Confused and angry. Unsure of diet and does

[kt89]

:mad: !! hmph

this is yesterday's meals, doses and levels (so confused)


level b4 (6,6)
breakfast:
43g special k (30g carbs)
66g banana (15g carbs)
1/3 cup milk (3.7g carbs)
cup of tea Dose: 10 units (doctor recomm.)
level after (3.1)

snacks: hypo jelly beans, anzzac biscuit, tea

level b4 (10.7)
lunch:
1/3 cup egg
2 lettuce leaves
1/2 tbsp mayo
2 slices bread (41.5g carbs) Dose: 6 units (")
level after (6.7)

snakcs: cup of blanched cabbage, tea

level b4 (8.1)
dinner:
60g tuna
2 lettuce leaves
2 slices of bread (41.5g carbs)
mandarin (13g carbs)
Le Rice (28.1g carbs) Dose: 9 units (")

after dinner: 1 vodka soda (working doing photography at a gig)
levels after (8.7)
snacks: Zambrero's taco (roughly 2 serves carbs) Dose: 3 units

Night time basal dose : 13 units

And then I was 4.7 when I woke up this morning. Is that from having a drink? I did eat after i had it and i felt fine all night?? And today I've had another hypo and I can't see im almost blind!!!

[matingara]

my opinion.

you are eating huge amounts of carbs! you are trying to match these huge carb loads with large insuin doses. this is almost impossible to get right.

i think you should read up on Bernstein's "Law of Small Numbers".

i.e. low carb input=low insulin input=steady BGLs.

i think you could try to limit your daily carb intake to a total of 30-40 grams for the entire day - while you work this out.

make sure you lower the insulin dose way down until you get the hang of it.

that is my initial input.

-- Joel.

[Subby]

You need to sort out your approach to dosaging and getting more suitable amounts. Care to step through how you arrive at getting a dose, kt89?

Are you taking a long acting insulin? Do you understand the idea of basal insulin?

While we might have these conversations, if you're getting daily severe hypos you should be getting medical attention and help to minimise them in pretty much any way, asap. Reducing hypos needs to be your number one priority, followed closely by keeping a lid on highs as you do so.

The amount and type of carbs may well be a factor for you, beyond your obvious dosaging issues. but whatever you do don't cut them out drastically until you have a better dosaging technique to deal with *whatever* carbs you eat, and a better understanding of what effects what. At this stage of being unclear with dosaging, carbs are your only positive weapon against the effects of excess insulin, and cutting them right down without knowing precisely how and why to reduce doses, will lead directly to more dangerous hypos and higher risks.

[oneluckyplay]

What is your insulin to carb ratio? Breakfast ratio = 47 carbs, 10 units bolus = 5 to 1. Lunch ratio = 41 carbs, 6 units bolus = 7 to 1, yet you were high and I don't see a correction bolus. Dinner ratio = 82 carbs, 9 unit bolus = 9 to 1 and no correction bolus. Do you have different bolus ratio's throughout the day? Are you testing 2 hours after a meal?

It looks to me like you took too much insulin for breakfast, then had too many carbs to fix your low. After that you went high had lunch and again took too much insulin but you were high so you didn't feel the effects and it brought you back to normal #'s, then you had a snack w/ no insulin that made you go high again. Later you had dinner w/ no correction dose.Then possibly too much insulin for late night snack. I could be waaaaaaay off on what I'm saying I'm just taking an educated guess w/ the information you gave us. I could be misunderstanding what you wrote too. Hope things work out for you.

[BlueSky]

It sounds like you are fumbling around in the dark there ... :o . If your Lantus dosage and timing is not right, maintaining control becomes almost impossible. My suggestion would be to cut way back on the carbs initially, do some basal testing, and adjust your Lantus until it keeps your numbers are reasonably steady in the absence of food. When you have got that sorted, re-introduce the carbs slowly, and work out what your insulin:carb ratio needs to be. You should find that your numbers become more predictable, and bolusing for meals becomes a lot easier.

