Please help, One x toast x 4hrs = 14.6mmol

HSSS

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This was someone from the hospital diabetic team, i'm still waiting for their consultant to call to discuss matters, i'm hoping something shall be resolved.
Fingers crossed for you. Please make sure they explain exactly what causes the risk of dka if it extends beyond the jardiance you are no longer on, so that you truly understand fully for yourself (and share with us please for our knowledge). Please check it’s not just an “allergy” to low carb in general from the hcp.
 

MillieT

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Update, I've now spoken to the endicrinologist and he was really nice, he was in awe i had been told to eat such things like toast and told me not to, so we're speaking the same language now. I've been put on 500mg of Metformin once a day and started me off on 12 units of Toujeo SoloStar but am now on 16 units with my evening meal, he had asked me to increase it if my sugars didn't go down. So, i've been on this new regime since Tuesday, today i've got up late and my sugars at the moment are at 18.8mmol and i haven't eaten anything yet so again i'm lost feeling hungry but scared to eat anything, even if it's an egg with some bacon i'm sure i'll spike even further, the other day my sugars were on 23.9mmol and that worries me.

I'm speaking with him again this week and hope something comes from it all, i'm tired of feeling horrid.
 

oldgreymare

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Update, I've now spoken to the endicrinologist and he was really nice, he was in awe i had been told to eat such things like toast and told me not to, so we're speaking the same language now. I've been put on 500mg of Metformin once a day and started me off on 12 units of Toujeo SoloStar but am now on 16 units with my evening meal, he had asked me to increase it if my sugars didn't go down. So, i've been on this new regime since Tuesday, today i've got up late and my sugars at the moment are at 18.8mmol and i haven't eaten anything yet so again i'm lost feeling hungry but scared to eat anything, even if it's an egg with some bacon i'm sure i'll spike even further, the other day my sugars were on 23.9mmol and that worries me.

I'm speaking with him again this week and hope something comes from it all, i'm tired of feeling horrid.
It does sound like you've come to the point that insulin is a good idea, but it will take some time to adapt to. Please do eat, (eggs and bacon are safe). Keep up a good testing protocol and if possible lower any carbs further. But don't starve yourself!!
 

MillieT

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Did he rule out LADA?
He hasn't come to a conclusion like one of my gp's had, he seems to be experimenting to find whatever works best for me, he's asked me to try these medications for a few weeks to see if everything settles down but I did tell him i was on insulin for a year perhaps 2-3 years ago and it didn't really do anything for me, hence why i ended up on empagliflozin as seems the only thing so far at reducing my sugars to an acceptable level.

If they haven't gone down by 5pm tonight i'll be on 20 units plus the metformin and I believe I have to carry on this route until they do start to go down, 2 days ago i was at 15mmol which is the lowest i've been since taking this regime, yesterday though i was back up to 18.5 so hence the increase.

I've had egg and bacon and that's it.
 

oldgreymare

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He hasn't come to a conclusion like one of my gp's had, he seems to be experimenting to find whatever works best for me, he's asked me to try these medications for a few weeks to see if everything settles down but I did tell him i was on insulin for a year perhaps 2-3 years ago and it didn't really do anything for me, hence why i ended up on empagliflozin as seems the only thing so far at reducing my sugars to an acceptable level.

If they haven't gone down by 5pm tonight i'll be on 20 units plus the metformin and I believe I have to carry on this route until they do start to go down, 2 days ago i was at 15mmol which is the lowest i've been since taking this regime, yesterday though i was back up to 18.5 so hence the increase.

I've had egg and bacon and that's it.
Check out dietdoctor.com for more tasty low carb meal ideas - it is weird to visit the supermarket isles and to realise how super carb intense most of the content is...
 

MillieT

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I'm finding this all quite unbearable and am literally losing the will to live, i've increased the Solostar to 20 units from 12 and still taking the 500mg of metformin with my evening meal, i woke up at 10.30am like i'd woken from a coma, my eyes were on fire and i feel dreadful, i just took my bloods and am at 17.3mmol so how on earth am i supposed to eat anything... even egg and bacon spikes me, it seems the more i increase the medication, the more my sugars go up and the worse i feel, i've just found one gliclizide and am going to take that, i'll try anything, trouble is that i know for certain that the Jardiance would lower my sugar levels and make me feel better- well, we live in hope.

The trouble is i'm getting side effects from all the medication and they all think i'm nuts- like as if i shouldn't be having them, well they should try and be me for 24hrs because i just can't deal with this anymore, my chest is tight, i'm tearful, i have the worst case of tourettes ever and just feeling so ill I think i'd sooner die than keep feeling like this.
 

Goonergal

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When are you speaking to the endocrinologist again @Millie_ ? It sounded as though he was being helpful. Any chance of bringing the appointment forward?
 

ert

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I'm finding this all quite unbearable and am literally losing the will to live, i've increased the Solostar to 20 units from 12 and still taking the 500mg of metformin with my evening meal, i woke up at 10.30am like i'd woken from a coma, my eyes were on fire and i feel dreadful, i just took my bloods and am at 17.3mmol so how on earth am i supposed to eat anything... even egg and bacon spikes me, it seems the more i increase the medication, the more my sugars go up and the worse i feel, i've just found one gliclizide and am going to take that, i'll try anything, trouble is that i know for certain that the Jardiance would lower my sugar levels and make me feel better- well, we live in hope.

