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Struggling!

Libby3781

Well-Known Member
Messages
162
Location
Bridgend, South Wales
Type of diabetes
Type 2
Treatment type
Insulin
Some of you will be aware I’ve come away to Germany for a long weekend. Prior to coming away I was given another insulin to add to my regime.

We came away Wednesday, straight after my hospital appointment. We have come away to an organised event that my husband takes part in. Therefore, all the food & drink is provided.

So firstly I’ve been struggling to get 4 doses of the new insulin in. It has to be administered 4 times daily, 20mins prior to food. I’ve also been weary to take my metformin, as the tablets sometimes cause my stomach to be bad. So everything is feeling very hit & miss especially as I’m even struggling to administer the Levemir last thing at night.

As the situation stands I’m currently due to see my DN in the hospital on Tuesday 2nd October. I’m really not sure if I should rearrange the appointment, as I feel the 7 days in between my appointment aren’t going to be an accurate reflection of the insulin’s, diet etc etc.

All advice welcome, thanks in advance.
 
That was the number the consultant advised. I think it might be because I need to get more structure into my eating.

That itself is rather challenging whilst away. It is all seeming overwhelming at the moment, and I guess being away isn’t helping.
 
But, but 4 meals a day might cause your weight to increase which might be counterproductive, maybe???
Who eats 4 meals per day? maybe those in heavy labour occupations or who are underweight and need to add weight or if maybe supper is counted as a meal?
Or who maybe have insufficient basal insulin injected and use extra short-acting insulin to make up the difference ?
May I ask how many grams of carbs you are expected to eat per day with the 4 pre-meals doses of insulin?
And what do you think he/she meant by "meal structure"?
 
@Libby3781 - Are your 4 injections all the rapid acting, or is it three rapid and one slow acting?
 

I haven’t been given any advice with regards to carbs yet. Been advised need to loose weight. I think the supper would be counted as a meal.
I currently don’t have any sort of eating regime, sometimes have breakfast sometimes don’t. Same applies for lunch. Tend to have evening meal.

The consultant suggested I must try and eat breakfast,lunch,& diner,supper.The meals that are hit and miss for me are normally breakfast and dinner.
 
So as per @DCUKMod, is it 4 injections including Levemir, or 4 of short-acting insulin PLUS levemir? And since diet is one of the corner stones of diabetes management why has not your consultant discussed this with you or suggested a dietitian or a dietary education via some source (Low carb being one example amongst others).?
 
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Hi Libby,

I hope you're having a good weekend in Germany although you're having problems getting used to the Levemir.

It seems strange to me that they told you at the hospital to use it four times on top of the basal (long acting) insulin. I have only started using the short acting in April and was told only to use it whenever i'm eating. The DSN said don't use it if you're not eating. No mentioning of eating three or four times. I have not been given any advise regarding carbs, not to this day. All i know i have learnt on this forum. Since i'm using Novorapid i have only seen the nurse once briefly. I must be doing something right because the hba1c has improved dramatically and i didn't put on any weight since then. I just continue to cut down on carbs although not strictly low carbing. The less carbs the less insulin.

Anyway, i hope you are able to cope very soon too. If i was you i would not cancel the appointment!
Best wishes x
 
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Hi Libby, if your eating isn't structured, I can see the argument for having four quite low doses of novorapid per day. Ironically, though, the event you are at probably enforced a three meal a day structure on you, so it's not surprising it's a bit hard. So I can see why you feel the last week is not representative of a normal week.

I wouldn't cancel the appointment though, because it's about more than just how you manage in a normal week. You've only just started using it, and it's best to check only on how it's going.
 
What is the 4x insulin called?
 
Libby3781 said:
It is called Nova Rapid (orange pen)
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Hi @Libby3781
I use the same fast acting insulin and have not been told to use it rigidly 4x a day. I use it when I eat, so sometimes 4x a day if snacking, sometimes 3 or 2x.
As you mentioned your team may be trying to get you into a routine of eating, but part of the advantage of the two different insulins is that you can eat irregularly and different amounts.
And 20 mins before eating can be helpful to reduce spikes, but real life sometimes gets in the way!
I would go to the appointment and ask for more info on why they are keen on 4x day when bolus insulin allows flexible eating.
 
I agree with @Diakat. When I was on the Novorapid before meals and the Levemir (twice daily) I could skip lunch if need be. or delay them. And there are people who do not have breakfast, or lunch etc because it does not suit them health-wise. Who is to say that 4 meals a day are required? And how many carbs are suggested per meal? Is the dietitian supposed to match meals to your prescribed insulin doses or what is sensible for you?
If the dose is fixed, then you may be eating to prevent hypos - not my favourite way to be managing my diabetes???
Sure, if one is low in weight, 4 meals a day might help put on weight but it seems a bit much to use when not under-weight?
Just my views - not professional ones.
 
Well I made it to my appointment with my DN. I worried way to much.
It was a review just to see how I was getting on with the new insulin (Nova Rapid).
She also clarified the routine required. Consultant said insulin 4 times a day.
The DN nurse confirmed 3 times a day (morning,lunch & dinner) nova Rapid, then Levemir last thing at night . Obviously, still 4 insulin’s, but sounds more like a feasible one.

So hopefully from today, I’ll be able to get into a routine of doing the insulin. I have been advised I have to do it 15 minutes before food, not during or after.
 
Hi @Libby3781, So glad your doses and timings have been clarified. Now, to see how well it works (thinking of it like a recipe), and what additions/subtractions are needed. ( more basal and sage anyone??
Best Wishes and please let us know how you fare.
 
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