Background Insulin

ATHOLLSMART

Member
Messages
9
Type of diabetes
Type 1
Treatment type
Insulin
Hi, I am type 1 and get high blood readings, The units of lantaus insulin is 78 which i find very high. Does anyone know how i can get this lowered. I now use a glucose monitor and this helped a great deal in helping to get my blood readings down.
 

GrantGam

Well-Known Member
Messages
2,603
Type of diabetes
Type 1
Treatment type
Insulin
Hi, I am type 1 and get high blood readings, The units of lantaus insulin is 78 which i find very high. Does anyone know how i can get this lowered. I now use a glucose monitor and this helped a great deal in helping to get my blood readings down.
Hello and welcome to the forum:)

Can you please provide some basic information such as your age, weight, diagnosis date, when your high readings occur, how high they are, etc. The more information you provide then the easier it will be for others to advise you.

How long were you managing your type 1 diabetes without a BG monitor?

@daisy1 will provide some information that may help with your query.
 

daisy1

Legend
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26,457
Type of diabetes
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Tablets (oral)
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Cruelty towards animals.
@ATHOLLSMART

Hello and welcome to the forum :) Here is the information we give to new members and I hope you will find it useful. Ask as many questions as you want and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 210,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
 

donnellysdogs

Master
Messages
13,233
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Hi
Good that you have a monitor. I hope you have enough blood strips.

Can you tell us a bit about weight/age and the types of food you eat please?

Have you ever basal tested?

How much quick acting insulin do you take each day?
 

ATHOLLSMART

Member
Messages
9
Type of diabetes
Type 1
Treatment type
Insulin
The readings was in the 20's but have got them down to 11-12, I am 52 and been on insulin for 7 years, My wight is 94kg, I have done the DAFNE course and it was the that my background dose was increased, I now take 78 units.My novorapid is on a 3/1 ratio, I eat all sorts of food. No i have never been basal tested
 

GrantGam

Well-Known Member
Messages
2,603
Type of diabetes
Type 1
Treatment type
Insulin
The readings was in the 20's but have got them down to 11-12, I am 52 and been on insulin for 7 years, My wight is 94kg, I have done the DAFNE course and it was the that my background dose was increased, I now take 78 units.My novorapid is on a 3/1 ratio, I eat all sorts of food. No i have never been basal tested

Thanks for the info there, it helps a good bit.

Are you a type 2 diabetic treated with insulin or a type 1? The reason I ask is because your 78u of basal insulin would suggest insulin resistance which is a common trait of type 2 diabetes. For a T2 to be on that much basal is quite possible, but a type 1 diabetic - not so likely.

Can you explain your bolus ratio please? For instance a ratio of 1:10 would mean 1u of insulin for 10g carbohydrate.

What's your diet like and do you exercise regularly? Diet, exercise and insulin are the best tools available for managing BG levels.
 
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ATHOLLSMART

Member
Messages
9
Type of diabetes
Type 1
Treatment type
Insulin
I am type 1, My ratio is 3 ; 1. As for diet i eat all sorts of food but not things that are high in sugar, As for exercise that is not a lot as i work 12 hours a day 6 days a week.
 
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GrantGam

Well-Known Member
Messages
2,603
Type of diabetes
Type 1
Treatment type
Insulin
I am type 1, My ratio is 3 ; 1. As for diet i eat all sorts of food but not things that are high in sugar, As for exercise that is not a lot as i work 12 hours a day 6 days a week.
So to clarify: type 1 diabetic diagnosed 7 years ago and 3u QA insulin for 1g carbs?

That would mean that if you were on a moderate carb intake of 150g per day that you would be injecting more than an entire cartridge of rapid acting insulin?

Please correct me if I'm wrong but from everything I've read so far it would suggest that either you are a T2D or your insulin isn't working properly.
 

Daibell

Master
Messages
12,655
Type of diabetes
LADA
Treatment type
Insulin
Hi. Even though you may be a T1, your weight sounds quite high and that implies insulin resistance which will stop the insulin working properly. You need to give a high priority to having a low-carb diet to get your BMI into a good place. I would set yourself a target of, say, a maximum of 150gm per day and less if you can. As your weight reduces so will your insulin needs to avoid going hypo so use the meter to check.
 

donnellysdogs

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Sorry for the amount of questions:-

Are you under a hospital Consultant or GP to monitor your diabetes?

Some people do require more insulin than others. However, there is a U200 and U500 version of insulin. for those that have high doses it means less insulin as it is effectively either double strength for the U200 or 5 times the strength for U500.
GPs generally only prescribe the normal standard strength.

There is also a tablet called metformin that can be added in but this again would normally be under a Consultant.

If you are under GP care only it may help to ask to go under a consultant. Or, if you have a consultant it may be worth asking him about these alternatives.

I'm concerned that 7 years on that you are not achieving lower bloods and would advise that you talk to the relevant health people about alternatives.

Weight can also impact.. and the qty of carbs that you have. How much quick acting are you taking on an averge day ie add up how many units you had yesterday.. I just basically use it as a comparison to your 78 units of long acting insulin to just check that the ratio is about right.

Basal testing is when you go without food and test every hour. You would have your basal injection as normal..
Ie
1) get up - inject basal (if you do a morning jab)
2) do not eat breakfast or until 5 or 6 hours after you got up.
3) test every hour and record your readings
4) eat if you go hypo

Then the next day:
1) Have breakfast- inject as normal.
2) do not have any food at all
(Unless hypo) for 10 hours.
3) test hourly and record your results.

