Just started insulin

Hi, I have also just started on insulin, I am on Humalin I, 10units before bed, been at it a week now, my numbers have down from high teens to10s but im still getting silly spikes, last couple of days been getting some 5s before food, this lunchtime Iwent from 5.1 before food, 15.3 after, my DSN has said next week I may need fast acting but I suppose she will tell me what is what then, I dont know how long exactly you have been at it but I am pretty sure its having a bigger effect now than last weekend, maybe (and this is a guess) it increases a bit over time, maybe you need to see how things go? But I am really clueless to be honest, just wanted to empathise and wish you luck with it

I have been taken off Alogliptin but still taking Jardiance and 2gMetformin

Kevrey said:

Hi everyone, I have just stated insulin having maxed out on all of the various oral meds. Started out on 6 units of novamix 30 twice daily. I was expecting the insulin to have a much greater effect, I am now up to 14 units and it still doesn’t seem to be lowering my glucose, I know I have to keep increasing it but why no difference between 6 units and 14?
Is this normal for someone starting insulin.
I have to say I am sure I feel better now I am not taking gliclazide, alogliptin and piaglitozone although I am still on the metformin.

Regards

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I've noticed that for people with T2D who start taking insulin the HCPs seem to start with quite a low dose, 14 units of n insulin mix isn't that high. I usually take a total of 24 units a day, and I'm fairly insulin sensitive. Maybe the next dose increase you'll start to notice a difference.

Fenn said:

Hi, I have also just started on insulin, I am on Humalin I, 10units before bed, been at it a week now, my numbers have down from high teens to10s but im still getting silly spikes, last couple of days been getting some 5s before food, this lunchtime Iwent from 5.1 before food, 15.3 after, my DSN has said next week I may need fast acting but I suppose she will tell me what is what then, I dont know how long exactly you have been at it but I am pretty sure its having a bigger effect now than last weekend, maybe (and this is a guess) it increases a bit over time, maybe you need to see how things go? But I am really clueless to be honest, just wanted to empathise and wish you luck with it

I have been taken off Alogliptin but still taking Jardiance and 2gMetformin

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That 10 units is still working then, that's good news. I remember your thread on this.

Alison54321 said:

That 10 units is still working then, that's good news. I remember your thread on this.

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Yes it seems to be doing a good job at my background bg, its just the spikes, im very happy because when im averaging my 100 tests a day, I think im about 9 which is much better than 11.1 HBA1c, my morning bgs are much much better, so far so good

Thanks

Yes I believe your right, I think the most harmful thing is high numbers so putting up the dose must be the lesser of two evils, not that im saying insulin is evil, or at least I hope its not lol

I’m also on Humulin 1 and started off on 6 units x 2 a day. A went up 2 units every 3 days until I settled at 20 units x 2 a day. My BG was within guidelines before meals but rose to upto 12+ after. I have since reduced my carb intake and my BS stabilised at around 4 -7 after meals but I experienced some hypos during the night. Since then my insulin has been reduced to 14 units x 2 a day and this has been suiting me fine with levels about 6-7.5 after meals. However, today I have been out and about and have only injected once at 4pm as that was the first time I had the opportunity to eat and I had a halloumi and salad pita bread and two cappuccinos. I’ve just had a chicken salad at 9pm but didn’t inject for that meal as I wasn’t eating any carbs and I didn’t know if the insulin was still active from the 4pm dose. I’ll see when I test at 11pm. I’ve got some questions about insulin when I see the DN next week.

Kevrey said:

Thanks for the replies, I suppose I was just expecting an instant result and thought the result would be more linear. From what I am reading T2,s are insulin resistant which makes it more difficult to dose as the insulin does not have the same effect on everyone as it depends on the level of resistance.

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I believe you are right. Starting insulin if you are overweight (don't know whether you are?) and possibly with insulin resistance could be adding insulin to a body already having too much insulin. The result is not much. Can you let us know what your BMI is and your typical diet?

This is such a complicated issue. Some people just have genes that make them more insulin resistant, but there are things that can increase, like being overweight, or other things.

But the thing is if you are prone to being insulin resistant it will mean that your insulin producing beta cells will have to have worked very hard, and might have got a bit tired, and be producing less. Which might well be the reason why you are now having to take insulin.

On the issue of your blood sugar going up over night this can often happen to people with Type 1 diabetes, when there is something called dawn phenomenon where the adrenal glands start working in the early morning, and the liver pushes out glucose, and blood sugar starts to rise. So that might explain the overnight rise.

Also your breakfast carb spike took you back down to 4.2 which suggests that the insulin is working reasonably well in the day time, because your breakfast was quite high carb, porridge spikes blood sugar quite a lot, and bananas.

I think that shows the insulin is working, and if you feel better using it, than the previous medicines that seems like a good thing.

I found this article on insulin resistance, below, that seems quite good. You may want to reduce your carb intake a bit, at least for a little while, because managing carbs and insulin is complicated enough with Type 1 diabetes, throwing in a bit of insulin resistance makes it even more complicated.

But getting down to 4.2 suggests it is working, so keep an eye out for hypos.

http://www.diabetesforecast.org/2011/jun/understanding-insulin-resistance.html

The other thing is that you may need to switch to an insulin regime that better reflects your needs throughout the day. If you're going high overnight then you probably need more long acting overnight, whereas if you're going down to 4.2 during the day, that's quite low, and maybe you need an insulin regime better tailored to your needs than novomix 30.

Maybe that is worth talking about with your DSN.

Kevrey said:

Thanks for your replies. I have just seen my DNS and he assures me this is normal and it takes time, the dose of insulin I am on is not large and there is plenty of scope to increase it, in fact he has suggested I go up to 22 units. I think the problem is I was expecting to go on insulin and have instant results, I don’t think I understood how complicated insulin resistance is.

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Have you thought about dietary changes? You seem to be eating things that will cause large spikes in your blood sugar levels...
porridge, blueberries and bananas necessitating larger doses of insulin. By not causing the spikes in the first place you might find better control? Just a thought.

Alison54321 said:

I've noticed that for people with T2D who start taking insulin the HCPs seem to start with quite a low dose

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Possibly to avoid killing their patients?

Eggs any which way, scrambled, fried, boiled without the bread soldiers mind........or how about some nice bacon and mushrooms with them...........I love poached eggs with crispy bacon.......mmmmmm.........or omelette with bacon and or mushrooms, or black pudding if you like it.........sets me up a treat for the day........