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Getting worried.

Lucy-M

Lucy-M

Member
Messages
24
Location
South England
Type of diabetes
Type 1
Treatment type
Insulin
I've been type 1 for 14years. Didn't have the best control when I was younger, but it was so much better as soon as I turned 20. I've just changed my insulin (was on Humalog & Lantus now on Humulin M3) and my control is atrocious. Past week I've noticed I've been having a lot of hypos but I wasn't aware of them. I only found out by the off chance I do a blood sugar test or my eyes go funny. I don't know a lot about loosing awareness of hypos. Any advice? I have made an appointment with my diabetes nurse.
 
Lucy-M said:
I've been type 1 for 14years. Didn't have the best control when I was younger, but it was so much better as soon as I turned 20. I've just changed my insulin (was on Humalog & Lantus now on Humulin M3) and my control is atrocious. Past week I've noticed I've been having a lot of hypos but I wasn't aware of them. I only found out by the off chance I do a blood sugar test or my eyes go funny. I don't know a lot about loosing awareness of hypos. Any advice? I have made an appointment with my diabetes nurse.
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As M3 is a mixed insulin, this means you need to eat at exactly the same time every day and the same amount of carbs for each meal, there is no way of correcting any highs and you also have to inject twice a day and between 20 and 45 mins before you can eat anything.
I suspect that's why you have no control at all.
Why were you taken off of MDI?
 
I was taken off Humalog and Lantus because there was an incident last year and I thought I'd overdosed on Lantus. It made me very paranoid and sometimes I would skip the injection. Told my nurse and she recommended Humulin M3 as I won't have to worry about doing a separate injection.
 
I would go back on to basal/bolus if you had good control before, you can buy devices that fit on the end of insulin pens that tell you when you last injected, one is called Timesulin, so you don't have to worry about whether you have injected or not.

As for your loss of hypo awareness, the usual advice is to run bg higher than normal until your awareness returns, your DSN will advise you further.
 
Lucy-M said:
I was taken off Humalog and Lantus because there was an incident last year and I thought I'd overdosed on Lantus. It made me very paranoid and sometimes I would skip the injection. Told my nurse and she recommended Humulin M3 as I won't have to worry about doing a separate injection.
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Then your nurse needs a kick up the bum. There are pens with memories so you can see what and when your last dose was and also meters that once set up properly can advise you on the correct amount of insulin for the carbs eaten. Another tip is to make sure you keep your Lantus pen in a different place than the bolus thus no mix up, Also have 2 different colours for the pens. Then again I have to question why a pump was not recommended as everything is in black and white before your eyes.
If you drive and think you are losing awareness then your driving licence is at stake.
 
It was separate pens and colours. It just made me sick with all the panicking. Even if I know I've done it, I would doubt myself and that's when it starts to get worrying.

I don't drive so that's ok. I was told going on insulin pumps is hard, you have to fit a certain criteria.
 
Lucy-M said:
It was separate pens and colours. It just made me sick with all the panicking. Even if I know I've done it, I would doubt myself and that's when it starts to get worrying.

I don't drive so that's ok. I was told going on insulin pumps is hard, you have to fit a certain criteria.
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Loss of hypo awareness is one of the criteria for getting on a pump, but you would need to do a carb counting course beforehand as this is a prerequisite.

If you get the Timesilun device or similar your concerns will ease, I use Novorapid as my QA insulin and I use the NovoPen Echo, it has a built in memory function.
 
Wow, what a dreadful nurse. I can only echo what the others have said - you need to be back on MDI. Set your mobile phone to remind you to take it.

The loss of hypo awareness might just be a result of the change of insulin, so get back on an appropriate regime and see if the awareness comes back - don't try to tackle two things at once.

I see an earlier poster has recommended low-carb for your control. I am a low- carber and it does work, but you must not attempt it while on mixed insulin as you need the right amount of carb for the insulin you have taken or it's dangerous. Get back on an appropriate regime, then tackle the hypo awareness issues, then tackle the control.

Smidge
 
Yes, go back to Basal/Bolus. I have two different colour pens and have my Levemir once a day at bedtime. I place it in a specific place in the bedroom and have yet to confuse it with my NovoRapid pen which is more mobile. I agree there is always a very small risk of mixing the pens but the degree of control you have with Basal/Bolus is far superior
 
"Going on a pump is hard"... In what aspect? From meeting criteria to get one (which you currently do) or to manage it when you have one?

You've tried different insulins-mdi and mixed... Your levels still swing....
You are now having unaware hypo's...

Two out of 3 boxes ticked for the criteria.

Many people have had to have a carb coubting course pre pump. Some, like me... Did not. I could prove that I knew how to carb count, had bad DP and also a bad driving incident......

A pump is hugely more effective at controlling the swings, providing the user puts time in to setting it up and managing it. Initially it can be hard work but longterm the initial work can reap huge benefits.

Just wondered in what context you were told it is hard to go on a pump.
 
I was told by my diabetes nurse -
"You were telling me you were researching about going on a pump. I can tell you that going on a pump is hard, you have to meet the criteria".

That is what was said to me.
 
Lucy-M said:
I was told by my diabetes nurse -
"You were telling me you were researching about going on a pump. I can tell you that going on a pump is hard, you have to meet the criteria".

That is what was said to me.
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Well you meet the criteria, so no problems there. The pump is a lot of hard work to start with but the rewards for that work are a fantastic quality of life. There's lot's of blood testing and basal setting everything is on the pump though including how much insulin you delivered for a meal or snack and at what time it was given. So that removes your worries :)
 
Lucy-M said:
Seeing my nurse tomorrow so i will bring it up.
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just my opinion...
have you got a referral to the hospital clinic? I would see a consultant to work out the best way to go forward, it will either be the pump or counselling to get rid of the anxiety about injection basal bolus. what you are doing isn't working that good
 
Lucy-M said:
Seeing my nurse tomorrow so i will bring it up.
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Hi Lucy, if you get a negative response ask to see your consultant, then if not happy talk to your GP and ask to be refered to a hospital that is pump friendly.
 
Tell her you do meet the NICE criteria and ask why she sees it as so hard for someone who meets the criteria to get one..

You tried mixed and mdi and not getting good enough results.. You need further help from fine tuning insulin medication and the pump can help you to achieve this....

Be prepared for dsn telling you that it will too hardwork for you to manage etc... Be prepared to argue your case that you WANT a better life with better control and to have a better future and prepared to put in the effort to get this..

Do you go to appts by yourself?
 
CarbsRok said:
As M3 is a mixed insulin, this means you need to eat at exactly the same time every day and the same amount of carbs for each meal, there is no way of correcting any highs and you also have to inject twice a day and between 20 and 45 mins before you can eat anything.
I suspect that's why you have no control at all.
Why were you taken off of MDI?
Click to expand...
Ive never used M3 but have used Novomix and Humalog Mix. I loved twice daily and changing to MDI was one of the worst things I ever did esp with all the jabs and to crown it all.......the hypos averaged on 2 per day. It was only when I found out about ratios that my bg control got a bit better.
re....twice daily and eating food......you do have to remember to eat some carb within certain time frames but the food is not the same carb content for every meal, it varies according to bg levels and the action the insulin has. My a1cs on twice daily were 7% and I tested 3 times per day.. before breakfast, before eve meal and before bed. I always had a bedtime snack to prevent low bg overnight but I was fairly happy.
 
Lucy-M said:
Yes I do.
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You keep saying diabetes nurse, if your seen by a gp practice nurse (DN) then you need to see a hospital diabetes specialist nurse (DSN) or a Endocrinologist to sort your control out and get referred for a pump.
 
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