Yes might sound odd, but I was a type 2 diabetic reasonably controlled with metformin and gliclazide for 15 years, then I got a blocked bile duct and had a routine procedure that ended up with me being in intensive care with sepsis, septic shock and acute pancreatitis. And after two further emergency trips to A&E, a week or so after leaving hospital, with acidosis , was declared an insulin dependent diabetic! Never got to see an endo, and eventually got a nurse to introduce me to insulin ( 24 hour acting humulin).. about 10 units in bum or tum before bed. My Hba1c has been raised recently over lockdown ( I do have other medical conditions with hypothyroidism and fibromyalgia, and being tested for sleep apnoea as developed resistant hypertension too...which might have affected it), and on the phone nurse now says inject insulin before bed and in the day. She was rather vague about this, and I couldn’t get an answer as why I needed ‘a top up’ of a 24- hour insulin. I tend to do the second after lunch. Fasting bloods tend to be about 4, but this morning 3.4, so I don’t need the second dose 12 hours after the first. Anybody any advice? Can’t have another Hba1c test for another couple of months. Incidentally still on gliclazide and metformin...nobody suggested changing their dose or use since taking insulin in the last 6 years...any thoughts?
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How do I describe my diabetes, and use of humulin?
- Thread starter JudithD
- Start Date
Hi @JudithD and welcome to the forums.
Unfortunately many of the regular posters are asleep now so you may have to wait a few hours before getting some more responses.
I'm sorry you've had such a stressful introduction to the world of insulin, and do feel that you could do with some more information from your diabetic team. (I guess this is the DN at your surgery? ) Have you had a chance to talk to your GP, even though you haven't seen an endocrinologist yet?
But I can make some comments. Firstly, illness can make blood sugars rise dramatically, so even excluding the pancreatitis situation it is possible that you would have needed insulin for your T2. Secondly, pancreatitis can cause diabetes T3c, which is basically a reduction in insulin production due to damage to the pancreas. Some T3cers need insulin, some don't, but they often get lumped in with T1s if they do need insulin. There is a T3c subforum here which may be of interest to you.
Type 3c (Pancreatic) Diabetes | Diabetes Forum • The Global Diabetes Community
But remember, without a chat to your doctor and/or a look at your release notes from the hospital, you don't even know if you have T3c, so you really need to find out from them. And if they don't know, it might be time to ask for a referral to an endocrinologist.
As regards the insulin situation, it's not uncommon for T1s to have two doses of 24 hours so called basal insulin a day, mainly because those insulins often don't last quite 24 hours, and better coverage is attained by splitting the dose into two, and having two doses, usually morning and night. (T1s have fast acting insulin as well, so called bolus insulin, which is given before meals so as to mop up the carbohydrate in their food. )
I'm going to stop here as I don't want to present you with a wall of text. In your position, I'd push my team hard for some additional information and help.
Good luck.
Unfortunately many of the regular posters are asleep now so you may have to wait a few hours before getting some more responses.
I'm sorry you've had such a stressful introduction to the world of insulin, and do feel that you could do with some more information from your diabetic team. (I guess this is the DN at your surgery? ) Have you had a chance to talk to your GP, even though you haven't seen an endocrinologist yet?
But I can make some comments. Firstly, illness can make blood sugars rise dramatically, so even excluding the pancreatitis situation it is possible that you would have needed insulin for your T2. Secondly, pancreatitis can cause diabetes T3c, which is basically a reduction in insulin production due to damage to the pancreas. Some T3cers need insulin, some don't, but they often get lumped in with T1s if they do need insulin. There is a T3c subforum here which may be of interest to you.
Type 3c (Pancreatic) Diabetes | Diabetes Forum • The Global Diabetes Community
But remember, without a chat to your doctor and/or a look at your release notes from the hospital, you don't even know if you have T3c, so you really need to find out from them. And if they don't know, it might be time to ask for a referral to an endocrinologist.
As regards the insulin situation, it's not uncommon for T1s to have two doses of 24 hours so called basal insulin a day, mainly because those insulins often don't last quite 24 hours, and better coverage is attained by splitting the dose into two, and having two doses, usually morning and night. (T1s have fast acting insulin as well, so called bolus insulin, which is given before meals so as to mop up the carbohydrate in their food. )
Have you been educated about hypos? 3.4 is getting dangerously low and I'd expect you to treat it with glucose. Hopefully you had some symptoms (shakiness, hunger, sweating etc) when you got that low, as it makes life much easier if you aware of hypos. Once you are on insulin you should keep glucose (or equivalent) to hand at all times so that you can take some if you go too low. I would contact the nurse urgently and tell her about this low reading, and get more advice on insulin amounts and your other medication.
I'm going to stop here as I don't want to present you with a wall of text. In your position, I'd push my team hard for some additional information and help.
Good luck.
I would ask to see a diabetes educator, I wouldn't be happy with the advice and supervision you are being given.
In general, if you are low of a morning, you reduce the evening dose and as suggested contact your nurse
Can you put up the full name of the insulin, so the insulin users can help when they come online. I don't know of a Humulin that will last 24 hrs. There is NPH, R and a mix of both 70/30 for example.
In general, if you are low of a morning, you reduce the evening dose and as suggested contact your nurse
Can you put up the full name of the insulin, so the insulin users can help when they come online. I don't know of a Humulin that will last 24 hrs. There is NPH, R and a mix of both 70/30 for example.
francesk
Well-Known Member
I take Humulin M3, and I take mine twice a day. I think you need a lot more advice from a specialist diabetes nurse or doctor, as I'm a bit surprised that you are still taking gliclazide and metformin with Humulin, but I'm not medically trained. But to me, you definitely need help from a professional. I'd make a list of questions to ask them, and keep note of your blood sugar readings and times, same with taking your insulin. I hope you feel better, and don't let your blood sugars get too low - keep sweet stuff such as lucazade and jelly babies to hand, and a blood sugar meter with you, so you can test if you feel tired or shaky. Best of luck.
