New to insulin

Hi

I've been diagnosed as a type 2 diabetic for almost 4 years after pain in my feet for the previous year - my HbA1c was 18. I got it down to 10.5 by dietary changes then medication got it down to just under 7. Over the last few years my medications have increased as my levels increased (and the pain in my feet has come and gone). Towards the end of 2011 with a HbA1c of 8.3 and on the maximum dose of Metformin I can tollerate (850mg twice a day) and Gliclizide and Sitagliptin we made the decision to move to insulin (I was hoping that lower levels would help with the pain in my feet). I've been put on Humulin I once a day (at bedtime) and have stopped the Gliclizide and Sitagliptin but have kept on with the Metformin. OK it's only 3 weeks since I started on insulin but my levels are all over the place which they weren't when I was on tablets alone and my feet are more painful. I was started on 10 units (now up to 18) but it doesn't seem to be having much of an effect but I don't know if it just takes time. So far I've only had one reading in the target range while on the Humulin and that was last night (8.8 - the lowest reading I've had at any time since starting insulin) but then this morning my sugar levels were up! My morning sugars were always my highest readings before but now I'm getting readings from 9.2 to 15.3 throughout the day.

Attended a group education session at the hospital last week in which I learnt nothing that I didn't know already! The DN asked if we were all feeling better, when I said no she wasn't really interested but told me to increase my dose by 2 units, leave it for a few days and then increase by another 2 if my levels still weren't in range which I've done and that she'll give me a ring this week. Each time I increase the dose it doesn't seem to make a difference.

What I don't know is if it's normal to have levels all over the place at the start of using insulin as a type 2? It almost feels like my body is acting against the injections as every time I get anywhere near the before bed target my levels have gone up in the morning! I don't know how many units I should probably be on (I've seen two totally different calculations on the internet one of which worked out at 24 units, the other at 67)? I've also read tonight that Isophane can/does(?) have a variable absorption rate so don't know if this is why my levels are all over the place - perhaps Humulin I isn't the right insulin for me.

Any advice, suggestions anyone can give would be greatfully accepted

Best wishes
Susan

Thanks. It's good to know I'm not the only one who has had problems. Will wait and see what the hospital come up with this week but I'll keep basal/bolus in reserve to suggest - I have read somewhere that this can be best for those with my type of neuropathy
Susan

Thanks for the reply. Seen the consultant at the hospital today who has explained a lot more about why I'm on the regime I am and where I am heading. I'm now up to 40 units of Humulin I and need to increase it by 6 units every week until the majority of my before breakfast readings get into range (he thinks this could be at around the 80 units level - I have PCOS which isn't helping with the insulin). If my other readings don't come into line at this point they will change the regime to twice a day. My HbA1c reading today was 8.5 so the drop in the tablets when I started insulin has had no effect. I'm feeling much happier now I understand more and know I need to be a bit more patient!

Driving licence has just gone off to the DVLA to be replaced by a 3 year licence.

My feet aren't liking this cold weather but I've agreed not to go onto any other meds which I'll almost certainly have reactions to until my sugar levels are sorted. Roll on spring and warmer weather (hopefully with lower sugar levels!)

Susan