[Lee]

Hi all this is my first post on this forum its nice to talk to people who have the same disease as me as i`ve not joined a forum made like this before.

My names lee im 24 from the uk, i`ve had type 1 diabetes for 22 years now.

My last hb1ac result was 9.2 and im having alot of trouble controlling my blood results, i work 11 hour shifts and its all physical work which results in me getting low blood sugars, currently my insulin system is:

Novarapid 3 (morning) 6 (lunch) 10 (dinner) and 40 units of levimir before bed. I am lowering the levimir to 38 before bed now along with having a bowel of cereal to keep my blood sugar up during the night. Im wondering what kind of diets you guys have to get such good hb1ac results? When i have a low blood sugar I tend to panic and eat a chocolate bar or two to get me out of it, which results in my blood sugar going highm i feel like im in a no win situation. My diet isnt the best in the world but im including fruit with my lunch.

Today I had my 6 monthly eye exam, I used to have this done every year but its been moved to 6 months, when I asked the nurse she said there was background changes and they`re keeping an eye on it, i`d just like to ask is this a normal thing that can go away with better control or am I in the early stages of going blind?

Thankyou for reading my post i`d love to hear from anyone who might be able to help

Lee

[princesslinda]

Hi Lee, welcome to the forums. Can't answer your eye questions, but there are many here who will chime in with information, i'm sure. You'll find lots of friendly people and good information here.

[notme]

Welcome to Diabetes Forums Lee.

If your doctor is wanting to keep watching your eye issues, you are ok for now. Thank goodness it is being watched.

This is a wake up call for you. You need to get your A1c down and protect your body from any further attack from high blood sugar.

You will learn a lot on this site and I know you will enjoy the great people here. Welcome!!!

[viranth]

Do you have to take all the levemir at bedtime? Could get better results by splitting ...

The yo-yo effect isn't good either, and since you're working really hard, that increases the effect of the insulin.

I would start by measuring the BG every 3 hours, but get a good nights sleep.

The next step is looking at your diet. My "system" is pretty simple.

My schedule when working out:

0715 - 4 slices of bread, cabbage or carrots
1030 - 2 slices of bread, pieces of apple, pear, orange and pineapple
1330 - 2 slices of bread, pieces of apple, pear, orange and pine apple
1612 - 2 slices of bread, no insulin, going to the gym
1830-1900 - dinner (healthy one)
2030-2130 - bedtime meal, one/two slices, fruit or vegetables.

With this I've lost fat, gained strength at the gym, my latest a1c was 5.3% and the next one I think will be lower. I rarely have BG under 4, and rarely over 10.

With low BG I usually drink one or two small glasses of apple juice (10g carb per 100ml).

I know it's a lot of bread, but have no idea what to replace it with. Working on that though. It's highish fiber bread and considered to be the healthiest.

[Mich]

Hi Lee,

In answer to your question about background retinopathy, I had it for about 30 years before it got any worse. At that point, the doctors started telling me I would need laser treatment at some point. It was another 15 years before that was needed. I'm still seeing pretty well and driving, even after a detached retina three years after the laser.

I keep my blood sugar as close to 100 as I can. In other words, keep the lid on your blood sugar and don't worry too much about going blind. Just make sure you have a good opthamologist that you trust to help you watch things.

We're all different, of course. I wish you the best with this.

Mich

[Kendall]

I'm glad you found us here at Diabetes Forum. You will find tons of useful information and you can always feel free to ask lots of questions. I see that you are on MDI (multiple daily injections)with basal insulin (in your case the Levemir). It should help you get under control with some new tips, some education, and hard work.


Two books that are really helpful are:
Using Insulin by John Walsh
and Think Like a Pancreas by Gary Scheiner

Then, a few questions so we can help you better. Do you count your carbohydrates? Are you taking fixed doses for meals or do you have an I:C (insulin to carb) ratio? If you aren't counting carbs, I suggest you learn...it can help tremendously.

Many here have found that a low carb diet and/or low GI index foods help their BGs remain very stable and lower their A1c a lot. I have recently started this and the results are amazing.

As for the going low at work, I would suggest either eating more food or lowering your insulin at the meals right before or during work. You could also try different basal doses for work vs non-work days but that is much trickier.

As for the eyes, I don't have personal experience, but I have heard from many that controlling blood sugars can halt or even improve many complications.

When possible, treat a low with 15g fast acting carbs. Then wait 15 min. and retest your BG. If still low, repeat. When BG is about 4 or 75, then eat something small if you will be active. The treating and then waiting helps reduce the over eating after a low. As you are getting your numbers down, try to remember that "normal" numbers may feel low. That will get better with time.

[shutterbug]

Welcome Lee. HOpe you find this place helpful

[xMenace]

Welcome Lee,

Originally Posted by Lee

i`d just like to ask is this a normal thing that can go away with better control or am I in the early stages of going blind?

All of the above. I've been fighting this some 15 years, and I still have 20/20 after some wars.

Much depends on how well you control your BGs from here on. An 8.5A1C is definately on the road to perdition. You do need to take steps to fix that.

