Uncontrolled and waiting for an appointment - UPDATE pg3

[IBEX82]

I hope your husband is Type 1?

@IBEX82 is Type two and shouldn't go anywhere that butty box. Ha!

I am definitely not going near that butty box - am having enough highs as it is! Lol
Itching to get started on my meds but the electronic prescription wasn’t ready yesterday so it will be Tuesday now

 

[IBEX82]

Hurrah! I now have my insulin, and gliclazide.

I also had a GP appointment to discuss my mental health, and the GP feels I’ve burnt myself out between a combination of work and health worries.

Their recommendation has been some time off and some therapy. They also prescribed something to help me sleep as that hasn’t been going too well.

So here’s to a good nights sleep, less stress and better BG control in the coming days.

Thank you to everyone who prompted me and supported me to take these steps. It was definitely needed

 

[IBEX82]

Took my first insulin this morning, now to see what happens

 

[IBEX82]

Okay, so results are in FBG was 6.8 and then I took insulin, two glic and my steroid as advised. No food, just water to drink then 3 hours later BG 12.9 (clean hands, tested twice, second reading was 12.3)

Hmmm.. maybe the insulin isn’t high enough. It’s Novomix 30, 8 units or maybe it might take some days to build up?

 

[Antje77]

Okay, so results are in FBG was 6.8 and then I took insulin, two glic and my steroid as advised. No food, just water to drink then 3 hours later BG 12.9 (clean hands, tested twice, second reading was 12.3)

Hmmm.. maybe the insulin isn’t high enough. It’s Novomix 30, 8 units or maybe it might take some days to build up?

The right dose of insulin is determined by trial and error.
This is why you start on a relatively low dose and titrate up usually once a week or every couple of days.
If it turns out that someone needs 100 units, it'll take a while to find the right dose by carefully titrating up, but imagine getting started on 50 units and it turns out you only need 5, that would be pretty disastrous!

When are you having contact with your doctor/nurse again to discuss your numbers?
You'll get it to work out, just a little patience.

 

[Antje77]

It’s Novomix 30, 8 units or maybe it might take some days to build up?

And yes, your insulin is a mixed long and short acting insulin. So the quick acting part likely had started working after 3 hours but the long acting not yet really.

 

[IBEX82]

The right dose of insulin is determined by trial and error.
This is why you start on a relatively low dose and titrate up usually once a week or every couple of days.
If it turns out that someone needs 100 units, it'll take a while to find the right dose by carefully titrating up, but imagine getting started on 50 units and it turns out you only need 5, that would be pretty disastrous!

When are you having contact with your doctor/nurse again to discuss your numbers?
You'll get it to work out, just a little patience.

Makes perfect sense. I saw them last Friday and they said I’d get an appt for two weeks from them so it should be Friday next week.

Only started today as there was a delay in getting my prescription.

 

[Antje77]

I saw them last Friday and they said I’d get an appt for two weeks from them so it should be Friday next week.

Can you contact them by phone should you have urgent questions? (Like if you go low regularly, or if you don't drop below 12 ever in the next couple of days?)

 

[IBEX82]

Can you contact them by phone should you have urgent questions? (Like if you go low regularly, or if you don't drop below 12 ever in the next couple of days?)

I can, I have a number for them - they’re not open until Tuesday now (weekend and bank holiday)

If I’m still double digits by Tuesday, would you give them a call?

 

[Antje77]

If I’m still double digits by Tuesday, would you give them a call?

I would, but I'm quite impatient with stuff like this.
Being in double digits at the lower end isn't immediately dangerous, so choosing to simply wait until your next appointment is perfectly fine.

But if it was me, I'd give them a call to ask how they feel about upping the dose a little.

Two situations to call 111 before tuesday would be seeing numbers in the high teens or above without dropping again, or experiencing hypos.
And keep your meter and something to treat a hypo with on you all the time: you do not want to have to navigate stairs while having a nighttime low, or having to walk back from your evening stroll before you're able to treat.
For me, hypos are easily solved, not much a problem, but it could be a problem if I didn't have a means to do something about it no matter where I am.

 

[IBEX82]

I would, but I'm quite impatient with stuff like this.
Being in double digits at the lower end isn't immediately dangerous, so choosing to simply wait until your next appointment is perfectly fine.

