Probably been asked a million times but ...

I'm 42 and have been T2 diabetic for 8 years now, although it's only in the last year that I've been moved onto insulin in conjunction with Metformin. I'm in a position now where I feel personally happy with my day-to-day blood readings (I'm down to 7 or 8 from 17+ daily), however, my morning blood readings are always high.

I was previously on a morning routine of Abasaglar, which lowered my morning readings from 20+ to 13, after which I could not get my morning readings any lower no matter what I did. And at one point I was on 140 units, and, still, it did nothing.

Recently I've been placed on a new injection (Tresiba) and take 110 units in a morning in place of Abasaglae. This has brought my morning bloods down to 12. In desperation I even upped the shot (rather foolishly perhaps) to 140 units and, still, nothing. The results remain identical as if I was still on 110 units.

I suppose the question is: what gives? What else can I do?

I rotate my shot sites, I do everything I've been told I should be doing, but because I need a cataract operation and because I have been told I need to sign a waver unless I can reduce my hba1c (my last two readings have been 91 - a personal best given it used to be 120), I'm beginning to panic slightly. I'm desperate to get my morning bloods down and thus lower my overall hba1c, but nothing seems to be working.

Anyone been in a similar boat?

Resurgam said:

When you say nothing - are you eating the normal diet full of carbohydrate as advised for many diabetics?

Have you tried - for instance eating a little less carbohydrate for each meal and seeing if it lowers your reading over the course of a few days.

For me, fewer carbs was the key, I needed to do nothing else to drop my test results to normal - so I am rather down on the idea of the eatwell plate and 'healthy' carbs - I burnt the diet sheet I was given for 'lowering cholesterol' and which increased my weight to 264lb.

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As a general rule I don't have a great deal of carbs in a day. I usually have 2 slices of granary bread for breakfast (on the days I don't have scrambled egg) and salad at lunch. My evening meal might occasionally have a few more carbs than it should (always in what I think is moderation), but as a general rule I tend to stick to what works for me. But then again I was told not to go without carbs entirely.

As for weight, I eat next to nothing and seem to have put it on.

Bluetit1802 said:

It sounds as though one of your problems is insulin resistance. This means you need more and more insulin to clear the glucose from your blood stream. The more insulin you inject (plus any natural insulin) the worse the insulin resistance becomes .... and the worse the IR is, the more insulin you need. It is a vicious circle.

One way to improve matters is to reduce carbs sufficiently. All carbs turn to glucose in the system, so the fewer we eat the less glucose there will be, and the less insulin we need.

Can you tell us your typical days food?

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Usually breakfast will consist of scrambled egg and tomato. On the days there's no egg I'll just have 2 slices of granary toast.

Lunch is usually soup and a small salad. Maybe with 2 cracker bread. Not always though.

Evening meal can occasionally be a little loser but not by much. In thinking evening meal might be the issue. Though I thought it wasn't carb heavy.

archersuz said:

Two slices of bread is probably around 40gm carbs - more than I eat in a day! Possibly you are eating more carbs than you realise. Milk cpntains carbs so every white tea or coffee is carby. What carbs do you have for evening meal? Could you try cutting out carbs for a week or two and see what happens? This would mean cutting out bread, rice, pasta, potatoes, cereals, and substituting in more fat for energy.
Do you have a meter and test your BG pre- and post meals?

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According to the packet I eat 26 grams of carb a day. That cant be too much for me can it??

Bluetit1802 said:

Most of us are told this. The NHS guidelines recommend we eat carbs with every meal, and plenty of starchy ones. This known as The Eatwell Plate, and is completely unsuitable for diabetics. If all carbs convert to sugar in the system, why on earth should we be eating them? It is wrong advice, but the tide is turning as more and more GPs and experts are advocating low carb.

Perhaps give it a try for a couple of weeks? I bet you are surprised at how much less insulin you need, but you must test regularly.

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I was told i had to eat carbs because of the insulin. Humalog

david1968 said:

You say that you're particularly worried about your morning readings. What are your bedtime readings like and what are your readings after you've eaten breakfast?

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I generally go to bed with readings of about 8 - a 50 unit shot of Humalog with food. 2 hours after breakfast im about 10. Another 2 hours after that and I'm down to 7 or 8. Occasionally a fraction lower.