The trouble is i'm getting side effects from all the medication and they all think i'm nuts- like as if i shouldn't be having them, well they should try and be me for 24hrs because i just can't deal with this anymore, my chest is tight, i'm tearful, i have the worst case of tourettes ever and just feeling so ill I think i'd sooner die than keep feeling like this.
Insulin will get your blood sugars down. I hope you get your insulin dosing sorted soon. I see you are only on long-acting. But you may also need fast-acting with your meals before this happens.
 
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MillieT

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Hi all, Thank you again for your kindness and advice, i haven't been about as feeling so ill and i had a blip, last week i really felt so bad that i stopped taking the metformin, i was having debilitating tummy aches, almost like you'd expect to feel if being stabbed, i also felt really wobbly and just odd. After speaking with the endicrinologist he said he was disappointed that i missed a dose and just take the insulin and nothing else, he has said he feels the insulin shall get my sugars down so that i can go back on the Jardiance.

After a dreadful bank holiday i'm starting to lose all faith in this, i've upped my dosage as per his wishes, 4 units per day until my sugars go down. it isn't happening. 24 units yesterday at 8pm only because i was late due to falling asleep, today since i woke up i've stayed on 19.5, i nearly passed out in the shops as had to go food shopping, my right thumb is numb and my feet are tingling too, my right eye felt like it was falling out earlier and since getting back home i'm just about to have my 3rd drink of the day, one coffee and 2 teas and i've still not eaten anything because how the hell can i when they're this high. i just don't understand this part f it all, the terror of eating when sugars are high gives me terrible anxiety. Should i or shouldn't i eat? please if any of you would still feel free to eat something knowing that even egg and bacon shall give to a rise, i'm not due my jab again until 8pm.
 

HSSS

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Has bolusing for meals and food been discussed? Can you ask for a second opinion if you’re not happy with the care you are getting?
 
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Antje77

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i've upped my dosage as per his wishes, 4 units per day until my sugars go down. it isn't happening. 24 units yesterday at 8pm
It can well be it takes longer to find the right dose for you. Some of us, like me, do need much higher doses, and it takes time to work it out in a safe way. If I were to take only 24 units of long acting I'd run very high as well.
I read you are upping your dose at 4 units a day, which sounds quite sensible to me.

I also agree with the above members to speak about mealtime insulin.

Wish you all the best!
 

MillieT

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@Antje77 are you type II aswell? I just wondered, so far the only thing to reduce by bloods to an acceptable level is the jardiance but they won't give it to me until mine are down which may take some time at this rate. Sorry all for being emotional with all this, i'm just tired of feeling ill with it. @HSSS no, nothing like this has been discussed, sorry to sound naive but i've never heard of diabetic bolusing.
 

Antje77

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@Antje77 are you type II aswell?
I'm in the books as a T1, which is most likely correct, according to my specialist and myself. However, I'm also dealing with insulin resistance and using the amount of insulin often seen in T2. For me this means I use close to 100 units of long acting insulin, plus short acting insulin (bolus) before meals and to correct.
MIND: this is what I need, not what you or anyone else needs, the only way to find out your dose safely is to slowly titrate up, like you're doing at the moment!
sorry to sound naive but i've never heard of diabetic bolusing.
Bolusing refers to quick acting or mealtime insulin. The standard way to treat T1 diabetes is to use a basal dose which works over 24 hour, like you do, and then take a quicker acting insulin to cover for meals on top of that. Some T2's use this method as well. However, it all starts with finding the right dose of basal insulin, which is what you are doing at the moment.

This means if I have a meal with little carbs, I take a very small amount or no insulin before the meal, but if I have a larger amount of carbs I take a larger dose of my quick acting insulin.
I also use this bolus insulin when I find my numbers to be unexpecedly high. It works within an hour or two, so I can use it to get it down again.
 
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EllieM

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You've got to remember that they make U300 and U500 insulin at 3 and 5 times the strength of normal insulin, specifically for those T2s who are very insulin resistant. If you need insulin in those quantities then it may well take a while to get there, but you will get there in the end.

But I am puzzled as to why @Millie_ isn't taking any insulin with her meals. Maybe they are waiting until her basal dose is right first?
 
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DavidGrahamJones

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Please please can anyone help enlighten me with any thoughts, I'm not asking for treatment or anything as such, I just want to feel normal whatever that is, i'm tired of feeling dreadful.

I agree with @Antje77, a c-pep would be very useful probably an insulin resistance test as well. I don't know about all NHS doctors, but mine does not give c-pep tests and I should imagine that's on the basis of cost. I paid for my own and found the results useful. Along with the output from a Freestyle Libre, self financed as I'm type II, which has been a godsend.
 
