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Reducing insulin injections

david1968

Well-Known Member
Hello everybody,

It's been quite a while since I last posted - crazy at work for most of the last twelve months and then went down with a rather nasty abscess.

I've been off work for just over three months now as the wound from the draining of the abscess still hasn't healed properly, but whilst I've been off I've really been watching what I'm eating and getting as much exercise as I can and I've also lost about 2 stones..

As a result, I'm finding that I'm getting some very good readings both pre and post meals and have been gradually reducing my insulin doses (I take Novarapid with meals and Levemir at bed time).

Previously, I've always found the Levemir dose difficult to judge but finally seem to have found the right level - currently either 5 or 6 units depending on my bed time reading. That's keeping my level stable until the next morning and I've been getting readings in the mid to low 5s most mornings from similar readings at bedtime.

As for the Novorapid, I'm now finding that even without injecting my levels 2 hours after eating breakfast and lunch are usually no higher than 7 and that I only need a small dose (2 or 3 units) after my evening meal.

I'm arranging to see the diabetes specialist at my GPs to talk things through and am due an HBA1c test next month as well, but am I persuing the right course of action in trying to reduce the amount of insulin that I have to take or should I still be injecting a small amount to keep my levels as low as possible without straying into hypo territory?

Thanks for your time and your thoughts.

Regards,

David
 
Hi David, I am a type 1 Diabetic, who was on 75 units a day of both Novorapid and Lantus. I was sick of taking high Doses so I took myself off a lot of the Carbs that the Dietitian had put me on as I also found it a bit strange that I should be on so many Carbs and so much insulin. I’m now on 8 units a day and natural things that lower your blood sugar that your Diabetic Specialist may agree with, like mine, but is not allowed to recommend natural things when working for NHS. I’m healthier than I’ve ever been in all my 50 yrs as a Type 1 Diabetic. My Diabetic Specialist is over the moon with me too. So I think you will be totally fine on less Insulin as long as you are monitoring it. I hope this helps in some way as I have been doing this for 3 years now and still feel great. Less of a Diabetic if you know what I mean.
 
Hi David
I've just seen your post.

Well done on your 2st loss and eating well with exercise too.

I love your low insulin units. Mine is outrageous compared to yours. I'm taking treble strength basal and I'm taking 63 units so equivalent to approx. 180 units of basal and currently 20, 30 and 25 units of novarapid.
I think if I was as low as your needs (novarapid) I'd try without your bolus by trying been lower carb and protein, if you can. However if bgs start creeping up continue back on novarapid? Is there no metformin in your management?
 

Hi,

No metforim, no - I was diagnosed five and a half years ago during a colostomy operation and they put me straight on insulin.

Initially I followed the doses they put me on, but I vividly recall the specialist telling me that setting levels was an art and not a science and that I should continue to monitor the amount of insulin that I was taking.

Having read about the Newcastle diet, I went to see my GP (who also happens to specialise in diabetes) and with her blessing I began to reduce my dosages. Then work got busy and I let things slip a bit, but I'm now firmly back on the path again and have slowly been reducing the amount I take.

I'm taking readings immediately before eating and then again two hours after every meal and provided that I'm constantly getting readings below the limits I've been given (7.0 pre-meal and 8.5 two hours after eating) for about five days I'm reducing the does by one unit.

Things may change when I go back to work, and I'll need to keep a close eye on things, but so far at least it seems to be working - readings yesterday for example:

Before breakfast 5.9 (from 5.7 at bedtime) ... 2 hours after breakfast (one medium sized banana) 7.1 (no insulin) ... before lunch 5.2 ... two hours after lunch (beef sandwich on brown bread, a satsuma and a greek yoghurt) 6.3 (no insulin) ... before evening meal 5.8 ... two hours after evening meal (beef sandwich on brown bread, a satsuma, a pear, a greek yoghurt and a square of 90% chocolate) 7.3 (2 units of novorapid) ... bedtime 5.7 ... before breakfast this morning (5 units of levemir at bedtime) 5.1.

Feels like I'm really going in the right direction.
 
Fantastic bgs.
Mine would be 12s and 15s on your units and would escalate upwards as the day progressed on those foods.
Are you desperate to drop novarapid or do you want to keep good management til back in work and rethink how to reduce further?
I don't eat fruit nor bread, except rare protein bread.

