fat/protein diet, just to feel good while keeping my weight down. I'd actually prefer to go back to that, so I'll definitely ask my Dr if there's any reason why I shouldn't. Thank you!

56

I agree, I think I will use up the the mix I have, unless switching seems like it will greatly benefit my health.

57

Ah, thank you, I'll ask about that. Do I need a prescription for that?

58

I dunno if I'd agree with that? There's a number of different reasons the mix is not the best stuff? When I got my pump, the endo suggested that NPH (part of the mix I think?) had only a 53% chance of peaking when it was supposed to. This makes it very hard to establish any control as, even with meticulous eating, the "peak" can hit earlier or later making it hard to hit targets, with a moving arrow, as it were? It also sort of "requires" that you have a ratio of food to medicine as getting a basal rate set will "cause" a specific amount of short term (is it R?) that, in turn, *must* be eaten to? I think that it's a lot easier to do fine tuning and figure out what to do if you are using the split insulins. I always had an R syringe and an NPH syringe because, despite my other failings, I was always meticulous about not wanting N "cooties" in my R.

59

I tend to agree with AR. As I re-read your post you are not only very very high, but you are miserable. If you are able to get decent control and get those symptoms down with the mix, then that's great. But from what people are saying and my (not strong) understanding of it, I don't know if you will be able to. I also don't know how long what you have will last. If it were me and we were talking a week or two, that's one thing. If we're talking months I don't think I'd be willing to hang in. You also don't mention your insurance situation so only you can balance your finances and what it would cost to start on basal/bolus.

60

HI!
I am also 33 and was diagnosed last July (2011). I had a TON of symptoms and noticed them when they went along, but my first single glucose test was "high" but not flagged by my doctor 2 years before diagnosis.

This is excerpted from my journal, just to demonstrate how much undiagnosed diabetes can mess with you:

weight loss starting in late winter/early spring 2009?
hair loss starting late winter/early spring 2010
nails growing slowly after I moved to oregon
pink eye infection this past spring (first ever!)
eye blob august 2010
near-UTI? Late winter 2010
near-DKA? Spring 2011
excessive weight loss-113-since oregon move
more drinking/urinating- spring 2011?
hit a wall- march 2011
extreme fatigue and depression june 2011?
wounds slow to heal
problems with memory, concentrating, rapid thinking summer 2010
dry skin
problems with balance summer 2010
problems sleeping summer 2010
unexplained headaches summer 2010

I've learned a TON in the first 7 months, and I can tell you that your symptoms were because of undiagnosed diabetes. Once you get it under control, IT WILL GET BETTER!!! I was so terrified that the changes were permanent. Don't get me wrong, I'm still physically recovering and not 100% of what I was before, but it DOES get better :) I know you're scared, terrified. But the best you can do is to eat well, exercise, and find joy and peace.

I also had undesirable numbers for my lipids and creatinine/albumin. My primary doctor freaked me out thinking I'd have to be on all these medicines. But she was wrong; my nutritionist and endo told me it was because I was undiagnosed. And once I started insulin, a few months later my numbers were wonderful!!! So just give your body some time.

You can have BOTH type 1 AND type 2. So press your doctor on this.

I was terrified that I had damage, because I was certain my symptoms started 2 years before diagnosis. But my endo told me that it takes *decades* of *unmanaged* diabetes to have this.

I was immediately set up with a nutritionist who specializes in diabetes. I strongly suggest this and he/she can help you work on a meal plan :)

I also started seeing a therapist, who has Type 1 as well. That has been an excellent thing to do to work through all of my diabetes-related issues.

Surround yourself with people and love. Contact JDRF and see if there is a group near you. Take deep breaths and remind yourself you know what the problem is, and knowledge is power.

It WILL get better! I know this because I feel so much more confident and enabled 7 months later.

Hugs to you!
Anne