Type 2 On fixed doses of insulin: so confused about insulin injections

Red28 said:

Ooh I love milk and didn't even think of it as being 'carby'

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Yep, my number one comfort hypo drink from when I was a kid.

But for me? It's more unpredictable with the "peaks" than Coke as a low treatment.. Metabolism I suppose?!

You may well have pinpointed one of your BS issues right there?

Custard creams are my go to anti hypo food

mist said:

Custard creams are my go to anti hypo food

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My vision of hell.. :***:

Jaylee said:

My vision of hell.. :***:

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I'm like that with mushrooms

Red28 said:

Yes I'm fine with cooked veggies and butter. Not heard of Dr Jason Fung but I'll have a look on you tube.

Congrats on your HbA1c figures ... May I ask how you managed to get them so low in such a short space of time?

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Hi again..

It's fantastic your getting a handle on the whole carb thing. All thes guys I've tagged I respect.. (Even you, @Oldvatr .)

But the insulin regime you are currently on?? Might I make a suggestion of working out the carb content in the research on some LC recipes (or LCHF.) armed with this information. liaison with your nurse so as to adjust insulin dosage.
Yarp, the nurse may "professionally" poo poo your plan.!?! However, they can't knock the "homework"!

mist said:

I'm like that with mushrooms

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I ruddy love mushrooms.. Especially when stuffed!

Jaylee said:

I ruddy love mushrooms.. Especially when stuffed!

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You would..

Hi. Yes, do cut the carbs way down. I suspect you may not need insulin at all once your BMI comes good. The MDI routine is better then the mixed insulin as it gives complete control. With excess weight as a T2 you may have too much insulin the body already and taking insulin may not achieve much. A good BMI will tell you if you still need it.

i can get away with tha

Red28 said:

Sorry to hear about your T1 friend's hypo hope he/she is ok.
Thank you I'll have a look at the info you mention.
Have you managed to control your diabetes through LC diet alone?

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My guitar buddy recovered, but needed half a large bottle of Lucozade and 3 tubes of fruit pastilles before he became compis mentis again.d
I am on oral meds, and although I have reduced my dose by 50% I still need some to keep bgl down around 5 mmol/l/ I am not too strict on my diet so could probably cut meds down a bit more, but both GP and DCN were horrified at it being too low, and I now have a target from them of 6.8 mmol/l. I intend keeping it around 6 so I can drive safely., and reduce the hypos.

I do not calorie count, just estimate the carbs, and I never weigh anything. As a T2D I can get away with that since I do not need to calculate bolus. I said I was different.

Red28 said:

Yes I'm fine with cooked veggies and butter. Not heard of Dr Jason Fung but I'll have a look on you tube.

Congrats on your HbA1c figures ... May I ask how you managed to get them so low in such a short space of time?

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On diagnosis I cut out breakfast, so immediately was doing a 16:8 fast only eating lunch and dinner. Also went very low carb (as few as possible- only eating green veg and salad as carbs probably less than 20g of carbs per day). Since then I have continued to experiment with more fasting regimes anything from 24 hours up to 7 days. Have had a couple of sub-4 blood sugar readings during the longer fasts and one 4.1 FBG. I have almost regained control over my food issues (mainly overeating) but still have the odd lapse but now make sure its low carb. Have also recently upped my fat content to try to achieve nutritional ketosis most of the time to overcome a weight loss plateau. I'm still officially obese in BMI terms but am now getting closer to my target of "overweight".

I, along with many others on this forum, manage my diabetes on diet alone. No meds at all. As I said in my initial thread, diet is the key - and low carb with higher fat is the way to do it. I have never fasted, and can never see myself doing it as I no longer have any weight to lose. It works wonders for some people, however.

Good luck with your nurse when you see her - and if you are serious about trying this, don't let her fob you off with the carbs are necessary spiel. Nod, smile, and say you are going to give it a try so please help me to regulate my insulin accordingly.

Red28 said:

I'm very limited with food as I'm a vegetarian and suffer badly with stomach issues.
So, I don't eat eggs, meat, fish and nowadays I can't tolerate any salad whatsoever but I'm ok with milk and certain types of cheese in small quantity.

All these years I've been eating good ole porridge oats, rice, potatoes, wholemeal cereals, bread and flour ... But I can and will change my diet so that I can come off insulin and get my life back and energy and health.

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That kind of diet will damage any stomach. Cut out all grain and see where it takes you, you might be surprised.