I'm awaiting a food shop for better nuts and other low carb ingredients to spruce up my diet. Decorating at mo and doing spring cleaning early to get a better handle on the house maintenance. (We'll hubby doing or companies and we are supervising).
I'm hoping for bariatric op this year. The more organised the better.

There is nothing wrong with good maintenance in insulin management. Don't rush yourself into a more detrimental situation. Sit and enjoy where you are at the moment. You've worked hard for it.
I'd reassess after returning to work, personally.

Once I start losing again, that's me, til ideal weight and weight maintenance will become my new goal.
 

Thanks.

I'm not desparate to drop novorapid, but as long as my levels are OK, I don't see the point in tsking more than I need to - don't want to start having hypos. My thinking really was to get as good a control as I can whilst I'm off work and then keep a very close check on things when I go back - my job can be very stressful and it'll be very interesting to keep on the same sort of diet and see how things change. It might be that I've got to change the doses again and if I do so be it, but then it'll be a case of looking at making changes elsewhere to counteract it.

Just looking at the known carb intake of what I'm eating - the bread rolls are 24.9g carb, 2.2g sugar and the yoghurts are 8.1g carbs and 7.2g sugar.

Fingers crossed for you op.
 
You definitely have it perfected. Any sign of hypos, reduce and reassess?
Some may suggest if you dropped the bread you'd need less insulin. As long as you have plenty of options to replace the bread with. This is for life so I feel your plan is an excellent one and one day you may try no bread when nothing else is helping, maybe. Its always nice to have those options in times of highly stressful times in life. Remember the liver and its stored up glucogen is what's released in stress, alongside adrenalin. More stressed more glucogen stored. More need for insulin.
I know all the mechanics but for me its having a clear head to put them back in place and keeping the perfect routine.
I think you have managed that thou. Well done. I look to follow in your footsteps, even thou I remember advising you on the outstart on how I was achieving the reduction of my insulin units.
Since Halloween I've had a not so low carb eating routine nor liver blocks and even thou my basal has reduced my bolus took the brunt of the extra carbs.
I've took my time to get things back available (money and low carb foods) so I'm improving my routine daily, at mo.
I'd love to get low units needed again. I was on humulin m3 but now on toujeo300 and novarapid. I feel its a lot harder on separates but once I'd reduced separates where the only way forward for me as I need more basal than bolus when eating very very little.
 

I've had a few readings in the low 4s, but no hypos for quite some time. Seem to be stabalising in the 5s between meals.

Bread in the amounts I'm eating it doesn't seem to be a problem (we're only talking about brown finger rolls or two slices of thin brown bread for a sandwich - gone are the days of big white baps) but I'm aso finding that a non-bread meal is giving me the same sort of readings.

As for the stress, the problem there for me was that eating (and eating the wrong sort of things) was one of my coping mechanisms - years of ingrained behaviour which I'm trying very hard to shake!

Think you've hit the nail well and truly on the head - it's all about having the head space to be able to deal with things ... and sounds like you're getting back on ghe right path. Keep going and fingers crossed.
 

That helps a lot - thank you. Sounds like you're doing really well ... and I know exactly what you mean about being less of a diabetic. A friend of mine refers to her good days as non-diabetic days!
 
Well. I did it. First time today since I was diagnosed as diabetic five and a half years ago and I've managed my blood sugar by what I've eaten without having taken any insulin.

Here's the story of the day.

Fasting reading (7.40 am) 5.2.

Breakfast (8 am) - one medium banana.

Blood sugar at 10 am - 5.9.

Blood sugar at 12.25 pm - 6.1.

Lunch (1.05 pm) - chicken sandwich on brown bread, a mandarin and a Muller Light yoghurt.

Blood sugar at 3.05 pm - 7.5.

Blood sugar at 5.55 pm - 5.2.

Evening meal (7 pm) - battered haddock, a mandarin, a pear, and a Greek yoghurt (and two sqaures of Lindt 90% chocolate).

Blood sugar at 9 pm - 6.7.

OK, things will change when I go back to work, but I didn't do very much physically today and there are still some changes I can make to my diet, but I'm feeling pretty chuffed right now.

Will be interesting to see what my bedtime reading is tonight (last night at 9 pm it was 7.3 and was down to 6.1 when I went to bed after a similar meal but having injected one unit of Novorapid).
 
Fifth day today without taking any Novorapid after meals and levels have been good so far.

Monday - fasting 5.2, 2 hours after breakfast 5.9, before lunch 6.1, after lunch 7.5, before evening meal 5.2, after evening meal 6.7, bedtime 5.4.

