Type 2 Stopping Insulin Injections?

[Keith Evans]

Hi,
I am brand spanking new here folks, so forgive me if i ask lots of questions especially if they have been asked before!

I have one question that I am attempting to find the answer to.

I am a Type 2 Diabetic, and have managed to get my blood sugars somewhat lower over the last few months while i have been taking Insulin. Speaking to my diabetic nurse, she told me that i cannot lower my insulin dose at all...as it can cause some kind of shock?... I have started a diet regime, and exercising and my blood sugars have responded well, and are a lot lower now than before. I am just about to start a regular fasting regime, to lose weight and get them down further, and have heard on several videos, that if i do I should stop insulin injections.... I don't want to just stop taking insulin in case my nurse is correct...Any advice would be welcome, and apologies if this is a stupid question!!
Cheers..

 

[bulkbiker]

What kind of levels are you currently seeing with your dietary changes?
Certainly not a stupid question in the slightest.

 

[slip]

Also what insulin are you on? as this will decide what you should do.

 

[Keith Evans]

My reading this morning was 7.2 (averages in the morning between 5.2 to 7 ish.) so not too good today (popcorn last night)!! , and the insulin is Humalin M3. also take 4 metaforim daily.. Its just that the videos i watched when i was considering this step, said to stop all medication! Thanks for the reply...

 

[bulkbiker]

And what dietary changes are you making?

 

[Keith Evans]

A fair amount of changes there...cut out most sweet stuff, cakes, choc. etc. and when i started the injections and metaformin my daily test sugars were over 15..also going to go back on the atkins diet that we did oh...over 9 or 10 years ago, and lost over 6 stone on that..( all back on now though!!) so have just ordered the book, and am going to start that asap..

Oh and just treated myself to a treadmill!!

 

[bulkbiker]

A fair amount of changes there...cut out most sweet stuff, cakes, choc. etc. and when i started the injections and metaformin my daily test sugars were over 15..also going to go back on the atkins diet that we did oh...over 9 or 10 years ago, and lost over 6 stone on that..( all back on now though!!) so have just ordered the book, and am going to start that asap..

Oh and just treated myself to a treadmill!!

How many times a day are you injecting?

 

[slip]

Humalin M3 is a mixed insulin 70/30 long acting and quick acting insulin, which no doubt you take twice a day before breakfast and evening meal. I recommend you speak to your DSN before going any further!

Edit to add: If you are completely cutting out/down carbs drastically you may be better off on just a single long acting insulin like Lantus or Levemir which will provide a low level of back ground insulin, but you may actually not need any extra insulin anyway, do speak to your DSN.

 

[Keith Evans]

Thank you for the reply, its appreciated.. will have a chat to the nurse then when i see what sort of results i am getting, and see what she advises, but when i dropped my morning dose from 37 to 35 she was not happy at all, and told me that i have to keep the same dose? I thought i had to adjust the dose, to whatever the readings were at the time, but she reckons not..will explain what i am doing to her and see what happens.. Thank you.

 

[Engineer88]

Thank you for the reply, its appreciated.. will have a chat to the nurse then when i see what sort of results i am getting, and see what she advises, but when i dropped my morning dose from 37 to 35 she was not happy at all, and told me that i have to keep the same dose? I thought i had to adjust the dose, to whatever the readings were at the time, but she reckons not..will explain what i am doing to her and see what happens.. Thank you.

Sounds like she doesn't have much of a clue however what she's concerned with is the background amount you're getting. Try and been seen at a proper clinic and avoid atkins try low carb instead - its much easier

 

[bulkbiker]

Thank you for the reply, its appreciated.. will have a chat to the nurse then when i see what sort of results i am getting, and see what she advises, but when i dropped my morning dose from 37 to 35 she was not happy at all, and told me that i have to keep the same dose? I thought i had to adjust the dose, to whatever the readings were at the time, but she reckons not..will explain what i am doing to her and see what happens.. Thank you.

Obviously I'm not a professional so can't give you medical advice but ... hypos are from too much insulin.

If you are cutting down on carbs and fasting then I would have thought (in a non medical / non advisory way) that you would have to reduce your insulin intake. I would suggest telling the nurse that this is what you intend to do if that is the case and then ask her the best way to proceed. She is obviously uncomfortable with you doing this (probably because she knows little about it) but what you will want to do is avoid hypoglycemic episodes due to taking more insulin than you need. That will be the reason most therapies involving fasting will require stopping/reducing insulin immediately before starting. It would probably be better to risk a few days of higher than usual sugars than to risk severe hypos.

