Need a little help/advice

Hello everyone,

 I am new here. I will be 30 in a few weeks and I was just diagnosed with type 1 diabetes a month ago. I was just prescribed insulin today (I haven't started it yet). My biggest problem is that I am currently a graduate student and have no health insurance. I am going to a free clinic in my area and the doctors are very nice and help as much as they can but none of them are specialists in diabetes. They gave me the guidelines for taking insulin but just said "before meals". When I asked about snacks they simply said "you should be eating 3 regular meals a day, then you don't need snacks". Well that's not very helpful to me because with my schedule sometimes it's a while in between meals and I need to snack. Do I need insulin before a snack or is that just a trial and error thing to see how my blood sugar is reacting? Does anyone have any advice at all they can give me to help deal with diabetes in general? Like I said, this is all new to me and I haven't found many resources for adults with type 1. Thanks in advance for your help!

Can you get health insurance through your school? When I was a student, I used my university's student  health insurance, which was fairly affordable and enabled me to have good diabetes care. if you can't get insurance through your school, is it possible to get a part-time job that will offer benefits? i know how difficult and time consuming school is, so i understand if that's not a possibility.

typically, when you first begin on shots. you are on a "fixed carb" diet, meaning at every meal you take the exact same amount of insulin and eat the exact same amount of carbohydrates. eventually, after the insulin has been properly adjusted, they'll allow you more freedom to eat what you wish and adjust your insulin accordingly. 

i take it they only gave you one kind of insulin? typically, you need both a long acting insulin (one you take only once or twice a day) and then a short acting one (one you take with meals and/or snacks). it really is quite unrealistic of your doctors to expect you to never eat snacks. AND as a dietitian, we don't recommend just 3 meals a day. we either say 6 small meals or 3 meals and 3 small snacks. not many people can only eat 3x a day and not feel hungry in between.

your doctors are being silly, but i suppose it isn't their fault because they don't specialize in diabetes care. 

you may also be a LADA diabetic (someone diagnosed with type 1 as an adult, who goes through a long period of time where they're still producing some of their own insulin. also called a "honeymoon" period). this means you may not need a whole lot of insulin in the beginning because your body is still kicking some out. i know that you don't have insurance, so blood testing often may be difficult, but do it as much as your prescription (and wallet) will allow. that will let you know if you are taking enough (or too much) insulin. 

there are also LOTS of resources out there for diabetes help. if you google "free diabetes supplies + your city" you can find lots of local resources. or you can google something along the lines of "diabetes supply assistance + your state". also, a lot of the diabetes companies that provide test strips, glucose meters, insulin, etc also offer ways to get free or discounted supplies. you may consider contacting them as well. 

good luck. please continue checking back in here, so we can help you out as much as we can! i'm so glad you found us here on juvenation. we are happy to have you around :D

Thanks so much for the info. I can get insurance through school but it's only a secondary insurance, which means that it is basically a backup and dosn't pay for basic care. I can't get a part-time job because I already work at school (plus I don't have the time =0).  I'm kinda stuck right now...

They put me on two insulins: Lantus and Humalog. They gave me a "schedule", so if my blood sugar is between 160-220 I take 5 units, between 220-300 is 10 units, and above 300  is 15 units. They didn't really instruct me on how many carbs to eat, I try to eat the same amount at every meal. The only goal they gave me for right now is to try to keep my blood sugar below 200. I'm assuming next time I go they will change the goal but they are starting out slow. Luckily I get pretty much all of my supplies for free at this point. I don't have to pay much for test strips so I test my sugar level several times a day. I log everything so I guess when I go back to the doctor next month they will look at my records and see what needs to be adjusted.

I try to be patient with the doctors because they are doing the best they can, I am just trying to get as much info as possible. I appreciate your input. I don't know anyone else with diabetes and it's nice to hear from people who have been in the same situation!

