Type 2 starting on insulin....how soon before you saw an improvement in your bg levels...

[Molly56]

Was just wondering how soon after starting on insulin it was that you started to see an improvement in your blood glucose levels...

My partner started on Humulin 1 about a week ago, starting at 10 units and has increased this to 12 units as per instructions supplied....so far I would say that there has been no noticeable reduction in blood glucose levels as such....morning readings range from 9.6 to 13.9 (average before insulin was 11.2) and readings before evening meal range from 11.7 to 19.8 (average before insulin was 15.7)...

Should he be seeing a reduction in these figures by now or is it early days yet ..

....he should be increasing the dose to 14 units as from tomorrow as per instructions...I know everyone is different but at what dose did others notice a reduction compared to their pre insulin readings....

 

[Daibell]

Hi. You can't generalise about this but the DN is probably getting your partner to increase the dose gradually hence it could take a few days to have an effect. Does your partner have excess weight? If so this can need large shots of insulin to have much effect. A low-carb diet is usually vital in conjunction with insulin to avoid further weight gain and help stabilise the BMI. I'm guessing of course about the excess weight.

 

[Molly56]

Hi. You can't generalise about this but the DN is probably getting your partner to increase the dose gradually hence it could take a few days to have an effect. Does your partner have excess weight? If so this can need large shots of insulin to have much effect. A low-carb diet is usually vital in conjunction with insulin to avoid further weight gain and help stabilise the BMI. I'm guessing of course about the excess weight.

@Daibell ...you are correct about the excess weight...to get down to what the NHS classes a "healthy weight" he would have to lose about 6 stone or a third of his body weight......the other issue is his almost total lack of activity which probably doesn't help either.....am assuming it will take some time and a number of increases in insulin to have any effect.....my assumption is that they will review his insulin regime once he has got used to it and that ultimately he will end up on multiple injections per day rather than the one at present...

 

[Mike d]

18 stone is a fair amount ...... is he averse to exercise? 6 stone is a lot to lose

 

[iHs]

Difficult one.......but eating less food will result in lower bg levels and will help the weight loss. Is the carb content in the food now being counted and if so how much is being eaten?

 

[PatsyB]

managed for four years on medication and diet then had to go onto Insulin...Humalog mixed am and tea time I am finding that after a few weeks I am having to increase the insulin at tea time to try keep it low...is this the norm?

 

[Jaxx01]

My levels are stabilising now at 2 weeks after starting however I'm on multiple daily injections. I have a long acting one I take at night and then I have rapid for mealtime sx

 

[LittleGreyCat]

Just out of interest, if insulin injections are started but there is no appreciable difference in BG does this mean that the main problem is probably insulin resistance and not lack of insulin production?

 

[Molly56]

Just out of interest, if insulin injections are started but there is no appreciable difference in BG does this mean that the main problem is probably insulin resistance and not lack of insulin production?

@LittleGreyCat ......that question had crossed my mind too especially as he does carry excess weight as mentioned above......is early days yet as only on the insulin for one week and at quite a small starting dose....as far as I know no specific test has been done to determine whether or not he is producing his own insulin or if he is then enough to be working.....insulin resistance may also explain why the tablets he was on (and is still on, in addition to the insulin) were not being effective....if the problem is insulin resistance then increased doses of insulin are not going to be the answer...
.....will be interested to hear other people's answers to your question....

 

[CollieBoy]

@LittleGreyCat ......that question had crossed my mind too especially as he does carry excess weight as mentioned above......is early days yet as only on the insulin for one week and at quite a small starting dose....as far as I know no specific test has been done to determine whether or not he is producing his own insulin or if he is then enough to be working.....insulin resistance may also explain why the tablets he was on (and is still on, in addition to the insulin) were not being effective....if the problem is insulin resistance then increased doses of insulin are not going to be the answer...
.....will be interested to hear other people's answers to your question....

I think C-peptide level testing should show if any "home made" insulin is being produced !

 

[Molly56]

@Mike D.....weight is obviously an issue and unfortunately 'exercise' does not seem to feature in his vocabulary....he leads what I would call a very sedentary life (minimal movement) and despite being told by myself and health care professionals that exercise will help he does not seem to get the message....
...he has also been told that he has arthritis and suffers from joint pain so uses this as an excuse not to exercise.....however as I understand it with arthritis the key is to exercise but however much I try to explain this and show him magazine and newspaper articles that support this theory it just does not sink in....feel I am losing the battle on that front as he won't change....don't know what else I can do...

@iHs ....he is currently only on one insulin injection a day so has not come across having to count carbs and calculate his insulin dose accordingly....I am guessing it will come to that at some point ....at which point I expect the diabetic nurse will explain to him what he needs to do....is no point me telling him for the reasons I mention above...
...in the meantime I am trying to keep the carb content of meals down where possible but can't be held responsible for what he chooses to eat whilst I am out at work or not here..I would estimate that he is eating more carbs than most on here would be comfortable with BUT he is not eating to excess or constantly picking at food / snacking.....the fact he does not exercise is a key factor of the equation but there again something out of my control...

@CollieBoy...I had heard of the c-peptide level test but assume this is not done as a routine test for Type 2 diabetics....when going to his first insulin appointment test they asked for HbA1c and kidney function tests if I remember correctly but no test to see whether he is actually producing any of his own insulin....am assuming they just make some assumption about this and dish out the insulin as their next step....