But if it was me, I'd give them a call to ask how they feel about upping the dose a little.

Two situations to call 111 before tuesday would be seeing numbers in the high teens or above without dropping again, or experiencing hypos.
And keep your meter and something to treat a hypo with on you all the time: you do not want to have to navigate stairs while having a nighttime low, or having to walk back from your evening stroll before you're able to treat.
For me, hypos are easily solved, not much a problem, but it could be a problem if I didn't have a means to do something about it no matter where I am.

Thank you so much, this is great advice and I really appreciate it.

I too am very impatient, so if still in the low double digits by Tuesday, I’ll give them a call to see if we can up it a bit.

It is slightly better than it was - I was getting 15s and 16s before so a little drop is encouraging

 

[IBEX82]

I did it.. I finally did it. I ended the day with an overall blood glucose of 7.1 - no variation above 2mmol/l and my highest number was 9.0.

I’m in shock as I’ve literally done nothing different. I’m wondering if the insulin has finally started working or if it is because my stress levels are coming down too thanks to actually sleeping.

It could just be a fluke.. but I’m hopeful for a repeat

 

[ajbod]

It could well be a fluke, BUT it proves to you that it will work. There is no need to stress about it as you now know. The better sleep will have helped a lot more than you could ever realise.
From now it's onwards, and upwards, eventually when the steroids reduce and hopefully go altogether, things will get even better. CONGRATULATIONS, keep it up, all the best.

 

[IBEX82]

It could well be a fluke, BUT it proves to you that it will work. There is no need to stress about it as you now know. The better sleep will have helped a lot more than you could ever realise.
From now it's onwards, and upwards, eventually when the steroids reduce and hopefully go altogether, things will get even better. CONGRATULATIONS, keep it up, all the best.

Thank you. It really meant so much to me, I haven’t seen a single digit day in a long while.

I am sleeping much better thanks to the medication and some time away from work has meant I’m feeling much calmer too.

Also pleased to report, no double digit numbers today yet either.

I’m wondering if I should now still seek to get my insulin increased, my highest reading yesterday and today has been 9. But obviously with meter fluctuations it could be a bit higher?

 

[ajbod]

I personally would give it a few days, keeping an eye on things, then you will be in a better position to know.

 

[IBEX82]

I personally would give it a few days, keeping an eye on things, then you will be in a better position to know.

Thank you. I’m all new to the insulin thing so I’m not really sure how much of a tight control they expect.

But in other news, my overall today was 6.8

 

[IBEX82]

So far, things are staying in the single digits, and I’m ending day with an overall BG between 5-7.

It’s early days but I’m counting it as a win so far

 

[IBEX82]

I just wanted to update this:

So the lower BG have continued, it seems between a small dose of background insulin, glic twice daily and low carb - we have my BG under control.

I still see the odd 9-10 spike an hour or two after taking my steroid but that’s from 14-18 readings.

I had a review with the specialist and he wants me to continue on the current regimen for two more weeks then have a HbA1c done to see where we are. I am scheduled for surgery and for that my HbA1c needs to be below 68-69 so the consultant said with a month of lower BG numbers, we should be able to see a change in HbA1c to see where it’s heading. I was initially told my HbA1c had to be below 65 by the GP but the nurse from the pre-op said it’s fine up to 68/69 - little bit of leeway but it feels more achievable.

He said if I wanted a tighter control we could try a basal/bolus regimen following surgery provided my HbA1c is good enough for surgery, if it’s not he’s suggested we start the basal/bolus affair sooner to get the HbA1c down quicker.

And… he’s also given me a Libre on prescription. He was happy I was monitoring so frequently as I’m on a lot of medication to lower BG but he felt bad for my fingers

Soooo all in all, I’m feeling much better with my diabetes and more in control. Feels like there’s something to be positive about - wish me luck on the HbA1c front, the last one was 82 so there’s a way to go!

 

[Lamont D]

Well done you!
And not a mention of anxiety or regret!
Keep up the good work!

 

[IBEX82]

Well done you!
And not a mention of anxiety or regret!
Keep up the good work!

Thank you so much. I am working on it

Getting some help for my mental health separately but hopefully onwards and upwards.