Meals

[Mastermind]

I am a type 2 diabetic diagnosed in 1986. Initially I was on diet and metformin. Myy occupation was a London bus driver for 25 years, up to 1999 when I had an MI. I was then put on insulin and metformin, and was medically retired. I had a triple bypass in 2002
However, I am not having any success with my control, often reading are elevated to between 11 and 20, and, even then, I am injecting up to 60 units. My main problem here is that, after having so many different meal times for 25 years, I am not hungry at the 4 times a day recommended. I can only, obviously, eat when I am hungry. This is the main problem, I think.
I am simply unable to get my body clock to regulate meal times. My diabetic team tell me I MUST do this, yet it is impossible for me to do so, even after 9 years.
Is there any advice for me to overcome this serious problem, remembering that I just CAN'T get my body clock right :?:
Thank you

 

[wiflib]

Welcome to the forum.

Interesting advice from your team. I wonder how they expect those with diabetes who work full time, rotating shifts to eat at regular meal times?

What sort of things do you eat? I suspect this has more baring on your BS numbers than when you eat them.

I hope we will be of help to you. Keep posting.

wiflib

 

[jopar]

Metromin several actions 2 of these is it cuts the amount of gluogen stored in the liver so it slow the proecess of the liver putting this into the blood as glucose... So the insulin has less to work with and in most cases it does surpress the appite so that you don't want to eat so much...

If I'm right they are giving you a long acting insulin that is injected once or twice a day! This is generaly called background insulin it is designed to tackle the glucose coming from the liver!

So if the medication is aimed at whats coming off the liver... Then how do they suggest you combat the increase of BG's via food input?

Do you know anything about carbs and carb counting?

 

[Mastermind]

Thanks to both wiflib and jopar
My insulin is NovoRapid 1x per day and lantus (Glargin) before bed. My diabetic team say to me quote" take sandwiches with you and eat regularly that way". I'm afraid that they live in a different world to me. If I took their advice I'd have to stop my bus midway, apologise to my passengers while I eat the sandwich. When I bring up these points they are ignored.
I find that my Metformin DOES help a bit but not enough to keep the BM low. Generally, as I'm now retired, I'd have plenty of fruit and, perhaps, a cooked dinner using low card items. I've tried to inject 4 times per day, yet the BM stay high, very rarely below 10. To compound my problems I can't exercise properly, having neuropathy in both feed and ankles, as well as a crushed vertebrae in my lower back. Also, I still have, occasionally, angina attacks, even though I've had a triple bypass in '02.
I won't be able to have another bypass until 15 years have passed. Therefore, I have to rely on my GTN spray. These make walking or swimming etc impossible.
All in all, my diabetic team are letting me down badly. Even my GP says so. I've had countless rows with the team members. These are the junior doctors. The consultant I've only seen twice in 22 years.
I know this is a long winded posting, but I think all these points are to relevant to the high BM's
I may take time to respond, but I promise I will read all and every posting and take ANY advice.
Thanks in advance

 

[Trinkwasser]

All in all, my diabetic team are letting me down badly. Even my GP says so. I've had countless rows with the team members. These are the junior doctors. The consultant I've only seen twice in 22 years.

Sadly I can only agree. Surely the point of basal/bolus is that you use the basal once (or twice) a day and use the bolus PER MEAL??? Also sounds like your doses are far too low, you are in serious need of professional help.

 

[LittleSue]

Definitely sounds like your dose needs major overhaul. Strange you're only taking NovoRapid once a day, its supposed to deal with food, it doesn't last all day yet they're telling you to eat regular carbs. Maybe you also need Lantus twice a day, many find it doesn't last 24 hours. If Lantus at bedtime isn't lasting and NovoRapid only once, unless you're eating no carbs its not surprising your bs is high.

What they told you about mealtimes is soooo outdated. If your basal (Lantus) is properly adjusted so it keeps your bs even (neither drifting up or forcing you down), and your NovoRapid injected to cover food, then meals/snacks can be as and when you want without risk of going to high or low due to irregular meals. Food can then be skipped if not hungry. (Does wonders for quality of life too though of course they won't care about that!) This is the whole basis for the DAFNE programme for type 1 - I know you're type 2, but as you need both basal and bolus insulin I think the same principles should apply.

As your GP agrees you've been let down, ask him to refer you to a different hospital. Mention Patient Choice and second opinion. If unwilling to do that, at least get him to ask the consultant to see you personally.