Type 1 or Type 2?

[Still_Here]

@SussexGeoff Just a thought from a T1D of many years.

In your first post you mention taking Levermir, but it appears to be only once a day. That insulin lasts around 12 to 14 hours. Most T1Ds on it inject it morning and evening for 24 hr coverage, with a flat action profile. There are others that last longer but due to the delay are harder to make quick adjustments with.

If you are only injecting once a day that might explain the erratic action/ effect.

And yes some T2s need some insulin support BUT you should demand access to the Freestyle Libre CGM to help you optimise its use.

Good luck.

 

[EllieM]

And yes some T2s need some insulin support BUT you should demand access to the Freestyle Libre CGM to help you optimise its use.

Unfortunately it's not guaranteed access for UK T2s, only for T1s. And I have my doubts that someone on a basal dose only will qualify, though am happy to be corrected. Though there is no harm in asking.

 

[Still_Here]

Unfortunately it's not guaranteed access for UK T2s, only for T1s. And I have my doubts that someone on a basal dose only will qualify, though am happy to be corrected. Though there is no harm in asking.

You are right @EllieM. T2D's do not automatically qualify but if you are taking insulin then there is a strong case to be made as you are probably at risk of more hypos and also need the pattern information to optimise use of this "dangerous drug".

At least that is what I advised a T2D colleague and his consultant agreed and prescribed L2 for him. It made a big change to his usage pattern and have him better understanding of his condition. If you don't ask ........

Apologies for not picking up that you had already mentioned the 14hr action for Levemir. That will teach me to speed read.

 

[Antje77]

Thanks Antje. Lunch maybe something simple like brown rice, onions and mushrooms (cooked in just a little bit of butter)

Don't get me started on what to eat

I've always been a fussy eater anyway so now it's really difficult. Carbs do my head in, everything has them.

I'm definitely not telling you what to eat, just looking at possible causes of your afternoon numbers being much higher than your late morning numbers.
Being a fussy eater isn't necessarily an issue, just depends on the foods you prefer.

With your lunch, it looks like you're choosing a low fat (just a little bit of butter) and high carb (brown rice) type of meal.
Fats are filling, so more fats means you need less carbs to fill you up.
So more butter, onions, and mushrooms, less rice may make a significant difference.

Do you eat meat?
What about butter, mushrooms, onion and bacon instead of the rice?
Or just let us know what types of food you like, and what types of food you do not eat, maybe we can help you find less carby options.

 

[SussexGeoff]

@SussexGeoff Just a thought from a T1D of many years.

In your first post you mention taking Levermir, but it appears to be only once a day. That insulin lasts around 12 to 14 hours. Most T1Ds on it inject it morning and evening for 24 hr coverage, with a flat action profile. There are others that last longer but due to the delay are harder to make quick adjustments with.

If you are only injecting once a day that might explain the erratic action/ effect.

And yes some T2s need some insulin support BUT you should demand access to the Freestyle Libre CGM to help you optimise its use.

Good luck.

Thank you. I spoke to the Diabetes Nurse the other day expressing my concern about the Levemir "running out" too quickly.

She still insists increasing by 2 units every few days but, in my mind, that won't make it last longer. And, if I'm doing vigorous exercise like gardening, it will burn off quicker, right?

 

[SussexGeoff]

I'm definitely not telling you what to eat, just looking at possible causes of your afternoon numbers being much higher than your late morning numbers.
Being a fussy eater isn't necessarily an issue, just depends on the foods you prefer.

With your lunch, it looks like you're choosing a low fat (just a little bit of butter) and high carb (brown rice) type of meal.
Fats are filling, so more fats means you need less carbs to fill you up.
So more butter, onions, and mushrooms, less rice may make a significant difference.

Do you eat meat?
What about butter, mushrooms, onion and bacon instead of the rice?
Or just let us know what types of food you like, and what types of food you do not eat, maybe we can help you find less carby options.

Apologies, my "Don't get me started on what to eat" meant me laughing and ranting to myself about the nightmare of choosing something that's ok lol!

You see, I thought brown rice or wholemeal rice was good? Even Basmati rice.

In the morning I may have two pieces of wholemeal toast (half size loaves so I guess you could say 1 big slice). Or a couple of boiled eggs with the toast.

