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Insulin not working well. Type 2.

Discussion in 'Diabetes Discussions' started by Doc_Watson, Sep 10, 2015.

  1. Doc_Watson

    Doc_Watson Type 2 · Newbie

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    Hi all, this is my first visit to the forum and hoping someone will be able to help.
    I am no spring chicken, aged 63 and have been diagnosed with Type 2 diabetes for 15 years.
    At present I am unable to control my blood sugar levels even though I am taking injections 3 times a day together with metformin and Bydureon.
    Insulin doses at present Humalog 50, 78 units at breakfast, 78 units at lunch and 88 units at dinner. Also 2 grms Metformin.
    My levels have never been really stable since the beginning, however for the last year they average around 16 mmol.
    Both GP and consultant are aware, however, it appears we have now reached the shoulder shrugging stage.
    Dietitian has decided to put me on a low carb diet yet again, cant remember how many dietitians I have had over the last 15 years who have all tried that approach to no avail other to making me feel worse.
    I also take many other forms of medication for other ailments that have not cased any problems to the diabetes.
    Anyone out there with any suggestions, however, I am not ready for the wooden overcoat just yet, hopefully.
     
  2. gillykins

    gillykins Type 2 · Newbie

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    Hi, I am in exactly the same position, but left without hope for any improvement. I am putting on weight despite a controlled diet and exercise. Where do we go from here! I am in despair! can anybody help?
     
  3. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Hi and welcome to the forum, and welcome @gillykins too.

    I will tag @daisy1 who has some info she posts for people new to the forum.

    If you could outline what you eat in a typical day we may be able to give you a few pointers there. Do you have a blood glucose meter and test strips?

    Here is some information about insulin for T2s:
    http://www.phlaunt.com/diabetes/15478720.php
     
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  4. graj0

    graj0 · Guest

    Welcome to the forum, I'm sorry that good BG control seems to be illusive at the moment. I'm no spring chicken either being 63 and type II since '97 (19 not 18 LOL). I'm interested that your dietitian has suggested a low carb diet and you say "yet again", those sorts of dietitians would seem like hens teeth when I read this and other forums and the attitudes towards low carb diet.
    I'm not sure why you should say "we have all tried that approach to no avail". I think you will find that a lot of diabetics in general benefit from lowering their carb input rather than "feeling worse". I accept that it's affects might not be the same for everyone and consider myself to be lucky in that by removing bread/pasta/rice/potato from my diet, increasing my vegetable input, watching out for fruit's hidden sugars and not intentionally increasing fats, I was able to avoid being put on insulin, and threw away Gliclazide, Januvia and Atorvastatin. I try to take my BG most days at different times after meals and usually keep to under 7, although at the moment it's all over the place because I've had appendicitis and peritonitis and after surgery I'm still on those horrible antibiotics.
    As I say, been lucky to feel so much better keeping my carbs to under 100 gms a day, but I do know that my pancreas works adequately which may not be true for every type II.
     
  5. nigelho

    nigelho Type 1 · Well-Known Member

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    The doses you're on are very high and seems to be fixed. Why don't your care team try novorapid or Apidra and teach you how to carb count. By reducing the carbs/low carb meals is best. I'm type 1 and very insulin resistant and use Apidra plus 2 x 500mg metformin tablets with each meal. I carb count. I was 60 years old on diagnosis and GP put me down as type 2 and gave me 1 tablet metformin. Within 2 weeks I was in hospital with my BSs in the high 20's and some ketones. Hospital put me immediately on insulin and I was reclassified as type 1 which I prefer to type 2 as I have better control with quick acting and long lasting insulins plus 6 X 500mg metformin SR tablets per day. Try novorapid or Apidra instead of Humalog 50. If you need long lasting insulin then maybe you're mare type 1 than 2. Some GP's still thing type 1 is for young people only....WRONG. What are your BSs and HBA1c.. Ask to be referred to your hospital's diabetes team as you might be type 1.
     
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  6. daisy1

    daisy1 Type 2 · Legend
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    @Doc_Watson

    Hello and welcome to the forum :) Here is the information mentioned above which we give to new members and should help you to improve your control of your levels. Ask as many questions as you need to and someone will be able to help.


    BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
    There are two approaches to controlling your carbs:

    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates

    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
    http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips

    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic

    Note: This post has been edited from Sue/Ken's post to include up to date information.
     
