 Hello everyone today, we are talking about type 1 diabetes mistakes now if you're a type 2 diabetic I think these still will apply to you But it applies more for type 1 diabetics and you will understand why in a minute. So anyways, I'm dr. Ahmet Ergen I'm an endocrinologist and a diabetes education specialist. I practice in Florida in New York. So Let's get started So guys we are going to divide this into pieces of course for you to better understand I'm gonna try to keep that short and precise so you don't get bored and leave the video But I would recommend watching the entire video to understand the whole concept fully now number one mistake for type 1 Diabetics is not counting carbs correctly in my diabetes practice. I get patients Who have been diabetic for 20 plus years 30 plus years they come and I ask them. Hey, do you count carbs? They're like, what's that? So that's a huge mistake you need to understand your carbs even people who are like health freaks and you know People who are into fitness they do that. They don't have that one diabetes So counting carbs is not a punishment But it's obligatory for even healthy people for even type 2 diabetics But for type 1 diabetics is such essential because if you don't count your carbs You will never be successful in controlling your diabetes because you're giving insulin based on the carbs you're eating So you have to match that and if you are not precise in terms of how much insulin you are taking and you're just Yanking it or whatever just thinking that it may work or whatnot and trying to do a trial and error method That's generally not going to work and most of the time it doesn't another common mistake is even if they know How to count carbs they eat a lot of carbs now if any you eat a lot of carbs You can cover those but number one You're going to gain a lot of weight, right? So you can say oh, I'm gonna eat 100 grams of carbs I'm just gonna take 30 units of insulin to cover that Well, if you're not gonna burn these carbs and just pump the insulin in the insulin will push those glucose into your fat cells You're gonna turn into an obese person I rather burn these carbs with exercise because if you exercise you will need less insulin or eat better In a better world don't eat carbs as much. So another mistake that can happen with this is there is always a margin of error It's up to 20% or more Every time even if you are perfectly calculating your carbs and you're giving the perfect amount of insulin It will change the your blood sugar or the efficacy of that method will be 20% off It's just because it's not a perfect world The insulin absorption is different every time you give a shot Even your different body parts will have a different type of absorption Your activity level will affect the absorption and so forth And the other thing is the food labels are not always correct So you may think that you are making a correct decision by looking at the labels And you should but you can still be off 20% now 20% of a small number Is much less of a mistake than a 20% of a larger number So 20% of 100 is 20 20% of 20 is only what for right? So you can see the higher the carbs the higher the margin of error Another mistake a lot of type one diabetics make even the doctors make that mistake is giving too much basal insulin So if you're a top one diabetic you should be able to understand what is basal and bolus insulin Basal insulin is the insulin you some people call long-term insulin or wrong acting insulin That stays in your system for 24 hours If you're on a pump, uh, you're actually using a short acting insulin But in small bursts, but it feels like a long acting insulin for pump users In your case though, most people consider the long acting insulin safer But actually it's not and the reason they think that sometimes when they take a bolus insulin like a short acting insulin in other words Or a fast acting insulin Their blood sugar sometimes drop very quickly and they get scared They think that the short acting insulin is going to drop them Well, that's true if you overdo it It can drop your blood sugars, but to compensate what they do They end up taking more and more long acting insulin such as levomir, lontus, tujea, terciba Or they just increase the basal insulin rate in their pump And as a result what happens is that you're constantly getting insulin to your body And then you start being constantly hungry and if you skip a meal your blood sugar will keep going down So the purpose of basal insulin is not to lower your blood sugar You have to understand that the purpose of basal insulin or long acting insulin or your basal rates in your insulin pump Is to maintain your blood sugar. So if you're fasting for a while, it's easy to test If you're fasting for a while, you're not extremely physically active, but normal day you're fasting You're skipping a meal, etc. If your blood sugars are dropping you're on too much insulin And that not only causes excessive weight gain, but actually it will cause low blood sugars Especially at night as well. And it's not going to help your blood sugar spikes because basal insulin is just a basal flat Insulin you're just increasing the basal rate But you may need way more insulin than that for a short time after you eat So as a result, if you are not really giving enough bolus and you're just relying on your basal insulin You are going to continue to have blood sugar spikes, which is the main reason for people to have complications from diabetes And in addition to that, you will have low blood sugars, which is not a good feeling and will make you feel miserable Even a few days after a low blood sugar people still not feel good So you're going to induce a lot of low blood sugars So and then you're gonna have