I will also too often have cauliflower mash with butter mixed in. Love most vegetables.

Meat wise, I like bacon, ham, corned beef and chicken but also like vegetarian versions of sausages, chicken, burgers etc.

I know cereals are a big no no but I do love the occasional bowl of supermarket own brand corn flakes with sweetener.

Green grapes, apples and bananas. Not into berries.

Potatoes I try to keep to a minimum now and only a few new potatoes or roasties if I do.

I've a weakness for biscuits. I buy sugar free ones but then see the epic carbs they have so try to be restrained!

 

[In Response]

Mis-diagnosis is a problem and the definition of T1 is even more of a problem. The assumption that 'T1' (i.e. lack of insulin) is only caused by auto-immunity is wrong as the beta cells can be attacked by viruses and that's not 'auto-immunity'

The definition of Type 1 diabetes from this website is

Type 1 diabetes is an autoimmune disease that causes the insulin producing beta cells in the pancreas to be destroyed, preventing the body from being able to produce enough insulin to adequately regulate blood glucose levels.

This is not a wrong definition., Yes, it is possible to lose beta-cells by other means and be treated as Type 1 but that is Type 3c as defined (again on this website)

Diseases of the exocrine pancreas

Yes, I am being pedantic and I am taking this thread off on to a tangent (for which I apologise) but, whilst it appears you were misdiagnosed, that does not mean you have Type 1 diabetes. There are other types which the OP may need to consider.

 

[catinahat]

You see, I thought brown rice or wholemeal rice was good? Even Basmati rice.

Our bodies have no Idea what colour our food is, all carbs when digested will be converted to glucose. The wholemeal/brown carbs may take a little longer to digest but eventually their glucose will make its way into your blood.
You can prove this to yourself by testing around your meals.
Test just before you eat your rice and again 2hrs later, the difference between the two results show what that food has done to your levels.
Depending on what the meal was, people who don't have a blood sugar control problem will see their blood sugar return to pre meal levels within the 2hrs.
If there were too many carbs for your body to deal with, your blood sugar will still be elevated for some time longer than the 2hrs.
Because our testing equipment is not as accurate as we would like, it's sensible to allow a 2mmol margin.
This is how many of us (T2's) have managed to reduce or avoid any medication, we use our meters to design a diet that keeps our levels in check.
Ps,
Rice of any colour sends my levels way higher than I like, same for grapes and bananas

 

[Antje77]

Apologies, my "Don't get me started on what to eat" meant me laughing and ranting to myself about the nightmare of choosing something that's ok lol!

Oh, no need to apologise, I'm in the Netherlands so English isn't my first language!
From your post, I see a lot of possibilities, not that picky at all.

I will also too often have cauliflower mash with butter mixed in. Love most vegetables.

I don't see how you can have cauliflower mash with butter in it too often, it's very friendly on blood glucose, a vegetable, and filling as well, especially with enough butter and cream mixed in. It's a staple in my house.

As for the rice, just compare the amount of carbs on a pack of white rice to a pack of basmati, nut that much of a difference in carbs.
Do you like bacon and eggs without the toast for breakfast?

The insulin you take is a basal insulin, it's designed to deal with the glucose your liver produces.
It isn't capable of dealing with the extra glucose from carbs, that's something your own body will have to do.
How many carbs a T2 can handle is highly individual, and that's where all the testing comes in, as @catinahat explained above.

You could for a while keep notes, logging how many carbs you ate with each meal and what your before and after numbers are, this should give you some data to work with.
Using a Libre can give you lots of insights as well. You won't get them funded on a once (or twice) a day insulin, but if you've never used one before you can get a two week free trial to use with a phone app: https://www.freestyle.abbott/uk-en/getting-started/sampling.html

I'll also link a very informative but short piece on food, testing and T2, written by one of our members: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html
Remember, you are on insulin and thus at risk of going too low, especially if you change your eating habits. So ALWAYS keep your meter and some quick acting glucose on you, not only when going out but also next to your bed. No navigating stairs to find food half asleep while having a hypo please.

 

[Melgar]

Depends.
I did an 8 month trial of metformin to see if it would make a difference in my insulin doses (relatively high doses, pretty well controlled diabetes) but I hardly noticed a difference.

Oh right, everyone responds to these drugs differently.