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Insulin Issues should I ask for a change of Insulin?

Discussion in 'Insulin' started by Silkroad77, Jul 31, 2020.

  1. Silkroad77

    Silkroad77 Type 1 · Member

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    Hello all,

    I'm on Tujeo Solostar and Novorapid, both of which I've been on for about 2 years.

    What I am going to talk about took a few months to develop:

    I'm having issues with the insulins I am taking, in that my blood sugar levels are insane, more or less every day.
    Per month I am having around 20 hypos during the night.
    Before bed, my sugar levels are often 13-16 and sometimes up to 18, then during the night they drop, and very often are 3 or below when I awake, I don't take any insulin just before bed-I'm afraid to!
    I've taken insulin before, but learned very quickly not to do so, unless I want to enjoy a lovely severe hypo!

    Often on waking when it says 'low' on my libre sensor, only to go up to 4.5 or 4, or 6 around 10 minutes later (this is without my eating anything at all!)

    I've put on 3 stones (19kg) and this is after changing from NovoMix 30, to Tujeo Solostar & Novorapid.

    When on Novomix30 I ate more for dinner than I do now, and very often skipped lunch and had snacks instead, I also used to like having dessert a few times a week after dinner-yet my weight was far better!

    Since changing to Tujeo Solostar & Novorapid I've changed the above, I use portion control, carb control, I watch my fat and carbs intake, I'm careful in the way I cook foods/the kinds of foods I eat.
    I cannot snack anymore-I feel too full and never feel like having a snack!
    My apatite has decreased and I find larger portions of one course or a smaller portion of food plus another course too much to handle!

    I've tried the carbs to units of insulin that makes my sugar levels go very high. I was recommended this by my Diabetic Specialist before lockdown-but it doesn't work at all!

    I've been more aware of portion control/carb counting and watching my fat intake, it's not helped.

    I exercise a little more than when I used to take Novomix30, yes I have tried more or less exercise, nothing helps-my blood sugar levels go up from 12-17 after exercise, the time and amount of exercise doesn't do anything, I do not go over the top for exercise, neither do I just walk for 1 minute and then sit down.
    I have been exercising for over a year now-again it's neither over the top, neither is it a tiny amount.

    I have tried the reducing the insulin by 1-3 units, taking time to see how if affects my sugar levels, this hasn't helped.

    I've tried increasing the insulin by 1-2 units and taking time to see how it affects my sugar levels, this hasn't helped.

    I have looked online and I've seen that Novorapid can cause weight gain, but my issues is both gaining 3 stones (19kg) and the insane levels of blood sugar levels, no matter what I do.

    I'm concerned about my health, as this yo-yoing of my blood sugar levels seems to be wreaking havoc on my body, and it's horrible.

    Should I ask to have my insulin changed, or should I just carry on with tweaking insulin levels/portion control/carb counting/exercise/types of food I eat?

    Please could you advise me and thank you for reading this.
     
  2. ert

    ert Type 1 · Well-Known Member

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    I'm sorry you're having a difficult time. I recommend that you write down at least four days of data and email it to your diabetes nurse or specialist. Record your waking, bedtime, before breakfast, lunch and dinner finger-prick blood values. As well as a food CHO diary, and insulin timing and doses. They will get to the bottom of this if you give them a chance.

    It does look like your background insulin is worth checking with your hypos overnight. That will be the first thing they usually get you to check by having a carb-free meal. They will also advise you on your CHO ratio for your different meals (different ratios for different times of the day) and dietary advice; and the dawn phenomenon where your liver pumps out sugar for your day as you put your feet on the floor.

    Good luck.
     
    • Agree Agree x 3
    #2 ert, Jul 31, 2020 at 5:34 PM
    Last edited: Jul 31, 2020
  3. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    Silkroad - Why were you changed to your current insulin regime? You talk about your weight being better, but made no mention of how your blood sugars were?
     
  4. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    If basal testing shows that Tujeo is making you go low at night and low in the day, there are other options. A shorter acting basal insulin, like Levemir or even NPH gives more timing flexibility. The main dose in the morning and, if necessary, a smaller dose before bed could be a better match.

    I recently switched from Lantus to split dose Protophane for similar reasons. I am not using Levemir only because it isn't funded here.
     
  5. Silkroad77

    Silkroad77 Type 1 · Member

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    Hello folks,

    Thanks very much for your replies.

    I'm on Libre Sensor and have been on it since this Feb, I check my bloods when I wake up, after and before meals, before bed, and sometimes during the middle of the night.

    So I'm looking at my results for the past few months, so per month I've had an average glucose of around 7.
    My monthly hypos are average 40 per month

    I take 30 of Toujeo each morning, the reason it's 30 is because when I was taking 28 units, I had more higher blood sugar levels.
    I can understand trying to reduce my Toujeo, however, my blood sugar levels are very often above 10 when I do, hence why I am reluctant to reduce the Toujeo.

    My target range is between 3.9 to 10 mmmol/L


    I had been on Novomix30 for over 20 years, and I'm afraid I was terrible at monitoring my bloods-as in not checking them for months on end, I also missed lots of appointments.
    So I'm sorry to say that I cannot tell you what my sugar levels were.
    It wasn't until I was diagnosed with borderline high blood pressure that I decided to sit up, and take my Diabetes seriously.
    I booked an appointment with a Diabetic Team Specialist and went to the appointment.

    I told the lady about being terrible at monitoring my blood and attending appointments, but also that I skipped lunch altogether, or just had snacks for lunch, and that I had a sweet tooth.

    My Hba1c was between 10.2 and 11.8, it was something close to 70, the reason I remember this is because I was surprised that it wasn't much higher-due to my poor management of my Diabetes.

    The lady asked me if I was interested in a basal & bolus regime, she said it would give me more flexibility, that I could skip lunch & not worry about taking insulin, or I could take a little bit of insulin (depending on the amount of carbs in the snacks I took), and I decided to go for it.

    Okay I shall reduce my Toujeo, and up my Novorapid a little, and monitor what happens.
    The only issue here is I have reduced Toujeo by 2 units (as I was told to do this by the Diabetic Team) but this led to higher blood sugar levels more often. I did adjust my Novorapid when I reduced my Toujeo, but ths time I'll stick to it and adjust my Novorapid more-I guess I just panicked and went back to my normal recommended dosage of Toujeo.

    Thank for for your replies again :)
     
  6. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    The reason I asked was many folks, livin with T1 have reported that they find if they run high numbers for a while, they lose weight, so it could be that may have been happening to you, in the past.

    Of course we have no way of knowing, rather than my speculating, but maybe just something else in the mix.

    You seem to have been adjusting your basal insulin in 2 unit amounts. Is that correct, and is there any reason your team suggested 2 units as opposed to one, as from what you are saying +2 is too much and you go low, and -2 and your numbers are high?

    Have you done a carb counting course, like DAFNE, or BERTIE? That might be something to help with the changes you seem to be experiencing.

    To be clear, I'm neither T1, nor an insulin user, but more just observing and playing back some of the things you say.
     
  7. Silkroad77

    Silkroad77 Type 1 · Member

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    I was going to go onto a DAFNE course in April but then lockdown occured.

    I was told to adjust my basal by 2 units, as I was told that 1 unit wouldn't be as effective, so instead of the usual 30 units, I was told to use 28, but that resulted in more higher blood sugar levels.
     
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