Starting Insulin

[Elthea]

Hi everyone

I'm fairly new to the forum and this is my first post (so be kind lol)

I was diagnosed with Type 2 about 7 years ago, and admittedly haven't been a very good diabetic. Got started on Metformin, Glimepiride and Sitagliptin last year, which has helped although my hba1c is still too high.

We're planning on starting IVF (I have PCOS) in a couple of months, so really need to get my sugars under control and lose weight. I started the Newcastle Diet 2 weeks ago, and so far have lost 1/2 stone. Got another 2 stone to lose to get me to a "healthy" weight. My bs have been the lowest they've ever been, which I was really pleased with. But last week my diabetic nurse stopped the Glimepiride and Sitagliptin as I can't take these during pregnancy and wants to start me on Insulin. This week, my sugars have been creeping up despite the strict diet, so obviously the Metformin alone isn't enough.

I'm really worried about starting Insulin. I know it's probably irrational, but the thought of it is making me really anxious.

 

[urbanracer]

Hi Elthea, welcome to the forums.

What aspect of insulin medication is worrying you, can you elaborate a little?

 

[Daibell]

Hi and welcome. Do continue with a sensibly low-carb diet as this is always important particularly if you have weight to lose. Metformin only ever has a small effect on blood sugar. Insulin is always best when you don't have excess weight as it minimises blood sugar swings and hypo risk. Don't worry about insulin; it's really quite simple and easy and works. I suspect you will be started on mixed insulin injected twice day. Yes, let us know what's worrying you.

 

[anna29]

Is the needles thoughts making you more anxious about starting or using insulin ?
This is a normal thought and reaction to have .
Not a daft or silly irrational anxiousness .

Please let us know more - then we can try and support you further .

 

[Elthea]

the needles don't bother me.... Insulin just feels complicated somehow. Tablets are easy, the doc tells you your dosage and I've just got to remember to take them. Is insulin a set dose or do I need to adjust depending on my levels and what I'm eating?

 

[anna29]

Any idea which insulin your GP or DSN wishes to start you off on ?

Once you find your unit needs and times of day it is needed .
It becomes a real mainstay therapy routine .

Gradually you will settle down with this new therapy and routine .
All will become a 2nd nature kind of thing .

You have us all here - for further help and support too .

 

[Elthea]

No idea Anna... I saw her for the 1st time last week and she stopped my tablets apart from the Metformin, with the intention of starting me on insulin when I go back to see her Tuesday this week. But she didn't say what type of insulin.

Silly me has been worrying about it all week

 

[June_C]

You're not being silly to worry. I find it incomprehensible that a gp can take almost all of your tablets away and then say she'll start you on insulin next week without outlining what that will involve. It may be mixed insulin or basal/bolus,but whatever it is, you need time to get your head around it, instead of being left up in the air to worry your socks off. I bet she wouldn't treat a colleague like this. She obviously has no idea of the impact her decision has had on you. I wish you all the best for Tuesday

 

[Paul59]

Hi. As you said, you have not been a good diabetic, meaning poor control & most likely been following the Nhs eating guidelines, which is most likely the reason they are starting you on insulin because of the high glucose levels.
You said your on the newcastle diet now, which is good but only really short term I believe, if this fails you then maybe as many do look at the low carb higher fat way of eating which can be sustained long term & has great health benefits.

 

[anna29]

No idea Anna... I saw her for the 1st time last week and she stopped my tablets apart from the Metformin, with the intention of starting me on insulin when I go back to see her Tuesday this week. But she didn't say what type of insulin.

Silly me has been worrying about it all week

Never feel silly for worrying .
It is a huge step for you .
Tuesday will soon be here and you can use the time now
to write up any questions you need to ask .

Take a family member or close friend along for moral support if
you wish .
Ask all your questions you need to .
As time goes by - you will use the time to adapt gradually .
Soon all will begin to make more sense to you .
Routine will give way to reason , all the hows and whys will be revealed .

Best to take and do things a step at a time .
Live for the moment only as things start to progress themselves forwards .

Do keep us updated as we care - and will continue to give support to you .
This is what the forum is about and what we do here best .

 

[Daibell]

Hi. As JuneC has said you will probably be started on one of two regimes. Each has it's merits. T2s moving to insulin may be started at first on twice a day mixed insulin. The mix comes in different 'grades' but consist of a 24 hr insulin and fast acting one. With this you will be told how many shots to do twice a day and guided on the typical carbs to have with each meal. It's simple and works pretty well if you still have some insulin production. If your own insulin is very low or you want total control then the Basal/Bolus regime can be used where you have two different insulins (24 hr and fast). The number of injections can vary from 3 to 5 as you inject for each significant meal and vary to mtach the carbs. The choice will depend on various factors, but it's useful to be aware of these and over time to discuss options with the nurse. You will be offered a disposable pen or a pen with disposable cartridges; the latter involves less waste and is what I use. The needles these days are getting thinner and less painful (if any) and if your weight isn't too high may be 4mm needles (not like the photos form the old days!)

