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Newbie Type 2

L

lesfingal

Member
Messages
11
Type of diabetes
Type 2
Treatment type
Insulin
Good Morning just checking in here. My diabetes has been controlled until last year when I was put on Insulin Toujeo and TBH that's when it all started to go pear shaped. I'm not sure if I post the issues in this thread or exclusively Type 2 so some advice would be appreciated. In short the Toujeo is very slow to have any impact so I am left with quite high levels late at night, I get steroid injections for arthritis and this sends the blood/sugars through the roof and Toujeo has little effect until the wee small hours, last night a case in point I was on the cusp of going to ED but the levels began to come down....eventually.....after 6 hours. Am totally frustrated that neither my GP or the Hospital seem to get it. Walking around at 1 in the morning to bring levels down is not sustainable, I eventually got to bed @ 0430. How do you get clinicians to take you seriously and how much say do you have over what is prescribed. Sorry for going on and apologies if this post is in the wrong place. I am retired aged 67 and just over 77kgs. Many Thanks
 
lesfingal said:
Good Morning just checking in here. My diabetes has been controlled until last year when I was put on Insulin Toujeo and TBH that's when it all started to go pear shaped. I'm not sure if I post the issues in this thread or exclusively Type 2 so some advice would be appreciated. In short the Toujeo is very slow to have any impact so I am left with quite high levels late at night, I get steroid injections for arthritis and this sends the blood/sugars through the roof and Toujeo has little effect until the wee small hours, last night a case in point I was on the cusp of going to ED but the levels began to come down....eventually.....after 6 hours. Am totally frustrated that neither my GP or the Hospital seem to get it. Walking around at 1 in the morning to bring levels down is not sustainable, I eventually got to bed @ 0430. How do you get clinicians to take you seriously and how much say do you have over what is prescribed. Sorry for going on and apologies if this post is in the wrong place. I am retired aged 67 and just over 77kgs. Many Thanks
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Hi and welcome to the forums.
Firstly, I am a T1 but having been around the forums for a while it seems that many clinicians take the view that if you are back in range by the next mealtime then there is nothing to worry about.
My diabetes is managed with fast acting AND slow acting insulin so I can always take a couple of units of fast acting to correct my levels. You obviously do not have that luxury and I do not know what to suggest other than watching your diet.
Do you normally eat a lot of carbohydrates with your evening meal?
 
Thanks for your prompt reply. No since a scare a few months ago I really watch my food and how I mix carbs, proteins etc. The problem is Toujeo just doesn't suit me, it takes far too long to work and leaves me hardly any latitude for the most modest of sweet things, a biscuit or a bottle of beer etc Toujeo has me miserable TBH and clinicians don't seem to listen.Clearly presenting at ED isn't taken as seriously as it once was. After hours you're on your own buddy and I am loathe to present unless I am desperate. Ov
 
How long have you been on Trujeo and how many units you use ?
I started on Trujeo ( it takes up to 6 hours before your body uses it as such) I found it made some difference but took ages to get up t the required number of units then I was also put on Trurapi as the one I use before eating
 
With Tujeo being a long acting insulin, it will never likely cope with meal times.
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I am really not supposed to give dosing advice in the forums and I must ask you to speak with your medical team (even though you already have).
All insulins have a 'profile' so have you tried injecting ahead of the curve?
Is your injection time prescribed by the clinicians?
Even as a type 1 with fast acting insulin (regular short acting in the graph above), I often inject up to 1/2hr before eating to try and hit the curve.

I probably don't know enough about the Tujeo insulin regime but maybe another question to put to your doctor is "can I have a faster acting insulin ?" - it might spark a different conversation.
 
Many thanks a lot if this I wasn't familiar with. Am awaiting a phone consultation with the hospital team although it's always rushed. I take 14 units @2100 having moved it earlier by 1 hour. I try to eat my main meal between 1900 and 2000 Toujeo can't seem to cope if I eat later and frankly is of little use in that scenario. I end up testing until stupid o clock when the insulin eventually strolls into my bloodstream.
 
I am on Toujeo for over a year now and to be honest, it is very slow to respond in the evening and often I may have late teen blood/sugar readings if I have my meal after 8pm. I am following a diet and am careful about pairing foods and the order in which they are eaten plus the actual portion sizes. My units have been increasing and now are @14 which I am not happy about. In effect I have to go walking at night time to try and bring down my levels before bed, which isn't sustainable.

On a practical level I cant always eat before 8pm, especially if socialising. This doesn't seem to compute, the anxiety of high levels especially at night, I already have had to present to ED @ 1am and I don't want a reoccurrence. I feel Toujeo is the reason, the clinic points to improvements since I moved my insulin one hour earlier but I still have late levels though not quite 1am

An added problem is the steroids I get every four months for arthritis this shoots up the levels as it did last night, I was on the cusp of going to ED but levels came down to 15 mmol/s but not until 4.30am. Again I see Toujeo as not being effective at all in this scenario. The hospital seem fixated with the current problem of the steroidal effect over the coming number of days. Yes, that's important but I want to look at the bigger picture of the unsuitability of the insulin for my lifestyle, physiology and the treatment of diabetes.

I have a phone consult next week, which is always rushed, despite my interruptions. How do I get them to listen? Insist on a face to face appointment?. I have great respect for the hard working staff in hospitals but equally I know my own body and what works and what doesn't. And Toujeo is the latter. Any advice or similar personal experiences would be most appreciated.

Many Thanks
L
 
Mid teens most nights after dinner, usually eating between 7 and 8. The toujeo doesn't kick in so by 12 or 1am I am concerned about going to bed on this mmol. Last night it was 21 due to the Depo Medrone effect but I felt toujeo was of very little use in treating a spike and elevated levels until 4.30am. I am polite by nature and hate to hear medical staff being treated disrespectfully, but how do you convince clinicians that some neds simply don't suit.
 
You mention you are food combining and eating in a certain order. Neither of those make much difference to me. What I find makes a difference is the amount of carbs I eat. The type of carbs can mean slightly faster or slower absorption, but it’s definitely the amount that’s the key.

Toujeo being a long acting insulin is not likely to cover a meal with a larger number of carbs. For me (using Lantus as long acting) I found it just wasn’t enough. So I presented my libre graph to my diabetic nurse, alongside the times and amounts of carbs I ate, and asked to move to a short acting (bolus) insulin as well. I’ve been able to use that the bring peaks down and at the moment after 7 months of this regime my libre is predicting an HbA1c of around 42.
 
WoW serious research there. I'm afraid the drug names don't mean anything to me I've only ever been on Toujeo.
 
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