Newly diagnosed Type 1

Hi All - I’m a newly diagnosed Type 1 diabetic and I’m delighted to find this community. I got diagnosed in late October after experiencing recurrent yeast infections - I went into urgent care, which revealed high glucose in my urine, and a finger stick pegged me at 309 ml/dl. I am a 37 year old woman, very active with a normal BMI and a family history of autoimmune disorders. An A1C of 14+ and GAD antibody test confirmed my Type 1 diagnosis.

In hindsight, I really should have noticed that losing five pounds in quarantine, despite eating everything in sight, was too good to be true :slight_smile: I gained 8 pounds in my first week of starting insulin. I feel much better already.

I’ve had initial meetings with an endocrinologist, diabetes nurse, and nutritionist. The nutritionist was really pushing me to eat more carbs. (I went strict keto after my diagnosis and before getting my insulin, then ate low carb, roughly 50-100 net carbs a day, in my first few weeks). I have been trying to eat higher carb these last few weeks (aiming for 200g net carbs/day), but I’ve noticed poorer sugar control as a result.

I’m currently using Levemir as my long acting, and Humalog for fast acting, along with a Freestyle Libre meter. I just started a new job where I’ll have better health insurance, and so I’ll likely get a Dexcom and possibly a pump early next year.

Everything is a bit overwhelming right now - blood sugar seems to be affected by so many different variables. I’m a bit of a data nerd and very willing to comply with the right diet, but I feel like there’s so much to tackle at once. Every day seems to be an unrepeatable experiment - even my basal insulin needs seem to vary daily with things like my menstrual cycle. I would love any tips from this group on what to tackle first in terms of figuring out my diabetes.

I’m old school so I’ve never heard of being told to eat more carbs, what’s the reason for this? I highly suggest getting a Dexcom so you’ll always know what your level is. You can check your BG 15 times a day and you won’t come close to the info a Dexcom provides.

Eat more carbs and less fat is the standard mantra of the majority of nutritionist. It is part of their crusade to rid our diets of what they have deemed to be the evil fats. This is the advice they give to everyone, not just diabetics.

This advice just seems wrong for a diabetic, consuming large amounts of carbs makes controlling blood glucose more difficult for many of us. No one says you must avoid carbs like the plague, make your own choices about how much you wish to consume, taking into account how well you can control the blood glucose that comes with them. Some people do well consuming a normal amount of carbs, others find they must limit them to keep their BG in control.

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Hi Lainey!
Sorry to hear about the diagnosis. We’ve all been there though :slight_smile:

I think you’ll see all the T1’s say “WHAT??” to the advice to eat more carbs! Did they say that this was temporary? Perhaps its to keep you safer in case the honeymoon period kicks in unexpectedly?

In the long term, most folks will say to try and limit carbs- it definitely makes control much easier.

You are 100% correct with this statement: “Every day seems to be an unrepeatable experiment”. I’ve never heard it stated more clearly! T1 is a moving target. You’ll always be adjusting and tweaking insulin, and you’ll make a LOT of mistakes. Just be ready for it, and know that its not easy.

There’s a ton of very smart, very nice folks on this board that post all kinds of information, and love to help. Definitely ask questions! :smiley:

Glad to meet you, @lainey683.

Yup. This is a thing. Infections will be more common with high BG.

Yeah, they kinda have a set diet plan that they start people on.
Are they telling you to deliver the same amount of insulin at each meal?
They are prob just trying to get you through this period of adjustment.
Down the line, once you get a handle on the basics, you will have more freedom.
They don’t want to overwhelm people who are newly diagnosed with too much complexity.

Yup. This is how its gonna be for a while. Getting a Dexcom will help a lot in figuring out patterns.

Your insulin dosages are prob not finely tuned yet. We will be able to work with you on that. Give yourself a little time to adjust and get to know how your body operates. That’s ok. It sounds like your doing a really good job. But, you will learn and get better over time.

Its not as fast acting as they say! Test your BG to see how it works for you. Many wait 15-30 minutes before eating. Longer if high bg before meal, eating non-carby foods first.