[Subby]

It sounds like you are fumbling around in the dark there ... :o . If your Lantus dosage and timing is not right, maintaining control becomes almost impossible. My suggestion would be to cut way back on the carbs initially, do some basal testing, and adjust your Lantus until it keeps your numbers are reasonably steady in the absence of food. When you have got that sorted, re-introduce the carbs slowly, and work out what your insulin:carb ratio needs to be. You should find that your numbers become more predictable, and bolusing for meals becomes a lot easier.

Radically cutting carbs seems a risky proposition without making it very clear what should be done with dose at exactly the same time. Any misunderstanding on that front is a recipe for disaster and dangerous exacerbation of the hypos that are occurring.

I think it was in another thread that kt89 introduced herself as having just been diagnosed. The level of existing knowledge of carb-insulin correlation, or current dosaging practices, is unquantified at this stage!

[ant hill]

Kt89 :), How are you taking the Lantus? Just once a day or every 12 hours also the doses are small and that makes it hard to get good control because that say for argument sake 6U and you take another unit as that's 20% larger dose!!! :eek: And that's the same as fast acting insulin too. That's a huge rise!!
Next time you see the endo is ask for a pen that will do 1/2 Units as single units are a big jump for you. :)
The vodka is evil to your BG as this will throw down the value very fast so eat with the drink. ;)

[kt89]

my basal is 13, which is what my doctor has given me. the set doses were working a couple of days ago but now i think maybe my 'honey moon' period is kicking in? or maybe everything is settling down now? i don't know.
my blood glucose was 42 one week ago when i was diagnosed. and its gradually come down with the set doses, which i think was what my doctor wanted opposed to just dropping me down to normal straight away. still, its not helping my eyes they're so blurred i can barely see my screen or edit the photos from last night because i cant make out the models faces!!! bah!
how am i supposed to limit my carbs more than that!! i've been told i need to eat 2-4 serves of carbs with each meal with insulin! i know it sounds like a lot. i think its a lot too, and i dont want to put on weight so im sketchy about it. but i get soooo hungry between meals and i dont feel like im eating enough. what s there to eat if you cut carbs and fat anyway!!! nothing!! celery?? im not a rabbit ppl !!

[matingara]

hi kt,

being diabetic and cutting down on carbs does not mean you need to starve or be hungry. in fact, if you do it right you will be far less hungry all the time. i know, it works for me.

there are three types of foods in this world.


carbohydrates
fat
protein


it is DEAD SIMPLE. if you cut down on carbs, you ramp up on the other two (fat and protein). there. that is it.

PLEASE DO NOT BELIEVE THE SYNCHRONIZED IDIOTS IN THE MEDIA about fat making you fat or unhealthy. THIS IS SIMPLY NOT TRUE.

so, when you are hungry eat: cheese, eggs, ham, salami, roast beef, chicken, pork, pork crackling, nuts, peanut butter. eat them until you are stuffed. they fill you up faster. they self limit. and you feel full for much longer.

if you MUST eat carbs for snacks choose from celery, lettuce, broccoli, cabbage, cauliflower, spinach etc.

all your friends will give you --****-- about how your cholesterol will suck. that is poor thinking. my cholesterol did suck UNTIL i cut down carbs and ate more fat.

read this forum. you will see many people who have found this truism.

:)

-- Joel.

[matingara]

still, its not helping my eyes they're so blurred i can barely see my screen or edit the photos from last night because i cant make out the models faces!!! bah!
how am i supposed to limit my carbs more than that!! i've been told i need to eat 2-4 serves of carbs with each meal with insulin! i know it sounds like a lot. i think its a lot too, and i dont want to put on weight so im sketchy about it.

your eyes will most likely settle right down once you get your BGLs under control. it is likely that your eyesight will be better than it has been in a long time once this happens.

2-4 serves of carbs per meal (30-45 grams) is LUDICROUS. rather than just being told this and acquiescing you should learn to argue. Read the book by Richard Bernstein PLEASE (it is available online for free). there is no such thing as an essential carb. you do not need carbs. you can get by without them if you want to. that said, 30-50 grams per day is a reasonable maximum according to Bernstein. i have been limiting my daily carb intake to 30-50 grams for almost 2 years now. get this - i am slimmer and healthier than i have been in ages. in fact my Doc says i am skinny. my Doc also cannot get over how brilliant my cholesterol and triglycerides are. he approves of my diet.

you do not put on weight just because you use insulin. in fact, if you eat low carb, the amount of insulin you need will also reduce.