  7. ronialive

    ronialive Type 1 · Well-Known Member

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    Hi, sorry to hear you are having problems. There are many other conditions which can affect control. When I had problems I had a young enthusiastic registrar who did a complete blood profile. It turned out that I had an underactive thyroid and low vitamin d level all of which affected blood glucose control. AFter treatment fo both my levels stabilised.
    maybe just ask for complete bloods to be done and feel free to quote me as a patient if needs be- I am treated in Bristol at Southmead hospital. Good luck and I hope that some of the advice on the forum helps you.
     
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  8. muggle666

    muggle666 Type 1 · Active Member

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    im sorry to hear your bs are not controlled, have you tried different insulin's, maybe have a word with your dn and see what they say, stress and anxiety can also play with your bs as can virus's and illnesses, maybe you have done something different to what you normally would do, see if you can see a pattern to your bs, maybe write them down and see if that helps to see it,hope you start to see a difference soon
     
  9. Doc_Watson

    Doc_Watson Type 2 · Newbie

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    Hi all,
    Thank you for the information and positive advice.
    It is very much appreciated and given me hope that some of it will be able to help with my health problems, not just the diabetes.
     
  10. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    So, can I ask what sorts of things you are eating at the moment, and if you are currently following the low carb diet recommended by your dietician?
     
  11. Doc_Watson

    Doc_Watson Type 2 · Newbie

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    Hi AndBreathe,
    Yes sure, no worries
    Have been following instructions of dietitian and booklet given out by the hospital of amounts of carbs in various foods.
    I have given up white carbs and alcohol and also following info from the book "Carbs & Cals" written by Chris Cheyette and & Yello Balolia in association with Diabetes UK.
    I have been on this regime for nearly a month now and have seen no real difference to my obese weight and blood sugar levels. I also have to be careful as to what I eat regarding saturated fats as I have Isochemic Heart disease.
    The weight problem could be helped if I was able to exercise more than I can, this being to fybromyalgia.
     
  12. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    I encourage you to read the article at this link because it explains why the type of insulin regime you are on may not help much in terms of losing weight and getting your BGs under control. If you read it and consider what it says then you might want to ask your nurse/doctor to consider changing your prescription:
    http://www.phlaunt.com/diabetes/15478720.php
     
  13. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    Many, many of us have found if we really tone down or give up carbs - not just the white carbs, it makes a significant impact on our bloods. I urge you to try that. As you are testing, you could see an impact fairly quickly.

    Many of us have also found we lost weight by cutting the carbs - whether we wanted to or not! In terms of the fat elements; that's a matter of choice, but by the nature of their manufacture, low fat products contain higher carb levels than their full fat brothers and sisters, so just giving up the low fat (as opposed to deliberately eating more butter, fat and cream) could make a difference. I also found I got less hungry on full fat yoghurt than on low fat.

    Whilst exercise is desirable, and all helps with toning it, it's almost the fine tuning for most people. By a long, long way, we have found the biggest impact is seen by what passes our lips.

    Clearly it's important that you continue to diligently test, so that you can ensure you don't go too low, once levels start to drop. Many T1s and T2s using insulin, who reduce their carbs, find that over time their doses tend to reduce a bit. By how much is a very personal thing, depending on the results.

    Good luck with it all.
     
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  14. Madame_Duke

    Madame_Duke Type 2 · Member

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    Your medications are on a par with mine, i agree it feels like a minefield. I am 68 and not a spring chicken either but want to be. I was on Humalog 50 x 158 twice a day. Currently on 20 twice a day and hoping to be off insulin in the next few ? weeks. Have you heard about insulin resistance.
     
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  15. uart

    uart Type 1.5 · Well-Known Member

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    That's a very impressive reduction in insulin requirement Madam Duke. :)

    Can you tell us what things contributed to this reduction. Was it mostly weight lose, or low carbing or some other factor?
     
  16. Madame_Duke

    Madame_Duke Type 2 · Member

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    I doo pay attention to a low carb diet and got sort of 50/50 responce. the appetite repression with Bydureon made it easier, not very hungry most of the time. Insulin is responsible for us putting on weight and the combination of the two seems to work for me.
     
  17. Mep

    Mep Type 2 · Well-Known Member

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    Can I ask... have you tried different insulin brands? The reason is that my endo explained that different brands of insulin have different profiles. So one may not work too well, yet another one may do. If you haven't already tried different types, it may be worth a try. Also some medications do affect sugar levels. For example one of the meds I'm on is baclofen and increasing blood sugar level is one of its side effects. I noticed when I was taken off it and put back on it my body reacted differently than the first by giving me high sugar levels and weight gain (another side effect of it). There are so many things that can affect our BGL's and not just food alone. I hope you can find something that helps... hopefully your medical team can help you do this too. :)
     
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