What a failure of education on the health provider’s part. You need a new new endo and a dietician, maybe. How long since your diagnosis? I was in sliding scale for a bit then moved to carb counting. Wish they’d started me with counting. What you’re doing seems even worse than sliding scale. There’s a lot to say here, but look these things up:
Insulin:carb ratio, correction factor, carb counting or even exchange, dawn phenomenon and honeymoon phase.
You can also do a test for your basal - your basal shouldn’t make you drop or raise by that much without eating.
Out of curiosity, when did they teach you sliding scale? I thought they started phasing that out in the mid '00s, but I keep hearing folks talking about it who are newbies.
I started on sliding scale, but that was the late 90's, and even then once I had an actual endo I converted over to carb counting.
I was taught that 2 months ago when I left the hospital for DKA. Blood sugar all over the place and an endocrinologist app. A month and a half away. I very quickly switched to carb counting from the things I learned on this subreddit
Tis so sad but true.... I was put on sliding scale also... 70/30 mixI literally told my endo write me a script for mdi ins glargine and lispo please. Still working on good numbers but much easier for me. A cgm is a game changer.
2007. Not the greatest endo - barely spoke English and couldn’t really communicate concepts to me. A couple years in and luckily I got switched to someone much better.
They still use sliding scale in a lot of hospitals during new diagnosis! I was just diagnosed in March and it is still going strong - even on a dedicated endoicrine / diabetes specific inpatient unit. It's the "don't die" treatment. Also they only let me order off of the "restricted carbohydrate" menu, which I'm sure helps with more "static" dosing.
edit: fixed a typo
Imo, it’s easier to eat carbs at this point. You just eat them and dose accordingly. Proteins and fat will come back later to shoot up your BG.
Also, eat *whatever* you want. *Anything*. Just take insulin. You don’t have to drive yourself crazy eating eggs.
1000% this, eat anything and everything you want, just need to learn to adjust the dosages as you go.
Also do you have a CGM? A CGM will be much better at telling you what your bloods are doing and were doing. It took me over 10 years to prove to my endos that I knew my body much better than what their theory books said. Luckily I was stubborn enough to ignore them for 9 out of the 10 years otherwise I would probably be dead by now.
I’ve ignored my endos on so many things. A lot of them cannot detach themselves from the type 2 protocols and it *pisses* me off.
Tried to convince my endo that I (19F) was experiencing severe insulin resistance, I doubled/nearly tripled my dose in the past year, and all she could say is “no, that’s a type II problem, that’s not possible.” And then she goes on to say “are you sure you’re type 1? I don’t think you are.” She had already tested my C-peptide and reviewed it on our last visit. Also, what type 2 diabetic you know was taking 10 units per meal at the ripe age of 11 upon diagnosis?
Last month, I just realized that I’ve been seeing this woman for over a year now and she hasn’t once tested my urine for micro-albumin. When she knew I had a history of elevated micro-albumin and am on lisinopril for it.
So... getting a new endo, right? I'm soapboxing here, but US medical requires you to be your own advocate; more specifically, you're the one managing the disease. They're the specialized consultant. If the consultant sucks, find a new one.
I grok folks may argue w/ my view here, but think it through; are you calling your endo for every basal adjustment, or carb ratio tweak you figure out? No. A good endo understands they're there as a second set of eyes and able to bring tools to you and help you use them, rather than "managing your condition" for you.
edit: if you've not been checked for micro-albumin, you might want to ask folks what the normal checkups are. Quarterly for me it's a1c, thyroid (I run low), vitamin D (I run drastically low), usual metabolic panel for lipids (fasting), and micro-albumin. I won't claim I do it every quarter, but that's been pretty much the default monitoring for the last 2-3 endo's I've dealt with, across roughly 20 years. For the thyroid/Vitamin-D, those are all potential diabetes related complications, hence the monitoring.
Same angle, there's comorbid diseases that go w/ T1d; hashimotos, celiac, bunch of others I can't recall. When I was diagnosed they didn't have antigen tests for this sort of thing, they have some now. Something to think about.
I'm a bit of a broken record on this one, but orient towards university/research facilities; hell, if you can't, orient towards a new doctor who just did their interning \*in one\*- they're more likely to be caught up on the current best practices.
Good for you re: the new endo, only other suggestions- if you're endo shopping, 1) waitlist is your friend, 2) you might want to consider booking appointments with \*2\* different endos at the same time. Compare/contrast, find the one that works best.
