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Type 2 on insulin help needed

Discussion in 'Type 2 with Insulin' started by Sadie_k, Mar 27, 2019.

  1. Sadie_k

    Sadie_k Type 1 · Member

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    I’ve been a type 2 on insulin for 5 yrs. until recently poorly controlled. I suffer from horrendous thrush and thirst and was wondering if there is much I can do about it?
    My latest hba1c is 90 I think. Iam sure it was around 117 before that. My reading in the am are between 7-10 and the pre dinner are very sporadic 5-13 and again varies at bed time. Before this normally around 15-19 sometimes a lot higher. I try my best to carb count and have been trying to follow the low carb programme however I know iam not fully committed. Sometimes it doesn’t matter what I eat...
    Iam on nova mix 30 and have been since day 1 of being diagnosed. I inject 26 units before breakfast and the same again before dinner. I also take 1 500mg slow release metformin in the morning. I recently got taken off forxiga (sorry maybe the incorrect spelling) because of the thrush. Which iam on frequent medication for as it can take weeks to get rid.
    I also get bad insomnia. The list goes on to be honest but at least they aren’t serious... right?
    Please help, what am I doing wrong? Probably everything! Iam literally giving up, I have no support
    Due to see my nurse on the 12th.
    Thanks for reading
     
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  2. urbanracer

    urbanracer Type 1 · Well-Known Member
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    Hi @Sadie_k

    I spent over 2 years on mixed insulin, it started out well but got harder and harder to control. It is generally recommended that T1's be put on multiple daily injections (MDI) for better glucose management so has this been offerred to you? Do you not have any contact at your local hospital?

    Your profile states that you're T1 but in the text you write T2??

    Edited to add, NICE guidelines indicate that MDI's should be considered for T2's if a1c is above 75mmol.
     
    #2 urbanracer, Mar 27, 2019 at 10:49 PM
    Last edited: Mar 27, 2019
  3. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    The reason many uncontrolled diabetics have thrush is that they are peeing out the glucose, and the fungus is flourishing in that environment. The thirst is due to the amounts of urine being made by the frantic kidneys trying to get rid of the glucose rather than reabsorb it and try to get it back into the already overly sweet blood.
    If you can reduce the amount of glucose and other simple sugars in your blood then both symptoms should reduce in sync with that.
    As you are using insulin and Metformin it will need to be a cautious approach, as eating low carb foods can be very effective in lowering blood glucose - I went from a Hba1c of 91 to 47 in 80 days of low carb.
     
  4. EllieM

    EllieM Type 1 · Moderator
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    Well, the thirst should disappear if you can get your blood sugars down. (It's a standard side effect of high blood sugars).

    Likewise, the thrush is also a common side effect of high blood sugars, though I would urge you to get your partner treated if you're sexually active, as it can be passed to and fro between partners. (And don't share towels, as I believe it really is that easy to transmit and unfortunately having high blood sugar gives the candida an ideal growth environment.)

    As a T1, and a female, I've had thrush many times, and I agree it is horrible. I assume you've had all the treatments going? (Pessary, cream, pills?) It should be possible to get rid of it if you can normalise your sugars, very very difficult if you don't.

    Normalising your sugars: are you T1 or T2? (Your profile and earlier posts say T1, but you've written T2).
     
  5. Sadie_k

    Sadie_k Type 1 · Member

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    Sorry for the confusion. Iam type 2. When first diagnosed I was treated as a type 1 but it’s been confirmed as a 2.
     
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  6. Caeseji

    Caeseji Type 2 · Well-Known Member

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    Honestly what everyone has said above is the best advice there, the problem with T2 as well is the insulin resistance that is inherent in the condition so your body is already flooded with insulin and can't take much more so when you're taking in external insulin it really has a hard time. I really hope you can get it under control, thrush really is never good to have to deal with. Low carbing will have an effect if you keep with it though with any luck!
     
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  7. Sadie_k

    Sadie_k Type 1 · Member

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    Not sure how to change my profile
     
  8. urbanracer

    urbanracer Type 1 · Well-Known Member
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    Click on your screen name - top right and open the pull down menu.

    Then click on personal details and edit to your hearts content !

    upload_2019-3-27_23-15-7.png
     
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  9. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    Sadie - I see @urbanracer has suggested how to change your profile, but just to add to that, it's best to do it in your browser. If you use the App, there are fewer options to change.

    If you get really stcuk, a Mod could help you out by making the change.
     
  10. Roseanne01

    Roseanne01 Type 2 · Well-Known Member

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    Sounds to me like you need reviewed. I’ve been struggling because of other Christians Nic illnesses and limitations on what meds I can take. My endo just added more lantus (slow release)., so I’m taking it before bed and breakfast. And novo rapid before every meal. So far my morning readings are way better, afternoons so so. But certainly better than it was.
     
