Type 2 - Carb Counting - insulin Dose

[cym-mru]

Bore da / Good Morning

I have been diagnosed type 2 diabetic for about 14 years. Unfortunately, over the years things had to change with my medication as they become less effective. A few months ago I started the long acting insulin and then about a month ago, after we realised that the GLP1 was not at all effective, I started fast acting insulin.

I quickly really understood the need to carb count to ensure I didn’t get a hypo. I asked my Diabetic Nurse for a course so I count adjust my insulin dose, as appropriate. She sent me Desmond course. Which is great for a refresher or if your newly diagnosed plus nothing on Carb counting and insulin dosage.

The course I need is something like DAFNE but fully understand that it is for TYPE 1. Type 2 with insulin seems to be so marginalised when it comes to training. Surly it makes sense to adjust your dose to the meal your eating? I also understand and agree that as type 2 I can’t and shouldn’t eat everything, without a care, and adjust the dose without regard to weight etc. I have a perfectly health meal the other day, was full and satisfied, I scanned 2 hrs after food and was dismayed to watch my CGM display showing a downward trend and I was heading towards a hypo - when I checked my carbs I hadn’t eaten many carbs but high protein and vegetables- I had taken too much insulin to my healthy meal! So I’m frustrated!!

I will keep trying to get the information on carb counting, insulin dose, insulin correction factor etc. my Diabetic Nurse has referred me to the hospital to see if they can advise- surely if your on insulin this information should go hand in hand?

Anyway, thanks for the rant!

 

[Antje77]

Surly it makes sense to adjust your dose to the meal your eating?

Makes complete sense to me, yes.

You can do a lot yourself (that's how I did it, and I was still thought to be a T2 at the time).
What I did was counting the carbs by checking labels for my meals, log the insulin I took and log what my blood glucose was some 2 and 4 hours later. This told me if the amount of insulin I took for that amount of carbs (at that time of day) was the right amount, too much or too little, so I could adjust next time.

There's also an online course aimed at T1s, haven't tried it myself though: https://www.bertieonline.org.uk/

 

[In Response]

@cym-mru as you mentioned, people with type 2 treated with insulin seem to be marginalised.
Have you ever been tested (c-peptide and GAD) to check you were not misdiagnosed?
Sadly, it is something like 30% of adults with Type 1 are misdiagnosed with type 2.
Although you may feel your treatment will be unaltered but you will be more likely to have access to DAFNE and newer technology if you have a Type 1 diagnosis.

 

[Fenn]

In my experience, T2s are treated disgracefully regardless of meds

The best thing about rapid insulin is you get to experiment with a direct answer to your experiment, just go slowly until you get it right, unfortunately getting it right is different tomorrow but hey ho we have a keep trying huh, best of luck.

 

[LouliePops]

My DSN was reluctant to give me the nod re carb counting vs fixed dose and took a little while to convince her fixed wasn't do-able for me and my eating patterns. "T2s usually just have fixed doses" was her initial response.

If you find a meal that makes you go "ooh that worked out beautifully" try the same amount of carbs in another meal on that dose and see if its repeatable. (just avoid pasta, rice and pizza as they like to make up their own rules as they go along when working it all out).
Trial and error & a lot of meal logging in libre app got me to my ratios. I had a number in mind and when DSN reviewed she came up with the same.
Important to note my basal was pretty much correct when all this happened. When my basal is off my ratios can be off.

I felt like I was doing something wrong when bolus wasn't working out but in reality, the methods were what were wrong.
Really messed up my head with the guilt and blame on myself because (for example) I had more veg on my plate pushing the carbs up over what I could tolerate on fixed dose.

Never been on a course but DSN and other diabetics have helped a ton along the way