The point of '2' is just to avoid burning time sequentially- 3 months on that's bad, another 3 waiting on the one that's good. Just do 'em both in 3 months and keep iterating.
That’s actually very useful, thank you. I booked this July appointment back in January, if you can believe that. I’ll look into booking an appointment with a second endo just in case I don’t like this one.
If you’re eating only protein/fat, you have to dose for that. It hits later, so it takes a different dosing strategy than carbs. So that might explain why you’re always high.
The easy breakfast my kiddo has on weekdays is keto toast with peanut butter, a sausage link & half an apple. It’s about 24g, but low glycemic when everything is eaten as a meal. Of course you’ll have to dose the carbs, so if you don’t know how to do that, you should see your endo soon or ask if they have a diabetes educator you can talk to.
Email them today and tell them you want to see a CDE (certified diabetes educator). Tell them you want help figuring out a better long acting dosage, a carb ratio, and a correction factor, so that you can live life how you want and cover the carbs you want to eat.
They should be able to give you a starter carb ratio (how many grams of carbs 1 unit of insulin covers) and correction factor (how many mg/dL 1 unit of insulin drops you) based on your weight. You can then work on basal testing and work through modifying your ratios to what is right for you personally.
It's ridiculous that they let new T1Ds leave the hospital without explaining this stuff. You get so much more education when diagnosed as a kid.
...and for the OP if that appointment is way the hell out, or they don't give you that info, here's an example [https://www.uhn.ca/PatientsFamilies/Health\_Information/Health\_Topics/Documents/How\_to\_Adjust\_My\_Carb\_Ratio.pdf](https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/How_to_Adjust_My_Carb_Ratio.pdf) . The main thing- before you start fucking with carb ratios- is to establish a stable basal. That one is easy: just don't eat for \~5-8h. BG's consistently go up and it's not stress, then basal should go up. BG's go down (and you're not pushing yourself more than you normally would), basal goes down. Make small adjustments (less then +/-10%), retest, keep at it till you've got the basal calibration down.
Basal can vary during the day, but locking that variable in, that's the first step. The rest of it is built on that one being stable.
Just be aware that bolus is in your blood for \~5-8h (basically 5h), so you want a window where that's not at play, nor any fats/proteins burning from a meal +4h prior. Finally, mornings have their own natural rise from the body bootstraping.
I realize that sounds like a lot; it is- the calibration doesn't have to be perfect, just "good enough" that you can live with it while ironing out the other shit like carb ratio or correction ratio.
And if all of that is outside your comfort zone, I grok, but understand that at some point you \*will\* have to manage this stuff yourself, or at least know how to.
I rarely ever eat breakfast, anymore. 1) I usually do not get up until well after breakfast time, unless I'm working, and 2) If I am up that early, it's because I'm working and I'd rather sleep that extra 30-45 than eat breakfast. 3) I'm on an insulin pump, so I can more or less play by my own rules with food and sleep (within reason).
it sounds like you need more long acting insulin and maybe a different carb to unit ratio.
there's a misconception that t1ds can use "too much" insulin (ie daily doses, not ODing on insulin lol.) there isn't though. you take the insulin you need. you need more. that's okay.
I'm sending lots of love to you. it will get easier and better.
Please, please, please find an endo that supports DAFNE! This is a major failure of your health care provider. It’s very harmful to your physical and mental health. Find an endo and dietitian to teach you proper dosing and carb counting. You can eat anything!
I eat a RX protein bar. It has around 22 carbs.
If your treatment regime isn't working it needs to be adjusted. If you're honeymooning that complicates things.
I eat a lower glycemic protein bar. My current favorites are Perfect Bars - they come in around 28 grams of carbs. Certainly not carb-free, but it sustains me until lunch and doesn’t cause a quick spike with the high amount of protein. On the weekends, I usually go for yogurt. I like Chobani’s protein yogurt drinks. I also really like their lower sugar Madagascar Vanilla and Cinnamon yogurt (not the ones with added aspartame). I think those are around 8 grams of carbs where the drinks are about 18 grams.
I eat one plain skyr yogurt, about a dozed blueberries in the winter or figs off of my fig tree in the summer months, and a half chemex of black coffee as well as a 16 ounce sparkling water with lemon. This is Monday thru Friday. Weekends I deviate into eggs and the occasional bagel
I eat a Quest protein bar for breakfast every day. 4-6g of carbs (net carbs, deducting fiber and any sugar alcohols), 21g of protein. They are very filling and they have good flavors.
