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Tablets to Insulin

bit8paddle

Newbie
Messages
4
Type of diabetes
Type 2
Good afternoon all.
I have as of today gone from tablet controlled diabetes to tablet and insulin controlled. I have stopped taking Sitagliptin and halved my Gliclazide but still taking metformin .I have 10 units of Lantus in the morning then 4 units of Humalog 3 times a day with meals. So far my sugar levels are going up not down and as of 5 minutes ago were on 17.3 which is the highest Ive ever had them . What am I doing wrong
 
Hi and welcome

Why did you make the move onto insulin? many of us find that we can control diabetes simply through a low carb diet . Were you already following a low carb diet before you went onto insulin?

It would be helpful to have a few more details before people can comment.
 
Did the doctor tell you to keep using gliclazide while taking humalog and lantus? My endo told me to get off them immediately when I was prescribed insulin because the combination can cause very dangerous hypos.

I still take metformin and statins alongside my insulin, but neither affect bloodsugar directly. What are you values throughout the day? How often do you check? Are you positive you're not having lows (under 4mmol/L) and are experiencing bouncebacks from liver dumps?
 
I was following a low carb diet which hasnt been working so my doctor decided I should make the change. I have had diabetes type2 for 12 years and my blood sugar has always been 8 to 11.5 never gone above until now . My latest blood test showed a rise from 57 to 69 which is why the decision was made
 
Have you started eating more carbs? Have you started carb counting? Carbs still raise bs unless the insulin dose is correct for the amount of carbs in the meal.
 
My doc told me to stay on half dose of gliclazide. Prior to insulin which I only started today my average throughout the day would be 9.3.Since starting this insulin regime following docs instructions Im getting readings steadily rising to now 18.4
 
Just as an FYI, insulin isn't always as easy as eat and dose. All the variables and macronutrient content of a meal effect how and when insulin will effect bs.
Carbs will raise it the fasted
Protein helps slow it
Far slows it
Fiber slows it
But a carb is still a carb so the other elements will effect the rate of digestion and how fast or slow the meal is absorbed which will determine how fast or slow your bs rises or falls.
 
Im on a low carb diet and have as yet had nil carbs today so its not carb intake and as my diet hasnt changed because of the insulin I dont get why its gone up so much on insulin . Sorry but being new to insulin I might appear to be a trifle stupid
 
Well you've reduced your oral meds that were helping to control your diabetes - that's the reason for the rise in blood sugar. The rise in blood sugar hasn't go anything to do with commencing insulin. It does however suggest your insulin doses need adjusting, you should discuss increases in your insulin doses with your doctor.
 
My doc told me to stay on half dose of gliclazide. Prior to insulin which I only started today my average throughout the day would be 9.3.Since starting this insulin regime following docs instructions Im getting readings steadily rising to now 18.4

I guess you were started on low doses of insulin to avoid hypos, and that these doses will gradually be increased if needed - hence your highs.
 
Not stupid at all. A bit puzzling. Are you eating large quantities of protein? In the absence of carbs 50+% of protein turns to bs. I need to keep my protein at the .8 g per kg LEAN body mass and I do take insulin for 1/2 of it. So if I'm eating 20 G protein (3 oz) I take insulin as if it were 10 carbs.

I do suggest you test often to see if your going low and then spiking or spiking and then dropping.

I now have a meal plan that works for me and I know my dose. I don't eat the same food ( except avocado at every meal) but I do eat the same amount of fat, protein and carbs ( I typically only eat vlc veggies at dinner)

Different meals act different at different times of day.

I need more insulin for less food in the morning and only fat is best for me so I have avocado for bf.

Timing your insulin dose can make a huge difference. I'll leave @azure to explain that. She really helped me.
 
Hi, unless you are overweight it sounds like you may be a LADA and not T2; I went down the same route as you. First, as you are on Basal/Bolus you should really be carb-counting and I'm surprised your GP hasn't suggested that. That means adjusting the Humalog at each meal to the carbs you are having. Many of us start with a ratio of 1 unit of Bolus to 10 gm of carb. You may want to discuss this with the GP. Doing this should improve overall control. I must admit I'm very surprised your GP has kept you on any Gliclazide. It is contra-indicated when on insulin as insulin does the same job but with better control if you carb-count. I would certainly discuss this with the GP. My lovely DN forgot to stop my Gliclazide when she started me on insulin but when I pointed it out she stopped it without question.
 
Has your fasting insulin level been tested?

When you put on weight where does the fat tend to go?

If you are in a room of people with diabetes do you look more like the people with T2 or the people with T1?
 
Have you suddenly lost weight for no reason? If so, this could imply the onset of LADA.
I believe, most LADA s tend to lose lots of weight for no reason shortly before diagnosis. However the next step is insulin which you are now on. The dosing looks like it needs to be adjusted. I'd ring your GP for discussion unless you are allowed/ comfortable adjusting your own. You're obviously very new and best to error on the side of caution until you get a feel for how much insulin works for how much food.
 
Remember it is also possible (but not common thankfully) for someone to have T2 due to insulin resistance and then have Type1 developed independently later……
 
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