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  11. MEValentijn

    MEValentijn Type 2 · Active Member

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    No, additional insulin does not make the situation worse - insulin resistance merely means that more insulin is needed to have the same impact as it would in someone without insulin resistance.
     
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  12. Caeseji

    Caeseji Type 2 · Well-Known Member

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    That is true enough really, there are a few schools of thought that look at the fact that flooding more in there will just make the resistance worse but it depends on the pathology behind the diabetes you have. Insulin resistance is the same either way to look at it, you’re absolutely right there.
     
  13. MEValentijn

    MEValentijn Type 2 · Active Member

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    Please provide a link to the peer-reviewed, published research which indicates that insulin ever causes insulin resistance. Otherwise, it's just scare-mongering which can be extremely harmful in making people avoid a medication when they need it.
     
  14. Caeseji

    Caeseji Type 2 · Well-Known Member

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    Just to preface this I am never going to say that someone should come off of something life saving nor is insulin to me a failure on part of the patient. If it helps you to manage your condition better and help make your life better then I can do nothing but support it but here we are:

    https://link.springer.com/content/pdf/10.1007/BF00279918.pdf

    This is one of the studies that I have seen quoted a few times and adjunct to this:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612791/

    There are so many unknowns and when it comes down to it I would rather people do what is comfortable for them and I would never want to scaremonger.
     
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  15. luna50

    luna50 Type 2 · Well-Known Member

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    There was an old person of Dean,
    Who dined on one pea, and one bean;
    For he said, 'More than that,
    Would make me too fat,'
    That cautious old person of Dean.

    This Forum is dominated with postulations for curative treatment of Diabetes Type 2 by “Low carbo method”. For that I can say: Latin “ Quot homines tot sententiae”

    Diabetes T2 is not represented by every person on the same way.

    LC method is effective by the persons on prediabetic and the persons on the beginning for DM T2.

    The treatment for these persons is with diet, exercise, Metformin and Sulphonylureas drugs.

    The DM T2 treatment with Insulin and metformin can be difficult to control it effective.

    The problem is the missing knowledge by the persons who have DM T2 and the useless explanation from the medical staff. NO one of this medical person explain exactly how to control the illness. All explanations are very superficially. Most people think if they take insulin, then all problems with DM T2 are away.

    The intake of exogen insulin depend of the grade of insulin resistance.

    I can tell You about my way how I control my DM T2.

    I have very high insulin resistance. I take on the morning 15 IE- Insulin Tresiba (degludec), the best insulin on the marked, and 4 IE – insulin Novo Rapid and 1.5 g Metformin. My BG on the morning is from 4.0 to 5.0 mmol/L.

    On the morning I eat 2 egg and one bread with butter and honey. (Ordinary office job)

    On 12.00 my BG is 4.00 mmol/l and I eat a moderate meal (I eat what I like to eat, no diet meals and no LC- meals). After 1.5 hour I measure my BG. Normally the BG is about 10 mmol/l. After that I take my Electrical Bicycle and drive about 10 to 15 kilometers. (You can RUN if you prefer that) All that take about 0.5 hour. My BG after that is only 4.5 mmol/l. By 18.00 hour I eat normal meal and do not make exercise. On the morning my BG is 4.5 – 5.0 mmol/l.

    If You control your BG only with insulin, without exercise, then you must take more insulin and the carbs will not be catabolized but they will be deposit in your adipose tissues. It will be difficult to control your weight.

    If You are an obese person, then You can use Insulin Tresiba (degludec) mixed with Victoza. You will have 100% positive results for los of weight. Your “doctor” must be involved in that.

    For all this the start point is to find what is your BMR (Basal Metabolic Rate).

    You body use 24 Cal / kg weight and if you like to have a weight of 60 Kg, then you can multiplicate 24 x 60 = 1440 Cal / day. The composition of This daily energy of 1440 Cal is: 50% must be from carbs, 30 % from fat ad 20 % from protein.

    The carbs and the proteins have 4 Cal / gram and the fat has 9 Cal/gram.

    You MUST eat carbs because your body need the energy molecule ATP (Adenosine Triphosphate).

    This energy molecules are used by every biochemical process in your body.

    You can read on the English Wikipedia about ATP and Metformin. It is very important to understand how this molecule works in your body.

    Ask me for all what you wish and you will get always a true answer.
     
  16. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    Luna - It is excellent that you acknowledge, up front that everyone is different in their health and how they manage it, but then you appear to go on to suggest that your way is the way to manage T2 diabetes.