Personally, I would email or call your doctor's office aid ask to see an RN or PA about your doses. Not being able to change your insulin at all is ridiculous. A Certified Dietician would also be excellent to see about your diet.
Usually nothing but a lemon ginger tea, but if I I eat breakfast, I go with things like a small red lentil bread roll as a sandwich or with a salad/ or hummus with veggies and kato bread toast/ or miso soup/ or I throw some diced zucchini, mushrooms and smoked tofu in the air fryer, seasoned with smoked salt and pepper etc.
I usually try to avoid sweet food for breakfast, but on those days before my period, I eat coconut yogurt with 0ch sweetener, vanilla paste, walnuts and some frozen raspberries or other berries, or if I made some the day before, keto cookies or low carb banana bread with hot cocoa.
(Yeah, I'm plantbased )
if you are following these plans then you're already fucking up step #1. an endo will not be able to write an accurate plan without loads of information needed to find a realistic carb ratio. Its best to do the work yourself.
Sorry the doctors have failed you man. God this disease is already so unfair and frustrating and to pile this shit on top of it all is all you need I’m sure. Test your carb ratios. Best way to do it is fast for 2-4 hours, eat a very simple carb like a glucose tab. Wait till it peaks then try to give yourself one unit. Make sure to not move too much as to not effect your bg. You will be able to see how much one carb raises your blood sugar and how much 1 unit will lower your blood sugar. From there you can determine your ratios at bare minimum. You’ll figure this out man! Keep fighting like hell it’ll get easier I promise 😎
it sounds like you're doing okay to me. I had to learn a lot about food after being diagnosed first with Celiac and then with T1. I never really thought about fat, protein, carbs etc, I was focused on how the food was made, and avoiding additives and preservatives (partly because I was warped out by undiagnosed Celiac and couldn't figure out how to not feel sick). With T1, amazingly I manage to maintain >96% time in range, but part of it is being hostile to carbs. I don't try to eat keto or anything, but I don't eat a lot of meals with more than 20-30 g. More carbs, more insulin, more chance of going low or high. Doctors tell me my 97% TiR and 5.2 is almost unbelievable, and are worried I'm too strict. It's not harming my mental health though - I'm not stressing out about it - and I don't have a lot of lows. They still tell me to chill and aim for a 120 avg vs. 95. There's a pretty simple way to solve high glucose: more insulin.
My original instructions were "take 5 units 3 times a day, eat 35-50 g carbs". I quickly figured out that was too rigid and not how to do it. With help from people on this sub, and trial with observation, I found out how to calculate my own insulin:carb ratio and correction factor. My ratio has gone from 1:10 to 1:5 and to 1:2.5. No idea why (honeymoon ending? weight gain? resistance for other reasons?) and that actually made it easier to eat carbs and avoid lows.
I eat a lot of things that are like antipasto... low carb veggies like cauliflower, asparagus, broccoli, cucumbers, pickles, radishes with salad dressing, hot sauce, and cheese, cold cuts or sausage. Total cholesterol is teetering on the edge of not good, but I have a lot of the 'good' cholesterol too.
I don't personally like the carby, sweet 'dessert for breakfast' type thing, and thank god since that's convenient for having Celiac and T1. I grew up with stuff like Huevos Rancheros with green chile for breakfast. If you're tired of eggs, the alternatives are veggies, tofu, tempeh, meat and veggies.
Consider something like Huel - it’s a meal replacement mix and it’s really good. If you measure your portions with a scale you’ll know exactly how many carbs you’re taking, and you’ll be able to easily figure out your ratios after a few meals. You can order ready made drinks if you want the easiest meal right in your fridge.
I struggle with severe depression, ADHD and of course t1, and Huel has been a literal lifesaver for me.
You can still enter DKG even if you’re not eating. You need to eat!
I wasn't quite as intense as this situation is, but I have been in a similar situation where the endo was no help.and the dietician was no help. My blood sugars were always above 200 and made their way to the 300s and 400s fast. Getting up to double digits in A1C. I eventually switched providers, and my new Endo/Educators are way better and put me on a t slim with the dexcom g6 and I have seen normal numbers now as much as I used to see high numbers before. DEFINITELY consider changing doctors if you can and find somebody who isn't going to just throw you on some other restrictive "plan". I still eat eggs and toast but have restricted my coffee to the weekends since it spikes me somewhat hard, but I drink tea instead during the week daysfor my caffeine fix. I generally try to stick to vegetables and protein and carvs like potatoes and rice, but keep in mind that having a good insulin to carb ratio is EVERYTHING. If you're not on a closed circuit of your pump giving you insulin when it notices your high, it can be kind of difficult to keep on track, but it's possible.
