Insulin advice

[Elaine p]

Hello all, i’m still getting used to diabetes so please excuse all the questions. I’ve been on insulin, Humulin 1, twice a day since diagnosis in April. I’ve read a lot about the influences carbs have on BG levels and just wondering that, if I reduce my carb intake enough, will my dose of insulin also be reduced? I also don’t want to eat breakfast when I wake, but rather about 12.00, but have been told to inject in the morning and before evening meal. Is this because of the insulin i’ve been prescribed, and is there something more suitable for my eating regime rather than me eating to suit the insulin? I’ve been messing about with my insulin intake the last few weeks and realise this isn’t ideal, as I don’t know what i’m doing! I’ve got an appointment with DN in 2 weeks (my first since diagnosis) and would like to be informed. Thanks x

 

[bulkbiker]

Are you monitoring your blood sugar levels and what are they doing while you are taking the insulin?

 

[Elaine p]

Are you monitoring your blood sugar levels and what are they doing while you are taking the insulin?

I currently check my levels before and 2 hours after each meal. When I tried to cut out carbs for 3 weeks my BS levels went very low and I had some hypos overnight and early morning. One very severe, being that I passed out in the bathroom, and this frightened me enough to start eating carbs again to bring BS levels back up. I’ve worked out that there’s some correlation between carbs and insulin but I don’t know how the management is achieved. For instance, on Saturday I ate late, my first meal was at 3pm, when I ate a pitta bread with haloumi and salad and 2 cappuccinos with cow’s milk, and at 9pm I had chicken salad (no carbs) so I only injected at 3pm. I didn’t inject at 9pm because I was concerned about hypo but I don’t know if this is good practice or not or i’m doing more harm than good. My BS levels were good that day, but a little up (7.1) on Sunday morning. Thanks x

 

[bulkbiker]

Did you have a very high HbA1c when you were diagnosed?
Its quite unusual for a newly diagnosed Type 2 to be put onto insulin as a first treatment.
Do you live in the UK?

 

[Diakat]

A basal / bolus insulin programme would give more flexibility if you stay on insulin. This involves carb counting and adjusting doses.

Given your upcoming appointment it may be best to wait and ask why insulin was chosen and if you can try diet / other medications instead.

 

[Elaine p]

Did you have a very high HbA1c when you were diagnosed?
Its quite unusual for a newly diagnosed Type 2 to be put onto insulin as a first treatment.
Do you live in the UK?

Thanks for reply. My HbA1c was 81 at diagnosis and my BS level at about 33/34. I started on insulin at 6 units then increased 2 units every 3 days until my average BS levels got to about 12 after meals, when I was using 20 units twice a day. My BS levels remained erratic around 12s until I gained a little knowledge around carbs and started to reduce my intake. Then I cut out carbs all together and my before meal BS levels were between 3-4 and after meals round 5. I have wondered about being put straight onto insulin.

 

[Elaine p]

A basal / bolus insulin programme would give more flexibility if you stay on insulin. This involves carb counting and adjusting doses.

Given your upcoming appointment it may be best to wait and ask why insulin was chosen and if you can try diet / other medications instead.

Than you for reply. Those would be good questions to ask. Do type 2s usually do the basal/bolus programme?

 

[Diakat]

Than you for reply. Those would be good questions to ask. Do type 2s usually do the basal/bolus programme?

Some do, one I can think of is @ickihun

 

[Jaylee]

Hello all, i’m still getting used to diabetes so please excuse all the questions. I’ve been on insulin, Humulin 1, twice a day since diagnosis in April. I’ve read a lot about the influences carbs have on BG levels and just wondering that, if I reduce my carb intake enough, will my dose of insulin also be reduced? I also don’t want to eat breakfast when I wake, but rather about 12.00, but have been told to inject in the morning and before evening meal. Is this because of the insulin i’ve been prescribed, and is there something more suitable for my eating regime rather than me eating to suit the insulin? I’ve been messing about with my insulin intake the last few weeks and realise this isn’t ideal, as I don’t know what i’m doing! I’ve got an appointment with DN in 2 weeks (my first since diagnosis) and would like to be informed. Thanks x