Do you recognize feelings of going low?
Consider a freestyle libre cgm, if dexcom not covered.

See Mastering Diabetes for a diet low in fat and high in good carbs. I eat close to 275 carbs daily have a A1c of 5.2.

When I started following Dr Bernstein about 15 yrs ago almost NOBODY was eating low carb. Slowly this way of eating has caught on. I followed Dr.Bernstein for 11 yrs and think that he is great, BUT, this way of eating made me very, very ill. My Alc was 4.6, my HDL was 100, but my LDL was close to 200. I am well aware that some people don’t think high LDL matters, but it did for me. While on Bernstein’s woe I suddenly needed two heart stents. I had had very few diabetic complications at this time after 52 yrs of diabetes. That was 10 yrs ago. I also developed very low blood pressure and severe migraines. My husband called an ambulance several times because I would pass out and hit my head.

Since being on a low fat plant based diet, my LDL is way down and I no longer pass out and I have had 1 migraine in 4 yrs.

PLEASE don’t discourage people from finding out about low fat, plant based diets.

I think the low carb diet works well for many people and it did for me until it didn’t, but some people can be harmed by this way of eating. A high carb diet with low fat is a very healthy way to eat. People have fewer heart problems and cancer.
Yes, it takes a while to adjust, but the change over is fairly easy to make. It also requires exercise, which is great for all of us.

Because eating a very low fat diet greatly lowers insulin resistance, I take almost the same amount of insulin now as I did when eating very low carb. A total of 23 units daily.

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Eating more carb and more insulin protects you from keto acidosis. However once you get on a long acting insulin, it is not really an issue anymore.
So this might be old school thinking on the part of your doctor.
I try to stick to 100 carbs a day and I often go over but that’s my goal.
It’s not really even low carb.
Your doctor suggests 200. That’s a lot of carb. Even for a non diabetic.
It is doable if you dose correctly and you are getting g lots of exercise.
When I was younger I did two marathons, I would eat 400 grams of carb and taking regular insulin.
No cgm I would do finger sticks while running. Sweat mixing in w blood. No idea how I managed.
But I completed 2.
I crashed in mile 21 but took a small break and ate sugar and continued.
Kind of stupid looking back but there were no rules back then. No plan. We just did the best we could.
So really you need to eat as much carb as you feel is right.
It takes a long time to figure out your insulin needs and since you are newly diagnosed you might be making some insulin still and that makes it tougher.

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Thanks all for the welcome and advice. I had my first post-diagnosis A1C and cholesterol tests earlier this week and got back great results. A1C at 6% and total cholesterol at 158, LDL at 81, HDL at 69 and triglycerides at 31.

I’ve been using a Dexcom CGM and Humalog with an In Pen for the past 3 weeks, along with nightly Levemir. Time in range at 91% (range of 70-180), 7% high and 3% low (some rounding here).

Cardiovascular / aerobic exercise seems to be excellent for my control. Just walking at a leisurely pace for 20 minutes a day seems to help. Diet wise I’m averaging 2,000 calories a day, 23% protein, 38% carb, 38% fat. Eating more than 60g of carbs in one sitting is problematic for my control, except if I am exercising directly before or after. For longer hikes I half my normal insulin dose for the meal directly beforehand and then consume 15g carbs per hour (mini Clif bars are great for this).

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This is great!

I did not do as well during my first few months, but that was before cgm’s. As a data person you have a huge advantage with that. And yes, it’s a daily challenge in titration, with far too many variables, but somehow it all works out.

With your post-diagnosis honeymoon, things will be relatively more unpredictable until, as eventually happens, your endogenous insulin production goes to nothing. It’s a mixed blessing and there’s other discussion about that in other threads here.
With Levemir, which has a shorter life than, say, Tresiba, you may find you can fine tune with two doses per 24-hr period. I find Humalog and Novolog largely interchangeable as bolus insulin, and there’s lots of discussion about that here too.

Congratulations on your newfound energy after diagnosis (isn’t it amazing?) and on your positive approach to T1D. It’s 24/7, some days will be better than others. Stay positive, be patient. And welcome to TuD!

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