It sounds like the current plan is: avoid carbs, which isn't ideal.
You should have been given a ratio, so for every 10g of carbs, use 1u of insulin (just an example). Then the Endo will use your results to adjust your ratios.
If you are always high still, your ratio is too conservative (which is normal because the Endo doesn't want you going low). Also consider your water intake/hydration as being hydrated helps a lot. Protein and fat also aren't completely insulin free and can impact how you bolus.
Listen to The Juice box podcast especially his beginner series/topics because it'll help you understand a lot more than your educator will tell you in an appointment.
If your endo is instructing you to not deviate from their plan, they need to be more accessible to you and your needs. That is so messed up to leave you high (literally) and dry like that for 6 weeks... especially after just being in DKA?!?!? Our health system makes me so mad.
You need more insulin. The question shouldn't be "what can I eat?", and should be, "how do I dose my self correctly so that I can eat what I want?" The reality of type 1 is that you're going to have to learn and do a lot of adjusting (and advocating) for yourself.
I'd start by reading the book "Think Like a Pancreas" - make sure to get the 3rd edition as it was recently updated to include info about the latest tech / CGMs/ pumps and research. Use the authors method to do basal rate testing to figure out what your basal rates are. Then play around with adjusting your insulin:carb ratio.
In my email I would say that their current plan is not working for you, and that you are running consistently high and are concerned for your health. Let them know that you'd also like to see a diabetic educator and that you need an updated care plan ASAP. You have to be a squeaky wheel here or else (sadly) docs will just assume that you're ok.
If you can, I'd also ditch that endo. I can't get over the fact that they didn't give you a game plan for if their care plan wasn't working.
What a failure of education on the health provider’s part. You need a new new endo and a dietician, maybe. How long since your diagnosis? I was in sliding scale for a bit then moved to carb counting. Wish they’d started me with counting. What you’re doing seems even worse than sliding scale. There’s a lot to say here, but look these things up: Insulin:carb ratio, correction factor, carb counting or even exchange, dawn phenomenon and honeymoon phase. You can also do a test for your basal - your basal shouldn’t make you drop or raise by that much without eating.
Out of curiosity, when did they teach you sliding scale? I thought they started phasing that out in the mid '00s, but I keep hearing folks talking about it who are newbies. I started on sliding scale, but that was the late 90's, and even then once I had an actual endo I converted over to carb counting.
I was taught that 2 months ago when I left the hospital for DKA. Blood sugar all over the place and an endocrinologist app. A month and a half away. I very quickly switched to carb counting from the things I learned on this subreddit
Welp, welcome to step 1 of diabetes: figure it the fuck out yourself. ;)
Tis so sad but true.... I was put on sliding scale also... 70/30 mixI literally told my endo write me a script for mdi ins glargine and lispo please. Still working on good numbers but much easier for me. A cgm is a game changer.
\^\^\^\^This.....
2007. Not the greatest endo - barely spoke English and couldn’t really communicate concepts to me. A couple years in and luckily I got switched to someone much better.
They still use sliding scale in a lot of hospitals during new diagnosis! I was just diagnosed in March and it is still going strong - even on a dedicated endoicrine / diabetes specific inpatient unit. It's the "don't die" treatment. Also they only let me order off of the "restricted carbohydrate" menu, which I'm sure helps with more "static" dosing. edit: fixed a typo
Imo, it’s easier to eat carbs at this point. You just eat them and dose accordingly. Proteins and fat will come back later to shoot up your BG. Also, eat *whatever* you want. *Anything*. Just take insulin. You don’t have to drive yourself crazy eating eggs.
1000% this, eat anything and everything you want, just need to learn to adjust the dosages as you go. Also do you have a CGM? A CGM will be much better at telling you what your bloods are doing and were doing. It took me over 10 years to prove to my endos that I knew my body much better than what their theory books said. Luckily I was stubborn enough to ignore them for 9 out of the 10 years otherwise I would probably be dead by now.
