Time Scales

[Wife]

I expect you can't give exact answers to this but any vague idea would help.

My husband was diagnosed T2 before Christmas and is currently taking insulin, using a Flexpen (insulatard) because his liver/kidneys won't tolerate tablets. Currently 20 units per day.

He is trying very hard to bring down his Blood Glucose levels - HbA1c at 16+% before Christmas, around 12% on January 3rd.
His morning fasting levels are now normally between 4.8 and 6 mmol/l, which, I assume, is fairly good.

He's only just started taking evening (after meal) readings and had 7.8 the first night and 9.7 the second.

Q: I assume a 12%, with a reasonable fasting level, must mean he spikes very high at other times. Is that correct?

The evening readings have depressed him. He is not patient and not terribly virtuous about testing. He's keeping off sugar but does eat bread and potatoes.

Q: Does it take some time (i.e. in weeks) before the insulin starts to really bring the levels down? Are the higher after-food readings really just the absolute result of what he eats or is it possible that they might come down gradually anyway with the insulin? How long might it take for him to stabilise?

I'm looking for some way to encourage him!
Help, please!

 

[lilibet]

Hi
There are two possibilities as I see it

Spikes in bg- 7.8 spike wouldnt give an hba1c of 12 I shouldnt think though insulatard is not great at tackliing post meal spikes as its not really intended as a meal time insulin as such but across the whole day. However it does seem to be working for him as the margin between pre meals and post is not gigantic considering

More likely is the fact is your red blood cells take around three months to 'turn around' or die so anything within the same three month period, ie the last two hba1c's wont show up his good progress or hard work. Ie my first hba1c after diagnosis was 7.9 which although my numbers were good for the weeks prio, reflected the fact I had been diabetic but not aware of it and therefore running higher numbers for 6 weeks before I knew I was diabetic

If I were you, tell him to keep trying hard as he is and wait for his next hba1c - I would be very surprised if its not a lot better. In terms of spikes, the less carbs he eats, the more likely he is not to spike his bg. HOWEVER, given he is on insulin ANY change in diet needs to see and adjustment in meds so please make sure he is safe if he decides to do this, by consulting with his team (who might try and talk you out of managing your carb intake :lol: ). Still ,just need to highlight it to you