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Type 2 Need to get control, and completely lost

nannoo_bird

nannoo_bird

Well-Known Member
Messages
215
Hi all. I have been a T2 for around 10 years. I take Metformin and insulin. My DN recently changed me to Humulin M3. Despite following a mostly low carb diet and getting regular exercise, my BG levels are all over the place. My fasting blood sugar was 9.8 this morning. I wasn't hungry and didn't have breakfast - and didn't take any insulin as I didn't eat. Just now my BG had gone up to 13.2, despite having no food. There seems no rhyme or reason that I can follow for my levels, and I cannot work out how to get them under control. I cannot see my DN until the end of June. Can anyone point me in the right direction, give me links to documents that will help me understand how to understand my body, my own metabolism, and whether there is a formula I can follow. I am so worried about my health now - I am nearly 62, and do not want to face complications if I can help it. Thank you so much.
 
There is no reason for BG levels to go down just because you have not eaten - we don't work that way.
Your liver is preparing for you to have to trek for miles to find food, or to have to chase something edible, or, having left the safe place you slept in, to run away from something wishing to make you its breakfast.
If I fast I see higher readings, so even if I don't feel hungry I eat a small amount, usually something with a few carbs and that seems to sort things out.
 
I am like @Resurgam. If I don't eat my levels rise and rise through the morning then suddenly plummet at about 11.30. I have to eat something in the morning to prevent that. I usually have eggs or a piece of ham. If I have berries and natural yoghurt my levels shoot up, even though I can eat that fine in the evenings.
I'm not on any medication though. I don't know if that makes a difference.
 
Hi. I wonder why your GP changed you away from the Basal/Bolus regime to a mixed insulin? Normally you would move in the other direction. The Basal/Bolus regime gives far better control than mixed insulin. Do ask the GP why he changed your insulin regime. Are you overweight? If so this may make control with insulin difficult. If you do have excess weight you need to keep the carbs down and if needed reduce the insulin. I would certainly ask the GP about the insulin and perhaps (tactfully!) suggest he moves you back to Basal/Bolus unless he has a good reason. Typically this would be Levemir and NovoRapid. On Basal/Bolus you adjust the Bolus (e.g. Novorapid) to the amount of carbs in the meal. Tables are not really relevant. The Basal is balanced (guidance on this forum if needed or from the DN) and the Bolus adjusted based on the carbs. When this is got right, blood sugar for most people can be quite well controled
 
Daibell said:
Hi. I wonder why your GP changed you away from the Basal/Bolus regime to a mixed insulin? Normally you would move in the other direction. The Basal/Bolus regime gives far better control than mixed insulin. Do ask the GP why he changed your insulin regime. Are you overweight? If so this may make control with insulin difficult. If you do have excess weight you need to keep the carbs down and if needed reduce the insulin. I would certainly ask the GP about the insulin and perhaps (tactfully!) suggest he moves you back to Basal/Bolus unless he has a good reason. Typically this would be Levemir and NovoRapid. On Basal/Bolus you adjust the Bolus (e.g. Novorapid) to the amount of carbs in the meal. Tables are not really relevant. The Basal is balanced (guidance on this forum if needed or from the DN) and the Bolus adjusted based on the carbs. When this is got right, blood sugar for most people can be quite well controled
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Thank you Daibell. Firstly, in our surgery the GP will not deal with diabetes, they leave it to the specialist DN, and I cannot see her again until the end of June. She is new, and she changed everything when I saw her for the first time. She is the only DN in a 50 mile radius, so is always busy. This DN does not believe in low carb. I do. I am overweight (BMI around 31) and struggle to lose weight, despite eating low carb 90% of the time. I just cannot get control - and I will do whatever it takes now.
 
If I were you I would examine what 90% of the time means - if that means 10% of the time you are eating the carbs you shouldn't eat then that may still give you problems, Also have you actually embraced fats ? its very easy to still be frightened of fats and with low carb that will lead to too much protein. The protein itself will also act on your blood sugars and in a much less predictable way than the carbs because it takes so much longer to process.

Why not get yourself a food program - I use cronometer and try recording everything that you eat for a bit. I brought my blood sugars under control with a diet that is 65% fat, 20% Protein, 10% carbs and 5% single malt whisky !
 
Put on HumulinM3 myself just over a week ago and my blood sugar has been all over the place too. However, I was given a sheet about what to do if my sugar levels are consistantly above target. I have now started to adjust my dose for both morning and evening following the guidelines of the information sheet given to me. I was also advised by the dietician not to skimp on meals as it'll totally mess with my BG. So, I'm keeping a food chart which is aligned to my blood sugar testing and I make sure tio eat 3 times a day. It really does help.
However, even though you can't see your DN for a while, do you have a main contact number or a mobile number for her? If so call and ask if she has a an information sheet about adjusting doses of HM3 depending on your BG levels - it appears different regions title their information sheets with various headers. This sheet, with our individual start doses was given to everyone who came to the "classes" we had to attend as newbies to insulin.
 
CherryAA said:
If I were you I would examine what 90% of the time means - if that means 10% of the time you are eating the carbs you shouldn't eat then that may still give you problems, Also have you actually embraced fats ? its very easy to still be frightened of fats and with low carb that will lead to too much protein. The protein itself will also act on your blood sugars and in a much less predictable way than the carbs because it takes so much longer to process.

