Starting Insulin, what should I expect?

diabolic sister

Well-Known Member
Messages
55
Type of diabetes
LADA
Treatment type
Insulin
ok so two and a half years since T2 diagnosis, bullying DN with intelligent and informed arguments to give me a meter and strips on prescription, been through Metformin, Sitagliptin and Gliclazide, now on Met 500g x4 a day and Forxiga (Dapagliflozin) HBA1C currently 69, Finally got to see a consultant last week, now I'm to start Insulin. i am seeing a nurse on wednesday, can anyone shed some light on what to expect? Do they start you with a background dose or a before/after meals dose. How easy is it to calculate dosages. I am thinking that it will be best to stick to a simple and repetitive diet to begin with so I know what to do with a typical meal and gradually add different things in as I get more confident. Any advice? Specifically worried about weight gain as I have lost three stone, I wasnt overweight to begin with but am really happy with the way I look now, I know vanity shouldnt come into it but I would be gutted if the past two and half years hard work were to be swept away by a few shots of a drug.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Sounds like you may be a LADA (Late onset T1) rather than T2? Unexpected weight loss is one pointer. Make sure your tabelst are reviewed when you start the insulin. I had to remind my nice DN to stop the Gliclazide and Sitagliptin. Metformin will still help a little but is marginal. People are started on insulin in random ways depending on the GP/DN. You may be started on twice a day mixed insulin or just once a day Basal. The best regime in the long term is Basal/Bolus (aka MDI) with once or twice a day Basal insulin and Bolus (Rapid) for meals. If and when you use Bolus the best way to use it is to carb-count i.e. adjust it to suit the meal carb content. Discuss the options with the DN and don't just accept what is offered without sensible discussion of the options. Do come back if you need anything clarified.
 

diabolic sister

Well-Known Member
Messages
55
Type of diabetes
LADA
Treatment type
Insulin
Thanks Daibell.
Still rather confusing as an Insulin newbie, I'm hoping it will become clear tomorrow. I am looking forward to feeling well again.
 

ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
Sounds like you may be a LADA (Late onset T1) rather than T2? Unexpected weight loss is one pointer. Make sure your tabelst are reviewed when you start the insulin. I had to remind my nice DN to stop the Gliclazide and Sitagliptin. Metformin will still help a little but is marginal. People are started on insulin in random ways depending on the GP/DN. You may be started on twice a day mixed insulin or just once a day Basal. The best regime in the long term is Basal/Bolus (aka MDI) with once or twice a day Basal insulin and Bolus (Rapid) for meals. If and when you use Bolus the best way to use it is to carb-count i.e. adjust it to suit the meal carb content. Discuss the options with the DN and don't just accept what is offered without sensible discussion of the options. Do come back if you need anything clarified.
I agree with all of the above. Here is some further information about insulin in T2s... the type of regime is all-important, as you will see:
http://www.phlaunt.com/diabetes/15478720.php
 

diabolic sister

Well-Known Member
Messages
55
Type of diabetes
LADA
Treatment type
Insulin
Well it turns out i am LADA. Still playing with insulin trying to get it right, its quite baffling as sometimes I get it right and others I get a completely different result. I have also had a short synacthen test for the weight loss, I assume they are looking for Addisons, and they are looking for Coeliac disease. Not heard the results yet. I have to say my DN is a bit rubbish, I ask questions via email, wait two days for a usually inadequate answer. I still cant get my head round the correction dose either. Using the 100 rule, but how can you calculate a days insulin dose and use that as a basis for a calculation when it varies from one day to the next? And doesn't the daily dose depend on what you have eaten that day, and what if you have'nt been on target on the day's doses?
Aargh it's just too baffling.
 

eddie1968

Well-Known Member
Messages
3,661
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Pasta, sorry to me it's vile, yeuch lol (and full of nasty carbs)
Generally they will start you on the lowest dose and titrate upwards if necessary. I now take well over double the dose I started on over a year ago. Good news is no side effects with insulin unlike the awful oral medications. More finger pricking I'm afraid and you will get a new shiny free meter and regular prescriptions for strips, needles and lancets.
 
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