Insulin regime change from mixed insulin to basal bolus

Hi all,

Finally had my meeting with the Senior DN at my hospital's diabetes clinic.

She agreed I might be better off switching from Humulin M3 to a basal bolus regime to give me more flexibility, especially where I want to miss a meal and/or reduce carbs a bit.

She is very supportive and has prescribed me Tresiba once a day and Trurapi before meals.

I feel a bit bombarded with info tbh and after thinking about what she said I'm confused by the dosages. Is it calculated on body weight?

I was using HM3, 44 units breakfast and dinner, 14 at lunch.

She has said start the Tresiba once a day, 50 units, then fixed dose of 15 units of Trurapi before meals. She said if I have a carb free meal, leave it.

When I saw the the Dietician straight after she said count my carbs (am happy to do) then calculate 1 unit of Trurapi to 5g of carbs.

I know you can't advise as such, but by these calculations the DN seems to think I consume 75g of carbs per meal? I certainly don't.

I don't want to "feed the insulin", that happens now sometimes.

I can't do very low carb due to taking Dapagflozin but the Dietician said as long as I have say some carb per meal I'm OK. Even a bit of fruit. No one can tell me the min carb while on the Dap.

The Dietician also talked to me about correction dose where my bg is higher than target before a meal. I get that, but didn't explain how many units per mmol.

Yes, I know I need to speak to them to clarify, just looking for anyone who might clarify some of it for me.

She said I can take the Tresiba am or pm, which is best?

I'm ready to grasp all this but am nervous, I wear the Libre 2 sensor, have it on script and have the app on my phone, also given permission to clinic for access.

Thanks for any input, wish me luck.

Chris

Thankyou! Think I'm allowing myself to over think it.

I think I'll start the carb counting and follow the dieticians advice.

It was a lot to take in.

Today I had a pre-op assessment for a throat surgery in 2 weeks time and they've postponed it until the end of March as I have to lose 3lbs in weight to get me under the BMI limit!

I've been trying hard to lose weight and have shed a stone, so the last thing I need is to eat for England lol.

Oh the joys! Lol.

Seriously, many thanks.

Antje77 said:

Let us know how it goes with your new insulins and don't hesitate to keep asking questions!
We can't give dosing advice but we can share our thoughts and experiences, or relevant links.

I'm sorry to hear your surgery has been postponed over a mere 3lbs, especially after having managed to lose a stome already. I'll keep my fingers crossed for those last pesky pounds before the end of March.

Click to expand...

Hi Antje
I've spoken to the DN today and she has agreed I start the Trurapi at 1 unit per 5g of carbs 15 mins before meals to start with.
Take the Tresiba, 50 units at night.

Obviously it's a learning curve and as she says, everyone is different so the ratios can, and prob will change.

She's going to ring me next week to see how I'm doing, or I can ring her if I want to before that.

Thanks for your support, much appreciated.

Chris