Blood sugars staying high

[UsmanMo96]

Hi

Haven't posted in a while.

I have gone onto insulin novorapid 10 units.
Still on metformin and gliclazide and sitagliptin. - past few weeks i have stayed in high Morning 13-14mmol and after meals 20-25mmol, with my medication and exercise im not coming down anymore. Spoken with DN and she thinks i need counselling and insulin but i dont think i will get anymore help from my GP or DN. I think my pancreas is probably damaged or liver - my breakfast is very light egg omelette and i am going high even with my breakfast and before my dinner its so high 25mmol that i only eat something light maybe Tuna mixed with vegetables, i dont know what has happened but my GP and DN think insulin will fix it, few weeks in on novorapid which is fast acting and nothing has improved oh and my oral medication isn't even doing its job gliclazide isn't bringing me down nor is sitagliptin. Not sure what else to try or do. I am prepared for the worst though.

Thanks

 

[Antje77]

Not sure what else to try or do.

I'm sorry to hear things aren't going too well.
Can you ask for a C-peptide test to check how much insulin you are producing? If you can't, for whatever reason, produce enough insilin, insulin is the only way.
Wish you all the best!

 

[UsmanMo96]

I'm sorry to hear things aren't going too well.
Can you ask for a C-peptide test to check how much insulin you are producing? If you can't, for whatever reason, produce enough insilin, insulin is the only way.
Wish you all the best!

Hi,
I asked for a Insulin Test, i have already done.a C-peptide test last year. Dont know the difference
I have only started on novorapid; might start lantus too, but my oral medication i may have to drop if i start long acting and short acting it will probably be bad to mix all together.

 

[oldgreymare]

Hi,
I asked for a Insulin Test, i have already done.a C-peptide test last year. Dont know the difference
I have only started on novorapid; might start lantus too, but my oral medication i may have to drop if i start long acting and short acting it will probably be bad to mix all together.

If you are injecting insulin, then a direct insulin test will be meaningless. The c-peptide test is useful as it measures (1:1) how much insulin your own pancreas is currently producing. If your BG levels were lower/OK when you had the test before, it may be worth repeating in light of recent very high BGs. High c-peptide level are indicative of insulin resistance, but with pancreatic beta cells still functioning. Low c-peptide levels indicate that your beta cells are struggling/failing to produce insulin. This can be due to autoimmune condition (Type 1) or beta cell exhaustion/ high pancreatic glucose toxicity (Type 2). In the latter case it can be helpful to take insulin for a few months to reduce BG levels and to see whether your beta cells recover. Do you have body fat to lose? Canbe reflected in how much your liver dumps fat via gluconeogenisis, as this typically gets lost before other body fat stores.

I think if you tolerate it well, no need to stop metformin. For other drugs check with your DN once you have an up-to-date c-peptide test.

 

[UsmanMo96]

If you are injecting insulin, then a direct insulin test will be meaningless. The c-peptide test is useful as it measures (1:1) how much insulin your own pancreas is currently producing. If your BG levels were lower/OK when you had the test before, it may be worth repeating in light of recent very high BGs. High c-peptide level are indicative of insulin resistance, but with pancreatic beta cells still functioning. Low c-peptide levels indicate that your beta cells are struggling/failing to produce insulin. This can be due to autoimmune condition (Type 1) or beta cell exhaustion/ high pancreatic glucose toxicity (Type 2). In the latter case it can be helpful to take insulin for a few months to reduce BG levels and to see whether your beta cells recover. Do you have body fat to lose? Canbe reflected in how much your liver dumps fat via gluconeogenisis, as this typically gets lost before other body fat stores.

I think if you tolerate it well, no need to stop metformin. For other drugs check with your DN once you have an up-to-date c-peptide test.

DN has got me to do a urine C-peptihde test, don't know if its the same as the blood test C-peptide.
Last year my C-peptide was
1324
pmol/L

I do have weight to lose only at 75kg at 165cm

 

[oldgreymare]

DN has got me to do a urine C-peptihde test, don't know if its the same as the blood test C-peptide.
Last year my C-peptide was
1324
pmol/L

I do have weight to lose only at 75kg at 165cm

Interesting - I didn't know it was possible to do a c-peptide test in urine - but to be accurate needs to be a full 24 hour urine collection sample? Sounds a faff compared to 12 hour fasting blood sample? To know what your result meant you also need the reference ranges quoted by the testing laboratory - should have been included in the data sent to your doctor.

 

[UsmanMo96]

Interesting - I didn't know it was possible to do a c-peptide test in urine - but to be accurate needs to be a full 24 hour urine collection sample? Sounds a faff compared to 12 hour fasting blood sample? To know what your result meant you also need the reference ranges quoted by the testing laboratory - should have been included in the data sent to your doctor.

My endocrinologist told last march that the C-peptide results indicate type 2 and he told me insulin will help me; but unfortunately on insulin right now fast acting and it isnt helping me i been told to give it time but i don't know how much time but i am checking my levels everyday

 

[Daibell]

Hi. Can you let us know what your BMI is to put it into perspective. Your earlier C-peptide test is strongly indicative of T2 and insulin resistance? Can you also let us know whether you are low-carbing. Taking insulin with insulin resistance can have little effect and the same for the Gliclazide and Sitagliptin. BTW it's not normal to take Basal/Bolus insulin and those two oral meds at the same time as they will be trying to do the same job. It looks like your GP/DN are trying hard to work things out but I would focus on whether you have insulin resistance. With regard to C-Peptide, it can be either via bloods or urine. I've had both and still waiting for my latest urine one. My diabetes consultant organised the urine one and it didn't need a 24 hour urine collection. I followed the NHS leaflet he sent me for the urine test. I've never found any information on whether one way is preferable to the other.

 

[UsmanMo96]

Hi. Can you let us know what your BMI is to put it into perspective. Your earlier C-peptide test is strongly indicative of T2 and insulin resistance? Can you also let us know whether you are low-carbing. Taking insulin with insulin resistance can have little effect and the same for the Gliclazide and Sitagliptin. BTW it's not normal to take Basal/Bolus insulin and those two oral meds at the same time as they will be trying to do the same job. It looks like your GP/DN are trying hard to work things out but I would focus on whether you have insulin resistance. With regard to C-Peptide, it can be either via bloods or urine. I've had both and still waiting for my latest urine one. My diabetes consultant organised the urine one and it didn't need a 24 hour urine collection. I followed the NHS leaflet he sent me for the urine test. I've never found any information on whether one way is preferable to the other.

Hi,

I'm 5 ft 5 and 75kg i know it's overweight at BMI of 27.55. My endo did say it wasn't needed for another C-peptide but actually think it should get tested every year like the A1C test. - i don't know if all those medications and insulin are actually doing me any good than bad but right now i just want my numbers down. I do try eat low carb and avoid snacking or drinks.