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Looking for some advice

S

scooterlad75

Active Member
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27
I'm type 2 diabetic for many years now. Last year I had cancer so was having radiotherapy and chemo. Christie's put me on Humulin I injections twice daily, as during treatment, I was having hyper episodes constantly. Anyway, I had been discharged from Christies with my libre monitor but now I have nobody to discuss ranges ect. My GP won't change my treatment, our practice nurse won't change or adjust, the diabetes team at the local hospital keep batting my referral back to my GP. My readings are all over the place especially at night, going up to and over at times, of 18.5mmol. At a loss of what to do. I have spoken to the diabetes team, who just then referred me to a healthy eating class for newly diagnosed patients. Not sure where to go from here. My last diabetic eye screening told me I'm at stage 1 diabetic retinopathy. Sorry for the rant. Any advice would be appreciated.
 
brightside you've got access to access to cgm :)
how long have you been injecting insulin for. can take a little bit of time for glucose levels to settle, then should have a follow up appt to discuss where to go from there. i've found exercise prior and after meals can help a little bit. hopefully you'll have another appt with dsn/endo in the near future which your able to discuss dosages, perhaps at next appt, you could ask if possible to perhaps give rapid acting insulin and information on correctional dosages if sugars don't settle down within a few weeks.
 
How long have you been on the insulin and how many units ?
as above it can take a long time for you to adjust to insulin and also ask if you can re a rapid acting insulin as well
that made a huge difference to my reading and Hba1c after 3 months but some one should explain to you jw to use the rapid insulin
 
Hi @scooterlad75 , I’m so sorry to hear you are going through this, you should be receiving better treatment and support. I think in your position I would book an appt. with your GP and express your disappointment at not receiving support with your health. You have been through enough already with your cancer diagnosis and treatment. Emphasise the high blood sugars and how they are already impacting on your eye health. If your GP can’t help with your actual treatment he should be referring you to an endocrinologist and you should insist on it. If you have no luck lodge a complaint with the practice manager.
 
Hi @scooterlad75 I am a little shocked that neither your GP nor your hospital seem willing to adjust your dosages, something which I would have thought was pretty essential for any insulin user. (Disclaimer I'm a T1 insulin user not T2).

While forum rules don't allow us to give specific dosage advice, we can describe our own experiences and I hope that there will also be some more suggestions as to how you can access the care you need.

The diabetes UK charity do have a careline which may be able to help?

Diabetes UK Helpline

Get specialist information and advice on all aspects of living with diabetes. Call us for answers, support or just to talk to someone who knows about diabetes. What is the Diabetes UK Helpline? Our helpline number is 0345 123 2399. It is a dedicated diabetes helpline for all people with...
www.diabetes.org.uk www.diabetes.org.uk
 
have they reviewed your insulin dosage at all within the last year?

have a look careful look over your cgm data, is the graph relatively flat in between meals and throughout overnight fasting if not would seriously consider asking to change to basal / bolus regime. long+fast acting something like toujeo/fiasp. i would at the same token ask regardless about dosage options.

I'd put your concerns on sugar levels in writing and send recorded deliverly asking in the letter about dosage advice and if perhaps another regime maybe better for you. if its in writing they would have to respond in writing. you are entitled to ask for a second opinion, could either ask your GP to refer you for a second specialist opinion or ask the current diabetic team to refer to another team for second opinion.

entirely upto yourself if would like pals to try assist. personally i'd try via letter. then if still not happy with reponse put in official complaint (with help of pals should you believe they are going to be beneficial).

curious if overweight or anything? other advice can give is exercise enough to burn more cals than your consuming you can use carbs n cals (or simular app) alongside a smart watch for that.

edit added below:
other alternative is ask to be referred to diabetic dietician. keep food diary alongside exercise + meds... written down give cgm data sharing. they are allowed to discuss dosages, and can further assist with cals consuming vs used :)
 
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Hi,

I am shocked that you seem to have fallen between the consultant and your GP here. I am a type 2 on insulin and I had one consultation at the hospital clinic and was then referred back to my GP practice for management (actually pretty much left to my own devices to find out what dose worked for me). I have in the past had problems where I was prescribed diabetic medication by another doctor that my practise nurse didn’t understand and therefore wouldn’t change. But that’s no excuse for leaving you without help.

Would you prefer to be seen at the hospital or GP. If the hospital I would certainly contact Pals, if the GP then contact the practice manager. Or big bang…..write a letter and send it to both asking them to find a resolution together.

You may know this already the Humulin 1 is an intermediate acting insulin intended to keep your baseline blood sugar (ie when you haven’t eaten) at a steady rate. It’s not an insulin I have any knowledge of so I’m unsure why you have been prescribed so much less at night.

This type of insulin won’t give you a lot of help covering for meals and therefore it is definitely worth looking at what you are eating. Can you give us an idea what your usual diet looks like?

One way to reduce the impact of meals is to lower the carb intake. If your blood sugar is going high overnight it’s worth looking at the timing of your evening meal and whether the content could be tweaked to reduce sugars. As you are on insulin though this should be done gradually, as the last thing you want is to start getting hypos.
 
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