Insulin Question?

You should get in touch with your diabetes team in the morning and mention this to them, very surprised those doses are having no effect on your bg levels.

Oh dear. Poor Susie. You'll need to think again. You can't safely sustain BG levels like that, and it'll make your heart and kidney situations worse. So if the current regime isn't working, you all really need to put your heads together again and plan to do something about this.

You must be very insulin resistant. Are you overweight? Can you get your BMI down? That sounds like the last obvious thing to do. If you are overweight, losing it will really really help. And low carb is the pleasantest way to do that, in my experience.

When you say you're careful with carbs, honestly, what sort of daily carb intake are you having? You need to be honest with yourself.

I can only say, if you count carbs strictly and keep to 30g carb a day - eating lots of lovely green vegetables and salad (6g a serving each) and nice meat or fish and eggs - the weight will melt off, and you will become much more sensitive to the insulin you take, so you'll be able to cut the doses. And/or it'll start working better.

It means all the obvious things, but also cutting out fruit and tomatoes. I use

http://www.carbsandcals.com/products/carb-and-calorie-counter-app/

Which I've customised under the 'My Foods' menu tab by adding foods I eat a lot.

And a real, gradual programme of exercise training.

You could also try swapping your basal insulin to see if another one suits you better. Levemir instead of Lantus, eg.

Make them take you seriously. You don't want to develop double diabetes.

Hug, Lucy

This news item today : http://www.diabetes.co.uk/news/2015/mar/high-intensity-exercise-reduces-glucose-levels-90842907.html

Hi Susie!

From what I remember, you have other serious health issues to manage as well as diabetes. I also seem to recall that you have difficulties exercising. Obviously, a lack of exercise won't be helping insulin resistance. I wonder if any of your other medication is reacting to stop the insulin being as effective as it should be? That's only conjecture on my part.

So, what to do? Well, I would probably discuss with your diabetes team moving off mixed insulin and onto a basal/bolus regime. This would mean more injections, but would enable you to increase the background insulin independent of the meal time insulin. Once you have a dose of background insulin working, you'd be able to target what you eat with a bolus injection calculated to your needs. The trouble with mixed insulins is that they cannot be finessed for your lifestyle - with your one, you get 70% basal and 30% bolus regardless of what you need. That mix is clearly not suiting you.

Good luck

Smidge

Dear Susie,

I wasn't assuming you were kidding yourself, only asking if you were .. Point taken about ex.

Agreed, basal/bolus good idea for flexibility.

As you have these figures, what about pressing additionally for a CGM for two weeks, so you can gather some hard data? And match that to your record keeping on meals, injections.

Sounds such a lot to cope with, all at once. Lucy

Hi. Is your BMI too high? It sounds like you need to move to the Basal/Bolus regime so do insist that the GP seriously considers this as my DN did from Day 1. Mixed insulins are a bit of a compromise and OK if you are still producing some of your own insulin. Basal/Bolus gives you total control but it's always better to have weight in the 'normal' range.

Susiespearish said:

I did five days ago noblehead .They just upped it to 20 from15 but I haven't had a reading less than 17 in months :-( They don't seem to take it seriously at all .I have another appointment with the consultant in late March but I'm getting fed up of doing injections that aren't having the slightest effect :-(

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Understandable your fed-up. You should get in touch with the clinic and ask if you can be seen sooner or ask to speak with a DSN, just say your upping the dose and its having no effect, as Smidge says basal/bolus would might be a better option and you should ask your team if this would be the best approach for you. Do give them a ring as you need to get your bg levels down.

Hi Susie . . .

A couple of years ago I had a stage where my injected Insulin was seemingly having very little reaction on my blood-sugar levels. I was upping and upping my dosage, but this wasn't doing much. After some research, I decided on trying a magnesium supplement.

Magnesium is an important mineral which is used by almost every biological reaction in the body, including the opening of the cell by the Insulin receptor to allow Glucose to enter.

