New to insulin

pamela59

Member
Messages
6
My husband has started insulin and doesn't seem to be getting any benefit and feels worse than when he was just on Metformin. His readings were middle 20's and now are coming down to 11 in the morning but still rises to middle 20's before bed. He is on one insulin for all day release about 24units and he takes another type of insulin 3 times a day with meals about 20 units. Although he is Type 2 it appears he has been lead down the Type 1 route or is this normal. It's such a minefield trying to get my head around it to support my husband. Any advice very welcome.
 

catapillar

Well-Known Member
Messages
3,390
Type of diabetes
Type 1
Treatment type
Insulin
If your husband has been in the 20s for a long time as his numbers get lower he could feel unwell as his body is used to being very high and, wrongly, thinks these lower numbers are hypos. Hopefully his health care team is avoiding this by gradually strepping his numbers down.

He's not "being led down the type 1 route", he is a type 2 diabetic treated with insulin.

If he is on fixed doses he will need to understand that those fixed doses can only deal with a certain amount of carbs. He should seek advice from his DSN or dietician on what they think that is.
 

Alison Campbell

Well-Known Member
Messages
1,443
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi and welcome to the forum. I am notifying @daisy1 for a new member post for you.

It's great that you are trying to get your head around this. Type 1 and 2 are very different conditions and have different treatments. Even types of insulin and doses are different between the types.

If you have not found it yet, this section of the forum will provide most info and experience of type 2 and insulin:

https://www.diabetes.co.uk/forum/category/type-2-with-insulin.57/
 

pamela59

Member
Messages
6
My husband has started insulin and doesn't seem to be getting any benefit and feels worse than when he was just on Metformin. His readings were middle 20's and now are coming down to 11 in the morning but still rises to middle 20's before bed. He is on one insulin for all day release about 24units and he takes another type of insulin 3 times a day with meals about 20 units. Although he is Type 2 it appears he has been lead down the Type 1 route or is this normal. It's such a minefield trying to get my head around it to support my husband. Any advice very welcome.
Thank you that's really helpful on 11 he has felt worse and we couldn't understand why he felt better when high. Slowly does it then.
 

donnellysdogs

Master
Messages
13,233
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
People that can't listen to other people's opinions.
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It sounds like hubby is an insulin dependent patient.
So really very little difference between a T1 and T2 in this scenario.

Your husband will not feel better until his bloods return to under 8.0. And this should be slowly done to reduce the risk of retinopathy.

He needs to have a 3 daily chat with a dsn to adjust doses and take gradual control and understanding of dose adjustment and carb counting..
 
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pamela59

Member
Messages
6
It sounds like hubby is an insulin dependent patient.
So really very little difference between a T1 and T2 in this scenario.

Your husband will not feel better until his bloods return to under 8.0. And this should be slowly done to reduce the risk of retinopathy.

He needs to have a 3 daily chat with a dsn to adjust doses and take gradual control and understanding of dose adjustment and carb counting..
Thank you will do, this hasn't really been explained to him in this way. Much appreciated.
 

donnellysdogs

Master
Messages
13,233
Type of diabetes
Type 1
Treatment type
Pump
Dislikes
People that can't listen to other people's opinions.
People that can't say sorry.
Levels do need to lower down to under 8.0 but its hard for any nurse to set up a starting dosage... it all depends upon weight, activity, lifestyle etc. We are all unique.

Whoever cooks and feeds needs to get their head around carb counting as that will help enormously.

If hubby drives he must always test before he drives and at least 2hourly thereafter. He must notify dvla.

Feeling unwell being lower with bloods will pass... ask nurse for eye scans asap.
Make sure he looks after his feet. No walking barefoot anywhere.

I dont know the exact guidelines for timeline for lowering bloods to under 8.0 but he needs to have at least two ohone chats or appts each week until his bloods are under 8.0 consistently.

He should have been given a blood/food log book for readings etc. Make sure these are done and taken to any appointments.

The more learning he does for himself the better...

As a partner you need to also be able to carb count and read food labels accurately for carbs. You also need to know what to do if your husband goes hypo and what his symotoms are... and how to help him. He will have to always have hypo stopoers with him when going our.

Sure some T2 insulin dependents will be along soon.

Its scarey to start iff with but you both need to gain undestanding and ideally go to appointments etc together..
 

daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
@pamela59

Hello Pamela and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 

h884

Well-Known Member
Messages
385
Type of diabetes
Type 1
Treatment type
Pump
I am also relatively new to insulin. I also started on once daily but have now progressed to long acting in the
morning and 3 lots of short acting with meals. There will be a lot of adjusting of doses. It will take time.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. You don't say whether the mealtime Bolus dose is fixed or varied to match the mealtime carbs? Varying the dose called carb-counting is necessary to get the best control and food flexibility. If your husband has some excess weight then that may reduce the insulin effectiveness. With excess weight and T2 there will be insulin resistance which prevents the insulin working well. He may already have too much insulin if there is excess weight. A low-carb diet is essential to get any weight down - I'm guessing of course. If he has lost weight recently without trying then Late onset T1 (LADA) is always possible.