6 years and still confused

[Steve Hare]

I have been diagnosed type 2 for 6 years now. Tablet dosage has increased over those years until last summer I hit my max dosage and Bg still not lowering, last summer my hba1c levels were up to 77. In November my tablet dosage was reduced and I was also put on Humilin injections currently up to a dosage of 22 once in the evening. I had an appointment to see my GP from recent blood tests, my urine test shows image leaking more protein and to my shock horror, my hba1c levels have gone up to 81. This has hit me quite hard as since November and starting the humilin injections, I pretty much stopped drinking alcohol, been really good over Christmas and I've just turned 40 years of age. I still don't understand everything, I don't even know if I am type 2 insulin dependant or non insulin dependant, what is the difference how do I know. My doctor sits there and tells me about all my blood test results (and there's lots) but I don't understand the codes, scientific name etc, don't know what it all means. Aaaarrrrggghhhh

 

[Clivethedrive]

Hi steve hare, sorry to hear your lack of improvements, can i ask , what do you eat and has your weight gone up?

 

[Daibell]

Hi. I can only generalise, but if you are noticeably overweight you would typically be a T2 with insulin resistance which means the body finds it difficult to use the insulin it produces. If and when tablets don't work insulin will be started and essentially you become insulin dependant. If however at some point you can get your weight down to normal you may be able to come off insulin or even tablets and are no longer insulin dependent. If you are slim at diagnosis you are likey to be Late onset T1 and may be started on tablets and before long insulin. You are then insulin dependent and will be for life. So, some key questions are what your BMI is and whether you are having a low-carb/low-calorie diet? If you are not overweight then you need to talk to the GP about the Basal/Bolus insulin regime whyich gives the best control but with more injections. It uses a daily '24hr' insulin and mealtime rapid insulin which you adjust for meal-time carbs. Humilin insulin comes in different forms and I know little about it. One injection a day won't give the best control but may well be adequte for some people but apparently not for you? There may be reasons I'm not aware of the the GP prescribed it? So, if you aren't already on a low-carb diet you need to start and discuss insulin options with the GP soon. Do come back with more questions.

 

[Steve Hare]

Hi there, a little bit more about me! I am 102kg in weight which is over weight, my bmi shows that I am obese and close to morbidly obese, everyone is know wouldn't even consider me being obese! Not sure if you can see from my photo on here if you think I am that bad. My bmi reckon I need to lose 37kg to be normal (I personally think that would kill me. I'm quite a broad build with muscle which I contribute to my weight but the doctors don't. I know I have to lose weight anyway but find it so hard with all this medication. I have to force myself to eat 3 times a day, normally only eat lunch and dinner.
I am thinking of trying a low carbon diet but everything i try it end up getting hypos. I have played sport almost all my life and still playing field hockey now. If I play too hard I suffer with muscle problems and it takes my body a week to recover before my next game, which means I can't go training mid week, if I train mid week then my muscles are sore when I play on the weekends. If I didn't have this problem I would be playing sport every day still.
I used to be a kayaking instructor which kept me fit, and I walk up mountains as a hobby (admittedly not as much as I want to due to travelling finances)

 

[Steve Hare]

I am also confused because my diabetic Nurse at my GP practice (who has just left so no more diabetic Nurse) told me when I started the humilin to not let my bg fall below 6? Also to check my levels before bed and not let them fall below 10? She said if I am below 10 to have a snack so that I don't have night time hypos. This is the regime I have been following. So my morning bg have been between 9 and 9.9
My hba1c has come back saying my daily average is 9 and I was told by my GP this is too high. Still confused with the different result readings 81, 9?

Speaking to my doctor yesterday she wants my fasting bg to be between 7-8. Was I given the wrong info by the nurse because I have been in fear of night time hypos for the last 2 months?

 

[chippers]

Hi Steve, sorry to hear you have been having a tough time with your control. I have been type1 since the age of 21 and have had good and bad times with my control.
Well looking at your picture I wouldn't say you were obese by any means and the camera never lies lol.
I recently changed to basal bolus injections to give me better control of by blood glucose due to poor control by the 2 injections a day. Was advised when I started to keep my bg a little higher until the levels sort themselves out, probably why your nurse told you to keep yours about 10 at night. An average of 9 a1c isn't the worst it could be. Being on insulin and taking a low carb diet and taking the same dosage will cause hypo's. 10 carb grams is 1 unit of insulin, 1 unit of insulin is 2 or three blood glucose mmols. So maybe adjust the insulin you take when on lower carbs. It may mean that your sugars are a little high until you get them evened out. Hope you get on with things a bit better, but chin up persevere and just check bg regularly.

All the best

Andy