I recommend you do some basal testing. High variances is a sure sign that you have gaps in your coverage that you do not understand. This is the technique to at least identify them. I'll send you some links, but here's one to read now.
Getting Down to Basals :: Diabetes Self-Management If you think it sounds like work, understand that the alternative is to do much much more work.

[Lee]

Originally Posted by Kendall

Then, a few questions so we can help you better. Do you count your carbohydrates? Are you taking fixed doses for meals or do you have an I:C (insulin to carb) ratio? If you aren't counting carbs, I suggest you learn...it can help tremendously.

Thankyou all for the replies its really nice to learn from people who have better experiance than me!
I dont count my carbohydrates, during a workday my system would be
NR 3-4, 6 and 10 with Levimir 38
and during a weekend when im less active
NR 10 , 10 and 10-12 with Levimir 38
If i find my blood result is a bit higher than normal, for example 11 mmol/l i would give myself a few more units of Novarapid beforehand to lower it back down, is this a bad technique to use? I have no idea howto count carbs and measure it against insulin dosage, i`ve noticed alot of you are using pumps and as far as im aware they`re quite rare here i dont think the nhs is giving them out at the moment, do they help alot with your results??
I`ve done some research on my eyes and apparently at some stage all diabetic who have had it as long as me will get some background changes, i think im being checked up every 6 months to spot major changes early though.
My diet is quite poor and i`d really like to hear what you guys eat to get your hb1ac`s down to such a good level, 9.2 really needs some work!!

What im confused on is when people mention the long term side effects of diabetes are these things in much later life or can blindness, feet problems, kidneys and so on effect people in their 20`s? I`ve never been ignorant to the outcome of not looking after myself and the thought of going blind is really frightening me im just unsure if i should be worried at this stage of my life or not??

[shiftzor]

Basal = long acting insulin i.e. levimir
Bolus = short term acting insulin i.e. novorapid

Firstly start with your basal, do basal testing by skipping breakfast and testing every hour. Watch trends and adjust basal dose accordingly. Then start carb counting get a correction factor and a Insulin to carb ratio, then you add carb totals for a meal and inject accordingly. Testing I:C ratio requires testing 2,3,6 hours later and watching for trends. Its effort to start with but once you have your basal sorted and a good bolus I:C it all becomes easier.

Complications are nasty including going blind and losing your limbs. It’s a time bomb waiting to explode and you won't see any signs until it is too late. Don't wait for it to happen make a difference now, its never to late to undo some of the damage done.

Heathly diet = little bit of everything, including the green stuff. Look into glycemic load and Glycemic Index (GI), these give a good indicator to how much a food will effect your bg. Carb quantities are not the only factor when it comes to raising your bg for example a simple carb such as ice scream will have a high GI and give you a spike, this spike might be useful if you are low or are playing a strenuous sport. Complex carbs such a noodles will have a lower GI and give you less of a spike however it will keep working for hours after consumption. This would be a good food to eat before a sport or at a main meal to maintain bgs through the night.

Standard Deviation is a important as it has been proven to that the smaller your SD the less chance of getting complications, it is easier to stay in a narrow bg band than it is to stay in a much larger band. Reducing bg spikes will help you lower your A1c and reduce your SD.

Complciations

Carb counting

Correction Factor

Standard Deviation

Read books like:
Using insulin by john walsh
Think like a pancreas by gary scheiner

We post so many of these replies, really need to make a guide.

[mortis505]

Hi Lee and welcome to DF! As you can see there is a ton of information here, and lots of good helpful people.

I would also like to recommend that you get some basal testing done and to start on a carb counting regime. This should help prevent the lows that you have been experiencing and having to correct for. One thing that will help is to limit or lay off the "white" foods. Pasta, rice, breads, potatoes. These carry alot of carbs and will spike your BG causing you to have to correct.

Your dosing needs looked at. Have a look at CalorieKing to determine the carb amounts in the food you are eating. Also there might be a listing on the packaging of the food you eat that displays carbs.

Once you get things under control, then you can start adding those foods back in, but remember that portion control is the key.

I dont really know much about the eye issues, but it looks as though the other have chimed in on that. I don know that once you get those number under control that you will feel much better and will most likely delay any complication for much longer.

Once again, welcome to DF!

[Busy Betty]

Welcome Lee!!!
I am fairly new to these forums too.
I have already gained a lot of info that is improving my BS!!

I know quite a bit about complications from my own experiences. I have had T1 for almost 30 years!! My control was poor for probable the first 20 years. I think that some of that was just trying to grow up and severe denial. Slowly I have been improving my control.

My eye problems started just like yours. Mine progressed to where I needed laser treatments in both eyes and surgery in the right eye to remove the blood. My vision is still excellent. (Near 20/20 with contacts) I think the MOST IMPORTANT thing to do to preserve your vision is to see you eye doctor regularly. There are many things that they can do to help.

The other complications I have are all mostly related to nerve problems. I have been told that nerve problems can improve with VERY GOOD control. That is my goal!!!

I have really been given a second chance to improve my control after 30 years. My complications are annoying, but I am still alive and relatively health. You too have a great opportunity to improve your control and stabilize your complications. Take this opportunity now and help yourself to avoid or prevent further problems.

GOOD LUCK!!!!