Why not get yourself a food program - I use cronometer and try recording everything that you eat for a bit. I brought my blood sugars under control with a diet that is 65% fat, 20% Protein, 10% carbs and 5% single malt whisky !
Click to expand...


Cherry, I am in awe of you. How on earth do you manage to work out all these figures? How do you manage to do this around work, a social life, holidays, unforseen events, eating out, going to friends for dinner, just generally being human and all the foibles that go with that?
 
LGuk said:
Put on HumulinM3 myself just over a week ago and my blood sugar has been all over the place too. However, I was given a sheet about what to do if my sugar levels are consistantly above target. I have now started to adjust my dose for both morning and evening following the guidelines of the information sheet given to me. I was also advised by the dietician not to skimp on meals as it'll totally mess with my BG. So, I'm keeping a food chart which is aligned to my blood sugar testing and I make sure tio eat 3 times a day. It really does help.
However, even though you can't see your DN for a while, do you have a main contact number or a mobile number for her? If so call and ask if she has a an information sheet about adjusting doses of HM3 depending on your BG levels - it appears different regions title their information sheets with various headers. This sheet, with our individual start doses was given to everyone who came to the "classes" we had to attend as newbies to insulin.
Click to expand...

Thank you LGuk. This DN is new, and I felt she jut anted to make her mark. I e-mailed her to say that my BG levels were all over the place with the Humulin and I was stunned to get her reply that she felt I was on the wrong insulin, and we would talk about a different regime when we met at the end of June. Surely it can't be good to chop and change - I felt she didn't giv my case much thought. No info sheet offered, but I will ask for one.
 
nannoo_bird said:
Cherry, I am in awe of you. How on earth do you manage to work out all these figures? How do you manage to do this around work, a social life, holidays, unforseen events, eating out, going to friends for dinner, just generally being human and all the foibles that go with that?
Click to expand...

If you try it out you will see that with a bit of practise it becomes second nature.

It takes me about 15 minutes per day to write down what I am eating using cronometer, These days I know pretty much what most of my meals are likely to turn out as, and because I have become familiar with the content of most foods, its much easier to decide what to eat in restaurants etc.
There is no doubt that there is a lot more guesswork involved when out and at friends etc, however once you see what those meals do to you when you record them, its easier to apply more structure to the next time you go out .My reward at present is that 99% of the time my readings are under 7.8 on my freestyle libre - that is worth the effort :) it doesn't mean i don't go wrong occasionally - I do !

It also means that if I eat moderate portions of meat, cheese, or fish, cook it in hard fats butter or coconut oil, drizzle olive oil on my salads, eat above ground vegetables and use nuts as snacks with the occasional dark chocolate, eat small portions of berries and clotted cream, and drink the occasional whisky I know that that is gong to end up as about 60%-70 fat, 15% -20% proetin, 10-15% carbs and 5% whisky and about 1450 calories tht day- all of which seems fine to control my bloo sugars. I know if I;' heavy on the protein my sugars will go up a bit for the next two days, as they will if I overeat anything at all - ie if I eat more than I need of anything then my loos sugar will rise a little-so staying stable or losing weight is key to control.

In the end, diabetes is the most important factor in my life, so I don't mind devoting 15-30 miutes a day to it !
 
in most cases peoples blod glucose will lower if one goes under 100 grams of carbs a day, if not then go lower like under 50 grams.
it is easier done if one eats a breakfast without carbs like f.x. bacon and eggs or cheese and ham and fried tomatoes, or avocado with taco sauce or garlic mayo, or shrimps... or just eggs and cucumber in sour cream, or greek yougurt 10% fat...or nuts ....

if one eat a protein rich breakfast people tent to eat less amounts the rest of the day, maybe because the body has already got most of its essentials.
most need around 0.8-1 gram of protein a day pro kg body weight , 1 egg is around 7 grams of pure proteins of the right combination for humans
 
CherryAA said:
If you try it out you will see that with a bit of practise it becomes second nature.

It takes me about 15 minutes per day to write down what I am eating using cronometer, These days I know pretty much what most of my meals are likely to turn out as, and because I have become familiar with the content of most foods, its much easier to decide what to eat in restaurants etc.
There is no doubt that there is a lot more guesswork involved when out and at friends etc, however once you see what those meals do to you when you record them, its easier to apply more structure to the next time you go out .My reward at present is that 99% of the time my readings are under 7.8 on my freestyle libre - that is worth the effort :) it doesn't mean i don't go wrong occasionally - I do !

It also means that if I eat moderate portions of meat, cheese, or fish, cook it in hard fats butter or coconut oil, drizzle olive oil on my salads, eat above ground vegetables and use nuts as snacks with the occasional dark chocolate, eat small portions of berries and clotted cream, and drink the occasional whisky I know that that is gong to end up as about 60%-70 fat, 15% -20% proetin, 10-15% carbs and 5% whisky and about 1450 calories tht day- all of which seems fine to control my bloo sugars. I know if I;' heavy on the protein my sugars will go up a bit for the next two days, as they will if I overeat anything at all - ie if I eat more than I need of anything then my loos sugar will rise a little-so staying stable or losing weight is key to control.

In the end, diabetes is the most important factor in my life, so I don't mind devoting 15-30 miutes a day to it !
Click to expand...

Thank you so much for this. I will do my best and follow your lead!!
 
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