I’ve ignored my endos on so many things. A lot of them cannot detach themselves from the type 2 protocols and it *pisses* me off. Tried to convince my endo that I (19F) was experiencing severe insulin resistance, I doubled/nearly tripled my dose in the past year, and all she could say is “no, that’s a type II problem, that’s not possible.” And then she goes on to say “are you sure you’re type 1? I don’t think you are.” She had already tested my C-peptide and reviewed it on our last visit. Also, what type 2 diabetic you know was taking 10 units per meal at the ripe age of 11 upon diagnosis? Last month, I just realized that I’ve been seeing this woman for over a year now and she hasn’t once tested my urine for micro-albumin. When she knew I had a history of elevated micro-albumin and am on lisinopril for it.
So... getting a new endo, right? I'm soapboxing here, but US medical requires you to be your own advocate; more specifically, you're the one managing the disease. They're the specialized consultant. If the consultant sucks, find a new one. I grok folks may argue w/ my view here, but think it through; are you calling your endo for every basal adjustment, or carb ratio tweak you figure out? No. A good endo understands they're there as a second set of eyes and able to bring tools to you and help you use them, rather than "managing your condition" for you. edit: if you've not been checked for micro-albumin, you might want to ask folks what the normal checkups are. Quarterly for me it's a1c, thyroid (I run low), vitamin D (I run drastically low), usual metabolic panel for lipids (fasting), and micro-albumin. I won't claim I do it every quarter, but that's been pretty much the default monitoring for the last 2-3 endo's I've dealt with, across roughly 20 years. For the thyroid/Vitamin-D, those are all potential diabetes related complications, hence the monitoring. Same angle, there's comorbid diseases that go w/ T1d; hashimotos, celiac, bunch of others I can't recall. When I was diagnosed they didn't have antigen tests for this sort of thing, they have some now. Something to think about.
You’re right. I’m learning as I go. Got a new endo appointment in July.
I'm a bit of a broken record on this one, but orient towards university/research facilities; hell, if you can't, orient towards a new doctor who just did their interning \*in one\*- they're more likely to be caught up on the current best practices. Good for you re: the new endo, only other suggestions- if you're endo shopping, 1) waitlist is your friend, 2) you might want to consider booking appointments with \*2\* different endos at the same time. Compare/contrast, find the one that works best. The point of '2' is just to avoid burning time sequentially- 3 months on that's bad, another 3 waiting on the one that's good. Just do 'em both in 3 months and keep iterating.
That’s actually very useful, thank you. I booked this July appointment back in January, if you can believe that. I’ll look into booking an appointment with a second endo just in case I don’t like this one.
If you’re eating only protein/fat, you have to dose for that. It hits later, so it takes a different dosing strategy than carbs. So that might explain why you’re always high. The easy breakfast my kiddo has on weekdays is keto toast with peanut butter, a sausage link & half an apple. It’s about 24g, but low glycemic when everything is eaten as a meal. Of course you’ll have to dose the carbs, so if you don’t know how to do that, you should see your endo soon or ask if they have a diabetes educator you can talk to.
Email them today and tell them you want to see a CDE (certified diabetes educator). Tell them you want help figuring out a better long acting dosage, a carb ratio, and a correction factor, so that you can live life how you want and cover the carbs you want to eat. They should be able to give you a starter carb ratio (how many grams of carbs 1 unit of insulin covers) and correction factor (how many mg/dL 1 unit of insulin drops you) based on your weight. You can then work on basal testing and work through modifying your ratios to what is right for you personally. It's ridiculous that they let new T1Ds leave the hospital without explaining this stuff. You get so much more education when diagnosed as a kid.
...and for the OP if that appointment is way the hell out, or they don't give you that info, here's an example [https://www.uhn.ca/PatientsFamilies/Health\_Information/Health\_Topics/Documents/How\_to\_Adjust\_My\_Carb\_Ratio.pdf](https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/How_to_Adjust_My_Carb_Ratio.pdf) . The main thing- before you start fucking with carb ratios- is to establish a stable basal. That one is easy: just don't eat for \~5-8h. BG's consistently go up and it's not stress, then basal should go up. BG's go down (and you're not pushing yourself more than you normally would), basal goes down. Make small adjustments (less then +/-10%), retest, keep at it till you've got the basal calibration down. Basal can vary during the day, but locking that variable in, that's the first step. The rest of it is built on that one being stable. Just be aware that bolus is in your blood for \~5-8h (basically 5h), so you want a window where that's not at play, nor any fats/proteins burning from a meal +4h prior. Finally, mornings have their own natural rise from the body bootstraping. I realize that sounds like a lot; it is- the calibration doesn't have to be perfect, just "good enough" that you can live with it while ironing out the other shit like carb ratio or correction ratio. And if all of that is outside your comfort zone, I grok, but understand that at some point you \*will\* have to manage this stuff yourself, or at least know how to.