    One of the frustrating things about T2 is that each person really does have to find their way to move forward, managing their T2 for the longer term. To be clear, I am certainly not saying that insulin is bad, but nor am I say a Low Carb diet is bad. Indeed, I follow a low carb way of eating myself. Additionally, not everyone exercises. Some don't care for it, and for others it is impossible, due to other limiting factors and/or medical conditions.

    Whilst I am pleased it looks like you have worke out how to balance your energy requirements by calculating a calories per kilogramme, I also find I am quite different in this regard. Personally, if I eat a lot of carbs, I can eat far less, in terms of calories, otherwise my weight creeps up. If I am eating a reduced carb diet, I can eat far more calories to maintain weight. I've just done a quite calculation and find on my LC way of eating, what I eat equates to about 51 calories per kilo, to maintain, and certaily way less that 50% of my calories are from carbs.

    Congratulations on finding your way, but I find it pays to keep an open mind on how I or others can best manage their health. My health is excellent at the moment, I'm pleased to say, and my HbA1c is low. I'm quite happy following my own route.

    With diabetes, whether T1, T2 or almost any other sort, there can be many routes to fulfull the same objective. Choice is important.
     
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  17. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    Hey Sadie,

    There's been a load of input, but from a fellow thrush sufferer... My husband asked me for the cream (for his toes) yesterday, and it went past its use before date in august 2017. I was surprised to see just how long I've been without that particular complication! For me, and stressing that "for me" bit, low carb high fat, and later keto, have worked. You say you're getting things wrong, maybe this'll help you find where: https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ Of course, you could put online what you eat on a typical day and we can pick it apart for you... Just be careful with low carb combined with insulin, because you could hypo.

    In any case... I hope you'll feel better soon.
    Hugs,
    Jo
     
  18. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    As soon as I see someone claim that carbs are essential in the diet for there to be glucose available in the body I can evaluate the worth of the rest of their advice.
    I just bought all ten of the packs of low carb bread in ASDA last night - I ate some with cheese last night and with chicken today. Honey will not be part of their future.
     
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  19. luna50

    luna50 Type 2 · Well-Known Member

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    DCUKMOD. Thank you for your comment and I find it very reliable.

    Some persons can find a way to manage DM, but there are a lot of people who cannot control DM properly.

    In the Biochemistry postulates that our body in rest use 24 Cal /Kg body mass, under ordinary conditions.

    This is how BMR is calculated on a simple way.

    Calculating the real BMR is more complicated. BMR depend on the body composition.

    On the top of the BMR, humans need additional energy for POSTPRANDIAL THERMOGENESIS. It is typical about 10% of the BMR. Digestion, absorption and storage of the fat require about 2% to 4% of the fat energy. Conversion of Carbohydrate to storage fat requires about 24% of the energy content of the Carbohydrate. In the fitness places there are an equipment to measure the BMR.

    If the person has a high insulin resistance, then the carbs (glucose) stay in the blood vessels for a long time.

    If the glucose is above 5.5 mmol/l then in the tissues where there is no need for insulin the glucose to enter the cells, as the kidney, nerves and the retina there will start the Polyol Pathway. You can read about this Polyol Pathway on English Wikipedia.

    The polyol Pathway can result in damage of this tissues as Retinopathy, Neuropathy and Nephropathy.

    This is the reason why the glucose levels must be very low.

    High insulin resistance and intake of carbs can be controlled on two ways.

    You can use more insulin and the result will be the glucose can be converted to fat and will be deposited in the adipose tissues OR

    You can after 1.5 hour make physical activities to bring the glucose level low and to catabolize the glucose.

    Low Carbo diet is starvation and is not healthy diet. The person catabolizes FAT and the levels of plasma free fatty acids rise and the liver turns fatty acids into ketone bodies. These are the same changes as in starvation. VLDL will be elevated because the oversupply of fatty acids promotes triglyceride synthesis in the liver. The rise in VLDL contributes to the accelerated development of Atherosclerosis and Coronary heart disease in Diabetes.

    I do not advocate for my approach to DM control, but I am very serious concerned about the missing attempt from the healthy persons to instruct the DM patient’s correctly
     
  20. Brunneria

    Brunneria Other · Moderator
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    @luna50

    If you are going to make wild statements (for instance claiming that a low carb way of eating is starvation and unhealthy), then please provide reputable scientific references to support your claims.

    If you are unable to provide these reputable scientific references, then do not make such claims. If you continue to do so, your posts will be deleted for unsubstantiated scaremongering.

    You may be interested in furthering your knowledge on the subject, to get a better understanding of why so many members of this forum flourish on the way of eating you think is ‘starvation’. I suggest the Voleck and Phinney book The Art And Science Of Low Carbohydrate Living to start you off. Jason Fung’s works (books and online articles, lectures and blog) will also give you a better foundation.
     
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