Joined a while ago but not really been on..

sharron59 said:

Hi Mike. Not sure on the Hba1C. My doc or nurse never explain anythibg except tell me what they want it to be is 7 on waking and around 9 on going to bed. No leaflets in the surgery on the ibsulin. Told me what to look for hypi etc. That's why thought would seek the forum out. Breakfast.... Porridge or two slices brown bread toasted. Piece of fruit mid morning. Often skip lunch but since insulin having small salad. Evening meal chicken and vegetables. Fruit low fat yoghurt. Cups of black tea as dont like milk and at least couple litres water per dayj. Maybe fruit mid afternoon¡ I have got more stressed since insulin though with no help or understanding and know nobody on it.

Click to expand...

It’s extremely important to know your HBA1C.

The target is 48 or lower.

Hi and welcome @sharron59

Looks like you have got a few things going on, which are probably working together to make you feel pretty miserable!

Your insulin is Lantus. Did your doc explain that this is known as a basal insulin? That means you inject it once a day and it slowly works in the background to keep your blood glucose steady overnight and when you haven’t eaten. It is supposed to be effective for around 24 hours, which is why you only inject it once a day.

However, because it is a background (basal) insulin it won’t be dealing with the rise in blood glucose after each meal.

The doc has suggested that you very slowly increase your Lantus a little every day to reduce the risk of you using too much at a time and having a hypo. So while it is frustrating, it is for a very good reason and you will feel better when you reach the correct dose

I know you are on metformin, but can you remind me of the name of the other tablet they just prescribed you? Some of them act in different ways.

You said you have a virus at the moment? Lots of us find that viruses drive our blood glucose up for a few days, as our body fights the infection. So you may be seeing higher levels than usual, which will be making you feel even grottier, on top of the symptoms of the virus. It will pass though, once the cold has gone.

Several people have asked you about what you are eating, and suggested that you lower your carb intake (carbs are bread, rice, potato, pasta, sugar and sweet fruit). That is generally very good advice for type 2 diabetics, since the more carbs we eat, the higher our blood glucose goes.

HOWEVER
If you start cutting carbs down, your blood glucose may drop quickly.
And when you recover from your virus, your blood glucose may drop quickly.
And since you are adding to your Lantus insulin injection every night, your blood glucose should also drop.
- and those 3 things together could give you hypos.

So first I want to ask if your doc or nurse have told you what to do in case of hypos? And that you are carrying your blood glucose meter and hypo treatment with you all the time?

And then I am going to suggest that you only change one thing at a time. Then you will know what effect that one thing is having. Please check with your doc or nurse about this, because they may want you to wait until you are over your virus before increasing your insulin.

And please don’t start cutting your carbs dramatically. There is plenty of time to do that later. But if you wait until you are over your virus, and you have a better understanding of how your insulin and other meds work together, then you will be able to reduce carbs safely and steadily.

In the meantime, concentrate on getting better, and please let us know how you are getting on?

Hope that helps.

sharron59 said:

I only went on it last week so roughly ten days and this is first time on for some time. Will amend it all tomrrow now back on.it is a pen and I have to take it at night before bed. Started at 10 and told until it went to seven in the morning to keep upping by 2ml every 2/3days.... Just reached 16 tonight..pen says Lantus Solostar insulin glargine.

Click to expand...

Hi @sharron59 ,

Lantus. A "background" or you may see the term "basal" insulin. Long acting.
Here is a link to trusted advice on how you can work out the dose for you.. https://mysugr.com/basal-rate-testing/
Get the foundations right? & the "house" should be solid.

You may need to wait untill your virus clears up before commencing a basal test.
Though to be fair there are also "sick day rules" regarding insulin use to keep the BS in check..

Are you prescribed any fast acting insulin, (in addition.) such as novo rapid?

With insulin you really must take heed of what those who know of what they write tell you - I went from full blown diabetic with Hba1c of 91 to no longer diabetic in 80 days of low carbing - after finding I could not live with the Metformin and statin tablets. It is going to help bring down your numbers if you alter the amount of carbs you eat - but as your HCPs seem to be in the chocolate teapot range of usefulness when it comes to dietary advice, you need to take on board just how effective low carbing can be. I have been a year in normal readings just using diet - and although I might just be one of the lucky ones I would like to think that low carbing can normalize a lot of people - so really be super careful about just how many carbs you are eating - I'd suggest cutting out no more than 5 gm of carbs from your usual diet and keeping close to that amount for perhaps up to a week before making another reduction - particularly if you are injecting insulin before bed - night time hypos are dangerous.
I used Dr Atkins New Diet Revolution - the last edition done by the Dr himself, and that does mention working backwards down the carbohydrate ladder rather than going fully low carb at once - the book can be downloaded free or it could be obtained for pennies, and might be useful in that it has a lot of information about making adjustments and the usual route back to normality for so many thousands of people.

Reduce your weight and stabilise it on Low carb diet without high fat. See a physiotherapist to integrate tolerable exercise daily for joints mobility and weight loss. Medication is NOT the only solution for diabetes.

Sent from my E6683 using Diabetes Forum mobile app

Porridge, toast, and fruit won't be helping, also doctors and diabetic nurse can't be trusted to know what they are talking about.

sharron59 said:

Hi guys. Age 62, disabled with severe arthritic condition. type 2 for a few years now on Metformin and Victoza injection. Apparently it wasn't doing its job so took Victoza away and gave me an extra tablet. That did nothing either to lower so last week went on Insulin. Don't know much about it, my practice nurse talks down to you instead of explaining so only know what I read on here. Started in 10ml before bed, raised to 12 last saturday, to 14 on Tuesday and 16 last night. Ideally wants me to get up with a reading of 7. Sadly still at between 8.6 and 9.2. Going to bed on average of 10.2 to 12.5. feeling so rough tonight and 13.2. not helped by having bad cough and cold. I have eaten the same exactly each day this week but varies so much, why?? On six other medications including Warfarin so have to watch what eat and drink there also. I really need to get on top of this as now stressing me out so any help going to be greatly appreciated as my surgery just give you prescription and on your way. I am greatly overweight not helped by limited mobility due to severe arthritis in both knees

Click to expand...

Hi Sharon I can’t help with advice on insulin,
I managed to convince my dn to let me try diet again as she was about to do insulin prescription.

Would some light stretching with pilates bands help with exercise.

My mum was on warfarin for years & controlled best when staying with me
I would do her.
Breakfasts sausage, bacon, scrambled egg mushrooms

Lunches omelette .salads tuna cheese cold meats

Dinners fish ( fav smoked haddock) meats veg

Hope this helps

Welcome here Sharron , I too was morbidly obese initially , now NOT so morbidly , low carb High healthy fats helped my artrithis lowered it a lot I could hardly walk , loosing weight has given me my mobility back , well sometimes it still hurts and I walk like a duck but most days the pain is gone now

Freema said:

Welcome here Sharron , I too was morbidly obese initially , now NOT so morbidly , low carb High healthy fats helped my artrithis lowered it a lot I could hardly walk , loosing weight has given me my mobility back , well sometimes it still hurts and I walk like a duck but most days the pain is gone now

Click to expand...

So very true. It is a bit unfortunate that weight loss gets pushed aside and all the focus goes into diet. For anyone who is overweight, trimming down is every bit as important. The good bit is that once on a good low carb diet the weight loss is much easier to manage as well. They need to go together.
Glenn