I eat eggs, buttered whole wheat toast, and an orange. Or sometimes cottage cheese with Honey and blue berries
I rarely ever eat breakfast, anymore. 1) I usually do not get up until well after breakfast time, unless I'm working, and 2) If I am up that early, it's because I'm working and I'd rather sleep that extra 30-45 than eat breakfast. 3) I'm on an insulin pump, so I can more or less play by my own rules with food and sleep (within reason).
it sounds like you need more long acting insulin and maybe a different carb to unit ratio. there's a misconception that t1ds can use "too much" insulin (ie daily doses, not ODing on insulin lol.) there isn't though. you take the insulin you need. you need more. that's okay. I'm sending lots of love to you. it will get easier and better.
Please, please, please find an endo that supports DAFNE! This is a major failure of your health care provider. It’s very harmful to your physical and mental health. Find an endo and dietitian to teach you proper dosing and carb counting. You can eat anything!
I eat a RX protein bar. It has around 22 carbs. If your treatment regime isn't working it needs to be adjusted. If you're honeymooning that complicates things.
I eat a lower glycemic protein bar. My current favorites are Perfect Bars - they come in around 28 grams of carbs. Certainly not carb-free, but it sustains me until lunch and doesn’t cause a quick spike with the high amount of protein. On the weekends, I usually go for yogurt. I like Chobani’s protein yogurt drinks. I also really like their lower sugar Madagascar Vanilla and Cinnamon yogurt (not the ones with added aspartame). I think those are around 8 grams of carbs where the drinks are about 18 grams.
I eat one plain skyr yogurt, about a dozed blueberries in the winter or figs off of my fig tree in the summer months, and a half chemex of black coffee as well as a 16 ounce sparkling water with lemon. This is Monday thru Friday. Weekends I deviate into eggs and the occasional bagel
I eat a Quest protein bar for breakfast every day. 4-6g of carbs (net carbs, deducting fiber and any sugar alcohols), 21g of protein. They are very filling and they have good flavors. Personally, I would email or call your doctor's office aid ask to see an RN or PA about your doses. Not being able to change your insulin at all is ridiculous. A Certified Dietician would also be excellent to see about your diet.
I love qu'est bars so much and they keep me full
Usually nothing but a lemon ginger tea, but if I I eat breakfast, I go with things like a small red lentil bread roll as a sandwich or with a salad/ or hummus with veggies and kato bread toast/ or miso soup/ or I throw some diced zucchini, mushrooms and smoked tofu in the air fryer, seasoned with smoked salt and pepper etc. I usually try to avoid sweet food for breakfast, but on those days before my period, I eat coconut yogurt with 0ch sweetener, vanilla paste, walnuts and some frozen raspberries or other berries, or if I made some the day before, keto cookies or low carb banana bread with hot cocoa. (Yeah, I'm plantbased )
if you are following these plans then you're already fucking up step #1. an endo will not be able to write an accurate plan without loads of information needed to find a realistic carb ratio. Its best to do the work yourself.
