Diagnosed Last Month
Hello! I’m a 22-year-old mother of an 18-month-old and I was diagnosed with T1 as the result of a routine blood test. After spending a few weeks in and out of the hospital due to general screwups I’ve levelled out and am back at home raising my daughter. With how many issues I had at the hospital I find that I’m still left with quite a few questions and I feel bad calling my Diabetes Nurse daily. The main thing I’m unsure of is what I’ve come to call my “cinnamon bun question”. What happens if I’m out of the house and it’s time to eat and the only option is something super high on the GI (such as a cinnamon bun or pasta). I know that my BS will spike, so do I:
1) Take my standard 4 units of NovoRapid and know I might have to take extra when I check before my next meal?
2) Take nothing before I eat and check my sugars 2 hours after the cinnamon bun, injecting NovoRapid then?
3) Take extra NovoRapid before eating to compensate for how much sugars I’ll be eating? (Which leads to how much extra would I need?)
please don’t feel bad asking for help. the CDE is used to it.
over the years I have found the best way to eat a cinna-bun is to figure out how many carbs are in it, inject for that amount of carbs, and then test at 2 hours after and make any additional adjustments then. it’s called carb counting. the actual amount you will need depends on your body. example: if 1 unit of novorapid covers 15 grams of carbs, and you decide to have a 12 oz. can of coke, you need 40g/15 g/u = 2.6 units of insulin. the tricks here are knowing your personal “Carb ratio” and knowing how many carbs are in the thing you decide to eat.
there is a book called “Think like a pancreas” which explains the whole thing.
You poor thing! That’s a lot to deal with. I agree with the last response, that you should never feel bad about calling your diabetes nurse. Things will get easier in a blink of an eye, but until then you’re going to have questions at every twist and turn. My suggestion is first to buy some low carb snacks or predictable carb snack and keep them handy. We use individually packaged bags of nuts. There are some nutrition bars that could help. If you have a fridge at works, stock it with yogurt, cheese and some lunch meat. If you know you’re going to be out and miss lunch, maybe keep a peanut butter and jelly sandwhich in your bag! But, of course there are times you’re going to eat that super carby treat (although, I would keep those times as a once in a while treat, not regularly) If you skipped a meal and you’re low, do not give yourself insulin until you start to eat and your sugar rises. Give yourself the full amount of insulin you need and check your sugar in two to three hours and correct the inevitable high. Once you know your body, and how the snack affects you, you can give yourself more insulin as soon as you eat it, but until you’re sure of these things, I wouldn’t try that. Once you get on a pump, this will all be easiser as well. Good luck and don’t be afraid to ask questions! You are not alone!!
What both of the two above writers offered is good, and I’d like to add a little more. Certainly you are learning and being able to know to ask questions is a great sign and intelligent; just like 18 months ago when you had a new daughter – hope she is well.
As @Joe offered “carb counting” is key to management and then applying the ratio that YOUR body requires for that time of day – for instance, I currently need one unit of insulin for every 8.5 grams of carb I eat at breakfast [ratio 1:8.5] but only need one unit for each 17 grams of carb at dinner [ratio 1:17]. Our bodies are all different and you will need to calculate, by experiment, what you require; and nothing gets “locked in stone”.
I will suggest that if you are really low, that you have a measured +/-15 grams of carb and wait 15 minutes and recheck your BG – never take insulin before you do a second check. Over years experience, I’ve learned if feeling woozy it is best to eat / drink first and then check BG. When I’m out and about, I always have at least one small granola bar with me – 17 grams carb including intermediate range carbs. Be cautious about taking inulin when you are below your safe range, especially when you are alone with your daughter; well until your daughter is like ours, a medical professional.
When someone is depending on you or when you are alone, being a little over range is much safer than being below range.