My Type 1 Diabetes Treatment Plan

Bonnie’s Story:

When I was first diagnosed the doctor referred to the change in my insulin as the honeymoon stage, which meant my pancreas was producing some insulin. I really do not know how long this stage lasted for me. Very early in my diabetes, I realized what worked one day may not work the next, (everyone is different and so many things have changed over the years.) Today my pancreas produces no insulin and this is known as Type 1 diabetes. The choices today are endless in diabetes care. I would like to share what is currently working very well for me. You will see I used the word currently as realizing things change is probably the best way to stay healthy with your diabetes.

Living well with Diabetes:

I have a choice each and everyday of my life to either do what works best for me or not.  This makes it sound so simple, I know it is not simple, although, I prefer to take each day as it comes and not dwell on what didn’t work yesterday. I track my tests when I can see something needs to be figured out. Change happens with diabetes as our bodies go through change, whats going on in our life changes, our workload changes, and you have to make adjustments.

Each and everyday I start my day with making the decision to do the best I can for myself.  This included testing my blood sugar (this wasn’t available until the early 80’s, taking my insulin, enjoying regular activity and eating regular meals and snacks. It becomes second nature and everything today happens automatically. At a very young age I figured out that paying attention to my diabetes was the only way I would live a healthy long life. At that time I thought old was 40 and I am happy to say I am now 56 years old and living a happy healthy life. I remember a doctor saying to me “get control of your diabetes before it controls you.” I get that, it’s been more then challenging at time, absolutely, and I know that each day is a new day.

I want to talk about what is available today:

The choices are endless. I find it very important to research what is on the market. If what you are currently doing is not working, do your research, and get to your doctor and find out what other choices you have. I wanted to share a few of the options that are working for me, always remember what works for one person will not necessarily work for another.  The nice thing about hearing what others are doing is you get another perspective.

Insulin:

Levemir_Insulin

Levemir® made by Novo Nordisk® Levemir Insulin

Levemir® made by Novo Nordisk®This insulin has worked for me.  I love the option of a 24 hour baseline insulin, this way I have the freedom to live a flexible life in regard to the timing of my meals and exercise. With my doctors recommendation I give my 24 hour Levemir®  insulin in two separate doses.

I give one injection at 0900am and one injection at 10:00pm. I use the Levemir® Penfill® as I find it convenient for carrying with me. The first 24 hour insulin I tried was Lantus® and for me it caused weight gain almost immediately. After further research I decided to give Levemir® a try. Both of these products are considered 24 hour insulin and you will see I have split my dose on my doctors recommendation as this gives me better coverage.

NovoRapid® made by Novo Nordisk®:

Novorapid

NovoRapid® Penfill® Insulin

I know this sounds a little crazy, although the Rapid insulin is like a dream come true in the insulin world.  I take NovoRapid® insulin each meal and/or snack depending on the amount of carbohydrates and considering my activity for the next couple of hours. I take the amount my insulin/carbohydrate ratio as outlined below.  I use the NovoRapid®  Penfill® insulin, as I find it very easy to use and compact to carry with me. I actually use the kids pen as it will allow me to give as little as 0.5 of a unit. I have always been very sensitive to insulin 0.5 can make a difference for me. It is very important to understand how the insulin works in your system. The timing of the insulin is shown on package insert. As I am very sensitive to the insulin it is important for me to test before my meal and at that time if I have any correction to make I do so and then I calculate my carbohydrates and give my insulin based on how many carbohydrates I plan on eating.  NovoRapid® starts working within 10 – 20 minutes after you take it, so I give my insulin when my meal is in front of me or in some cases I do not give it until I have started eating.  This is again why I like using the Penfill® as I can very discreetly give my needle and it is easy to carry with you.  One very important note when using an insulin pen, you must always prime it to ensure you will get the accurate dose. If you leave the needle on, some insulin will leak out.

Novopen 4 - Insulin pen

Novopen 4 – Insulin pen

This regime is referred to as multiple injections and you will also hear people call it the poor mans insulin pump. I used an insulin pump for a number of years and I made the choice to go on multiple injections for two reasons….the cost and also the flexibility. Watch for upcoming post on what to consider when using an insulin pump.

I love the freedom of being able to take less insulin when my activity has increased, this option keeps me away from having low blood sugar. I also like the option of correcting a high test when at times they come out of no where. Getting a high test corrected in approximately two hours makes me feel good.

I met a wonderful lady at a diabetes conference, she has type 1 diabetes and she is also a nurse. I was telling her how hard I was finding it to keep my blood sugar at a normal range.  She looked at me and said “you have diabetes your blood sugar is going to go up and down.” This was one of those moments where I realized my perfection was going to make me crazy. My blood sugar was going to go up and down and working one day at a time I could consider my food choices, take the amount of insulin needed for my food intake with the consideration of my activity level. Sometimes with everything considered it doesn’t work and I have to just make a correction in insulin or deal with a low and and move on.

How I figured out my correction bolus dosage:

Your doctor will advise you where to start. This of course is trial and error. Testing is the only way you will get to this number. For me it also depended on the time of day as my insulin just seems to work differently in the morning to the afternoon. Lets say I gave my insulin to carbohydrate ratio for a meal in a restaurant and It was a bit of a guess because I really didn’t know exactly what was in sauce lets say. I then give my insulin for the amount of carbohydrates that I guessed would be in the food. I would test two hours after to check if I got the number right. If I need to correct I do so. My correction bolus is 1 unit of NovoRapid® insulin to bring my test down by 3 mmol/L. My doctor has recommended that I work with aiming for 6 mmol/L. Always remember what works for one person will not necessarily work for another. This is why you have to figure out what works for you. Over correcting a high test of course gives you the end result of going low. Trying to stay away from the ups and downs can be a challenge, stop and think what your next step could be.  My doctor has always recommended getting rid of the lows first.

How I figured out my Insulin to carbohydrate ratios:

If you are new to carbohydrate counting, it simple means taking the amount of insulin needed for the food that is going to turn into sugar, which are listed as carbohydrates on the food label. Tracking my blood tests to find the amount of insulin needed to cover the amount of carbohydrates eaten, keeping in mind all carbohydrates are not the same.  What other foods are you eating at the same time, are you eating protein that will slow down the absorption of the insulin. Are you having a beverage that will get into your bloodstream faster? What is your activity level going to be? I know right now you are most likely saying…”are you kidding me, who has time for all of this”  it really does become second nature. If you haven’t met with a dietician to better understand how different foods work in your system with your insulin, it might be worth your time. It means extra testing to find out how this all works, although it is worth the time. Quality of life can be maintained while living with Type 1 Diabetes.

Have a great day and looking forward to hearing from you on what has worked for you.

Thanks Bonnie

Disclaimer – This website does not provide medical advice or treatment recommendations.  All content on type 1 diabetes treatment website is for informational purposes and is the personal experience and opinion of the author.  Always seek the advice of a licensed physician with you medical questions and concerns.

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