Premix insulin and low carb - advice please.

[lilibet]

Evenin all

Following low carb debate with interest and have couple of questions re same and also re insulin. Apologise in advance for any questions that might seem daft! Am on premix and desperate to get things under better control
Insulin has been cut (likely honeymooning - and I cant tell you how much I HATE that phrase) in the morning but cant seem to gain consistency- though fasting readings generally getting better. Unsure if this is down to

-newbie status - ie things still settling (diagnosed 3 wks ago)

-Insulin regimen - seems to peak mid morning (bout 4 or so hours after injection) and is always around 4. something, now matter what I eat in the morning. Have tried avoiding recommended mid morning snack and having lunch early but no change. Although not 'medical' hypo, is hypoish for me and therefore quite disabling.
However, pre dinner or mid afternoon, readings are high again as presumably insulin 'wearing off'. Seems a bit lower at bed after tea time but not consistent. If high ish, am not eating snack pre bed. Or if im hungy im just having cheese/slice chicken etc.
Have cut carb portions and all others are low GI,-avoiding potatoes, noodles, most cereals but still eating some carbs. Made scotch broth recently - wont be eating that again even if barley is super duper GI food!!
Cant actually believe how much bloody carbs are in EVERYTHING. Family and friends are sick already of my 'ooh, do you know how many carbs are in that proclamations .

So (finally she gets to the point........) is it worth starting to look more closely at them whilst I am still settling, or should I wait? Do other carb counters count veg and fruit as part of calculation or is it just starchy carb type things. Also, am I correct in assuming it is total carbs and not ' of which sugars' only that is counted. Also, do most folk start on premix and then move to basal/bolus. Not sure if increased jagging would put a smile on my face but consistent and ongoing good bs would. Havent yet met with endocrinologist and it is the first question I will be asking - esp given I was seen by 4 different docs with 4 different approaches during my first 12 hours of being diabetic!!

Sorry for the scope of the questioning. I appreciate things are very individual but the experience of others is invaluable as this site has shown time and time again, and might give me different things to try if I dont get things as I like.

Thanks in advance,

lillibet

 

[CLP]

Hi

I am by NO MEANS an expert. However am currently on a premixed insulin (novomix 30), having been diagnosed at end of Feb this year. In a couple of weeks I'm moving on to a basal/bolus as this will give me far more flexibility.

Hopefully what I have experienced might help you somewhat. Just for your info I'm taking 10 units of novomix 30 before breakfast and tea. So it is VERY roughly 3 units of fast acting to cover breakfast and 3 for tea.

I have managed to cut down the carbs and get fairly good readings. But its quite tricky as you have to have some carbs - but not too much!! I have carbs for breakfast (usually 2 small pieces of toast (20g carb) but then try and have as little carbs as possible at lunch - which means that I have salad at lunchtime - but no starchy carbs (bread etc). The carbs at breakfast usually make sure I don't drop too low before lunch (but I have to keep an eye on it) - for instance today I was 4.8 at 10am and I know that if I don't have a snack I'll be hypo before lunch (I find an apple keeps me going till 12). If am I a little high before lunch I try and get a 30 minute walk in afterwards. So if you did want a sandwich at lunchtime a walk could help you bring your readings down in the afternoon.

I do also find that my readings can go up a bit in the late afternoon/early evening (even without eating anything). The walk at lunchtime can help with that as well, as even if they do go up a bit the walk should mean you are lower to start off with.

In the evening I have my insulin and try and have about 30g carb and if I've had too much carb and go on my exercise bike, if not enough then have some supper. You are right that theres carb in so many things so I've ended up making from scratch most meals. As I have to have some carbs I tend to have a few small potatoes, very small potion rice, 2 pieces bread. Trying to make sure that it matches the fast acting insulin I've just taken. I have a carb counter book and do count vegetables and fruit (definately), even if they don't contain starchy carb.

Hope this hasn't been too waffely. You should find that things settle down a bit but it can take a little time.

If you find that mixed insulin doesn't suit you then ask your DN about basal bolus.

 

[Stuboy]

im not an "expert" either.

But my advice would be to get off of the mixed insulin and onto Basal Bolus regimen.

The thing with mixed insulin is that you end up having to feed the insulin, rather than feed yourself and take the required insulin to cover for that food.

Because it's covering your background needs, you really need to take enough to cover that, and the whatever the ratio of rapid insulin that comes with that background requirement needs to be covered by food.

It's an ideal solution for people who live by a fixed routine and dont need or want flexibility... like the elderly for example living in a retirment home... they probably get up at the same time each day, each at the same time, do pretty much the same activities... go to bed at the same time...you get the idea.

With basal and bolus you have the power to eat what you like in effect, low carb or not, even skip a meal if you want.

I have been on mixed insulin and hated it with a passion (and i didn't know any better then either!) was much happier on MDI... but now hoping to go that one step further onto a pump!

 

[Stuboy]

oh yeh... to answer some of your questions... lol...

It is total carbs that you want to count... not of which sugars. SOME people subtract the protein but most of those people use a pump and have the ability to deliver TINY doses of insulin (0.05U).

I do not count veg... such as broccoli, cauliflour, sweetcorn (hi in carb but you dont digest hardly any of it), carrots, peas... those sort of veg....

DO count route veg like potato's, parsnips, turnips etc.

Pasta is a pain, but if you can learn how to handle it with MDI is a doddle. Pasta tends to hit you twice on the carb:blood sugar front. once when you eat it and again 2-3 hours later.

Fruit you should count for as well... natural sugars still affect you!