Diabetes - Insulin Adjustment for twice daily mixed insulin.pdf

Maybe print that out and take it with you?
Suggests adjusting doses if you are experiencing low blood sugars.

 

[kokhongw]

The question to ask is. Are you eating to match your medication? Or are you medicating to match your carbs intake?

 

[Keith Evans]

Sounds like she doesn't have much of a clue however what she's concerned with is the background amount you're getting. Try and been seen at a proper clinic and avoid atkins try low carb instead - its much easier

Thanks for that mate...the only reason i have decided to go for atkins is that we tried it about 7 years or so ago, and it worked very well for weight loss..

 

[Keith Evans]

Obviously I'm not a professional so can't give you medical advice but ... hypos are from too much insulin.

If you are cutting down on carbs and fasting then I would have thought (in a non medical / non advisory way) that you would have to reduce your insulin intake. I would suggest telling the nurse that this is what you intend to do if that is the case and then ask her the best way to proceed. She is obviously uncomfortable with you doing this (probably because she knows little about it) but what you will want to do is avoid hypoglycemic episodes due to taking more insulin than you need. That will be the reason most therapies involving fasting will require stopping/reducing insulin immediately before starting. It would probably be better to risk a few days of higher than usual sugars than to risk severe hypos.

Diabetes - Insulin Adjustment for twice daily mixed insulin.pdf

Maybe print that out and take it with you?
Suggests adjusting doses if you are experiencing low blood sugars.

The head nurse from the clinic called me this afternoon, and we had a good chat about it... she told me to monitor closely and if i felt i should to reduce the insulin as i saw fit... but then call her and have a chat. She did say that I may well have to cut the dose by up to 50% depending how it worked out..but she would make sure that she would be available to me.. Very nice lady actually...so hopefully it will work out ok... only way to find out is to give it a go eh!!!

 

[Keith Evans]

The question to ask is. Are you eating to match your medication? Or are you medicating to match your carbs intake?

My stats are just about static now, so I just keep an eye on the Blood sugar levels and if i need to reduce them i do so, and then let them know...as long as i dont get the one that told me that i had to use the same amount regardless reckon i will be ok like that..

 

[Fenn]

I think we are in charge, if I tested and was going low due to lowering carbs and therefore lowering the amount needed of course I would take less, no one cares about or knows us better than us so, we are in charge, but im very grateful for myDSN’s help, best of luck with your new diet.

 

[Daibell]

Hi. Your nurse obviously doesn't understand the action of insulin very well. It can be adjusted up or down BUT you need to take account of the amount of carbs being eaten and the insulin regime will affect how you adjust the insulin. Personally, based on many posts over the years I've read, it seems that too many T2s with excess weight are started on insulin when it can be counter productive i.e. there is insulin resistance present. You are doing the right thing reducing the carbs and weight which means you may well be able to seriously reduce the insulin and may be even stop it. Just seek advice from the head nurse and possibly change the insulin to just Basal (e.g. Levemir or Lantus); discuss with her.

 

[Resurgam]

I eat the things on the Atkins allowable lists and need no medication at all - plus my BG doesn't shoot up when I eat carbs in the way it used to - but if I do eat more carbs my weight increases - I check regularly and adjust my carbs according to my weight these days - I am not going to increase more than a kg or two before cutting back again.
My CCLL was 50 gm a day, and that was exactly what I needed to eat to control my blood glucose levels and drop them to normal. I was diagnosed two years ago and am so much better now, but I put on so much weight eating 'healthy' carbs I need to drop another couple of stone or even more. That is why I have set my normal intake at 40 gm per day, and am going to be a lot stricter in the run up to Christmas, because just getting good BG levels obviously is not good enough.
You should perhaps try lowering your carb intake in small increments, and watch your BG levels so you can reduce your insulin levels. Low carb is a powerful tool for lowering BG levels and insulin overdose is no joke.

 

[Engineer88]

Thanks for that mate...the only reason i have decided to go for atkins is that we tried it about 7 years or so ago, and it worked very well for weight loss..

Yeah low carbing is the new version which is a lot healthier - it excludes less and is slightly less prone to carb flu plus is more sustainable good work though

 

[bulkbiker]

The head nurse from the clinic called me this afternoon, and we had a good chat about it... she told me to monitor closely and if i felt i should to reduce the insulin as i saw fit... but then call her and have a chat. She did say that I may well have to cut the dose by up to 50% depending how it worked out..but she would make sure that she would be available to me.. Very nice lady actually...so hopefully it will work out ok... only way to find out is to give it a go eh!!!

Cutting carbs can have a very immediate and quite dramatic lowering effect on your blood sugars so be prepared to cut more than 50%!