[aidenjazz]

Hello, I registered here because I dont know anyone else with type 1 diabetes and I dont think there is anyone in my life that understand this really.. I am 24, I was diagnosed about 9 months ago...I was told i have to do 4 shots a day.....3 shots of novalog....one before each meal 3 times a day, and a shot of lantus each night before bed. Before this i was terrified of needles but i got over it and began eating 3 meals a day with 5 or so carbs per meal and doing the shots like they told me. I was doing pretty good sticking to this plan for he first 6 months...lately It has been hard for me and i dont know where to get answers, my doctor is nice enough but he is not personable..he doesent take even 5 minutes with me or give me a chance to ask a few questions. Lately I have been having such a hard time because im just not hungry enough to eat all 5 1/2 carb choices per meal.....i have figured out how to adjust the novalog to take just enough for whatever im going to eat...but i dont know if i should still be taking the same amount of lantus at night..For example they sent me home eating like 18-20 carb choices throughout the course of a day the novalog with each meal and 18 units of lantus at night.....now if i only eat 8 or so carbs through the whole day..do i still take the full 18 of lantus at night? I have been having a really hard time lately, my emotions are all over the place.....nobody uunderstands that sometimes i just do not feel right...the past few months i have given up testing myself...i find myself saying im not hungry or skipping breakfest and or lunch just because i dont want to do a shot...i mean 4 shots a day thats like a shot every 4 1/2 hours or so....i dont know if its okay to eat a breakfest like 2 scrabled eggs and one peice of wheat toast with water...without taking a shot is this ok? I would love to be able to just do the lantus and night and do away with at least one of the 3 novalog shots....i just dont know if i can...when i ask the doctor i get a 2 second answer...just try to stick to the plan...and then he runs away fast.....no time to ask anything. I dont like having a sort temper with my family, sometimes i will get very heated because ive been runnun around all day i come home smelling good food and when i sit to eat i look down.......a unmeasured pile of stuffing and an unmeasured pile of packaged cheddar rice with some chicken...so rather than try to guess and wonder and gamble on how ill fell if i try to take a shot to compensate for this unknown carb amount...i just eat a few bites of chicken and leave.. I feel very bad putting my wife through all of this, like i said i havent been checking lately, just taking the novalog for the carbs i do eat........my last A1c doing this was actually good a 5.5! But i was eatin 3 meals a day with 5 carbs each following the plan they gave me, just not checking......now im not checking and im probobly eating 1 good meal per day. Im sorry for rambeling..i just dont feel like 100% anymore i cant take giving myself 4 shots a day...i still have a time with that the shots are uncomfortable and i find myself doing it in generally the same spots on my butt most of the time because there are only a few spots where i really cant feel it....thanks for listening and allwoing me a place to get some of this out...god bless you all

[Cormac_Doyle]

It's rough when you're just starting out.

However, especially if you are eating less than you used to, you should be checking your blood more.

The Lantus might still be perfect, or it might be way off ... there's no way for you to know without checking your fasting/pre-meal levels.

If you are on the "right" amount of Lantus, your pre-meal levels should be in the 4.6-6.0 mmol (82.8 - 108 mg) range ... if they are running higher than that, you may need to increase the lantus; conversely, if they are running lower, you should decrease it.

You are correct in stating that the amount of rapid acting insulin should be calculated on the overal number of carbs you eat, but fat and protein count too ... they take longer to hit.

if you eat alot of fat in a meal, you may need to take one small does of insulin 10 minutes before the meal, and another correction an hour later!

Again, the exact numbers need to be calculated by checking your blood 1 hour, 2 hours and/or 3 hours after eating.

Only you can know exactly how much insulin you need ... the doctors are there to help you, not dictate to you ... but you definitely need to test regularly.

[Scratch]

Hang around on these boards. Continue to ask questions and look when people ask questions related to your own.

Second, if your doctor won't explain things to you, get the book Think Like a Pancreas by Gary Scheiner. With that book, you can really learn what it is you want to do with the Lantus and the Novolog. You can learn to take care of yourself and not be dependent upon a doctor who can only give you a few minutes of time. Which in a way is reasonable. You're the one who has to live with it 24 hours a day, you're the one who needs to learn what your body needs to have done, the doctor just can't know you like you can know you.

[mortis505]

Hello and welcome to DF! Are you seeing an Endocrinologist or a GP for your diabetes care? Using carb choices is generally phased out and many doctors now suggest injecting based on the amount of overall carbs that you eat.

But first and foremost, if you dont feel comfortable with your doctor, fire him and get a new one. The doctor is there for your support not his paycheck. If he/she isnt willing to spend time with you, then you dont need to spend time or money on him.

Lastly, sorry to say this, but the only way to make sure that your numbers are good, is to test, test, test. We all feel sick and tired of the constant monitoring that comes with this monster, but it is the best way that we have of staying healthy and living a full, long life.

[poodlebone]

Lantus is a background/basal insulin and if you're on the correct dose, skipping meals or eating more/less carbs at a meal or throughout the day shouldn't matter. For meals/carbs, it's the Novolog you have to think about.

You're using carb choices, which is another word for exchanges. That's the old way of figuring out insulin doses to match food. You should be carb counting - that is, counting the actual grams of carbs in your food and basing your insulin on that. Your bread choice is equal to approximately 15g of carbs. You might want bread, but what if the brand you buy has big slices that are 22g each? With carb counting, it doesn't matter. Just total all your carbs and base your insulin on that.

