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Type 2 new to insulin advice much appreciated!

Discussion in 'Ask A Question' started by Monty19, Jun 29, 2020.

  1. Monty19

    Monty19 Type 2 · Member

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    Hi All
    I was moved onto insulin Novomix 70/30 3 months ago after failing to get blood sugars under control after a virus (no, not that one!). Thought I was managing this quite well ( keeping within 4 and 9 mmol) butI have now been told I should move to more injections with 2 different types of insulin. Now in a bit of a panic! Seems incredibly complex. All help and advice would be really appreciated
     
  2. KK123

    KK123 Type 1 · Well-Known Member

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    Hi there, well 4 to 9mmol is doing quite well so that seems strange, are you SURE they have not now diagnosed type 1 first of all and if not, what was your hb1ac, I'm wondering if that was high thus implying that outside of your actual finger prick tests, your 'fasting' levels have been high. Please let us know as much info as you can with how it all started, what has been said so far etc, as this can help us to comment. x
     
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  3. Gleny

    Gleny · Active Member

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    Hi there

    I’m in the same boat as you I take NovoMix 70/30 twice a day I seem to be able to keep in the same B/G range as you 5 - 9
    as long as keep my food intake down.my AB1levels were very high When blood was taken.I'm not really sure am I TD1 or TD2 either I feel much better after using insulin.5.10 and 13 stone.

    Glenn
     
  4. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    Hi there - I'm not an insulin user myself, so don't have any specific wisdom to offer you. What I will mention though is others who have moved from a mixed insulin to separate long and fast acting insulins have often said, once they have the hang of it, they have much more flexibility in terms of what they can eat, and when, because they can adjust their doses to suit hungry or party days, or for days when they don't want to eat so much, or exercise a lot.

    Good luck with it all.
     
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  5. Monty19

    Monty19 Type 2 · Member

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    Thank you for such a quick reply! And apologies I’ve just re read my message and I wasn’t clear at all!
    Initially I was on metformin 4 years ago after diagnosis.( 2 tablets) Responded well and lost 2 St 12 lbs over 2 years . HbA1c 44 - then last March HbA1c was 46 , then in Sept it had gone up to 51 And metformin was increased to 4 a day . In December HbA1c was 46 . I had a sickness virus in February. Then in March this year HbA1c was 93!
    My blood sugars in early March were 18.6 on my meter! I was taking 4 metformin a day at that point and surgery put me on aloglyptin too as so high. No change over 7 days so ended up at hospital clinic when they put me on Novomix Insulin at a dose of 10 twice a day initially. Now on a dose of 3 in the morning and 4 in the evening. (my blood sugars, testing 4 times a day have been in 4-9 range for the last month.)
    Nurse at hospital wondered whether I was type 1 but consultant thought probably not ( no blood test yet though because of COVID)
    Diabetic nurse now suggesting I move to a base insulin twice a day and add quick acting depending on my meals carb content.
    Hope that is now making sense and giving a clearer picture. Thanks for your patience!
     
  6. Jaylee

    Jaylee Type 1 · Moderator
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    Hi @Monty19 ,

    Not to worry this point in time regarding what type you maybe. It's about the treatment that suits you..
    What you may find with your new intended insulin prescription, is a more flexible lifestyle regarding when you wish to eat. As opposed to some on the mixers sticking to a strict meal timing regime.

    Did your nurse tell you what type of insulins were proposed?
     
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  7. Monty19

    Monty19 Type 2 · Member

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    Hi Jaycee
    No I don’t know what insulins yet. I guess if I can eat when I want that would avoid occasional lows without the need to snack?
     
  8. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    Yes, the snacking. Forgot about that.. Theoretically you shouldn't be held so at "ransom" so much having to keep a basal bolus regime happy with the snacks?
    But there maybe (correction there will be.) the odd low with the long acting insulin. Which hopefully will only need a nominal amount of treatment, once the dosage is right.. It's still the nature of exogenous insulin.

    If you choose to go with what your nurse proposes, there are always folk who can point you in the right direction. Just ask as you go along..? It's quite a common regime. We all have our tips & tricks with it.
     
  9. Antje77

    Antje77 LADA · Moderator
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    Using 2 insulins is a basal/bolus regime. The basal is your long acting, which (in an ideal world) covers your base need for insulin throughout the day without adding food to the mix.
    The bolus is your quick acting, which you take before eating or to correct a high blood glucose when something didn't go according to plan.

    This means you can suit the bolus to whatever you eat. Don't fancy breakfast today? Don't inject your bolus. Suddenly craving that extra portion at dinner? adjust the amount you inject for that meal. No fixed mealtimes, no fixed meals.

    To make this work you'll need to adjust the amount of bolus insulin to the carbohydrates you'll eat. Big fat steak with onions and mushrooms? Hardly any carbs so no bolus or a very low dose. Eating at a friends place and they cooked spaghetti? Many carbs, so higher dose.

    In real life it won't be as perfect as this theory. Stuff happens. You'll find things like exercise change the amount of insulin you need. You'll find you'll still need a snack occasionally when your blood glucose goes low. But you won't need a snack at set times and you won't need to eat set meals at set times.

    It takes time to learn how much insulin you need, and it may well be you'll start out on fixed doses and more or less set meals to see how the food and insulin affect your bg.

    Wish you all the best, and remember, it's a marathon, not a sprint, and you don't have to learn everything all at once!
     
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  10. Daibell

    Daibell LADA · Master

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    You will find the Basal/Bolus regime much better but it does mean 4 to 5 injections per day. It gives you a high level of control so go along with it. If you have lost BS control following a virus it may mean your beta cells have ben damaged making you effectively a T1. When life settles a bit do ask for a C-Peptide test which will tell you whether your own insulin is low. I believe my beta cells were damaged by a a virus as I had a high white cell count before diagnosis and the diabetes came on quickly after that.
     
  11. Monty19

    Monty19 Type 2 · Member

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    Thanks Glenn Good to know I’m not alone! my food intake is still low carb and that certainly seems to help
     
  12. Monty19

    Monty19 Type 2 · Member

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  13. Monty19

    Monty19 Type 2 · Member

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    Thanks for the reassurance. I will definitely have questions!
     
  14. Monty19

    Monty19 Type 2 · Member

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  15. Monty19

    Monty19 Type 2 · Member

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    That’s really interesting and I will take that advice re the test. Thank you x
     
  16. Monty19

    Monty19 Type 2 · Member

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  17. Monty19

    Monty19 Type 2 · Member

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    Hi Antjee 77,
    Thank you for your help.
    It has certainly felt like a sprint to catch up. I guess I now pace myself! Thank you for your clear and simple explanation which I really needed. No fixed mealtimes would be great. Just a little bit of panic about increasing the injections so much. Doing them at home is one thing but whist out and about is a different matter. How do you cope?
     
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  18. Antje77

    Antje77 LADA · Moderator
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    I flip out my pen, screw on a needle, dial up the dose, lift an inch of my shirt and stick it in. Usually while simply continuing the conversation, and no-one bats an eye really. Sometimes you get a curious question, which is fine with me as well.
     
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