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type 2 about to go on insulin - advice please

Discussion in 'Diabetes Discussions' started by gefmayhem, May 7, 2010.

  1. gefmayhem

    gefmayhem · Well-Known Member

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    Hi folks
    After 20 years of diet and tablet control, I have just had a diabetic clinic and have to go back next Friday to start taking insulin to supplement my tablets.

    I'm looking for advice and suggestion of questions I should be asking when I go back?
    Also, any stories form others who have gone through this change in medication.

    I'm type 2 and currently take glipizide, metformin and rosiglitzide.
    The rosiglitizone will be stopped before I start on the insulin.

    I'm away this weekend but I'm looking forward to reading your replies.

    Thanks
     
  2. HLW

    HLW Type 1 · Well-Known Member

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    I've recently started insulin, after about 5 years of diet and tablet control, after they finally did the relevant tests and found I had type 1 diabetes. So some of this might be a bit different for type 2 diabetes but it's mostly the same I think.
    Here are some things that would have saved time if I'd known about them before the appointment about starting insulin. In no particular order:

    1) Make sure they tell you clearly what your target blood sugars are for self testing. You want to know the levels for: fasting (first thing in the morning), 2 hrs after eating, and before you go to bed so it doesn't drop too low at night.

    2) Ask about injection sites - NICE guidelines say use thighs for long acting insulin and stomach for short acting.

    3) Do you self-test blood sugar? If not, ask them to show you how to do this. Either way make sure you have lots of test strips and lancets on prescription, if you already get them on prescription it might only be a small amount. You want like 200 at a time, something like that, I was recommended by the nurses to test 6 times a day so they get used up pretty quick.

    4) Get some of the calibration solution for your meter from the manufacturer's website, I think it is free for whatever meter you use, just so you can make sure it is working ok.

    5) Get some lucozade or other sugary drink and keep it somewhere handy. Have some near your bed. This is in case you are sick etc and the glucose tablets don't work because you aren't digesting them at all.

    6) You want 2 of everything, so you can carry one set with you and leave the other somewhere safe in case you get mugged or probably more likely drop/step on/sit on your insulin and break it! You want two:
    - blood testers and finger prickers.
    - packs of glucose tablets.
    - each insulin type you are taking, and spare pens if you are using the refillable ones.
    - leave some needles and test strips with your spare stuff too.
    I also got a spare prescription for my insulin from the Dr to keep in my wallet when I am travelling, in case I lose my bag or something.

    7) I would get them to confirm that you should be still taking the glipizide.

    8 ) Does the metformin ever make you ill? If it does, tell them at the diabetic clinic how often it does and are you sick etc.

    9) You'll need a sharps bin for the needles (if you don't already have one for lancets from a blood test meter). Don't do what I did, and close the lid fully when it is empty. They can't be reopened...

    10) The insulin comes in disposable pens or cartridges for refillable pens (you can also still get it in syringes I think, but the pens are much more user friendly and have smaller needles!). If you are on two types of insulin in refillable pens, make sure both pens are a different colour so you can tell them apart! You might prefer to have one or both in disposable pens because these have the type of insulin written on the side, so it's easy to tell which is which. If you are on a long acting insulin and a short acting one, you might prefer the long acting one in a disposable pen, but the short acting one in a refillable pen, because you might be using the short acting one during the day in public and the refillable pens look less 'medical'.

    11) Ask if you can see the pens and how they work before choosing which to use. The ones I was given at the hospital are fine, but they have some useful features that not all pens have, eg. you can turn the dose section dial back if you dial too many units (like if you want 4, but dial 5 by mistake, you can turn it back to 4). You can't do this with all pens apparently. The refillable one I have is a NovoPen4, the disposable ones are FlexPens. I've had no problems with either.

    12) I don't know how long acting rosiglitizide is, but it might overlap with the insulin if you stop taking it and immediately start taking insulin. Ask the Dr or nurse about this.

    Hope this is of some help!
     
  3. gefmayhem

    gefmayhem · Well-Known Member

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    Thats is brilliant!
    I'm about to print it off and study it over the weekend

    thanks for all that and for your time

    gef
     
  4. borderter

    borderter Type 2 · Well-Known Member

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    Good advice from HLW ,one very small point to add is if you will be injecting in public make sure the pen device is not bright orange as its not very discreet having said which I do it all the time and if you are very casual about it no one notices!!!! I have been diabetic for 14years and only five months ago had to change to insulin feel very much better on it too
     
  5. busybee2

    busybee2 · Member

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    when you star injecting dont do in the top of your leg because the insulin is upsurb vwry quickly i inject in my tummy but use it in different areas dont for to ask how much insulin you will have to use good luck jean :)
     
  6. Dave56

    Dave56 · Newbie

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    Towards the end of 2009 I was told I would probably have to start insulin because my sugars were very erratic, (I was type2 tablet control at the time). But my GP suggested I try a product called BYETTA, its primarily made from lizard spit and has some minor side effects, mainly with the digestion. But since starting it I have been able to reduce my tablet intake and although my sugars still need a bit of work they are certainly a lot lower and more consistant. (BYETTA by the way is a twice daily injection).
    So to anyone who has been told they may have to start insulin, it may be worth asking your GP about BYETTA.
     
  7. normanparcis

    normanparcis Type 2 · Newbie

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    Hi
    I've been a type 2 diabetic for approx 6 years and in that time I have progressed from a small amount of metformin a day to Metfomin,gliclazide and Insulin in large doses.
    The discussions on low carb diets on this site are informative and I have recently restricted my carb intake at each meal to see the effect.A lot of physical exercise like gardening/digging also helps.

    The results for me on low carbs has been a reduction in insulin injections from 58 units a day to 52 units a day and my blood sugar readings are more under control. I am actualy keeping in the 5-7 range for a large part of the day which for me is a great result.
    I can only recommend from personal experience but weighing the carbohydrates that you are eating and more exercise does seem to be the way forward.( I do cheat occasionaly with chocolate etc but this carbohydrate reduction does seem to be working on my sugar levels)
    Best of luck for you working out what works for you
    Norman
     
  8. gefmayhem

    gefmayhem · Well-Known Member

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    Thanks for all the information folks.
    A bit of further info.
    A do low carb and usually manage a self test average of 7 to 8.
    After going off the rails a bit (a lot) at Christmas and during a January holiday, I went back to low carb.
    General work day food.
    Breakfast - cheese
    Lunch - cold meat, salad and sour cream with chive dip. Low sugar jelly
    Dinner - fish or meat with veg and dip.
    Snacks peanuts or a few squares of Green and Blacks 85%.

    With this diet I was having extreme difficulty getting my 2 hour after meal readings into single figures.
    Eat 2 oatcakes - 7 to 8 grams of carb and I would be up to 13 to 15.
    I actually ate some cake one day and hit 25.2.

    In all these cases the readings were double what I was getting in September/October.

    I've been told I will be on 10 units a day, late inthe evening.
    I start on Friday.

    cheers
     
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