Insulin and Honeymooning: tips for a Newbie

[Andrea _NuBe]

Hi everyone,

Thought it was about time I introduced myself, I’m Andrea.

First and foremost, I’d like to thank all those who offer advice on this forum, it has been incredibly valuable to my journey so far.

So my diabetes journey started in August 2018 when I had a blood test after having repeated thrush. Soon I was diagnosed with type 2 diabetes after having a HBA1c of 98. I couldn't get my head round it, I had no other symptoms, I’m 33, I eat fairly healthily (I have a bmi of 25) and every specialist I saw appeared bemused.

I asked for a GAD test, got the result back which came back as they were positive, recently got my islet cell test results back which was also positive. My HBA1c has reduced to 60 (as of December 2018)

So now I am being treated as a Type 1/LADA but DSN and doctor say I may never get a clear diagnosis. Although I’ve found it challenging to accept, I’m trying not to let it consume my life.

Yesterday I had my appointment with DSN and have started on Novorapid insulin which I take 3 times a day with each meal. I’ve always been anxious around injection, it’s taking me a while to psych myself up, I’m 4 injections in now, does anyone have any tips on getting use to the injecting yourself, making it as painless as possible, any spots on the body better than others?

I’m really keen (as I’m sure all newbies are) to preserve the functioning beta cells I have left, hence my move to insulin. Anyone have any idea on prolonging the honeymoon period? I have read a few papers on about starting on insulin asap but that’s about all I can find.

Any advice, much appreciated

Andrea

 

[Providence 62]

I can only speak for myself, but I use my belly for my jabs (2 daily) as long as you stay away from the central line of your tum it will be less ouch-y, apparently there are less nerves towards the sides. One thing I found that really stopped any stings or ouchies making sure I grabbed a good bit of skin between finger and thumb. It's virtually painless for me doing it that way.

Hope this helps. I have been injecting for about three months now, so am by no means an expert.

P

 

[Juicyj]

Hello @Andrea _NuBe and welcome

I remember having the exact same thoughts as you about prolonging my honeymoon period, thinking it would be easier to cope with taking smaller amounts of insulin, however I found my control very hard after a few months simply because my levels were erratic and it affected my mood, the truth was that once my pancreas stopped working that things levelled out more and my control was much easier. In regards to injections try not to fixate on the act itself so much, so use a distraction technique, look at a clock or hum a tune as you pinch an inch and inject to the count of ten, always keep insulin at room temperature too, from the fridge and it will sting and trust me injecting does get a lot easier in time, soon you will do it without much thought.

Also keep talking to those around you or here, support is vital. Best wishes J.

 

[Daibell]

Hi and welcome. I've not heard of any way to lengthen the honeymoon period other than starting insulin earlier rather than later. You should be injecting in the stomach area avoiding the centre. You will find over time the nerves deaden which makes life easier. As you have positive test results you are T1/LADA and the GPs should accept the test and not be so silly. How do they think every other T1 has a confirmed diagnosis? As you go thru the honeymoon period and you need more insulin you should be put onto full Basal/Bolus by adding the daily Basal. This is the NICE standard for T1s, so do ask for it as your BS controls becomes more difficult.

 

[Andrea _NuBe]

Thanks @Juicyj @Providence 62 and @Daibell for your responses
Maybe that's where I'm going wrong, I haven't been grabbing a bit of tummy to inject, I'll try that and see if it helps!
At the moment I am on a fixed amount of insulin, I do wonder how it will pan out once I return to work and have a little less control over when I eat and may eat out more.
Yes so I've done a fair amount of reading around the different types of diabetes, LADA does seemed to fit.
Thanks again

 

[Juicyj]

Hello @Andrea _NuBe

Yes always grab and inch, it's the easiest way to inject, like anything new it will get easier in time.

At some point in the future rather than taking fixed amounts of insulin you can learn to carb count and take (bolus) fast acting insulin to cover food and for corrections and a (basal) long lasting insulin to cover your bodies needs over 24 hours, it gives you much better control over managing fluctuating blood glucose levels and over what you can eat, but this is a conversation you can have with your DSN in the future if you feel this would suit you better.