Cristina-- I just saw your post and it's making me nervous. Too much insulin can lead to unconsciousness and too little can lead to ketones/DKA. Is there any way you could find enough money to see an endo or diabetes nurse educator once so they can start you on a program? In the meantime, I'd test before each meal and 2 hours after so you can bring the doctors information about how the doses are working.

In answer to your question, yes, you should take humalog w a snack that has carbohydrates, but not less than 3 hours between shots.

Post again if you have more questions. I hope you can find more support soon!

HI Cristina,

I'm 44 and was diagnosed last October A shocker to say the least.

Anyway it all depends on what the snack is and what your levels are at the time you eat it.  I personally have found I like to snack on cheese sticks and I don't need to "shoot up" as they are sugar and carb-less.

I think the hardest thing of all is deciding your new menu plan. I'm a PASTA freak and well you got it ALL CARBS!!     

Ask the clinic to give you a prescription to some nutritional classes maybe at your local hospital. They can help you understand better how to read the labels - I was unaware that you can deduct the fiber from the carbs to get your net carbs.  Took me a while to figure that one out.  Why whole grain is better than regular white bread  etc... (OH yeah grocery shopping takes a whole hell of a lot longer now)

GOOD LUCK and stay strong

Hi Cristina -

I'd like to recommend a couple of books to you that were incredibly helpful to me in learning the ins and outs of insulin therapy.  I didn't read them until after I'd already had diabetes for three decades and they still taught me plenty.  The books are:

Using Insulin, by authors Walsh, Roberts, Varma and Bailey.  If you just search the title and Walsh, you should be able to find places that sell it online.  It actually teaches you how to regulate your insulin.

The other is Think like a Pancreas, by Gary Scheiner.

Since you are new to Diabetes, I'd start with Gary's book as it's easier to understand and actually kind of funny here and there.  Walsh's book reads more like a text book but really goes in depth to information all insulin users should know. Both books understand people sometimes need to snack.

To be clear, I'm not saying you should treat yourself out of these books, care from a doctor who specializes in diabetes is the ideal.  But reality being what it is, some people just don't have access to that high level care - there were years when I didn't.  Years ago when I went through a patch without a specialist, I actually would highlight portions of these books and take them to my regular (non-specialist) doctor to talk about things I read and we learned together.  If I had a million dollars, I'd set up a fund to make sure people got handed these two books with their first vial of insulin - that's how helpful they were to me.

Good luck and don't give up on trying to get the best medical care you can.  Grad school is a tough time in life but it won't last forever.



Contact the insulin manufacturers to see if they can help with the cost of the insulin and also provide diabetes specialists (diabetes educator would be great for you) to help with low to no income patients.  Is there a medical university in your area?  Is there a teaching hospital in your area?  Check with them too.  Somebody in the diabetes field will obviously be the best person to tell you how much insulin to take based on the amount of carbs you are eating.  They'll be able to tell you how much Lantus to take to get you through a 24 hour period.  Sometimes there is guessing in diabetes care.  When I went on the pump, I had to play around with extending my meal insulin, how much to back off when I exercised, etc.  But everything else was in place.  To guess at everything can be scary.  You're a graduate student and no doubt running non-stop.  Keep making phone calls until you can find somebody to help you understand this disease more and how it affects YOU.



Being a pasta-addict is okay with diabetes.  Try Dreamfields pasta.  It really is wonderful.  I calculate about 10 grams of carbs per cup of cooked pasta instead of 45-50.  It's good stuff!!



Thanks for all of your input everyone! Hopefully I can get through this dissertation soon so I can get a real job with insurance! In the meantime I will try to find some more resources in my community to help me out. I meet with my doctor again on the 16th so I will ask her about matching carbs to insulin.

Thanks for the book recommendations Ali, I will definitely check those out.

I am confused about the carb counting. I have heard that you can subtract the fiber from total carbs to get net carbs; however, the nutritionist I talked to and the books I have read so that total carbs are what I should be counting. They said that whole grain is better because it's high in fiber but that it doesn't affect your blood sugar any differently and therefore all of the carbs need to be counted. Can anyone shed some light on that?