Multiple injections, yes or no?

[tia_]

I'm in the middle of deciding if I should change to multiple injections I've been on twice a day injections for 11 years but still haven't got control over my diabetes I need help weather it'll be a good decision to change? I have tried in the past but I couldn't get used to it so changed back?

Is it really as good as the doctors say?

 

[zjed]

It's not a magic bullet and will only be as good as you make it.
With MDI you have to count carbs, calculate dose adjustment, calculate BGL corrections and probably take more BGLs to make those calculations. It's not a set and forget system.
If you are going to switch to it I would highly recommend further education on dose adjustment with a course like DAFNE.
But if you want tighter control and are willing to work for it, the answer is yes.

 

[mammamia2006]

Personally, I think its better doing more than 2 injections a day.

My brother is on 2 a day and his control is terrible, I am on 4 a day and I feel like I have a lot more freedom than he does as I can take correction doses if bgl is too high, can see what works in regard to making bgl rise too much and adjust insulin dose to suit where needed.

It is totally your cjoice and what you feel would be better suited for yourself and your lifestyle.

 

[tim2000s]

As someone who uses MDI but does about 10-12 jabs a day, mostly due to diet, it definitely gives better control but also requires more involvement from you. The main benefit is that you don't feed your insulin.

 

[Jaylee]

I would have to agree with @tim2000s . It's been over 25 years since that regime & from memory it seemed like a constant pandering to taking in carbs & between meal snacking to feed a set dose.. Lol I don't always feel hungry. Especially before a gig.

 

[LucySW]

MDI is much better. But you have to work hard for it.

 

[victry77]

I stayed on 2x injections for 4yrs, mainly as I had a very prolonged honeymoon, but I was also a bit scared on MDI. When I switched to MDI, I wondered why I hadn't done it a lot sooner as I had so much more freedom and choice with my diet. Obviously, you need to learn and understand carb-counting, but I definitely give it a go, but don't just give up if you hit a bit of a stumbling block, try and persevere.

 

[urbanracer]

I'm primarily on 2 injections 25/75 per day but my endo's nurse told me I could still use the rapid acting pen to bolus if I wanted to.
I've done this several times now with reasonable success.

My last 2 a1c's were both 6.8% so it seems to work for me. But I had poor control when I started out with 30/70 Novomix and it got much better with the 25/75 Humalog, which surprised me a little.

I too am thinking about a proper basal/bolus regime but I'm in 2 minds as I seem to be coping at the moment.

 

[tim2000s]

I reckon you'll cope even better on MDI @urbanracer.

 

[himtoo]

firmly on the MDI side having done 1 injection a day for about 12 years and 2 injections a day for another 14.
the freedom in comparison to fixed dose was a revelation.
it does take work though

 

[noblehead]

Having used both I'd have to say MDI is far better, it gives you greater flexibility on what you eat and when you eat, on MDI you can even miss mealtimes should you choose.

 

[urbanracer]

Having used both I'd have to say MDI is far better, it gives you greater flexibility on what you eat and when you eat, on MDI you can even miss mealtimes should you choose.

Hi noblehead.

I know you've mentioned this before and sorry if I'm being a bit slow here but I don't quite get this. So the concept of bolusing is fairly straightforward with carbs and insulin etc, but how come your background insulin doesn't drive you low without food intake?

(Apologies to @tia_ for hijacking your thread - and welcome to the forums by the way.)

 

[tim2000s]

Hi noblehead.

I know you've mentioned this before and sorry if I'm being a bit slow here but I don't quite get this. So the concept of bolusing is fairly straightforward with carbs and insulin etc, but how come your background insulin doesn't drive you low without food intake?

(Apologies to @tia_ for hijacking your thread - and welcome to the forums by the way.)

You balance your background insulin to the natural levels of glucose that your liver produces throughout the day. That's the 75% part of the insulin you are currently using.

In order to get the balance right, you need to basal test, fasted, which tells you whether your level is too high or too low, by virtue of what your blood glucose level does with no food or bolus.

 

[noblehead]

Hi noblehead.

I know you've mentioned this before and sorry if I'm being a bit slow here but I don't quite get this. So the concept of bolusing is fairly straightforward with carbs and insulin etc, but how come your background insulin doesn't drive you low without food intake?

(Apologies to @tia_ for hijacking your thread - and welcome to the forums by the way.)

The background (basal) insulin is just there to deal with the slow trickle of glucose that is released from the liver when fasting, if you get the basal dose right there's no reason why your bg levels should go low unless your more active than normal, hence why there's no need to snack on MDI and you can go without meals should you wish.

 

[urbanracer]

The background (basal) insulin is just there to deal with the slow trickle of glucose that is released from the liver when fasting, if you get the basal dose right there's no reason why your bg levels should go low unless your more active than normal, hence why there's no need to snack on MDI and you can go without meals should you wish.

You balance your background insulin to the natural levels of glucose that your liver produces throughout the day. That's the 75% part of the insulin you are currently using.

In order to get the balance right, you need to basal test, fasted, which tells you whether your level is too high or too low, by virtue of what your blood glucose level does with no food or bolus.

OK - thanks guys. Consultant has already written to GP about Basal/Bolus regime so I guess I'd better get an appointment sorted out.

 

[noblehead]

OK - thanks guys. Consultant has already written to GP about Basal/Bolus regime so I guess I'd better get an appointment sorted out.

The following is a great explanation by Gary Scheiner about basal insulin, what it's role is and why its important to get the dose right:

http://www.diabetesselfmanagement.com/managing-diabetes/treatment-approaches/getting-down-to-basals/

Good luck with the changeover @urbanracer

 

[Daibell]

Hi. As you already have experience of insulin you shouldn't need to attend any training. I went onto Basal/Bolus after 4 weeks on just Basal and have never had any training or hypos and my HBa1C is only 6%. My DN explained carb-counting when she added my Bolus insulin; simples. Yes, go MDI.

 

[Heathero]

Changed to multiple injections many years ago, made my life so much easier could eat when I wanted and hypo reduction was great. Now about to change to pump. After 48years years of diabetes. Also able to do adjustment doses to bring highs down.

 

[jackvdbuk]

i was on two injections for a very long time 10 + years (im only 25) and hated the the thought of more injections.

due to lots of hypos/highs and gym it was very difficult to eat what i needed and stay within a good range. moving onto 4 injections has really helped and you can eat what you want with the relevant dosage of fast acting (usually novorapid). i personally should have done it ages ago

 

[urbanracer]

Saw my GP's DN today and she told me that my A1c has come down further from 6.8% to 6.5% .

We discussed the letter from the hospital about a basal/bolus regime and she is trying to persuade me not to change over from 2 injections per day (with the odd RA correction) - on the grounds that I'm already doing very well.

I now have another appointment in 2 weeks time, and one of the specialist nurses from the endo centre will be at the GP's clinic, so I have a bit more time to think about it.