If you did this for tea time l/evening testing you would see how well your basal is actually working over your waking hours. You would then need to do the same overnight-but two hourly instead.

That is basal testing. You are testing yourself to see if your basal rate of insulin is correct.. this would enable you to accurately change your basal amount...and then enable you to see whether your bolus ratio is right..
 
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ATHOLLSMART

Member
Messages
9
Type of diabetes
Type 1
Treatment type
Insulin
OK here we go
I take 3 unit of insulin to every 10 grams of carbs, I do come under a consultant, i now have a Libre sensor and show that my bg is about 11-12, i have lost 6kg in the past month, all this i can understand, the thing that gets to me is the 78 units of background insulin and looking at my reading over the past month i may have to increase them. I was on Metformin about 4 years ago but they stopped that last year.
 
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donnellysdogs

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Was that metformin on top of injections?

Good you are under consultant.

If you are concerned solely about the qty of insulin take a look at this link:- http://www.iddt.org/news/new-high-strength-insulins

I cannot personally imagine having to take that much insulin.. I would be going to see him/her armed with a print out of the details on the link given and asking to change my insulin...
 

donnellysdogs

Master
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Are you averaging about 75 units of quick acting a day?

My main concern is that your TDD total daily doses of insulin are not totally out of sync. It does appear though on 3 units to 10g that the ratio would be about right...
 

azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
How many grams of carbs do you eat a day on average?

I know your basal dose sounds high, but there are others here who take similar amounts. The right dose is the amount that controls your blood sugar. If you can lose some weight, that might help reduce your insulin needs.

Has your consultant made any comment on your basal amount or given you any advice? Is there a dietician you could see at your hospital clinic?
 

himtoo

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Retired Moderator
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why can't everyone get on........
Hi @ATHOLLSMART
sorry for bombarding you --- all of us want to help
perhaps if you just give a complete description so that people don't make assumptions

for example - me ----- I am type 1 diagnosed 44 years ago -- on an insulin pump for 1 year previously on MDI for 18 years-- I take meds for BP control , statin , and meds for oseaphagitis
I have done a DAFNE course , know how to carb count , know how to self adjust for meal variance, and exercise variance.
etc etc etc
this helps people to respond to you without asking silly questions.

some of your early posts including your first post do not tie in with a type 1 diagnosis -- normally a type 1 is given a meter and strips from day 1--

also your timeline of events is somehow not in a coherent order for a type 1

were you mis - diagnosed as type 2 at first ?? have you had to push for additional treatment as a result of Blood sugars not reducing ?


I want to help -- but need a bit more info from you

thanks for reading -- all the best !!!!
.
 

ATHOLLSMART

Member
Messages
9
Type of diabetes
Type 1
Treatment type
Insulin
Yes to start with 12 years ago I was told I was type 2, I was on meteoric tablets starting on 1 a day, this was increased over the years until I was on 6 a day. Then I was put on insulin and 1 meteoric. They then told me I was type 1. My background insulin was put up every 3 months. I then landed in hospital with very high blood sugar and some doctors told me I was type 1 and some said type 2. Itchen got a glucose monitor to wear for 2 weeks and they put up my background again. Next was the DAFNE course which was very useful. Again my background was put up again. Another trip to hospital with a infection and landed with keytones. My blood sugar keep going up during the night and in the mornings can be as high as 28. I can get them down during the day with the quick acting insulin. I now have a glucose monitor and am fine day time but it looks like I will have to increase my background insulin again. This is really getting me down, I get swollen legs every day then leg cramps at night, not sleeping well and really just want to give up with it all. Doctor keeps saying that I am insulin resistance and need to get Bg down. God I am trying.
 

tim2000s

Expert
Retired Moderator
Messages
8,934
Type of diabetes
Type 1
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Other
Hi @ATHOLLSMART I think the reason that everyone here is asking many questions is that you seem to be exhibiting the symptoms of what is commonly called "Double Diabetes". This is where you have Type 1 but also high insulin resistance that results in needing more insulin.

When your doctors diagnosed you as a T1, did they undertake any GAD or ICA blood tests?

Secondly, do you undertake any form of exercise? Most of us find that one of the best ways to reduce insulin resistance is by exercising. For me personally, that is mostly weight training.

Another way of reducing your insulin resistance is to not need to use as much insulin. This is best achieved by T1s by reducing the amount of carbs you eat and losing visceral fat. Your 6kg weight loss is a great start to this.
 

donnellysdogs

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Agree with Tim...but just in addition think its worth considering the strength insulin you have.

Trouble is with you, ypu may be in a catch 22 position. Some exercise if your levels are above 12 can make levels go higher.
On a normal eating, regular exercise basis and loss of weight your insulin requiremwnts would go down. However, you may find a walk before bed or some time during the evening would lower your levels during sleeping.

You have not understood at all about adding up your total daily quick acting bolus amounts. You repeat your basal ones but don't mention at all how much quick acting insulin you give approximately in a day.
This is important.. for as mych as we know you could be only having 10 units and that would be a total imbalance of insulins......
 

iHs

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Messages
4,595
I have always found that if I eat less food, I need less insulin and I then loose some bodyweight so I never become insulin resistant even though I don't do loads of exercise in gyms......For me it's just walking a bit and trying not to sit down too much if I can help it.