How do you manage a 14 hour fast when on insulin?

Meg2009Arm

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I have my annual diabetes review in a few weeks so need to get my bloods done and this is the second year running since I have been on insulin and I remember last year I had to abandon my first attempt at fasting because of a hypo. I think in the end I just had to forego using insulin with my last meal before starting the fast. Has anyone else struggled with this?

Cheers
Meg
 

Andy12345

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hi, on the leaflet they give me about fasting it says you cant fast that long if type one and they do a non fasting test instead but im sure others will know more (im t2)
 

Meg2009Arm

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Hi Andy
They're not sure but have labelled me type 2. It's hereditory in my family and I managed to control it with diet and metformin for a few years after being diagnosed in pregnancy. My doctor didn't really know what to tell me when I asked her how I was suposed to fast! In the end she suggested not taking any for my last meal. Think I will do that again and just stick to a very low carb option.
 

noblehead

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Meg2009Arm said:
I have my annual diabetes review in a few weeks so need to get my bloods done and this is the second year running since I have been on insulin and I remember last year I had to abandon my first attempt at fasting because of a hypo. I think in the end I just had to forego using insulin with my last meal before starting the fast. Has anyone else struggled with this?

Cheers
Meg


Not sure why you would need to fast for 14 hours Meg :? A fasting cholesterol check only requires you to fast for 12 hours max, my own surgery say 10 hours is sufficient.

I just eat and inject as normal the night before and obviously skip breakfast and any QA insulin, I've not really had many problems except once where I did go low before bed, if you like you could reduce your evening QA by a unit or two to avoid a hypo and to make sure you keep the appointment.
 

Andy12345

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hehe i knew someone clever would happen by :thumbup:
 

Meg2009Arm

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I'm not sure why but they used to ask for 12 hour fasting and now say 14! If I only reduced my insulin by 2 units before evening meal I'd still struggle. Will just keep carbs very low. Skipping breakfast is not a problem until after the test.
 

donnellysdogs

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Try to get an early morning appt for blood tests and just fast overnight??.... The only blood test I 've needed to fast for was cholesterol not hba1c for diabetes.
 

iHs

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If a blood test is being done within a hospital pathology dept, then getting an appointment might be difficult as many departments just work on take a ticket and wait your turn and depending on how many people are waiting, the test might take 1-3hrs to do and so for insulin dependant diabetics its thought that fasting is not necessary unless a doctor states it at the top of the blood test form in bold letters and also explains what is required to the patient. For diabetics using twice daily insulins and not mdi, blood glucose levels could go very high without insulin and food.
 

mentat

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I'm Type 1 and have done some 24 hour fasts without a problem. You do need to be careful (don't fast that long if you're alone), as once your liver runs out of stored sugar it's much harder for your body to recover from a hypo.

When you don't have a lot of extra insulin in your system, your body automatically increases blood sugar before it gets too low. So the main danger is going hypo while your last injection of fast-acting insulin is still acting.

If you take long-acting insulin, you may want to reduce the dosage somewhat before the fast. If your sugar goes high you can always inject correction dosages of fast-acting insulin (whereas if it goes too low you have to break the fast).

I suggest you try it once a few days in advance to see how your body reacts and adjust your insulin appropriately the next time you try.

Cheers
 

noblehead

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Meg2009Arm said:
I'm not sure why but they used to ask for 12 hour fasting and now say 14! If I only reduced my insulin by 2 units before evening meal I'd still struggle. Will just keep carbs very low. Skipping breakfast is not a problem until after the test.


Don't forget if you keep the carbs low you also need to lower your QA insulin, if they insist on 14 hours then I would do so.
 

CarrieB

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Its very unusual to be asked to do a fasting bloods when you're on insulin, however lots of professionals (who should know better) don't understand that type 2s can be on insulin.

When anyone tells me I need fasting bloods done I gently remind them I'm on insulin and they generally apologise and say it will be a non-fasting reading.

Don't be afraid to question anything that doesn't sound right to you.
 

noblehead

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CarrieB said:
Its very unusual to be asked to do a fasting bloods when you're on insulin.

Not at all Carrie, if you want a full lipid breakdown of your cholesterol then fasting is the only way. There was some reporting last year that fasting wasn't necessary but the general opinion among the medical profession is that you do, anyway for people like myself on basal/bolus it isn't a problem as long as you know what your doing.