I have been diabetic for some years now. Initially this was controlled by Gliclazide but as time went on I ended up taking this together with Metformin and then Saxagliptin and Metformin and finally Pioglitazone and Metformin in order to control my BS. All of these worked for some time but slowly and surely my BS rose to an average of about 10. Doctor said that the only alternative at that stage was to opt for insulin control and I started with some Insulatard at night which didn't really help increasing the dose from 2 units up to 10 units per night. A decision was then taken to supplement this with rapid acting insulin, Novorapid after each meal, again starting off with 4 units and rising in 2 unit increments every three days but only for one of the injections at a time, i.e. breakfast, lunch or dinner. The amount I now inject is 22 units with breakfast, 14 units with lunch and 18 units with dinner. This is slowly beginning to work although two hours after my meal my bloods can still be 11+. However before my next meal they can be as low as 4.4. This brings me to my point. If I increase the dose to get the a BS level of 8 after a meal this will have an effect on the pre-meal readings which are quite low already and, I assume, would get even lower. The doctor thinks that I may have to have a snack between meals to raise the BS but this just adds to the effect of weight gain by eating more. I eat fairly little in any case but have gained about a stone in weight since taking the insulin. I try to do exercise each day always wary of the effect that the insulin can now have on my BS. Is there anyone out there that has had a similar experience and can pass on any advice on this.
New(ish) to Insulin
- Thread starter oldgent
- Start Date
Hi
I'm in a similar situation but having smaller units than you. The decision to put mew on insulin was due to me having to be very restrictive and controled with my diet to keep my BS at a reasonable 6-8 after meals whe I was taking SR Metformin and Stigliptin for a few years after being diagonosed 4 years ago whilst pregnant. My weight dropped too low so my BMI was 17.
I started on Novorapid, then went onto Insuman Rapid but as with the Novorapid if I get my post meal readings good I fall very low between meals so have to eat between breakfast and Lunch, Lunch and Dinner and before bed! Yes I am also worried about weight gain as I am now a weight I would like to stay at (60kg) My consultant told me last Monday to try a slow acting 'background' insulin late at night and try lowering my fast acting units before meals. I have done this for a week and have found no difference. I'm still snacking (mainly apples, so fed up of them now!) often and have the occasional hypo in the night. I have to get back to my consultant to let her know how it's going. I suspect she'll tell me to increase the background units and see what happens then. I'm sure I'm loosing some of the feeling in my fingers from testing so often ( at least 4 times a day).
I also exercise and this only makes the situation worse. I was tiold to take jelly babies with me if exercising to avoid hypos.
I'm sorry I can't give you the solution but your not alone. Every time I have a meeting with a doctor or consultant they looked puzzled and say 'well you are a unique case'. Maybe so, but not very helpful
If you get any good advice please let me know and I'll dfo the same for you. Good Luck!
Meg
I'm in a similar situation but having smaller units than you. The decision to put mew on insulin was due to me having to be very restrictive and controled with my diet to keep my BS at a reasonable 6-8 after meals whe I was taking SR Metformin and Stigliptin for a few years after being diagonosed 4 years ago whilst pregnant. My weight dropped too low so my BMI was 17.
I started on Novorapid, then went onto Insuman Rapid but as with the Novorapid if I get my post meal readings good I fall very low between meals so have to eat between breakfast and Lunch, Lunch and Dinner and before bed! Yes I am also worried about weight gain as I am now a weight I would like to stay at (60kg) My consultant told me last Monday to try a slow acting 'background' insulin late at night and try lowering my fast acting units before meals. I have done this for a week and have found no difference. I'm still snacking (mainly apples, so fed up of them now!) often and have the occasional hypo in the night. I have to get back to my consultant to let her know how it's going. I suspect she'll tell me to increase the background units and see what happens then. I'm sure I'm loosing some of the feeling in my fingers from testing so often ( at least 4 times a day).
I also exercise and this only makes the situation worse. I was tiold to take jelly babies with me if exercising to avoid hypos.
I'm sorry I can't give you the solution but your not alone. Every time I have a meeting with a doctor or consultant they looked puzzled and say 'well you are a unique case'. Maybe so, but not very helpful
If you get any good advice please let me know and I'll dfo the same for you. Good Luck!