this roller coaster of blood sugar and you're gonna be like i'm taking so much insulin Why is my blood sugar is also up and down? Well, that's because you're taking too much insulin I mean basal insulin and of course in addition to that one of the biggest mistakes is skipping boluses They for example, especially young diabetics with type 1 diabetes. They'll say i'm too busy. I'm at work. They don't allow me Oh, you can you can have countless excuses for not to take an insulin shot But if you make a rule to yourself, you will find a way to do it You can just go to restroom quickly or you can just find a way to either use your pump or Get an insulin shot with your pen Before your meals is essential You have to do that otherwise Once you skip a dose your blood sugar will climb so high It's going to be difficult to bring it down and then that's going to cause more problems If you you may if you over correct you will go low And then you will try to correct that and it's going to be a mess So try to avoid skipping bolus doses the insulin doses before the meals the short acting one At all cost in addition to that one more mistake is Overcorrecting low blood sugars So when you're using too much basal insulin, not only you're causing low blood sugar But when you are low you feel like you're so hungry you can eat the whole world And we tell people to only eat 15 20 grams of carbs, but actually in reality that doesn't satisfy them So if you had a low blood sugar, you will know how it feels and you feel like that's just not gonna do You're so hungry and then you end up over treating and your blood sugar goes from 50 to 300 And then now you have to correct that that are that are that so it's endless So do you not over correct your low blood sugars? The best is to avoid low blood sugars, but do you not over correct your blood sugars? And I always say, you know one gram of carb will increase your blood sugar on average three to four points So if you're you know depending on how much you want to raise your blood sugar You can just estimate those carbs So for example, if you want to increase your blood sugar by 60 points Because you're really low and you want to feel like you're in a safe range Then you can eat 20 grams of carbs and that's going to increase your blood sugar by 60 points If you have a lot of insulin in your system, if you inadvertently gave insulin You can continue to monitor your blood sugar if your blood sugar is trending down You can take another carbohydrate ingestion But if you are not careful about this, you may just end up in the sky and that will be difficult to control later And one more mistake is being resistant to technology guys open your eyes We live in 21st century. We have a lot of technology available and they are evolving Just because you had a bad experience with a device in the past For example a cgm a continuous glucose monitoring system or insulin pump Does not mean that you will have a problem today I would say, you know, if you have never tried it try the Monitoring systems. Nowadays, there's no finger sticks. Yes, they're not perfect. Yes, they have problems We have videos about that just type on the search button dexcom versus libre You will see I have a lot of videos about that But it's still an essential part and you need to understand how to use those devices Most people end up getting those devices just to avoid finger sticks But you need to know how to use it. You know, yeah, you may want to get a car Just to avoid walking But if you don't know how to use a car you'll end up crashing So same thing with the devices, you need to really know what you're doing with your devices Understand what they mean and what the numbers mean and what the arrows mean on those devices And the insulin pump is the same way Depending on how you use it, it may turn out to be great or it may turn out to be horrible So make sure that you are seeing an endocrinologist who's on top of these as well One final mistake is not understanding the effect of the proteins and fat in your diet Yes, we are shooting for carbohydrates However, if you're on a high fat diet and if you're especially overweight Your insulin resistance will go high So you will need actually more insulin when you're eating higher fat Up to 30% more insulin may be needed on a higher fat diet For example, the the pizza is a best example when you eat pizza Your blood sugar will go high and will stay high for a long time Because fat will keep your blood sugar high will make you insulin resistant And the ball is insulin that you are giving only will last you three to four hours But then after that up to Six to eight hours the blood sugars are running high because of the pizza and fat content And you will have to have multiple boluses or you will just stay high Of course proteins raise your blood sugar too. Some people will say, hey, I don't even eat carbs I don't know why my blood sugar are going high Well, you're eating protein if you're eating a whole chicken That's a lot of protein and those proteins actually raise your blood sugar as well Not as much as carbs definitely maybe one fourth of a carb, you know Like maybe you know 10 grams of protein will increase your blood sugar as much as a 40 grams of carbs But that still will do something so you need to understand that the protein has a role in your blood sugars as well So guys, I hope that helps. So if you have questions comments, please put it down Share this video, especially with people you love and I think they will find it useful And give a like if you like the video. Thank you very much. We'll see you in the next one All right. Thank you for watching and I want you to be more informed and more educated So to do that go ahead and watch this next video right here