I currently check my levels before and 2 hours after each meal. When I tried to cut out carbs for 3 weeks my BS levels went very low and I had some hypos overnight and early morning. One very severe, being that I passed out in the bathroom, and this frightened me enough to start eating carbs again to bring BS levels back up. I’ve worked out that there’s some correlation between carbs and insulin but I don’t know how the management is achieved. For instance, on Saturday I ate late, my first meal was at 3pm, when I ate a pitta bread with haloumi and salad and 2 cappuccinos with cow’s milk, and at 9pm I had chicken salad (no carbs) so I only injected at 3pm. I didn’t inject at 9pm because I was concerned about hypo but I don’t know if this is good practice or not or i’m doing more harm than good. My BS levels were good that day, but a little up (7.1) on Sunday morning. Thanks x

Hi,

From what I can make out, you apear to be moving your insulin dosage of Humulin around at different times of the day? Or omitting a dose due to a low carb meal? Which doesn't seem to work. You may also be "stacking" insulin which is a dangerous practice with the meds. Causing severe or recuring hypos...
Your advice from the HCP was to inject approximately 12 hours apart by the looks of it? Which would be right regarding an insulin regime working profile such as the one you're prescribed with a rigid "3 square" meal plan timing a day...

Basal/bolus is more flexible. I don't do breakfast myself, often opting for a "brunch" or a slightly later midday'sh meal.

You need to get back to your doc & enquire about an insulin regime more suitable to you..

Kind regards.

 

[Grizz 2]

I really don’t know what I’m doing on here? I’m not sure how to post & ask questions? Anyways my question is what can I do to try and lower my sugar if I’m traveling and left my insulin pens at home? I keep doing reading on my thing and it just says hi every time?

 

[Diakat]

I really don’t know what I’m doing on here? I’m not sure how to post & ask questions? Anyways my question is what can I do to try and lower my sugar if I’m traveling and left my insulin pens at home? I keep doing reading on my thing and it just says hi every time?

Are you traveling in the UK? Call 111 for advice.
Outside UK? Contact local services if possible. Or go to a pharmacy and explain- show test kit.
Drink lots of water.
Let us know how you get on.

 

[Alison54321]

@Elaine p Humulin 1 is an intermediate acting insulin, not a short acting, so it's similar, but not exactly the same, as a basal insulin.

The method for starting people with Type 2 diabetes seems to be to start with a longer acting background insulin, similar to a basal insulin, and see how it goes.

So stick with 2 doses a day, and it does mean that if you don't eat any carbs you'll keep your blood sugars down, but that doesn't necessarily give a reliable indicator of what is happening with your blood sugar.

 

[Elaine p]

Hi,

From what I can make out, you apear to be moving your insulin dosage of Humulin around at different times of the day? Or omitting a dose due to a low carb meal? Which doesn't seem to work. You may also be "stacking" insulin which is a dangerous practice with the meds. Causing severe or recuring hypos...
Your advice from the HCP was to inject approximately 12 hours apart by the looks of it? Which would be right regarding an insulin regime working profile such as the one you're prescribed with a rigid "3 square" meal plan timing a day...

Basal/bolus is more flexible. I don't do breakfast myself, often opting for a "brunch" or a slightly later midday'sh meal.

You need to get back to your doc & enquire about an insulin regime more suitable to you..

Kind regards.

Thanks for reply, very useful info x

 

[Elaine p]

@Elaine p Humulin 1 is an intermediate acting insulin, not a short acting, so it's similar, but not exactly the same, as a basal insulin.

The method for starting people with Type 2 diabetes seems to be to start with a longer acting background insulin, similar to a basal insulin, and see how it goes.

So stick with 2 doses a day, and it does mean that if you don't eat any carbs you'll keep your blood sugars down, but that doesn't necessarily give a reliable indicator of what is happening with your blood sugar.

Thanks for that

 

[bulkbiker]

Thanks for reply. My HbA1c was 81 at diagnosis and my BS level at about 33/34. I started on insulin at 6 units then increased 2 units every 3 days until my average BS levels got to about 12 after meals, when I was using 20 units twice a day. My BS levels remained erratic around 12s until I gained a little knowledge around carbs and started to reduce my intake. Then I cut out carbs all together and my before meal BS levels were between 3-4 and after meals round 5. I have wondered about being put straight onto insulin.