Can't really add much to what the others have said, but think I will tag @Avocado Sevenfold for her experience as a LCHF veggie - it can be done

When you talk to your health care provider you may want to ask for a c-peptide test so you know how much insulin your body makes on its own. That will give you a good idea of whether you can eventually come off injected insulin or not. If you make too much like the majority of T2's you can probably get off insulin if you change your diet radically. If your pancreas has been damaged to the point where you are not making much of your own insulin then coming off exogenous insulin may not be possible. I just can't understand how supposed diabetes specialists can make these decisions without having a clue what is going on. I think it is criminally negligent. Good luck to you.

Low Carb Program - http://www.diabetes.co.uk/lowcarb/

@Red28 , @Jaylee tagged me in on this yesterday but I've only just got to it.

You've had lots of input already, all of which has merit. I'll give you my own take your scenario, as I observe it, from what you've mentioned on the thread.

Firstly, let me state, I'm not an insulin user; in fact I'm not a meds user in any format. My treasure chest of meds is joyfully empty, and always has been, so I have no personal experience of insulin use or dosing and so on, but I still feel I have some potentially useful suggestions to make.

Obviously in all of this, you need to have the support of your Medics, in order to help you manage the changes you will need to make - whatever option you choose. Each option is likely to involve a slightly different form of support, but I strongly believe you will need it, especially as you will want to be mindful of your colitis.

So, my understanding is your current regime isn't returning the sorts of blood glucose you need to stand the best chance of a long and healthy life, so something has to change. Your Medics have suggested a change of insulin from twice a day to more frequent injections.

You have stated that you currently consume a generous amount of carb, day-to-day, so it seems highly likely that moving to multiple injections each day you will need to learn to carb count, in order to be able to match your insulin doses against what you eat and drink.

For the huge majority of T2s, the most important weapon in their management of T2 is what they eat and drink. As a result, many of us have become carb aware, and many carb count, in order to track personal tolerances or targets. There have been some fabulous results from this methodology. My personal stats are in my signature. I did well, but there are others on the forum who have made far bigger shifts than me, including some who have been able to ditch their insulin altogether, and many, many who have been able to empty their diabetes meds chest totally.

It doesn't work for everyone, but it is a very impressively successful method for many, and the site's Low Carb Programme has published some gob-smacking numbers, which I don't have to hand right now.

But, in a very rambling way; to my points.

It strikes me that moving forward you will need to gain a better understanding of carbs and how they impact your bloods, if you are to change insulin regimes and achieve more flexibility.

What I might ask you to consider is to take a short while to make your final decision, but in the meantime start to really learn how carbs affect you. I can tell you what I do. Others can tell you what they do, but although there will be common trends, everyone has their own little nuances creating their very own, personal brand of diabetes.

If you are learning about carbs, and you have stated you would like to trim them back somewhat, you could find that by learning about carbs, and trimming them back that your insulin needs change, but in a more positive way - needing less, rather than needing more.

So, if I were in your shoes, I'd be keen to get on the learning curve to learn more about carbs and start trimming back. If I were in your shoes, with colitis, I would take the time to do a period of one or two weeks testing and recording both insulin, carbs and blood readings, before making changes at all. So, that would mean testing before you eat, then a couple of hours after, for every single meal (actually, every time you eat). If you use something like the website myfitnesspal or the book Carbs and Cals you will quickly get a handle on the numbers of carbs you are consuming at the moment.

Once you've done that you can start to trim back on the carbs. - provided you've had input from your Medics about what to do if you were to go low. If you are eating fewer carbs it is likely firstly your numbers will improve, then after a while, you might find yourself dipping a bit low for your current insulin doses. So, it would be useful (in fact it's important) to have discusses how you would trim back the insulin doses if you go consistently low.

I'd take it steadily, rather than the cold turkey approach many have adopted in order to have a decent chance of keeping your digestive system on an even keel. Big, big changes all at once can put anyone's system off balance, so I imagine yours might be a bit more delicate, and the last thing you need is a big colitis flare up.

Diabetes is a long game, so there's little point flying off the starting line only to find it drives you off plan down the road a bit.

All of that involves being organised to record foods, bloods and doses, but it can pay huge dividends.

I really do wish you well, whatever you decide to do.

@Red28

Hello and welcome to the forum As mentioned above, here is the information we give to new members and I hope you will find it will help you to keep your weight and levels under control. Ask more questions when you need to and someone will be able to answer.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 210,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

I'm of the notion that you can eat pretty much whatever you like as long as you inject the right amount of insulin (if insulin dependant) and exercise daily and have sensible portions, three meals a day.

Life is too short

But I'm a bad diabetic so never take my advice..