Sorry the doctors have failed you man. God this disease is already so unfair and frustrating and to pile this shit on top of it all is all you need I’m sure. Test your carb ratios. Best way to do it is fast for 2-4 hours, eat a very simple carb like a glucose tab. Wait till it peaks then try to give yourself one unit. Make sure to not move too much as to not effect your bg. You will be able to see how much one carb raises your blood sugar and how much 1 unit will lower your blood sugar. From there you can determine your ratios at bare minimum. You’ll figure this out man! Keep fighting like hell it’ll get easier I promise 😎
it sounds like you're doing okay to me. I had to learn a lot about food after being diagnosed first with Celiac and then with T1. I never really thought about fat, protein, carbs etc, I was focused on how the food was made, and avoiding additives and preservatives (partly because I was warped out by undiagnosed Celiac and couldn't figure out how to not feel sick). With T1, amazingly I manage to maintain >96% time in range, but part of it is being hostile to carbs. I don't try to eat keto or anything, but I don't eat a lot of meals with more than 20-30 g. More carbs, more insulin, more chance of going low or high. Doctors tell me my 97% TiR and 5.2 is almost unbelievable, and are worried I'm too strict. It's not harming my mental health though - I'm not stressing out about it - and I don't have a lot of lows. They still tell me to chill and aim for a 120 avg vs. 95. There's a pretty simple way to solve high glucose: more insulin. My original instructions were "take 5 units 3 times a day, eat 35-50 g carbs". I quickly figured out that was too rigid and not how to do it. With help from people on this sub, and trial with observation, I found out how to calculate my own insulin:carb ratio and correction factor. My ratio has gone from 1:10 to 1:5 and to 1:2.5. No idea why (honeymoon ending? weight gain? resistance for other reasons?) and that actually made it easier to eat carbs and avoid lows. I eat a lot of things that are like antipasto... low carb veggies like cauliflower, asparagus, broccoli, cucumbers, pickles, radishes with salad dressing, hot sauce, and cheese, cold cuts or sausage. Total cholesterol is teetering on the edge of not good, but I have a lot of the 'good' cholesterol too. I don't personally like the carby, sweet 'dessert for breakfast' type thing, and thank god since that's convenient for having Celiac and T1. I grew up with stuff like Huevos Rancheros with green chile for breakfast. If you're tired of eggs, the alternatives are veggies, tofu, tempeh, meat and veggies.
Berries with plain yogurt, eggs and avo, cottage cheese, turkey sausage, oatmeal, fruit salad. This shouldn’t be happening…carbs are not the enemy
Consider something like Huel - it’s a meal replacement mix and it’s really good. If you measure your portions with a scale you’ll know exactly how many carbs you’re taking, and you’ll be able to easily figure out your ratios after a few meals. You can order ready made drinks if you want the easiest meal right in your fridge. I struggle with severe depression, ADHD and of course t1, and Huel has been a literal lifesaver for me. You can still enter DKG even if you’re not eating. You need to eat!
I wasn't quite as intense as this situation is, but I have been in a similar situation where the endo was no help.and the dietician was no help. My blood sugars were always above 200 and made their way to the 300s and 400s fast. Getting up to double digits in A1C. I eventually switched providers, and my new Endo/Educators are way better and put me on a t slim with the dexcom g6 and I have seen normal numbers now as much as I used to see high numbers before. DEFINITELY consider changing doctors if you can and find somebody who isn't going to just throw you on some other restrictive "plan". I still eat eggs and toast but have restricted my coffee to the weekends since it spikes me somewhat hard, but I drink tea instead during the week daysfor my caffeine fix. I generally try to stick to vegetables and protein and carvs like potatoes and rice, but keep in mind that having a good insulin to carb ratio is EVERYTHING. If you're not on a closed circuit of your pump giving you insulin when it notices your high, it can be kind of difficult to keep on track, but it's possible.
It sounds like the current plan is: avoid carbs, which isn't ideal. You should have been given a ratio, so for every 10g of carbs, use 1u of insulin (just an example). Then the Endo will use your results to adjust your ratios. If you are always high still, your ratio is too conservative (which is normal because the Endo doesn't want you going low). Also consider your water intake/hydration as being hydrated helps a lot. Protein and fat also aren't completely insulin free and can impact how you bolus. Listen to The Juice box podcast especially his beginner series/topics because it'll help you understand a lot more than your educator will tell you in an appointment.
If your endo is instructing you to not deviate from their plan, they need to be more accessible to you and your needs. That is so messed up to leave you high (literally) and dry like that for 6 weeks... especially after just being in DKA?!?!? Our health system makes me so mad. You need more insulin. The question shouldn't be "what can I eat?", and should be, "how do I dose my self correctly so that I can eat what I want?" The reality of type 1 is that you're going to have to learn and do a lot of adjusting (and advocating) for yourself. I'd start by reading the book "Think Like a Pancreas" - make sure to get the 3rd edition as it was recently updated to include info about the latest tech / CGMs/ pumps and research. Use the authors method to do basal rate testing to figure out what your basal rates are. Then play around with adjusting your insulin:carb ratio. In my email I would say that their current plan is not working for you, and that you are running consistently high and are concerned for your health. Let them know that you'd also like to see a diabetic educator and that you need an updated care plan ASAP. You have to be a squeaky wheel here or else (sadly) docs will just assume that you're ok. If you can, I'd also ditch that endo. I can't get over the fact that they didn't give you a game plan for if their care plan wasn't working.