Type 2 diabetes on insulin

[pollyr]

Hi everyone
I was diagnosed T2 about 10 yrs ago and was taking 2 x 500 metformin and glicazide until I had a severe acute pancreatic attack six years ago as a result of gall stones. I am now prescribed Humalog Mix25 insulin and 4 x 500 metformin. Starting with 6 units x 2 injections daily it has now reached 28units x 2. This was to keep my HBAlc below 7mmol.

Problem is I am having to eat larger and more frequent amounts of food to avoid almost daily hypos. The result is I am one stone heavier that I have ever been now at 10st7lbs. I am retired and do not feel comfortable with the extra weight. I am very active, walking twice daily, gardening, decorating and general housework etc. Also the hypos are getting worse, sometimes happening during the night and at times when I am not home. They make me feel ill for about an hour afterwards and I am getting quite upset and depressed by the whole situation. Yearly podiatry and eye checks are always good and I have no history of cholesterol or heart problems. I do not now have a DSN to ask for help.

I am seriously considering stopping taking the insulin as it is quite possible, I suspect, that my damaged pancreas could produce insulin, I would be happy to have suggestions and feedback from members of the forum as to how they would deal with my problems.

Thank you
Polly

 

[mrman]

If your regularly eating extra to treat/avoid hypos, then your hanving too much insulin. Do you test your levels often? What sort of numbers do you have pre meal and 2 hours after, and morning before breakfast.

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[pollyr]

Hi Brett and thank you for your very quick reply. I test usually 2 to 3 times daily. AM- before breakfast is 7 - 9. Pre meal usually 5 - 8 or 9. A little higher after dealing with a hypo. Post meal 7 - 8 though it normally goes really low if I don't eat before bed. Three hours after my breakfast of coffee and toast today it was 2.7 and really makes me ill to the point I can hardly function. My meter shows the 7, 14 and 30 day average and it is currently about 7.6.

 

[mrman]

Hi Brett and thank you for your very quick reply. I test usually 2 to 3 times daily. AM- before breakfast is 7 - 9. Pre meal usually 5 - 8 or 9. A little higher after dealing with a hypo. Post meal 7 - 8 though it normally goes really low if I don't eat before bed. Three hours after my breakfast of coffee and toast today it was 2.7 and really makes me ill to the point I can hardly function. My meter shows the 7, 14 and 30 day average and it is currently about 7.6.

Hi polly, 7~9 in the morning is ok but, a bit on the high side, so, if you was to reduce your insulin amounts these would probably be higher. Have never used the mixed insulins, but, do know they can be quite tricky. Might be a timing issue, as its peeking 3 hours after your breakfast. Could do with the peak of the insulin a few hours earlier so your morning reading is better and peaks in correlation with breakfast. One thing with mixed insulin is they are better suited to eating same size carb portion meals at set times (i think). Hopefully someone will pop along using the mixed insulin. Would really urge you to arrange to see your dsn though

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[pollyr]

Many thanks for your suggestions Brett and I understand your comments re the carbs. I think they are the cause of my weight problem. Would it be worth asking for a C-peptide test to check if my pancreas is producing insulin. I think I am not good at rationalising this. The diabetic nurse at my surgery told me to eat less but think it poses more questions than it answers.
I will go to the GP.

 

[mrman]

If you reduce the carbs you must reduce the insulin also otherwise you end up feeding the insulin, causing weight gain from having.to eat extra to avoid the hypos, but, either way you need to have good numbers, so testing is paramount.

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[pollyr]

I will mention this to the nurse and perhaps she could work it out for me as I wouldn't know how much to reduce the insulin by but what you say does help me understand. It is just a minefield and I have read loads of stuff but still find it hard work. Thanks again.
Polly