-- Joel.

[Lindy 4]

I am not sure if this will help or not but i went to the dietician today.

She recommended 1 carb per meal and to try eat some sort of fat (I do not like margerine/oil/fat so going to be difficult) or protein with any carbs if my BG is normal. A carb before i go to gym, and when i do intensive aerobic exercise 200ml fruit juice halfway thru. Also to stop trying to correct BG with injections inbetween meals coz it could be contributing to my hypo's.

And my current consumption of a 400g tub of peanut butter per week is not excessive...

Good luck, I shall be experimenting myself!

[Lindy 4]

PS: I currently only eat between 2 - 3 carbs per day (not counting what i eat to correct hypo's)

[CaitE]

hi kt,


if you MUST eat carbs for snacks choose from celery, lettuce, broccoli, cabbage, cauliflower, spinach etc.



-- Joel.

as far as I understand those are not carbs?????????

[CaitE]

Is anyone familiar with the total daily carb intake (in grams) required for brain function??? My friend recently told me 80 g per day is required to maintain proper brain function, but haven't found this number online??

Just curious.

[Cormac_Doyle]

ZERO

your body is more than capable of working with ZERO carb intake

[fgummett]

Is anyone familiar with the total daily carb intake (in grams) required for brain function??? My friend recently told me 80 g per day is required to maintain proper brain function, but haven't found this number online??You could read the following: Is dietary carbohydrate essential for human nutrition? -- Westman 75 (5): 951 -- American Journal of Clinical Nutrition (http://www.ajcn.org/cgi/content/full/75/5/951-a)
It is my understanding that any Glucose which the brain and CNS may need, can be synthesized in the Liver by Gluconeogenesis from Amino Acids (dietary Protein)

[Scratch]

Your doctor can only know so much. You can know so much more about yourself.

You have to do basal tests and find your numbers that your doctor will never know in such limited time of an appointment.

[Subby]

my basal is 13, which is what my doctor has given me. the set doses were working a couple of days ago but now i think maybe my 'honey moon' period is kicking in? or maybe everything is settling down now? i don't know.
my blood glucose was 42 one week ago when i was diagnosed. and its gradually come down with the set doses, which i think was what my doctor wanted opposed to just dropping me down to normal straight away. still, its not helping my eyes they're so blurred i can barely see my screen or edit the photos from last night because i cant make out the models faces!!! bah!
how am i supposed to limit my carbs more than that!! i've been told i need to eat 2-4 serves of carbs with each meal with insulin! i know it sounds like a lot. i think its a lot too, and i dont want to put on weight so im sketchy about it. but i get soooo hungry between meals and i dont feel like im eating enough. what s there to eat if you cut carbs and fat anyway!!! nothing!! celery?? im not a rabbit ppl !!

Set dosaging doesn't work very well at all, for most people. If you want better stability, regardless of the carbs you eat, you simply need to move to carb counting (which means, counting or being aware of the specific carbs you eat in a given meal, be it 5g or 50g). Using a set number finetuned to how your body uses insulin, you simply add up the insulin you need for that meal. That's it. Using this method means two important things.

First, it just works better. You will remove a lot of the highs and lows, because the dose is more appropriate every time.

Second, you don't need to eat carbs if you don't want - so you can start eating the diet you wish, rather than a slave to a certain amount of carbs both overall and at each meal/snack.

So, using a carb counting method (not so much as a diet - as a dosing method) will if adjused correctly, improve your control immediately across the board, and allow you flexibility in trying different levels of carbs to see what might work right for you.

Here's an example. I have an insulin to carb ratio of 6:1. This means for every 6g of carbs, I take 1 unit of insulin. So if I eat a small banana with 12g carbs, I would the inject 2units. If I had a sandwich with 30g carbs, I would take 5 units. Simple, yes? But you need medical help to work out what your I:C ratio is. Don't attempt this until you have a safe I:C to use. Chances are even then you'll need to change your I:C ratio to get it right. Expect tweaking.