 

[NewlyLADA]

Hello @andrea_NuBe
America does the process backwards they start you in Basel 24 hour dose so it works in the background then as you lose the good cells and need insulin to eat they start you in carb counting/ fixed units prior to eating (fast acting)
I am still learning and I have not started my fast acting yet I’m still eating less and controlling it with the 24 hour Basel.
I have read the same as everyone else about the honeymoon phase .. insulin helps... glad you had the right tests
done it was a confusing mess for me to get the dr’s to find out what was going on. I was just diagnosed in December, then in January I received insulin and was diagnosed with LADA, after about a month my nausea went away and my ketones were gone. The high ketones is what lead the dr’s to the conclusion of the LADA or type 1.5

 

[Marie 2]

I have heard insulin helps, my original endo had also said there is a drug available that could have helped slow down the process too but that it was too late to help me. I was misdiagnosed for years and already on insulin for years. It is honestly easier once you aren't making any because of the fluctuations that occur during the honeymoon phase.

But pinch up an area to inject, I used to like the area below my belly button the best, just change areas so you don't get any scar build up. You can distract yourself when giving the shot by focusing on tapping your foot or scratching your skin with your pinky finger. I never minded the shots, but sometimes I hit a nerve and it was useful, that happens!

 

[Andrea _NuBe]

Thanks everyone for your advice, it's helped a lot.

I had been trying to inject without pinching the skin as the nurse had suggested but it's far less painful to pinch!

@Marie 2 sorry to hear that you were misdiagnosed for so long that must have been frustrating and unfortunately it doesn't sound uncommon.

Just to give a little update. I'm still honeymooning, my doctor has now said I'm a Type 1 rather than 1.5. I am now taking basel and bolus insulin, I'm calorie counting so eating more freely which helps me feel like my old self again! I've stopped religiously logging my blood glucose 4 times a day (which has also been freeing) although I still check regularly before meals. Plus my HbA1c is now down to 44 (April 2019), it was originally 98 back in August (2018), so I am pleased with my progress so far.

Thanks again for the support

 

[Lynnzhealth]

Hello @andrea_NuBe
America does the process backwards they start you in Basel 24 hour dose so it works in the background then as you lose the good cells and need insulin to eat they start you in carb counting/ fixed units prior to eating (fast acting)
I am still learning and I have not started my fast acting yet I’m still eating less and controlling it with the 24 hour Basel.
I have read the same as everyone else about the honeymoon phase .. insulin helps... glad you had the right tests
done it was a confusing mess for me to get the dr’s to find out what was going on. I was just diagnosed in December, then in January I received insulin and was diagnosed with LADA, after about a month my nausea went away and my ketones were gone. The high ketones is what lead the dr’s to the conclusion of the LADA or type 1.5

It's a confusing mess for me, too. I was diagnosed T2 in 2017, at 69. I just went on insulin in May, but still not sure if I'm T2 or LADA since my DKA episode in May, with sugars at 23 and high ketones, when I went to ER I'm awaiting the blood work results so the specialists can determine which type I am. I have to say that I feel much better since starting the insulin. It has been reduced a few times in the last few weeks, however, I'm still being 'encouraged' to eat carbs. I did have my A1C controlled while on the LCHF regimen, however, my hospital stay damaged that. I really need to get myself back to the LCHF lifestyle and I'm sure I'll feel even better. I walk the dog a lot for exercise, along with grass cutting, etc. I have been doing plenty of reading up on T1 and LADA, just in case. It was overwhelming at first because I was treated one way for two years, then a total switch occurred. I just want it figured out so I can get on with life. Good luck all.

 

[ert]

Dr K Bernstein suggests aiming and thrusting like a dart at 45 degrees. And avoid the navel area by 3 inches either side. Day three using insulin. First day of short-acting. 7 injections today. Two long-acting, morning and night. Two BS corrections with short-acting Fiasp. Then two before meals, one an hour and a half after due to HF content. My skin leaves a red spot so I know where I've been to keep moving.
My nurse disliked the idea of LCHF enormously, so I kept rather quiet. My consultant is keeping tabs on me. There were a few tears tonight after I was asked by someone why I couldn't just have one injection.

 

[NaijaChick]

I can not recommend the tickleflex enough. You have to go in slow but you don’t feel the needle going in, you may feel the sting of the insulin but that just lets you know that you’re in. Also if you can afford it then you could try the iPort advance, buy it direct from the manufacturer. Sorry about everything and good luck

 

[Gaffer type 1]

I use top of the thigh and buttock more than the tummy once you have done it a few times it becomes second nature.
Best to alternate between injected areas so you don't get fatty lumps and it can eventually interfere with insulin absorption
I tried my arm once never again... Good luck

 

[Swillbos]

Hope you're now confident and now thriving on your regime Andrea. The LADA diagnosis is quite perplexing. I am still waiting for my blood test results, but I wonder if anyone can say with any certainty what proportion of diabetics are LADA? Presumably a fair chunk of folk will be labelled Type 1 and others Type 2 depending on whether certain tests are undertaken and how individual health professionals interpret the results?