Very odd that they put you on insulin to start with.. my HbA1c on diagnosis was 87 but insulin wasn't even mentioned apart from the nurse threatening me with "chronic, progressive condition you'll end up injecting it".
In your shoes and if you want to carry on with low carbing I'd go back to the Docs and request that you try dietary control (maybe with metformin) rather than insulin. Eating more carbs to allow you to continue injecting seems a bit crazy to be honest.

 

[kitedoc]

I currently check my levels before and 2 hours after each meal. When I tried to cut out carbs for 3 weeks my BS levels went very low and I had some hypos overnight and early morning. One very severe, being that I passed out in the bathroom, and this frightened me enough to start eating carbs again to bring BS levels back up. I’ve worked out that there’s some correlation between carbs and insulin but I don’t know how the management is achieved. For instance, on Saturday I ate late, my first meal was at 3pm, when I ate a pitta bread with haloumi and salad and 2 cappuccinos with cow’s milk, and at 9pm I had chicken salad (no carbs) so I only injected at 3pm. I didn’t inject at 9pm because I was concerned about hypo but I don’t know if this is good practice or not or i’m doing more harm than good. My BS levels were good that day, but a little up (7.1) on Sunday morning. Thanks x

Hi @Elaine p, As a diabetic on insulin, not as professional advice or opinion: That is the thing about insulin. If you are prescribed it you need to balance its blood sugar lowering effect with food, otherwise the hypos like you experienced happen. Once injetced you cannot take it back !! That is not to say that insulin cannot be altered in dose and type to allow more flexibility in lifestyle.
Question for your DN - Am I overweight, and if so, will losing weight help to improve my diabetes? do I need to be on insulin long term or is the insulin just to get my BSLs down whilst another treatment is worked out ? If I need to stay on insulin how do I adjust it for a lower carb diet than at present as a means to help lose weight and lower my BSLs and where I do not wish to have breakfast? ( dictate your terms, diabetes management is about tailoring treatment to your lifestyle). And some information on hypos from your DN is important also. (And see home page and using question box, upper right - hypoglycaemia - for more information). Best Wishes!!

 

[Elaine p]

Hi @Elaine p, As a diabetic on insulin, not as professional advice or opinion: That is the thing about insulin. If you are prescribed it you need to balance its blood sugar lowering effect with food, otherwise the hypos like you experienced happen. Once injetced you cannot take it back !! That is not to say that insulin cannot be altered in dose and type to allow more flexibility in lifestyle.
Question for your DN - Am I overweight, and if so, will losing weight help to improve my diabetes? do I need to be on insulin long term or is the insulin just to get my BSLs down whilst another treatment is worked out ? If I need to stay on insulin how do I adjust it for a lower carb diet than at present as a means to help lose weight and lower my BSLs and where I do not wish to have breakfast? ( dictate your terms, diabetes management is about tailoring treatment to your lifestyle). And some information on hypos from your DN is important also. (And see home page and using question box, upper right - hypoglycaemia - for more information). Best Wishes!!

Thanks very much for your reply, it will help at my next appointment x

 

[Elaine p]

Very odd that they put you on insulin to start with.. my HbA1c on diagnosis was 87 but insulin wasn't even mentioned apart from the nurse threatening me with "chronic, progressive condition you'll end up injecting it".
In your shoes and if you want to carry on with low carbing I'd go back to the Docs and request that you try dietary control (maybe with metformin) rather than insulin. Eating more carbs to allow you to continue injecting seems a bit crazy to be honest.

Thanks for info x

 

[Elaine p]

Hi,

From what I can make out, you apear to be moving your insulin dosage of Humulin around at different times of the day? Or omitting a dose due to a low carb meal? Which doesn't seem to work. You may also be "stacking" insulin which is a dangerous practice with the meds. Causing severe or recuring hypos...
Your advice from the HCP was to inject approximately 12 hours apart by the looks of it? Which would be right regarding an insulin regime working profile such as the one you're prescribed with a rigid "3 square" meal plan timing a day...

Basal/bolus is more flexible. I don't do breakfast myself, often opting for a "brunch" or a slightly later midday'sh meal.

You need to get back to your doc & enquire about an insulin regime more suitable to you..

Kind regards.

Thanks, info is very informative x