 

[June_C]

With apologies Daibell,but I'm going to have to correct you. Mixed insulin that I'm on consists of a 12 hour slow insulin that has to be injected twice a day not 24 hours.

 

[Daibell]

With apologies Daibell,but I'm going to have to correct you. Mixed insulin that I'm on consists of a 12 hour slow insulin that has to be injected twice a day not 24 hours.

HI. Yes, I should have said 12 hour not 24 hour for the mixed as it's taken twice a day. Thanks.

 

[Elthea]

Thanks for your replies everyone. Will see what she says tomorrow.

In the meantime, anyone have any ideas why my sugars are higher in the morning than at bedtime when I haven't done or eaten anything? For example, last night my sugars were 6.8 at bedtime which was only 2 hours after eating, so I was pleased with that... but my fasting sugars this morning were 9.1.... !?

 

[urbanracer]

Thanks for your replies everyone. Will see what she says tomorrow.

In the meantime, anyone have any ideas why my sugars are higher in the morning than at bedtime when I haven't done or eaten anything? For example, last night my sugars were 6.8 at bedtime which was only 2 hours after eating, so I was pleased with that... but my fasting sugars this morning were 9.1.... !?

Your liver stores glucose and can 'dump' it to give you a kickstart and get you going in the morning (or sometimes when you start exercise) it is often referred to as the dawn phenomenon.

 

[anna29]

@Elthea
Goodluck with all things tomorrow (tues 5th) with your DSN
The dawn dump can raise your upon Waking BG's .

Ask any questions you need to here .
There is always someone who will help support you .

Let us all know how you go on tomorrow .
Will be thinking of you .

 

[Elthea]

Well, just got back from Diabetic Clinic. I'm now the proud owner of an insulin pen! As my sugar's aren't "too bad", she's started me on Lantus Solostar, which is a 24 hr insulin. So only 1 injection a day. With a low starting dose of 10 units, to be reviewed at the end of the week. So we'll see how we get on. Had a long chat with the nurse about insulin and my diabetes in general.

Also saw the dietitian who was surprisingly very supportive about me doing the Newcastle Diet, with the only advice apart from keeping a close eye on my levels and insulin is to take a multi vitamin supplement to make sure I'm getting everything I need and that I won't be malnourished at the end of it.

So, overall, although still have feels of sadness and guilt surrounding the insulin, and I'm also feeling more positive. I have to look at this as a short term treatment to help me get pregnant and ensure a healthy pregnancy and baby.

Onwards and upwards and ready to take control...

Thank you everyone for your words of encouragement and support x

 

[urbanracer]

Congratulations (I think ). Should help you to get your bg's down. Good luck.

 

[Elthea]

Ok, so been on Insulin a week now... started at 10 units daily, now up to 14 units. Sugars are going down, but slowly. Fasting reading was 6.8 this morning, so quite good... my target is 4 - 6, so just a little bit high.

Rather disappointed that I've gained weight this week though! I'm on day 24 of the Newcastle Diet.... I had lost 5.3 kgs in total when I weighed myself Saturday, just weighed myself again this morning and I've put ON 1.4 kg since Saturday!!! How can this be???

Feeling very frustrated

 

[BooJewels]

I would suggest that the weight gain is likely to be fluid or something else incidental and unlikely to be body fat. To have gained that as fat, you'd have to have eaten in excess of 10,000 extra calories since Saturday - and that's some binge!

Insulin certainly changes the way your body deals with food and one of its functions is to store energy that hasn't been used, so insulin is said to increase weight if nothing else changes. If you're doing the Newcastle Diet, I would imagine that would counteract much of that - I'm doing a moderate LCHF, started around the same time I went on insulin and have lost weight throughout. I spoke to my DN yesterday and she was somewhat surprised at my weight loss.

It's possibly something to do with glycogen storage - which causes more water to be carried along with the molecules - and likely that some of the weight you lost initially was this being dumped and now maybe being replaced.

My weight fluctuates daily, so I only consider actual weight to be a gain or loss when I've been at that for a week anyway.

It's good that your BG is lowering slowly, I don't think sudden drops are good for you, a steady decline will allow your body to adjust to the changing levels. I had a couple of false hypos in the early days on insulin - even though it was over something like 12 - where it had been 26.