Insulin Goals...

Hi all,

Am a new-ish type 2 using Insulin and recently started metformin.

Have been gradually building up my basal insulin dosage and am now at 34 units per day.

Given that I started in late Jan with readings >25 I'm now, I think, doing quite well.

Last few readings first thing on a morning:

8, 7.2, 3.6, 5.7, 9.4, 7.8 and 6.3.

Was talking to the nurse the other day for a variety of things and mentioned that at that time I was at 36 units and rarely having to take insulin at mealtimes (anything below 7 = no insulin). I thought this was good (ok, the 3.6 was low but was a one-off, the 9.4 was high as i'd snacked overnight).

Anyway, she suggested I drop back down to 34, it almost felt like I *should* be taking insulin ahead of a meal even though the chart she wrote out for me said not to (i.e. I'm now regularly between 5-7 before and after meals).

Can someone help me understand the thinking here - have I misinterpreted? I thought the ultimate goal was to have levels sufficiently within "normal range" that the pre-meal shot wouldn't be required?

Thanks

kaylz91 said:

Are you dropping on the dose of insulin you are taking? Basal insulin should keep you steady in the ABSENCE of carbohydrates so if your still eating carbohydrates but not spiking and only taking basal then it suggest there is too much of it in your system and it is dealing with the food which it shouldn't be

Sorry, does that make sense? I know what I mean but it's often difficult to try and explain things over the net! xx

Click to expand...

Thanks.. i think it does! I'm still eating carbs but have cut them from what I was having prior to diagnosis.

I am seeing an increase after eating (whether i take the fast acting insulin or not). Usually after a couple of hours it more or less returns to where it was.

Case in point, 08/03 -

Morning (pre breakfast) - 9.4
Insulin: 4 units.
Morning (2 hours after eating) - 6.2

So i'd have thought that was good. It's within target 2 hours after eating.

Lunch

Pre meal - 6.8
Insulin - 0 units
Post meal - 8.6

My table (handwritten by nurse) suggests no insulin if pre meal is <7. I'd have thought, having regard for what i was going to eat i'd have taken 2 - 4 units and expected the post meal reading to be lower because of it. That is, the lack of insulin/intake of carbs left my post meal reading too high and I should adjust my fast acting insulin to take this into account.


Evening meal

Pre meal - 6.5
Insulin - 0 units
Post meal - 10.7

As with lunch, going from my own experiences so far i'd have looked at taking 4 units so that the post meal level was similar to the pre meal level.

Does that make sense? Wonder whether my thinking is right or wrong on this?

Have been offered a training course through the CCG so I'll take that but in the meantime its difficult to work out!

Have a free trial of Libre2 coming which I'll use to better understand the interaction of meals and BG levels.

Hope all is well Kaylz.. thanks as ever for your support