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Do you carb count and use insulin based on this?

Albee7740

Well-Known Member
Messages
45
Type of diabetes
Type 2
Treatment type
Insulin
In July I was placed on insulin and told to start to take 2 units of insulin (novorapid) with each meal and 4 units of Levemir at night and to increase this each week by 2 units (both novorapid and Levemir) un til my blood sugar was in the range set for me.

I did this religiously initially but realised that depending on the amount of carbs I had in a meal sometimes I would be out of range and knew that I would be. I read about carb counting and began to take as much insulin as I though I would need and this stoped the hypos and being too high in terms of my blood sugar. Still high in the morning but think this is the dawn effect.

I have my appointment with the diabetes specialist in a couple of weeks and am panicking that he will say that I should have stuck to the regime set by him and using as much insulin as need to cover carbs is only for type 1 diabetics. My 30 day average is now 6.1 which converts to a HbA1c of 36 which if accurate is amazing given that I had a HbA1c in the 90s in April and 81 in June

Does anyone know if it is ok to just use as much insulin as needed to cover carb intake for type 2's?
 
Hello,
I think it is ideal to carb count when using insulin to reduce hypos and hypers. I think it'll benefit those who are basal/bolus to learn about carb counting, have you looked at BERTIE online course for a better insight? Diabetes team are usually very nice and I'm sure he or she will be delighted you're trying to manage your condition better.
 
I use insulin to control steroids. I was told by the Specialist Diabetic Nurse that if I wanted to splurge on (say) a chow mein, I should calculate 1 unit per 10g carbs. I use humulin I in the morning and novorapid during the day once BG starts to rise. Finally getting good reading, not sure if I want to risk carbs yet.
 
Thank you! So it sounds as though it's ok for type 2's on insulin to take variable amounts of their fast acting insulin with meals and not have to stick to a fixed amount - phew!
 
There are many type 2's on a basal/bolus regime (exactly what you are on) that carb count and adjust their insulin to suit and match what they are eating so in my opinion if they have a problem with it they are absolute idiots and need retraining and also told to stick it where the sun don't shine! Sorry I do apologise but here you are working out correctly exactly what you need to do so they shouldn't criticise that especially as your doing it to better and look after yourself

Interestingly though you seem to assume all Type 1's carb count which isn't the case, I have come across many diagnosed 20+ years that don't carb count and adjust their insulin, some never even having heard of it! I however could never have lived like that so self taught carb counting less than a month after diagnosis and my team were fine and dandy with me wanting to do so, so off I went, I can tell you it made Christmas day by far easier for me!

Well done you and keep up the amazing work!
xx
 
It makes sense to me that healthcare professionals might not want to overload someone who has recently been placed on insulin with too much information by introducing the idea of carb counting as well, but my view is that we should be given all the information we need to manage our condition (perhaps in take home leaflets as well as verbally) rather than taking a paternalistic attitude and treating patients like children.

I had really poor experience of healthcare support with respect to my diabetes and told to ensure that I ate carbs with each meal (the plate should be half carbs) and being "a good girl" I did as I was told with by HbA1c getting progressively worse. I became pregnant (unplanned) with an extremely high HbA1c told to terminate and unfortunately lost the baby. At this time I was placed on insulin and told that my HbA1c need to be 42 or below at the time of conception if we were to try to conceive.

I couldn't see how that would be possible when I had followed every piece of the limited advice I was given by the professionals. I found this website and discovered low carbing and other pieces of useful information and threw myself into the advice I found here - which often seems to be the opposite of what I had been told to do for years!

But if more the my meter readings are correct and my HbA1c is what I estimate it to be I will continue to ignore the advice given! I had a less brave moment when posting this thread thinking that I might have missed something as everything I have read about carb counting has been Type 1 related....
 
As a bit of an aside, type 2 on insulin is a different ballgame to type 1 since type 2s who have reached the stage of using insulin will likely also have very high levels of hyperinsulinemic resistance to contend with. In my opinion insulin dependent type 2s would be well advised to consider that each time they ingest carbohydrate and inject insulin to cover it, they are very likely making the resistance incrementally worse.

Of course that doesn't help directly with the question, but nevertheless it is a worthwhile consideration.
 
I think when OP is on board with carb counting, she can consider LCHF or keto later on which I have seen some type 2s on insulin do. Which then she can adjust her insulin for as well.
 

