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insulin

J

jubbtravel

Member
Messages
13
Location
Saddleworth Manchester
Type of diabetes
Type 2
Treatment type
Insulin
Hi,

I am type 2 diabetes, I also have other autoimune diseases, underactive thyroid, asthma, addisons disease, rheumatoid arthritis, fybromylagia. I have been having high blood sugars as I am taking steroids for life for addisons, my GP has started me on insulin for afternoon and evenings thats when my blood sugars are high, it is Apidra, I have been using it for just over a week now and find my blood sugars are even higher, I can't understand why as i am eating exactly the same things. I am going to stop the insulin today and see if they lower. I wondered if anyone else had come across this?

Thanks

lesley
 
hya lesley,
welcome to the forum, unfortunately i cant help with your query but i too have diabetes,asthma and underactive thyroid, im sure someone will be along to help soon :D
 
Hi Lesley
Sorry your having a rotten time of it.Not by any means an expert but am as Im waiting to go for the Synacthen test for Addisons after a low morning cortisol so i have been doing my research, but of course this reply is only my opinion!

Firstly, I think your GP needs to refer you to an Endocrinologist who can deal with all the problems you have, if they havent already. Given the impact of thryoid and adrenal glands on blood sugar you will likely need all your meds balanced to complement one another. Preferably by someone who knows what they are doing.

Cortisol increase blocks insulin and steroids also impact on this so between the Cortisone and thyroid meds any insulin you have will have to work harder to control you bg. Time of day will be important because of the times your steroids kick in though with the cortisone it should mimic your adrenal glands (and therefore be morning dose is highest).

Apidra is short acting insulin that works in about 15 or so minutes and stays in your system for a few hours. I dont understand why you take it only 2x daily. Do you only eat 2x daily? Apidra is a bolus insulin, which you take before each meal.

Do you test after you eat? At which point, 1 or 2 hour? These are the kind of things to keep an eye on and get a picture of whats going on when you eat.

Also how are you dosing the Apidra? It sounds like you are just not taking enough to cover it or eating too many carbs at meal times and the Apidra is not covering it.

I think you need your insulin looking at and I think this needs to be via an Endocrinologist led clinic.

However, please feel to add more so we can help some more

Best
L
 
Hi L,

I do have an endo proff davies at manchester royal but he deals with all my other stuff, I also see a rheumatologist and chest specialist there, but it is over 40 miles round trip for me, my GP specialises in diabetes so I was trusting her to sort me out, she put me on insulin lunch and evening as she said my prednisolone will peak then and that is usually when my sugars are higher. She has only put me on 4 on the solostar I have also tried 6 myself but they don't make any difference. Tonight i tried 12 but that didn't either just done my bloods an hour and 2 hours after and they were 17 and 13.5, for dinner I had chichen breast cooked in slow cooker with celery carrots and onions and half a jacket potato followed by a yogurt. I usually only eat very small portions, for breakfast conflakes and granary toast, nothing till lunch one ham sandwich and rich tea buscuit or yogurt, mid after noon banana (small) or a few nuts and rasins, and dinner most days is either fish or chicken, or homemade soup (no creams or anything added).

I am wondering how much insulin other people take? I have made an appointment with my diabetic nurse again as I am worried now about the high blood sugars, they always used to be around 5 or 6 but now they are 8/9 in a morning lunch time 10, before tea 13, and after tea 12-16, I take amalodipine and I know that raises blood sugar but I just take 5 mgs if I take 10 it goes really high.

I also work full time and also sometimes in the evenings too and have a stressfull job, and at present my asthma is not controlled so I often need more steroids for that, it just seems a big circle, I get one thing right and something else goes wrong!!
Any help would be appreciated, also my brother is also diabetic and he is getting high readings too, but he has a gall stone problem so I thought that may be doing his, and my auntie died in a diabetic coma.

thanks,

lesley
 
Hi Lesley

Lots of people carb manage/low carb diet when diabetic as there is a direct link between carboyhydrates (sugar being just one) which makes an impact on BG. Many folk on bolus insulin (like Apidra) try to work out a ratio to carb:insulin as a way to tackle any carbs they eat. Others limit carbs which limits how high your bg spikes. Has anyone spoke to you about how to dose your Apidra?

Things like jacket potato, cornflakes, granary toast can impact on bg so these might be the culprits for higher readings and it might be worth trying to cut down or look at carb intake and see if it makes a different. If the thought fills you with horror, then maybe look at GI tables to help you make better carb choices. FWIW Ive not eaten bananas, cereal or baked potato since dx though your mileage may vary and you should test for each food to see

It may be that you require insulin full time basal/bolus ( background and meal time insulin) . When you say solostar, do you mean the Apidra pen? If you are taking 12 u of Apidra without an impact on bg then you do need to be referred to someone who knows what they are doing.

It also might be that your asthma and stress have an impact on bg so this also needs to be factored in. Whilst not very helpful to tell you to manage stress, its worth looking at all angles. Dont assume anything however and dont let GP assume it either. They might think its ok to run high for a bit but how long is a 'bit' before they do anything about it

If you post more detail re insulin/food some people may be able to make more specific changes
Also have a flick about the site and see if any of the lower carb stuff motivates you.

L
 
Hi Lesley

When most people start on insulin therapy it is a slow build up to get to the correct therapeutic dose. So you will start on a very low dose which will almost certainly have no real effect. You will then increase by (say) 2 units every 3 days, testing with each increase to see if it is beginning to lower your levels. This may be what the problem is. You may need to slowly increase your dose...
 
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