Tuesday - fasting 4.7, after breakfast 5.8, before lunch 4.3, after lunch 6.2, before evening meal 4.6, after evening meal 7.0, bedtime 5.7.

Wednesday - fasting 5.2, before lunch 5.4, after lunch 6.8, before evening meal 6.1, after evening meal 6.8, bedtime 5.9.

Thursday - fasting 5.4, after breakfast 6.3, before lunch 4.9, after lunch 7.1, before evening meal 6.3, after evening meal 6.7, bedtime 5.9.

Today so far - fasting 6.4, before lunch 5.2, after lunch 6.7.

Seeing my GP (who's also the practice's diabetes expert) on Tuesday but hoping she'll agree that I can continue to try and control things by diet.

Still taking a night-time dose of Levemir but only of 2 or 3 units.
 

What’s your current HBA1C?
 
NewTD2 said:
Just curious mate.

If you’re T2, why do you need to take insulin?
Click to expand...

I was put on it following a colostomy operation about five and a half years ago. I hadn't been diagnosed previously but one of the first questions they asked me after the operation was did I know I was diabetic. Put me on insulin straight away (Novorapid and Levemir) and at the time I didn't really question it - had enough on my plate dealing with the colostomy.

Didn't bother me too much and at first I was managing my levels really well. GP was happy with how things were going but there was never any suggestion of trying to reduce my doses or whether I needed to be on insulin. Then a couple of years ago I found out about the Newcastle diet and decided to start being more proactive - my weight had gone up to about 20 stone and I was starting to struggle with my levels.

Started a low carb diet and getting more exercise and with my GP's blessing started to reduce the amount of insulin I was taking. Had halved my doses and lost about three stone, but then I started struggling again - under a lot of pressure at work and let things slide - put most of the weight I'd lost back on again. Then I had to have another operation and that brought me up short - couldn't carry on like I had been.

My weight's now back down to just over seventeen stone and I'm managing without Novorapid, albeit on a limited diet and off work.

Big question for when I see my GP next week is do I actually need to be on insulin? I accept that I'll need to continue to monitor things and keep a close eye on my levels once I'm back at work, but if I don't need insulin then I don't want to be taking it.
 
It's a week now since I stopped taking bolus insulin and whilst my levels have generally been within my target ranges (4.0 to 7.0 before eating and 4.0 to 8.5 two hours after eating) there have been a couple of readings that have been above range, albeit not by much, and generally readings towards the end of the week have been slightly higher than at the beginning of the week.

I've tried to eat the same sort of meals each day to try and get some idea of what effect not taking insulin is having, but I've notice that even within a week my appetite's reduced - breakfast each day has been a banana, lunch has usually been a sandwich and evening meal either another sandwich or some fish, followed by a piece of fruit.

Readings over the period (fasting, 2 hours after breakfast, pre-lunch, 2 hours after lunch, pre-evening meal, 2 hours after evening meal, and bedtime);

Day 1 - 5.2, 5.9, 6.1, 7.5, 5.2, 6.7, 5.4.

Day 2 - 4.7, 5.8, 4.3, 6.2, 4.6, 7.0, 5.7.

Day 3 - 5.2, didn't test, 5.4, 6.8, 6.1, 6.8, 5.9.

Day 4 - 5.4, 6.3, 4.9, 7.1, 6.3, 6.7, 5.9.

Day 5 - 6.4, didn't test, 5.2, 6.7, 5.6, 6.7, 5.8.

Day 6 - 5.3, 7.2, 6.7, 8.7, 4.8, 8.8, 6.3.

Day 7 - 6.1, 7.3, 6.6, 6.8, 5.8, 7.2, 5.9.

Today so far - 5.9, 7.1, 5.7, 7.3.

Basal injections were 3 units of Levemir on Days 1, 2 and 3, and 2 units on the other days.

Weight loss over the course of the week was two and a quarter pounds and I'm now tipping the scales at 17 stone 2 and a quarter pounds.

I'm seeing the diabetes specialist at my GPs tomorrow afternoon and it will be interesting to see what she has to say (she was very encouragaing when I saw her previously about going low carb and trying to reduce the amount of insulin I was taking but we never talked about coming off it entirely).

My own view at the moment is that it probably won't be sustainable long term without losing more weight and that I may have to take something when I'm back at work as it's noticeable to me that whilst the levels were good at the start of the week they have shown an upward trend over the course of the week, with Day 6 being a very up and down day.
 
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