Type 2 What is normal?

120 units sounds like a high total daily dose to me, but then I'm not type 2.

This guide for GPs starting type 2 on insulin suggests a normal TDD at 0.5 units per kg of body weight - http://www.gpnotebook.co.uk/simplepage.cfm?ID=x20040129231916799480 but I wouldn't be too bothered about what's normal or what sounds excessive. What matters is does it work to manage your blood sugar.

I think @ickihun has experience of mixed insulin and high dosages, she may have more info on what's normal or excessive dosages in type 2 diabetics.

Goacher55 said:

I was first diagnosed in 2004. I've been on the usual journey from diet through various combinations of medication and injections to finally being prescribed insulin. Humulin M3 I started 8 weeks ago on 10 units am and pm. after various permutations I am now taking 50 am and 70 pm. My question...Does this seem excessive ? Morning bg 7.8 evening bg 8.0,

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It does sound like a large amount, yet it appears what is required to maintain good glucose levels. I'm on 3-4 doses of novorapid (bolus) and 30 units lantus (basal). All up around 70 units. I started off with two doses of mixtard 30/70, 18 units in the morning and 30 units in the evening. My needs have risen over time.

If you have doubt, get an opinion from your diabetes educator to ensure the dosage is correct. It always pays to be sure.

@Goacher55

Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask questions when you need to and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.

Goacher55 said:

I was first diagnosed in 2004. I've been on the usual journey from diet through various combinations of medication and injections to finally being prescribed insulin. Humulin M3 I started 8 weeks ago on 10 units am and pm. after various permutations I am now taking 50 am and 70 pm. My question...Does this seem excessive ? Morning bg 7.8 evening bg 8.0,

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It all depends on your level of insulin resistance. The higher your level, the more insulin you will need to regulate your bgs.
Many reduce their carbs and protein to reduce their bgs and amount of insulin you will need. Carbs especially.
Once you have cut out cake, biscuits and chocolate. The next stage is to reduce bread, potato and rice/pasta. The aim is to reduce your meals to children portions if you need to lose weight to reduce any insulin resistance. Exercise regularly if your able. Walking can be the best for lowering cholesterol.

ickihun said:

It all depends on your level of insulin resistance. The higher your level, the more insulin you will need to regulate your bgs.
Many reduce their carbs and protein to reduce their bgs and amount of insulin you will need. Carbs especially.
Once you have cut out cake, biscuits and chocolate. The next stage is to reduce bread, potato and rice/pasta. The aim is to reduce your meals to children portions if you need to lose weight to reduce any insulin resistance. Exercise regularly if your able. Walking can be the best for lowering cholesterol.

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I know I'm not on insulin, but not too many people need to reduce their portion sizes to child sized. Even when I was trimming up, I wasn't on small portions. I just kept an eye on the carbs I was eating.

@Goacher55 - Are you looking to trim up a bit?

Many people find that trimming back their carbs can really impact on their bloods, which can, in turn, impact on the medication they take. As you seem to be on fixed doses of insulin, if you are going to change your diet, you really will need to keep an eye on your blood numbers; looking out for dips down.

Over time, a fair proportion of T2s find they can trim back the medication they take too, but we're all individuals.

Good luck with getting a good handle on your insulin regime. I'm sure there's a lot to learn.

Goacher55 said:

I was first diagnosed in 2004. I've been on the usual journey from diet through various combinations of medication and injections to finally being prescribed insulin. Humulin M3 I started 8 weeks ago on 10 units am and pm. after various permutations I am now taking 50 am and 70 pm. My question...Does this seem excessive ? Morning bg 7.8 evening bg 8.0,

Click to expand...

It's usual to build doses up gradually so I wouldn't worry too much about the fact that your dose has increased. You mention trying "various permutations" so that sounds like you're getting good input from your nurse/doctor. The right dose is the one that controls your blood sugar

Do you test your blood sugar at other times of the day? Do you count carbs?

Goacher55 said:

Think you, I do have a fabulous diabetic nurse who is giving me amazing support. I do need to lose more weight! 15 more kg, I also take glucophage and gliclazide - alogliptin didn't lower my bg. I've recently stopped taking Victoria. I test regularly and my bg is usually 5 ish before eating and takes around 3 hours to reduce after eating even low carb meals. I swear that in the past 8 weeks I have done more research than I did for my entire phd and most definitely learning more every day.

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It does sound like you have some work to do on your insulin resistance.
Low carb gives you the ability to reduce the amount of insulin to control your high bgs. Some also lose weight by doing so.
I have to do low carb, low fat to lose weight.
Losing weight helps with the insulin resistance. In the past I've used excessive exercise to keep my health in order. Pcos and infertility due to what I know now was insulin resistance.
There are many previous threads on the forum discussing insulin resistance. They are definitely worth I good read. Some excellent videos there too which explain insulin resistance very very well.
Keep me posted on your fantastic journey into a lighter, healthier you. You won't look back.