For low carb diet information, I have found this to be a good, thorough and sensible source of introductory information. I'd suggest you can read through some of those topics. Low Carb 101 - Basic Info About Low Carbohydrate Diets - Atkins, South Beach, Zone, and More (http://lowcarbdiets.about.com/od/lowcarb101/Low_Carb_101_Basic_Info_About_Low_Carb_Diets.htm)

Be aware of course that that website is not aimed at type 1 diabetics: what you need to remember at every step of the way, is to modify your dose for the amount of carbs. This you cannot currently do on set doses. You need to learn I:C carb counting, even if that means finding another doctor.

Another thing right up there in importance when it comes to carbs and any foods, is simply whether they spike you or not. This again changes a lot from person to person, so you need to start observing and build up your own understanding. It is together and seperate with the issue of getting the right dose.

So lets talk pasta: some 30g carb amount wholemeal penne with meatballs might work well, but 30g carb amount of lasagna might send you through the roof. This may be an individual reaction. You may find you need to simply avoid lasagna, or try other types. The other tool worth looking into that might give you more hints and tips, is GI (Glycemic Index) and sticking to low GI foods. This is an attempt to rank carbs in the order that they spike. It may apply a great deal or not at all to you, you will only find out by trying it. Available on the web and in books.

It might take a little longer for your eyes to adjust kt89, hang in there. You should be feeling better in a week or so, but you need to get your dosaging better to avoid hypos and highs as much as possible: that's your task for the short and long term to stop diabetes impacting badly upon your life.

[Subby]

Sorry, I had a typo in there, my insulin to carb ratio was supposed to read "1:6" not "6:1" ... it is expressed in Units of insulin : grams of carbs. Ask any questions about this: as I said you need help that we can't provide to get safely started on this method, but more than happy to talk about it.

[REDLAN]

kt89 seems like you've received a lot of advice.

I noticed your post was entitled confused and angry, and yet you don't say what you are confused and angry about.

You do give us one days test results and your carb/food intake for the day.

I looked through them and thought bearing in mind you have only been dealing with this disease for a week, that you are doing really well. They aren't bad test results by any means.

I second Subby's suggestion to look into using insulin:carb ratios rather than a fixed dose for each meal. You are already doing the tedious bit of counting the carbs.

Personally speaking I don't get too worried about one days test results. What I look for instead are patterns. It is the patterns that I react to. I generally look for 3 or more repeats to confirm a pattern.

Take your 3.1 after breakfast. One on it's known is just all part of testing noise and the joys of diabetes. 3 hypos out of 5 days, means I am injecting too much insulin and I need to reduce it.

With testing there is a really important idea to get your head round. When you do a blood test it can only tell you how well your regime was working up to that point. It can not on it's own tell you how well your regime will work in the next few hours. Your only guide is the test results you already have collected - i.e. the patterns you have already noted.

You appear to have been given a lot of advice about diet. And I'm going to give you some more advice.

Whatever you do, do not restrict your carbohydrate intake and continue injecting the same amount of insulin, this is a recipe for disaster.

Low-carbing is very popular among many posters on this forum, and it is a contentious issue. You need to bear in mind that the regimens being talked about have only come about from data gleaned from 100's if not 1000's of blood tests. I would strongly recommend that you get to grips with your current diet and regimen before making major changes.

My regime involves eating 300g+ of carbs daily and 120+ miles of cycling each week. My current insulin and carb intake is the result of about 100 or so pre and post cycle blood glucose tests. However, I'm certainly not going to recommend you try it just because it works for me.

[jenb]

You wrote: "my blood glucose was 42 one week ago when i was diagnosed. and its gradually come down with the set doses, which i think was what my doctor wanted opposed to just dropping me down to normal straight away. still, its not helping my eyes they're so blurred i can barely see my screen or edit the photos from last night because i cant make out the models faces!!! bah!"


Hi KT - just a little suggestion for you, based on my own experience right after diagnosis. I, too, had such blurred vision that I despaired of ever seeing again. One day, in desperation, I put a pair of over-the-counter reading glasses over my prescription glasses and voila! I could acutally read the page in front of me. So for about a month I walked around with 2 pair of glasses perched on my face. I looked a little crazy, but it allowed me to continue working. And by the way, my vision did eventually return to normal.

Jen