Type 1 diabetics and extremly bad hypoglecemia??

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Permalink Reply by Kelly Rawlings on November 15, 2009 at 11:59am

Not sure that putting words in ALL CAPS really helps clarify the situation.

People are taught many different methods of counting carbs (especially those of us who started on the exchange system way back when).

A person with type 2 who is not on insulin may be able to use basic carb counting quite effectively. Basic carb counting tends to use 15 grams carb (of any type) as a unit of measurement. Those of us using insulin tend to talk about carb grams. Let's just try to be specifici and talk--more or less--the same language!

"Carbs" isn't a precise measurement or term. Use thse terms to be clear:
g or grams
1 carb serving = 15 grams carb
1 carb exchange = 15 grams carb
1 carb choice = 15 grams carb

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Permalink Reply by Terry O'Rourke on November 17, 2009 at 8:52pm

Kelly,

I think your summary of carb "terms" is reasonable. It helps to clarify the confusion between those who used the "exchange system" in the past and those of us who count individual carb grams to decide dosing.

I don't think your summary is presumptuous at all!

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Permalink Reply by Jon Clarke on November 15, 2009 at 6:38pm

The rest of us agree? That's pretty ambigious statement on your part. Have you talked to the 1000+ plus people? If not, just simply state your opinion, and don't speak for the rest of us. Don't take this personal as an attack, but I am upset when people speak for all of us diabetics. We are individuals and prefer to speak on our own behalf.

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Permalink Reply by Gerri on September 27, 2009 at 11:31am

Steve,

Taking 2 units at 200, I'd be hypo at 40. Taking 1 unit per carb, I'd be dead. Your ratio may be 1:1 (?), but that's hardly the norm. Dangerous to advise people on what doses to take.

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Permalink Reply by MelissaBL on September 27, 2009 at 11:40am

I've met people here on TuD with insulin:carb ratios as high as 1:30 and as low as 1:5. Using someone else's dosing standards could be disastrous!

Not only that, but I've seen mine change throughout my 19 years with diabetes. I have seen mine go from 1:15 when I first started carb counting in 1996ish to now 1:6 or 1:8, depending on the time of day. We're not only different from one another, but different throughout our lives and throughout any given day.

Tiera, I agree that the books "Using Insulin" and "Pumping Insulin" would be very helpful to you. John Walsh gives some criteria that are pretty standard among endos as to how to figure your personal insulin:carb ratio. If your doctor isn't able to help you adjust this, Walsh's suggestions are usually safe and conservative. He considers your age, weight, daily total insulin needs, etc. Any time I go back to that book and compare what my docs have me taking to what he suggests for my age/weight/etc, I find it's VERY close.

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Permalink Reply by Brigid O'Donnell on November 15, 2009 at 7:16pm

Melissa,

I was wondering if the Pumping Insulin book is one that you refer to often or do you feel like you have it down since you have been pumping for such a long time? I was diagnosed as type 1 last year and started pumping in Augsust of thsi year. I am always trying to learn as much as possible. I do go tto Joslin in Boston where I feel like I have gotten excellent training/ diabetes education. Thanks in advaance for your opinion.

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Permalink Reply by MelissaBL on November 16, 2009 at 7:34pm

I bought it last fall, so I've gone back to it twice since I bought it just to see how my numbers fit his suggestions. I've pumped for nearly a decade, but I was really glad to have new insight. It made me realize that I've moved from version to version of pumps without ever really maximizing what each version offered.

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Permalink Reply by Jim Wright on September 27, 2009 at 11:04am

Too much insulin my friend. Discuss with your doctor, immediately, don't wait (see my thread on brain injury and hypo) - and among other things, a good first step would be to figure out whether they seem to be happening at the peak of any short-term/meal insulin you're taking, or due to basal rate (if on a pump) or long-term/suspension insulin you're taking like NPH or Lantus.

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Permalink Reply by Zoe on November 15, 2009 at 5:47pm

I absolutely agree with what everyone else has said, Tiera about your insulin doses being too high if you are experiencing frequent lows. You don't say if this has been recently, where before you were managing well? One thing I thought of just to complicate things is that since I believe you are LADA my understanding is that our pancreas acts in fits and starts for awhile unlike a regular Type 1 who is more "going, going, gone". I took two c-peptide tests and the first one was .38 and the next one a month or so later was .70. It could have been lab difference but could also have been a pancreas spurt. So is it possible you weren't producing any insulin and then had a spurt? Just another thought, though I mainly think everyone else is right on that you are taking too much insulin for the carbs you are eating. I re-evaluate my I:C ratio every 3 weeks which is one page in my log and tweak it a bit depending on what percent of the time I'm in target range.

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Permalink Reply by Betty J on November 15, 2009 at 7:31pm

I know you are recently diagnosed this year so I understand your confused state (by the way it sounds like your honeymoon is over). What you need is a CDE (Certified Diabetes Educator) to get you on track. An educator can give you info regarding your insulin to carb ratio and where your basal rates need to be. Also an educator can tell you how much insulin it takes to correct a high. Here's the link where you can find an educator in your area http://www.diabeteseducator.org/

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Permalink Reply by Stephen Woodward on November 15, 2009 at 7:42pm

Best book from my experience, you need to look at everything to determine what is happening. Most lows on the pump when I have not been eating are due to activity or the basal being to high.

The best book I know of if you really want to learn about your D is "Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin" (Paperback) ~ M.S. Gary Scheiner M.S. (Author).

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Permalink Reply by Sami on November 16, 2009 at 7:28am

Hey Stephen - I've seen that book. I'm wondering if covers a lot of pump stuff or just diabetes in general?

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