Hi Jim - do you have a link to something I can read? I have reduced my daily carb intake significantly to under 100g per day (I know that it could be lower but this seems to work for my lifestyle) and so take insulin to cover it - it does seem that I need more than the 1 unit to 10g of carb though. Does what you are saying explain this?
 

I don't wish to unnecessarily overcomplicate the topic, but for more information perhaps in due course you'll be inclined to research the overflow hypothesis. Jason Fung has written some great and easy to understand literature on the subject.

I mention it here only because, as a type 2, the insulin required per gram of carbohydrate may quite quickly escalate. But it seems like you're already making sensible measures with carbohydrate reduction. I wouldnt pay too much attention to my comments just now unless you find your requirement creeping upwards.
 
I'd agree with Jim about the problem of insulin causing further insulin resistance. Insulin is a necessary drug for type 1s and works for type 2s also in the sense that it controls your blood sugar but taking insulin isn#t tackling the root cause and as Jim points out, can make that root cause worse as well as worsen the potential complications. To find out more, without needing to change anything before you fully understand your options, Jason Fung and others explain this well on Diet Doctor (don't be put off by the name as it is simply a low carb website):
https://www.dietdoctor.com/member/courses/fung-diabetes#2
Btw the average Western diet is reputedly at about 240g carbs so you are already doing well on keeping those in check and please don't make any sudden changes downwards otherwise you'll risk hypos!
 
Ok so just watched a youtube video on the overflow hypothesis (lazy version of reading!). So taking insulin as a type 2 might increase insulin resistance? So as a type 2 on insulin the goal is to reduce carbs, lose weight and get off insulin as quickly as possible, but the insulin will make it harder to lose weight so fasting may be helpful?
 
Albee7740 said:
So as a type 2 on insulin the goal is to reduce carbs, lose weight and get off insulin as quickly as possible, but the insulin will make it harder to lose weight so fasting may be helpful?
Click to expand...
Reducing carbs will for many lead to weight loss as well as lower blood sugars so insulin becomes unnecessary.
Fasting helps this process along as by not eating carbs you won't get blood sugar spikes so won't require the exogenous insulin.
That at least is the reasoning behind it.
Have you ever had your own insulin production tested?
 
That makes sense @bulkbiker. Unfortunately, I haven't been offered an insulin production test by the NHS and previously had a poor understanding of the difference between Type 1 and 2 so I just accepted the diagnosis of type 2 because as my GP said "you're probably type 2 as you're overweight, but you are a bit young, we'll just treat you as a type 2 and see what happens"!
 
Albee7740 said:
we'll just treat you as a type 2 and see what happens
Click to expand...
Odd as few "classic" T2's would go straight onto insulin.. most T2's over produce so adding more into the mix is considered quite deleterious.. Out of interest how old were you when diagnosed?
 

Hmmmm, it sounds like they are not sure whether you are type 1or type 2 then? Personally I would go back to the Docs and ask for further tests, I'm not sure how you would be able to make a decision about whether you should be on insulin or not or whether low carbing would help you on its own or whatever, be very careful, don't be tempted to assume type 2 or stop your insulin at this stage. x
 
bulkbiker said:
Odd as few "classic" T2's would go straight onto insulin.. most T2's over produce so adding more into the mix is considered quite deleterious.. Out of interest how old were you when diagnosed?
Click to expand...

I was 36 when diagnosed and put on metformin. This increased over the years by my GP who was the only healthcare provider I saw for my diabetes - I didn't even know that you could be referred to a diabetes specialist. Aged 40, I was put onto insulin after I fell pregnant and referred to a diabetes specialist doctor. It's never been confirmed as type 2 (no tests) but has been treated as such. I am now thinking I should query the diagnosis with the diabetes doctor as he's taken it as given that I'm type 2 based on the referral from my GP.
 
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Might be worth seeing if you can get tested properly... a c-peptide or fasting insulin test.
Any idea what your most recent HbA1c was?
 

Every single time, you say the same thing. Do you have it ready somewhere to paste? Do you know how damaging this advice us? If I had not done my research and listened to you, I would have ended up with serious diabetic complications.
I’m now on insulin with BG from 16 after meals to 7 and losing weight with it.
Please reword your statements.

OP- I’m going on a carb counting course and consultant will allow me to adjust insulin after this. He is scared that I might go hypo/hyper. Why not try to get a space on this course?
 
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