In order to carb count you'll need an Insulin:Carb ratio (I:C). Some people have a ratio of 1:10, or 1:13, or 1:25. It's different for everyone. You might be able to figure yours out based on your current carb consumption and insulin doses. So, if you have a 1:15 ratio and eat a meal with 52 grams of carb, that would be 3.47 units of insulin. You can't do that with a syringe or pen but you can approximate 3.5 units with a syringe. Some pens will also dose in 1/2 units. Otherwise you'll either have to add or remove carbs or take a little more or less insulin to match things as close as possible.

Is your doctor an endocrinologist? If so, he's doing a lousy job! If it's just a primary care doctor, find an endo. Better yet, see if you can find a CDE (certified diabetes educator) who is a nurse. They should really be able to set you up with the correct I:C ratio, correction factors and everything else.

You don't have to eat all of those carbs if you don't want to. You can skip meals if you're not hungry. You can eat junk food if you feel like it, but you should try to count the carbs, take insulin and test!

[aidenjazz]

That you all for the helpfull responses, i really do appreciate it. yes my doctor is an Endo., i understand he is busy and i really should have followed up with the nurse that called me soon after i left the hospital...i just figured the doctor told me everything i need to know before i left and i really didnt have any questions at that time...thanks again for the info, i was stressing out about taking the full dose of lantus and not eating all those carbs like they told me....i just picked up 100 new strips so Im going to start learning again...

[andypoo]

you hit the jackpot by coming here! This forum has changed and saved my life Great to have you here.Ask away!

[xMenace]

Originally Posted by poodlebone

Lantus is a background/basal insulin and if you're on the correct dose, skipping meals or eating more/less carbs at a meal or throughout the day shouldn't matter. For meals/carbs, it's the Novolog you have to think about.

Just a quick reiteration. Most noobs don't understand this basic concept, even after being told.

We have two sources of blood sugar. One is food. Carbs are the primary source, but protein and fat also contribute; though we typically ignore them for dosing. The second is your liver. It continually converts stored sugar to glucose. It also helps store glucose as fat - tryglycerides. Our livers tend to produce a fairly consistant flow of glucose, day over day, but the pattern is not flat within a day. We have humps and valleys, some have dramatic swings and many are flatish. This "basal" sugar is treated with a basal insulin. In your case this is the Lantus. Your Novolog is used to cover your food.

If you don't eat, your liver releases sugar. If you eat, your liver releases sugar. Things that affect your liver's activity are alcohol, which keep it busy so that it releases less sugar, hypo's which cause a dump of sugar, and intense excercise -- fight or flight syndrome -- which can also cause a dump of sugar. There's probably a few other things too. The position of planets has been rumored

[SuzySushi]

I agree with the advice the others have given you.

Lantus is your basel/background insulin to cover the glucose your body produces on its own. Novolog is the "bolus" to cover the carbs you eat during the day (at meals or snacks). Some people need to take more than 3 Novolog shots per day. (The other choice is to go on a pump, in which you set your basel rate and bolus for each eating occasion with the same type of insulin.)

If you're not getting sufficient explanation from your endo, please please follow up with a Certified Diabetes Educator (CDE). They will spend as much time as needed with you to get you on track.

And hang in there!

Suzy

[yannah]

I am not on insulin but I just want to give you a hug! I understand just how you feel. I have been down and frustrated lately too. You have come to the right place!

[lorilei]

Wow Aiden...I feel your stress...you seem totally overwhelmed, but you certainly are on your way down the correct path. i have found this site immensely helpful in adjusting to this diagnosis, in preparing for the future, and in sharing a few tears and some great laughs. It is very hard to go through this alone...you are no longer alone. hang in there...

by the way, at the advice of fellow dfr, SoSo, i just received my own copy of Think Like a Pancreas...pick it up if you can...it lays things out so nicely and may help you put the control back in your court, where it belongs.

[jenb]

Don't feel alone! I was diagnosed a year ago (happy anniversary yesterday lol) and vividly remember the confusion and frustration of the first few months. It will get better.

Several people have recommended "Think Like a Pancreas" and I agree - my copy is absolutely dogeared! You'll understand much more about your Lantus (basal insulin) and Novolog (covers your carb intake) after you've read it. Also, go to the Calorie King website and explore their database. It will help you with carb counting and will aid in in determining your bolus doses with each meal. Don't be tied to "exchanges" - carb counting allows you to operate in the real world.

Do find a doctor or certified diabetes educator who will answer your questions and work with you to find the best insulin program for you. You'll hear it a million times, and it will be true - no two people will respond the same way to the same foods and insulin regimens. Keep good logs of your food intake, insulin doses, and BG readings - you'll become a pro at determining what foods work well for you and which ones to avoid (rice is my Waterloo!), and how you react to your basal and bolus insulin.

Let us know how you do, and welcome!

[Siri]

Hey There..... I have been recently diagnosed type 1 also...for a while...first 4 months everything was perfect and I was handling everything fine......then CRASH....everything went out of wack and I didn't understand why and neither did anyone else around me........I hit rock bottom and didn't understand anything. BUT they saved my life here....quite literally!!!! Sometimes it's the emotional side of this disease that takes a bigger understanding than the practical side and the only way I have been able to cope recently is to tackle ONE thing at a time.....and I take it ONE DAY at a time and slowly my body AND my mind started to come back to me!!!!!! Stay strong....you came to the most amazing people here!!!!
Hugs to you....
Siri x