Hi all,
This is a my first time posting here so please take it easy on me; I’ve been reading the forum for a good couple of years and have found some pretty good advice and a wealth of knowledge here.
I have been a Type-1 diabetic for over 35 years and have been on the pre-mixed twice a day daily (currently Human M3) regime most my life, anyway my results are pretty good on it (HBA1c of around 6 to7ish) and I’m happy with that.
However over the last 12-15 months my insulin sensitivity has gone through the roof to the point where I have had to reduce my evening dosage by around 20 units in order to prevent night time lows and some days it’s like I’m attached to a glucose drip just constantly drinking fruit juices to keep levels in range. Thing is if I lower the evening dosage too much to prevent the lows I get a huge spike in the morning and wake up with anything from a 7- 12mmol/lm getting that happy medium I used to have seems to have disappeared without any reasoning that I can think of, is it a case that my body is changing and I need a different type of insulin to work efficiently?
Anyway I have been advised that changing from the pre-mixed insulin to the current MDI Basel/Bolus system would give me better control overall and should prevent the regular lows; so before I commit to making the change I have a few questions that I’ve listed below answered if possible, and I’d like to find out more from anyone that has swapped from premixed to MDI.
Sorry about all the questions I just wanted some feedback from actual users of the regime to help me decide, I’m just concerned that switching to this new insulin may not actually fix the sensitivity issue.
Thanks in advance
This is a my first time posting here so please take it easy on me; I’ve been reading the forum for a good couple of years and have found some pretty good advice and a wealth of knowledge here.
I have been a Type-1 diabetic for over 35 years and have been on the pre-mixed twice a day daily (currently Human M3) regime most my life, anyway my results are pretty good on it (HBA1c of around 6 to7ish) and I’m happy with that.
However over the last 12-15 months my insulin sensitivity has gone through the roof to the point where I have had to reduce my evening dosage by around 20 units in order to prevent night time lows and some days it’s like I’m attached to a glucose drip just constantly drinking fruit juices to keep levels in range. Thing is if I lower the evening dosage too much to prevent the lows I get a huge spike in the morning and wake up with anything from a 7- 12mmol/lm getting that happy medium I used to have seems to have disappeared without any reasoning that I can think of, is it a case that my body is changing and I need a different type of insulin to work efficiently?
Anyway I have been advised that changing from the pre-mixed insulin to the current MDI Basel/Bolus system would give me better control overall and should prevent the regular lows; so before I commit to making the change I have a few questions that I’ve listed below answered if possible, and I’d like to find out more from anyone that has swapped from premixed to MDI.
- Do I need to take insulin every time I eat something that is 10g or carbs and over?
- Is the insulin taken before or after meals?
- What happens if my levels are high after a meal do I have to take another injection post meal or just wait and see it it the levels drop?
- Do I need to take insulin for protein only foods?
- How do you work out the bolus dosage for foods where you can’t accurately calculate the carbs?
- How would it work with exercise, currently insulin doses stay static but carbs are cycled high and low dependent on if I'm exercising or not, each meal has about 40g carbs if not exercising and 80g+ carbs if exercising ? Would I need to adjust insulin intake on days I train?
- U usually train 4 days a week, my exercise usually consists of about 10 mins cardio and then about 1hr -1.5hrs of heavy weight lifting both of which lower my levels I like to start excise with a level of between 10-12
- I either exercise first thing in the morning after breakfast or in the evening after dinner, both meals contain carbs, I will either have a meal (40g carbs 50g protein) after the morning training session or a protein shake after exercise at night usually about (10g carbs 40g protein) do I need to take insulin after these? If so how much and how do we prevent lows later that day/night without constantly feeding the insulin?
- Is it OK to use good fats rather then carbs for fuel if lowering the insulin in take, to support it?
- Will the way my body handles carbs change on the new insulin type? At the moment things that have a high GI load are a nightmare but lower GI foods such as porridge, brown rice, sweet potatoes etc rise the glucose levels slowly but no major spikes, will the different insulin have different results or will my body still handle them the same way?
- Is this administered through a vial and syringe or pre-filled pen?
- How does it work on a night out with alcohol, if levels are high after a night of drinking do I need to take insulin before bed? what if I eat food after a night out would I need to take insulin to cover it?
Sorry about all the questions I just wanted some feedback from actual users of the regime to help me decide, I’m just concerned that switching to this new insulin may not actually fix the sensitivity issue.
Thanks in advance