 

[iHs]

Molly

Even with one injection per day, carbohydrate still needs to be accounted. Years ago when I was first diagnosed type 1, I injected a once daily injection of bovine Lente insulin which released its action over a long time period. Its stability on controlling my sugar levels was through eating set quantities of carbohydrate at different times of the day. Things havent really changed that much regarding food as we still need to be aware and cant just eat whatwever we want even though we'd all like to without worrying. OH has 2 choices, reduce food, get thinner and eventually need less insulin as bg levels will get lower or eat more carb, get fatter, need more insulin and more tablets because bg levels will stay the same or get higher.

 

[jnhutton]

I am in exactly the same position, similar weight, similar readings and started last Tuesday with humilin. My diabetic nurse advised me that it could be several weeks before I see any effect. I go up to 14 units on Monday so keep in touch so we can see how we are doing

 

[Molly56]

@jnhutton .....as you say it looks like my partner is on very similar medication...he has now been on Humulin for three weeks and is now up to 16 units per day ...

Unfortunately he has not been well for the past three days and has been in bed and not eating so insulin regime has been interrupted....blood sugar levels have plummeted to levels which are very low for him (lowest this morning was a worrying 5.4.....his 'normal levels' are currently around 9-11 in the mornings and 11-13 before evening meal).....is a bit odd as I thought levels would generally go up if ill rather than down....

....was difficult to know what to do about the insulin as no-one to speak to over the last couple of days....the diabetic team have an annoying answerphone system so you just can't get through to speak to someone for immediate advice....have had to make a decision as to what to do for the best over the weekend and then hopefully get back on track sometime next week...

I wish you well and hope you manage to get your levels down and under control.......since he started on the insulin his levels have started to come down from the much higher levels he was getting so think it is having some effect....the last few days have just been a bit of an unexpected blip!
Keep in touch and let us know how you are doing....

 

[jnhutton]

The advice I was given was don't change my routine for a single reading, but if you get 3 low fasting readings you should discuss with your DN. Your partners readings are very similar to mine but don't forget a BG of 5.4 is somewhere near where you are aiming for so maybe the insulin is beginning to work. Did you get a leaflet about a routine for when he was ill? If you send me your email I'll scan it and send it to you. I was advised if Ill to sip full sugar coke if I didn't eat anything or had been sick. I hope he feels better soon and you are able to help him manage his BG

 

[Molly56]

The advice I was given was don't change my routine for a single reading, but if you get 3 low fasting readings you should discuss with your DN. Your partners readings are very similar to mine but don't forget a BG of 5.4 is somewhere near where you are aiming for so maybe the insulin is beginning to work. Did you get a leaflet about a routine for when he was ill? If you send me your email I'll scan it and send it to you. I was advised if Ill to sip full sugar coke if I didn't eat anything or had been sick. I hope he feels better soon and you are able to help him manage his BG

@jnhutton ....thanks for reply and advice....my partner always takes his insulin in the morning when he gets up as advised by dn...this is generally about 10am as he doesn't get up all that early...on Thursday he didn't take his medication until about 5pm when I got back from work....he has had a series of low readings which are uncharacteristic for him....
...unfortunately as I was unable to speak to dn and am unable to contact them until Monday at the earliest I thought it best to seek advice from both the local pharmacist and a friend here on the forum ....with this advice and the knowledge that I needed to go out to work and leave him for a few hours (not knowing if he would eat or drink) I thought it best to give the insulin a miss for today and to start again tomorrow if blood sugar levels are at a better level....at least tomorrow I can be here ....
...I hope that I have done the right thing and will be contacting the dn on Monday ....at least restarting tomorrow will get the timing back in sync otherwise there could have been an overlap between one injection and the next....is all a bit of a learning curve....he has continued to take his other medication at the normal times so is at least covered by this....
....if it turns out that I have done it wrong at least I will know for next time.....was only trying to do the best and make sure I didn't return from work to a worse situation....

 

[jnhutton]

@jnhutton ....thanks for reply and advice....my partner always takes his insulin in the morning when he gets up as advised by dn...this is generally about 10am as he doesn't get up all that early...on Thursday he didn't take his medication until about 5pm when I got back from work....he has had a series of low readings which are uncharacteristic for him....
...unfortunately as I was unable to speak to dn and am unable to contact them until Monday at the earliest I thought it best to seek advice from both the local pharmacist and a friend here on the forum ....with this advice and the knowledge that I needed to go out to work and leave him for a few hours (not knowing if he would eat or drink) I thought it best to give the insulin a miss for today and to start again tomorrow if blood sugar levels are at a better level....at least tomorrow I can be here ....
...I hope that I have done the right thing and will be contacting the dn on Monday ....at least restarting tomorrow will get the timing back in sync otherwise there could have been an overlap between one injection and the next....is all a bit of a learning curve....he has continued to take his other medication at the normal times so is at least covered by this....
....if it turns out that I have done it wrong at least I will know for next time.....was only trying to do the best and make sure I didn't return form work to a worse situation....

As he is presumably T2, missing an insulin dose will not do any harm, its just his BG will be a little higher until his next dose. We are all in the same situation, though, its all a learning curve, but I take great comfort from the fact that im not on my own, and that there are others in a similar position to myself, and I think this forum is great.
As long as he doesn't go hypo, a series of lower readings is what we are all hoping to achieve, so don't be too despondent, but check regularly and make sure he has some glucose tablets or something if he gets too low to counteract.
All the best to you both,
J.

 

[donnellysdogs]

I wonder why some people are told to take at night and some at getting up?