Meg
Hi Meg
Thanks for your response. Since my last post I have had another discussion with the diabetic specialist at my surgery but it really has not sorted anything out at all. I am now taking 24 units novorapid at breakfast, 20 at lunch time and 20 at dinner with 10 units Insulatard at night as the long acting variety. My bloods after each meal vary from 8.4 up to 11.6 but according to the specialist I should be aiming for about 8 two hours after eating. My pre-meal figures are hovering around 5 to as low as 4.2 and so there is not much room for manoeuvre any more. His last comments to me were of the ilk, "well we are getting quite close so adjust the amount taken by one unit at a time to see if things can be improved.....I will see you after your check up in October." So in essence it appears that near enough is good enough although this leaves me feeling a little ignored and overlooked... I intend to play with the units to see if I can get any better post meal results but it appears I am left on my own to do this. As for my fingers, he has me testing pre and post every meal and one in the evening resulting in 7 tests per day. I am looking forward to getting some stability and not having to test so much. I will let you know how things develop.
Thanks for your response. Since my last post I have had another discussion with the diabetic specialist at my surgery but it really has not sorted anything out at all. I am now taking 24 units novorapid at breakfast, 20 at lunch time and 20 at dinner with 10 units Insulatard at night as the long acting variety. My bloods after each meal vary from 8.4 up to 11.6 but according to the specialist I should be aiming for about 8 two hours after eating. My pre-meal figures are hovering around 5 to as low as 4.2 and so there is not much room for manoeuvre any more. His last comments to me were of the ilk, "well we are getting quite close so adjust the amount taken by one unit at a time to see if things can be improved.....I will see you after your check up in October." So in essence it appears that near enough is good enough although this leaves me feeling a little ignored and overlooked... I intend to play with the units to see if I can get any better post meal results but it appears I am left on my own to do this. As for my fingers, he has me testing pre and post every meal and one in the evening resulting in 7 tests per day. I am looking forward to getting some stability and not having to test so much. I will let you know how things develop.
Hi Oldgent
Out of interest what kind of things do you eat? I pretty much stick too wholemeal bread and never more than two slices per meal. also wholewheat pasta, brown rice etc. And in general I try to keep my carb portions fairly small (certainly much smaller than I used too)
It's interesting that they tried you on the background insulin first then added rapid acting afterwards. It was the other way round with me.
I also am looking forward to some stability, I feel abit like a guinea pig at the moment. Not that it's anyone fault just frustrating! :|
Out of interest what kind of things do you eat? I pretty much stick too wholemeal bread and never more than two slices per meal. also wholewheat pasta, brown rice etc. And in general I try to keep my carb portions fairly small (certainly much smaller than I used too)
It's interesting that they tried you on the background insulin first then added rapid acting afterwards. It was the other way round with me.
I also am looking forward to some stability, I feel abit like a guinea pig at the moment. Not that it's anyone fault just frustrating! :|
I have tried to keep my meals similar in both quantity and content so that I can get a "feel" for how the insulin is working so I have two slices of seeded toast for breakfast, a sandwich and a piece of fruit for lunch and an evening meal with either a small portion of potato or rice dependent on the content of the meal. I eat nothing after dinner until the following morning. My blood sugars after breakfast are currently between 9.4 and 11.6, after lunch 11ish and after the evening meal they are now good at about 7.5ish. So that's one down with another two to adjust. It is the instability of it all that is the most distressing because I recently had two post breakfast meal reading of 8.5 and 9.2 but on the next day it was 11.6 despite having exactly the same for breakfast and exactly the same dose of insulin. We have to factor in the inaccuracy of the meter but it is still quite a difference. I will keep you posted. The reason that the doctor decided to go for the slow acting insulin first is that he thought that this alone would control my bloods, he quickly prescribed Novorapid when it was certainly not the case.
I find my post breakfast reading is always the hardest to get right. if I have 11 units I can usually keep it around 6-7 but if I have 10 it can go up to 14! Also like you, you get it right one day and then the next it's different even with the same food and units. I seem OK after lunch and dinner generally between 5-7. I'm going to try to up my exercise and make sure I stick to eating the healthy snacks between meals to prevent hypo's so hopefully I won't put on anymore weight.
