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Haven't got a clue what I'm doing

A

allan mallinson

Member
Hi I'm 54 and was diagnosed with type 2 at age 36, I take Sukkarto and Humalin M3, but my readings are all over the place, in sept they were 53 now they're 77, need to get them sorted as I was refused an operation because they were too high. Would appreciate some advice.
 
My approach would be to request a switch from a mixed to separate long/intermediate and short/rapid acting insulins. That allows the maximum flexibility to adjust insulin to match the food you eat. Then I'd drop the carbohydrate intake - assuming that is what is causing the higher blood glucose levels (rather than some other medication/medical condition).
 
thanks I'm on loads of medication, atorvastatin, aspirin, fexofenadine, candesartan, dapagliflozin, glimepiride, indapamide, omeprozole. I have never been told about carbs or anything and just told to increase insulin if glucose goes up, never been under control in 18 years
 
allan mallinson said:
Hi I'm 54 and was diagnosed with type 2 at age 36, I take Sukkarto and Humalin M3, but my readings are all over the place, in sept they were 53 now they're 77, need to get them sorted as I was refused an operation because they were too high. Would appreciate some advice.
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Hi @allan mallinson and welcome to the forums.

I have to be a bit careful what I say here because I am cross posting (giving advice from one diabetic type to another), so though I have quite a bit of experience of insulin (as taken by a T1 who is not producing much if any) I am not a T2 (who may be taking insulin because of insulin restance and/or insulin deficiency).

My first suggestion would be to talk to your medical team urgently. It may just be that your doses need tweaking or it may be that you need a different insulin regime as suggested by @jonathan183

And I've just seen your reply. How/when are you testing? Has something changed between September andnow?
 
testing in the morning before breakfast and again straight after tea, today was 13.6 and 17.6. I've eaten2 x shredded wheat for breakfast, 3x poached egg on toast for lunch and corned beef, light oven chips and peas for tea
 
allan mallinson said:
testing in the morning before breakfast and again straight after tea, today was 13.6 and 17.6. I've eaten2 x shredded wheat for breakfast, 3x poached egg on toast for lunch and corned beef, light oven chips and peas for tea
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All carbs (shredded wheat, toast, oven chips) turn to glucose in the blood, where your own body plus your medication needs to convert that glucose to energy.
So it looks like this is more carbs than your current medication can handle.

You might see lower numbers if you eat a bit less of the carby foods.
But be careful, being on insulin means you can go too low!
So if you reduce the carbs a bit, please test as soon as you feel odd in any way, and keep some quick acting sugary stuff on hand in case you go too low.

If you only test twice a day, it's very hard to spot patterns or to work out what foods spike you more than other.
It could be very helpful to increase your testing for a while and test before and two hours after each meal to see how your body handled that meal. With that information you can adjust the carbs in your meals to a level that works for you.
 
ok, spoke to Dr today, told to increase morning and evening insulin to 30 and referring me to a dietician, to say he was a diabetic Dr. he didn't seem to have much idea.
 
allan mallinson said:
ok, spoke to Dr today, told to increase morning and evening insulin to 30 and referring me to a dietician, to say he was a diabetic Dr. he didn't seem to have much idea.
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So he wants you to increase medication to reduce glucose rather than reduce the glucose at source? makes no sense considering your diet is pretty carb heavy and has a lot of room for adjustment if that’s the approach you’d prefer. Hopefully the dietician you see has more sense and gives you better choices. Whatever you decide carbs and insulin need to match up. Increase one and you’ll need to increase the other to keep them in balance. And the same is true in reverse.
 
As a newly insulin dependent type 2 I won’t give advise but just my experience. The cereals and potatoes I cannot go near as it spikes me way too much even with insulin. I think your issue might be getting the balance of carbs and insulin right. I have had to learn a lot on my own as I was sort of given insulin and told away you go. No talks in how to adjust it to suit the carbs etc. I think you do need to speak with someone experienced to find what works for you. What works for one doesn’t work for another and there is so much mixed information out there it can be really confusing. I am sure you will get sorted but the only advice I would give is test, test, and test some more! This will help you find out for yourself what carb /insulin ratio works for you.
 
pennyk said:
As a newly insulin dependent type 2 I won’t give advise but just my experience. The cereals and potatoes I cannot go near as it spikes me way too much even with insulin. I think your issue might be getting the balance of carbs and insulin right. I have had to learn a lot on my own as I was sort of given insulin and told away you go. No talks in how to adjust it to suit the carbs etc. I think you do need to speak with someone experienced to find what works for you. What works for one doesn’t work for another and there is so much mixed information out there it can be really confusing. I am sure you will get sorted but the only advice I would give is test, test, and test some more! This will help you find out for yourself what carb /insulin ratio works for you.
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thanks, I was the same, never been told about insulin vs. carbs, just here you are that will sort you.

I was even told when diagnosed it's fine to eat cake if I fancy, medication would fix it!
 
Can i ask who prescribed the mixed insulin, GP or a DSN (not the nurse who does diabetes at the gps but specialist nurse).
If you are dealing with a GP I would push to be referred to a DSN who can help straighten things out.
In my experience most GPs can "deal" with uncomplicated diabetes (the have a metformin and off you pop kinda consults or follow the chart on what to prescribe next) but are very unknowledgeable about insulin and balancing your bg with insulin. (I'm sure there are some outstanding GPs who do but few and far between - not met one yet).
A DSN deals with the more complex cases and insulin users day in day out and can probably help you better with getting on the insulin regimes that suit you and let you stay on top of your BG and get you ready for surgery.

I'm not saying don't pay some attention to diet. I know for me, on basal bolus regime, I still have a threshold where I struggle to keep control when I overload on carbs but in the same breath, please be very cautious when reducing carbs as not to plummet and end up with multiple hypos.

Insulin controlled T2 is very very different to diet only/most oral meds and can be very dangerous to suddenly cut carbs. Slow and steady there if you are confidant on adjusting your own insulin in response to the lower numbers.
 
allan mallinson said:
thanks, I was the same, never been told about insulin vs. carbs, just here you are that will sort you.

I was even told when diagnosed it's fine to eat cake if I fancy, medication would fix it!
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Yes, I was told I can up my insulin for those nights I have a take away! The nearest I get to a treat is an apple
 
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