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MillieT

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Just to mention I had been on just Toujeo and the endicrinologist had said for me to restart metformin perhaps 10 days ago, so i collected that prescription and took one empagliflozin with my evening dose and meal which was over 70 grams of carbs and i immediately went into the start of DKA, my sugars were 15 and my ketones went to 0.7, by the morning they were 2.5 and my sugars still 15 but dropping, and lunchtime i started to fight against it and ate some more carbs and an awful lot of water and managed to get them down in 24 hrs.

What i've noticed in this is that every single time my ketones go up, my bloods go down and vice versa, this time though when they were 2.5 i felt ready for my coffin only my head felt like it was going to explode literally and i could barely walk in a straight line.. so because of that i just didn't take anymore empagliflozin and waited the 4-5 days until the consulatant called again. After reading on here i suggested Bolus and he agreed so on another post i've mentioned what i've started on but the results so far aren't very good so far but is early days yet.

Re C Peptide, I had mentioned that in this thread somewhere I believe and that was recent, from memory i think they were slightly elevated but nothing serious.

Please see #18 "my CPeptide result is at 4.09 and my HBA1C is at 88"
 

Peterj12

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Hi, I spoke with the diabetic community nurse this morning and had said i've always suffered from what i think is dawn phenomenon, i.e. this morning when I woke up i was on 13.7mmol and as such didn't wish to eat any carbs because I just don't wish to go any higher, sugars over 9mmol affect me really badly so hence why before i feel happier trying keto. Anyhow, when we spoke she said to double my dosage of Gliclazide to 2 x 80mg on a morning and see how I go and that I must eat some carbs to balance it out so that i don't return to Dka.

So, I took 2 x 80mg of Gliclazide, as anticipated and I told her if i eat 1 slice of toast I pass out soon afterwards and need to sleep for an hour or two and usually, i feel ok when I wake up again, however, I've slept for 2.5 hours and been up a further 45 minutes and my sugars are now on 14.6mmol.. this just cannot be right, i done as she required and had 1 slice of wholegrain toasted bread with egg. My chest is tight, i feel like my head is going to explode and my eyes are being forced out, I feel sick and very dizzy, my ketones are just 0.2mmol.

14.6mmol for me is like a non diabetic having 2-3 bottles of wine or a few shots, i'm not sure where to go with this, she has ordered me another weekly shot of dulaglutide for Friday- not sure i want any of it to be honest, sadly, the best i've felt for a long time was when i first go into ketosis on a low - 0 carb diet.

Please please can anyone help enlighten me with any thoughts, I'm not asking for treatment or anything as such, I just want to feel normal whatever that is, i'm tired of feeling dreadful.

Hi Everyone I am a type 2 diabetic and on insulin twice a day .
When I have my Breakfast I Do my blood sugars before the Breakfast and sometimes they are 9.4 and other times they are anything up to 19.5
I recently did a test of my own, If I Didn't have toast the night before I went to bed my readings were 6.7 to 9.4 if I didn't have toast with Flora spread which Flora says doesn't affect Blood Sugars. Well with the tests I have done over the last month If I don't have toast with Flora spread on the toast it was anything between 6.7 to 9.4.
But if I had 2 slices of Toast with Flora spread on my toast then my blood sugars were anything between 11.0 up to 25.4. Which I know is dangerously high. Flora company says that Flora doesn't effect Blood Sugars and its safe for diabetics to use.
But going by the tests results that I have done it doesn't back up Flora company claim. I know that Diabetes UK have questioned The company that makes Flora spread if it affects Diabetes and the answer was no.
But I am quite sure that it doe's play on the blood sugars readings.
Has anyone else had Flora on toast or bread and it has sent your blood sugars sky-high? Peter

(Mod edit for clarity)
 
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KK123

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Hi @Millie_ I hope you're feeling ok, if you can please let us know how things are going. x
 

KK123

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Hi Everyone I am a type 2 diabetic and on insulin twice a day .
When I have my Breakfast I Do my blood sugars before the Breakfast and sometimes they are 9.4 and other times they are anything up to 19.5
I recently did a test of my own, If I Didn't have toast the night before I went to bed my readings were 6.7 to 9.4 if I didn't have toast with Flora spread which Flora says doesn't affect Blood Sugars. Well with the tests I have done over the last month If I don't have toast with Flora spread on the toast it was anything between 6.7 to 9.4.
But if I had 2 slices of Toast with Flora spread on my toast then my blood sugars were anything between 11.0 up to 25.4. Which I know is dangerously high. Flora company says that Flora doesn't effect Blood Sugars and its safe for diabetics to use.
But going by the tests results that I have done it doesn't back up Flora company claim. I know that Diabetes UK have questioned The company that makes Flora spread if it affects Diabetes and the answer was no.
But I am quite sure that it doe's play on the blood sugars readings.
Has anyone else had Flora on toast or bread and it has sent your blood sugars sky-high? Peter

Hi Peter, to put it bluntly, forget the Flora, it's the TOAST! I realise of course that you have done your experimenting and Flora appears to send you higher when it's on your toast than when it's not but I reckon if you did a test with a spoonful of flora and NO toast you'd see what the flora on its own did to you. Also you might be better off asking the mods to start a new post for you?