It may have been coincidence, of course. But I found that after I added a magnesium supplement to my diet, my blood-sugars reduced drastically. It seems that the Insulin was finally able to do its work.

This may be a little out of "left field" but it's cheap, safe and easy to try (if you didn't already).

I now try to get my magnesium from my diet, by choosing organic foods where possible (foods grown in soil that has not been stripped of all nutrients by modern farming methods and pesticides). But I know that budgets don't always allow this.

Adding a Magnesium & Calcium supplement is a quick and easy thing to try, if only to rule it out.

Hopefully this may be helpful for you . . .

Regards
Antony

Susiespearish said:

Now THAT is very interesting Antony as part of a blood test a while ago flagged my serum magnesium levels as low .I'm a keen organic fan and used to grow a lot of my own veg before I was hampered with heart disease and the gardening became too much . We have chickens as well so lots of lovely fresh eggs . I'll have to make a concerted effort to plant up my beds again this summer but in the meantime I will try a supplement .I'd quite forgotten that blood test .

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Well, hope it works!

If you do try the supplement, 2 hints:

Try to find a soluble tablet. Magnesium is notoriously difficult for the body to absorb as a supplement. If you can find a soluble tablet and drink it, this will help the body to actually absorb and use it.

Take a Calcium supplement too. Magnesium and Calcium work together in all their biological reactions in the body, so it's not helpful to have one without the other. If you take a supplement of both, this helps to keep the balance.

Best wishes
Antony

Susiespearish said:

Hi all.
I'm finding my Insulin isn't having the slightest effect on my BS despite it being upped to 20 in the morning and 20 in the evening .I'm using the Novamix 30 Flexipen and i notice it doesn't go up much higher in dosage .At present I'm on 1000mg SR Metformin. 100mgs of Sitaglipten (Januvia) and STILL my fasting BG's are up in the 17's to 20's .I thought Insulin was the great white hope so what's going wrong ? Despite not being a lover of the LCHF diet I'm always careful with my carbs .What would be a high dosage of the Insulin ?

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Susiespearish said:

Hi all.
I'm finding my Insulin isn't having the slightest effect on my BS despite it being upped to 20 in the morning and 20 in the evening .I'm using the Novamix 30 Flexipen and i notice it doesn't go up much higher in dosage .At present I'm on 1000mg SR Metformin. 100mgs of Sitaglipten (Januvia) and STILL my fasting BG's are up in the 17's to 20's .I thought Insulin was the great white hope so what's going wrong ? Despite not being a lover of the LCHF diet I'm always careful with my carbs .What would be a high dosage of the Insulin ?

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hi susies i am on 2000 mg metformin and 180 units of novamix 90 morn and 90 night my doc says there are peps on twice that amount

Susiespearish said:

Hi all.
I'm finding my Insulin isn't having the slightest effect on my BS despite it being upped to 20 in the morning and 20 in the evening .I'm using the Novamix 30 Flexipen and i notice it doesn't go up much higher in dosage .At present I'm on 1000mg SR Metformin. 100mgs of Sitaglipten (Januvia) and STILL my fasting BG's are up in the 17's to 20's .I thought Insulin was the great white hope so what's going wrong ? Despite not being a lover of the LCHF diet I'm always careful with my carbs .What would be a high dosage of the Insulin ?

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Hi, Contact your team as it would seem that you need something better than Novomix 30. You may now need novorapid or Apidra for quick acting insulin and 'proper' long lasting insulin. It's not good to be that high over a period of time and I'd ask about carb counting for ALL meal, i.e. injecting quick acting at least 3 times a day and then injecting the long lasting as well. I use Apidra, Humulin I and 6 x 500mg metformin SR tablets as I very insulin resistant..

terry175 said:

hi susies i am on 2000 mg metformin and 180 units of novamix 90 morn and 90 night my doc says there are peps on twice that amount

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Hi. Can I ask whether you have excess weight? This is often the reason for needing large amounts of insulin and can cause inflamation at injection points and so on. Are you on a low carb diet?