Humulin I - Things seem wonky, where do I get advice?

[Nlck]

I've read around the website, but the acronyms don't help (e.g. T1 & T2 are presumably Type 1 & Type 2 but it's not obvious to me). I'm not getting great help with my medication from my GP so I thought that I would ask here for some opinions.
I was identified as T2 around 15 years ago, controlled by diet for 5 years then started on Metformin. I have really bad problems with diarrhoea with Metformin, but it's a simple choice - glucose damage or Metformin, I chose Metformin & it kept my HBA1C at <50.
6 years later (5 years ago) my HBA1C went bonkers (90) and my GP put me on Humulin I and a Nurse started dealing with me instead of the GP.

The results from dealing with the nurse were fantastic, I got a lot more time & attention, and together we achieved a way of minimising the side effects of Metformin & brought my glucose levels back under control (daily measurements of 5 - 8) & my HBA1C down to 40ish. I was taking daily Insulin doses of 50 - 60 x 2 which I knew was high, but research suggested that there is no "too high" as long as you are controlling glucose levels.

The diabetes nurse left the surgery during the pandemic & I stopped getting support but continued with my regime & 6 monthly tests. 6 months ago I received a phone call from my GP to say that (based on my HBA1C) I was taking too much insulin and should reduce my daily dose to 40 units x 2.

Over the last 6 months following my blood sugar measurements I have targeted 8 rather than 5 & am currently (for the last 24 weeks) taking doses of 25 - 28. My latest HBA1C reading (yesterday) was 44.

I want help & guidance that I am not getting from my GP, but it looks to me as if my sugar level target needs to be 8, not 5.

 

[Angelofthemarches]

Hi Nick, what is your diet like, generally?

 

[Nlck]

Hi Nick, what is your diet like, generally?

I am not a disciplined person, but in general I think that it's good.

Breakfast is Meusli, berries (fresh) & Keffir. Occasionally porridge sweetened with 1/3 mashed banana.
Lunch Salad or home made vegetable soup.
Dinner Fish Pie, Kale & Chickpea
Obviously lots of variety and the occasional mistake (last night I had sticky toffee pudding with cream), but basically no fast food, processed food, chips/french fries, sweeteners, added sugar, limited bread or pasta (only wholemeal).

 

[bmac2560]

Hi Nick, You have to excuse me but I am one of those stupid Americans with their own measurement systems. When you are talking about 5 - 8 are you talking about mmol/l? That is a measurement we do not typically use in the U.S. as we tend to use mg/dl. Living in Europe now I am needing to get used to the European measurement (mmol/l). If that is the case, a reading of 5 seems a bit low. I have recently started insulin since my meds were not doing the job anymore and my doctor set my target at 8. When I convert 5 to a scale I am more familiar with I get a reading of 90. That seems quite low (in my totally non medical opinion). There may be a concern about you having a hypoglycemic episode (low blood sugar). I don't think I am too off the mark since the threshold for hypoglycemia is below 4 mmol/l.

I have to admit I am not familiar with HBA1C (like I said, Stupid American). My doctors in the past have used A1C as an average metric. Obviously, I have much to learn,

 

[Antje77]

Hi Nick, You have to excuse me but I am one of those stupid Americans with their own measurement systems.

Nothing stupid about it, just different countries with different units to measure stuff.

You might like to save or bookmark this chart, it has hba1c in both %, which you are used to, and mmol/mol, which is generally used here.
It also has the corresponding average blood glucose levels in both mg/dl, which you are used to, and in mmol/l which most members of the forum use.