End of my tether - again!

Trulee said:

Really don't know what the right question is anymore, or who to ask :cry:

Was switched to insulin about 2 months ago now, since when I have been struggling to get levels stable again. Over the last couple of weeks seem to have, finally, started to get them levelling out, but now have another problem - am hypoing all over the place and am putting on about 1lb a day in weight even though I am keeping my calories to approximately 1700 a day.

I am taking Levemir (32 units a day) with Novorapid (12 units before/with meals) and 1gm Metformin with each meal.

I also take blood pressure and other heart medication after having a heart attack almost 3 years ago, so the weight increase cannot continue - another heart attack would surely be a major problem to me and not one I'm prepared to risk. I swim twice a week and work out on Wii fit at least three times, so am not quite sure what else I can do

I have an appointment with my DSN next week to discuss the possibility of using Bydurion instead of the insulin, but tonight am at the end of my tether because I really don't know what else to try - anyone with any suggestions gratefully received.

thanks to anyone who takes the time to read this

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Would you be confident to try reducing your insulin, as this is what's causing the hypos? I don't think you mention whether you have a meter, but I assume you do otherwise you wouldn't know that your levels were stabilising. Testing at different times would help you to work out whether it's the levemir or the novorapid that's causing the hypos. If I was having lots of hypos and hadn't been given the information needed to adjust my doses I would not be waiting until next week, I'd be on the phone to the DSN to ask for advice re the hypos, as your quality of life is suffering, not to mention the safety aspect. Good luck!

Hi Trulee, sorry to hear of your troubles, I'm not sure if I can offer much assistance because I am not yet on insulin. I just wondered what other meds you are on, maybe something like Gliclazide might be lowering your BG too much, your GP might need to review your meds.

Hope things settle for you, best of luck, Jane

What are you eating Trulee? Just wondering if its possible to bring the carb content of your diet down a bit? I am not on insulin so I don't want to steer you wrong but some reduction in carbs might help. Plus I saw on the Hairy Dieters this week Professor somethingorother said that to keep up a continuous level of weight loss you have to reduce your calories week on week. Maybe reducing your cals by 100 a day for a week could help? I think our bods get used to what we eat so ringng the occasional change could be beneficial.

Hi again Trulee, I think you need the specialist advice of your DSN, I don't know enough, I'm sorry. I can offer you my support though and friendly ear if you want to talk.

Take care, Jane

Trulee said:

thanks both :thumbup:

No - am not on Glic - what I listed is all I take for the diabetes, everything else is heart related
Yes I do have a meter - and use it regularly

My DSN trusts me to alter my meds as I need to - but one unit less of anythign and the levels are back through the roof again, so not quite sure how else to 'alter' them

Due to work commitments am not able to get in to see her before the bank holiday, but it is the weight gain that is really worrying me - up to last week it was fluctuating up and down by a couple of lb a week (which it has always done) but since Friday its going up by a 1lb a day

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Depending on what insulin you are on, you can get pens which allow you to adjust dosages by half a unit. Some DSNs say that it's neither here nor there, but since I've got my pump I've realised that there's a massive difference between a half a unit and one unit! Perhaps this finer control is what you need?

Hi Trulee
I am also type 2 on insulin.
It would be worth reducing your levemir a little, this deals with the glucose produced by your liver independently of what you eat, the NovoRapid deals with what you eat and unless you go hypo within about 4 hours of this injection then its probably the basal thats too high (would explain the weight gain as well).

There is a way to check this
Inject pre breakfast as normal
Eat usual breakfast - no mid morning snack water is fine
4 hours later (carbs and Novorapid out of system) check blood, keep checking every hour if BG's are falling then basal (levemir is too high) the idea is to get your fasting Bg's constant when you have achieved this then you inject NovoRapid to take care of the meal (adjusting dose as necessary). Hope this makes sense.
It worked for me however because we are type 2's our pancreas messes things up a little.

I have achieved a HbA1c of 5.6% with this method
As a matter of interest I inject 10 units of basal morning and evening and 12 units of NovoRapid per meal with only small adjustments for more carbs.

The way I see it Type 2's have a slow response to food but still have some background insulin so I would expect the basal to be lower than the Bolus.

Please take care

Trulee said:

hi Fraddycat - already eat low carb whenever I can and have recenty switched from my usual sandwich with two slices of bread to Warburtons thins instead cutting the carbs for my lunch in half

Carbs eaten with dinner are very strictly weighed as well roblem:

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I take it that you are on wholemeal bread.?
If I eat white bread or most fruit my readings go though the roof.Period.Same with any
Heinz products.Also My morning fasting score is always high if I east anything after 6pm.Especially cheese.It doesnt mean the cheese is high in glucose,just slows down the insulin effect,ie becomes wasted?
PS Very much liked Homers reply..even though i cannot get myself under control,Not feeling like yuk is NOW my priority not the readings.