Type 2 Type 2 for 34 years. Glucose 250-360. Now @ 75-250. Considering Humalog. Never used insulin. Help!

[Thriving2]

Doctor wants to start me on Humalog, a short acting insulin 15 minutes before meals. Worried how to catch hypos with insulin and not get dangerously low.

Which insulins do people find working best for them? What is the advantage of short-acting vs. long-acting (lantus or other) Which short-acting insulin best? What are considerations people consider?

I am highly irregular about eating times, amount and types of food. Getting better now with setting alarms and portion control, still combining carbohydrate, fat, and protein is challenging. Doctor offered to let me try with diet/exercise for a month. But haven't been successful. Worried about managing insulin regimen, exercise and amount of food needed so no hypoglycemia. Suspected celiac disease. Lost 15 pounds in seven months without trying. 5 feet, 107 lb, frail, lost muscle.

Severe hypoglycemia 19 or low two times @ 2017. No ER visit. 60 to 70 in past two years. Never passed out. Glucose 250-360 from Mid October to End of November when doctor reduced repaglinide (Prandin, which stimulates insulin, oral med) from 2 mg breakfast, lunch, and 1-1.5 mg dinner because of hypoglycemia. to 1 mg breakfast lunch and none with dinner.

Nurse told to reduce glucose with exercise when on 1 mg Prandin & glucose 250-360; but I couldn't. Kicking myself for not being assertive and asking to increase dose of Prandin. Now restarted 2 mg Repaglinide breakfast, lunch, 1 to 1.5 mg dinner. Glucose 72-250. Catching glucose at 67-72 and treating with glucose tab (3-5 grams glucose). Also taking Metformin 1,000 mg breakfast, 500 mg lunch, 500 mg dinner which lowers glucose for me.


TIA.

 

[Chris24Main]

Hi @Thriving2 - and welcome to the forum;

I'm going to tag a member - @Lamont D - I, and I suspect others, will be hesitant to say anything, because your description of the things you are taking and the effects on your blood glucose seem strange, and we prefer to speak from experience.

I'm particularly curious that you would both be taking glucose tablets and ... well, I kind of get stuck there; it's very unusual for a Type 2 to be adding to their blood glucose, but if you have been T2 for 34 years - you will have been on a journey I can barely imagine, with recommendations that I may find surprising - the understanding of Type 2 has transformed over that time...

 

[Lamont D]

Doctor wants to start me on Humalog, a short acting insulin 15 minutes before meals. Worried how to catch hypos with insulin and not get dangerously low.

Which insulins do people find working best for them? What is the advantage of short-acting vs. long-acting (lantus or other) Which short-acting insulin best? What are considerations people consider?

I am highly irregular about eating times, amount and types of food. Getting better now with setting alarms and portion control, still combining carbohydrate, fat, and protein is challenging. Doctor offered to let me try with diet/exercise for a month. But haven't been successful. Worried about managing insulin regimen, exercise and amount of food needed so no hypoglycemia. Suspected celiac disease. Lost 15 pounds in seven months without trying. 5 feet, 107 lb, frail, lost muscle.

Severe hypoglycemia 19 or low two times @ 2017. No ER visit. 60 to 70 in past two years. Never passed out. Glucose 250-360 from Mid October to End of November when doctor reduced repaglinide (Prandin, which stimulates insulin, oral med) from 2 mg breakfast, lunch, and 1-1.5 mg dinner because of hypoglycemia. to 1 mg breakfast lunch and none with dinner.

Nurse told to reduce glucose with exercise when on 1 mg Prandin & glucose 250-360; but I couldn't. Kicking myself for not being assertive and asking to increase dose of Prandin. Now restarted 2 mg Repaglinide breakfast, lunch, 1 to 1.5 mg dinner. Glucose 72-250. Catching glucose at 67-72 and treating with glucose tab (3-5 grams glucose). Also taking Metformin 1,000 mg breakfast, 500 mg lunch, 500 mg dinner which lowers glucose for me.


TIA.

The only things I can ask, is, what diagnostic tests have you had?
What was your last hba1c?


It does seem that the information being given are very confused.
If you haven't been tested for antibodies or for insulinoma where are your doctors going with this?

Hypoglycaemia should not be dismissed with you may need insulin!
More insulin for someone who is already, going hypoglycaemic, seems over the top.
Unless you are LADA or T1.

 

[Kiwigal]

Has your doctor done C-peptide blood test - to check how much of your own insulin you are producing?

Esp you are Type 2 Diabetes for many years... would gradually decreased your beta cells over the years.

And also checked for antibodies of GAD test to rule out LADA and Type 1 Diabetes?