T2 Poor Control

[Tartan4957]

Hi I am a T2 using 78 units Toujeo once a day and varied Fast Acting (Humulin s) between 8 and 20 units dependent on what I am eating.
In the past month I have kept a food Diary and monitored carbs and cals.I am sticking to a low carb diet which has shown some improvement.My big vice s I eat fruit for breakfast (apple, orange grapefruit kiwi pomegranate) which will put my BS up too 14 (CGM monitored). I like to eat cereal but that will push BS up to 20 in the blink of an eye and despite using 20 units FAI it takes about 4 hours to come back down to 10.I will usually have egg and bacon about 11am and BS will continue to drop to about 7 by 5pm when I eat again.What am I doing which is so wrong

 

[Resurgam]

@Tartan4957 Are you sure you are on a low carb diet?
If you are using the insulins as though you are eating low carb ( I have no experience of that BTW) but eating fruit and cereal there could perhaps be a mismatch.
I find that my ability to deal with glucose is lower in the mornings, I tend to eat fruit - mostly berries but the very occasional apple after dinner and limit my morning meal to around10gm of carbs - some people find my breakfasts of steak and mushrooms or a chop and stirfry rather surprising.
I eat twice a day, at around 12 hourly intervals, but I do select nutritious if low carb options so I can manage without medication.

 

[Jaylee]

@Tartan4957 Are you sure you are on a low carb diet?
If you are using the insulins as though you are eating low carb ( I have no experience of that BTW) but eating fruit and cereal there could perhaps be a mismatch.
I find that my ability to deal with glucose is lower in the mornings, I tend to eat fruit - mostly berries but the very occasional apple after dinner and limit my morning meal to around10gm of carbs - some people find my breakfasts of steak and mushrooms or a chop and stirfry rather surprising.
I eat twice a day, at around 12 hourly intervals, but I do select nutritious if low carb options so I can manage without medication.

Hi @Tartan4957 ,

Welcome to the forum.

I’m T1.
How long have you been using insulin?

In my experience managing insulin dosage for food is like comedy.. you have to get the timing right as well as the dosage for any carbs? (Due to the insulin working profile & when it kicks in after injecting?)

But the first thing I personally would look at because you need a good foundation on a building or the walls start to crack is make sure your long acting (“basal”) dose is correct, before looking at the dose for food?

Doses are personal we can’t advise on that.

When was the last time you saw your diabetes consultant or nurse?

I’ll tag in @Lakeslover who has T2 & uses insulin.

Best wishes.

 

[Lakeslover]

Hi and welcome,

I am type 2 but currently just on a basal insulin.

Personally I wouldn’t be able to eat either cereal or that type of fruits without it raising my blood sugar. If you wish to keep doing that you could talk to your diabetic team about changing your fast acting insulin to carb ratio. It would help to take a log of food and insulin taken and resultant blood sugar rise for them to review.

Or you could consider a lower carb breakfast, maybe Greek yoghurt and berries. I would be cautious lowering carbs though and make sure you are matching carbs to insulin to make sure you don’t go too low.

 

[Mark Rawlinson]

I use Trujeo 43 U and 4a day Trurapi 6u each time. I also eat cereals and fruit however I have been surprised how much sugar there is in some fruit. Grapes, Pineapple dates tend to be really bad also most dried fruits have high sugar. Try eliminating certani things one at a time and see if they make an difference, Also anpther surprise I had was rice i avoid it now and rice based cereals

 

[grantg]

looking a the insulin profile for humalin s: https://www.medicines.org.uk/emc/product/8197/smpc#gref it would appear it is short acting. nhs medicines page states same: https://www.nhs.uk/medicines/insuli.../common-questions-about-short-acting-insulin/ how long before meals are you injecting will be worth speaking to dsn to see if that needs altered somewhat. Have you done any courses at all if not have look at the following two pages https://dafne.nhs.uk/victor/ https://www.diabetes.co.uk/education/desmond.html and could try see if dsn could perhaps refer you to one of them alongside asking them which one they would recremmend would suit your circumstances the best

T1 diagnosed however have experience with family members T2 treated with insulin. the person whom had t2 ended up just trying to eat the same amount of carbs as they struggled (partly age thing) to work out their dosages. if relatively good with maths either programs should help

best wishes.