Which Insulin to request

[mbudzi]

Hi

I'm see the DSN this afternoon to request a change to my insulin regime. Currently I only take bolus (novarapid) to cover meals as I am constant 4-7 through the day and I eat low carb to keep post meal spikes no higher than 8 as often as possible. But for the last few months my BG on waking has been steadily climbing (never below 7 and usually at 8 or 9) This week I hit a 10 on waking and this isn't good.

I've tested at night and I stay constant till about 6am when BGs seem to rise - dawn phenomomimimim? But not sure if basal would help with this.

Problem is, our surgery have a view that until I hit 10 - 13 range there isn't a problem. I am not happy that every day I exceed the magic 7.8 ... I want to argue to try a basal evening dose, but having never used it, I'm not sure. Anyone got some ammunition or guidance before I square up to the nurse?

Anyone have any idea why they are resisting giving me Basal and Bolus as this seems a regular sort of regime to be on?

Thanks

 

[copepod]

The most common long acting insulins are Levemir and Lantus, but there are others - I've been using Humalin I for over 15 years, in 2 doses for the past 8 years. I can't understand why the NHS doesn't try the cheapest option first (Humalin I costs half of Levemir or Lantus) and only go to more expensive medications if the the cheapest isn't suitable.

 

[Hydrazine]

Not sure how long you've been diagnosed but maybe you still have some residual pancreas function (honeymoon phase). From what you say about your levels increasing in the morning it sounds like your liver is releasing glucose and your endongenous insulin is gradually becoming unable to cope with it.

In your position I would request a basal insulin trial. I'm on levemir. Never tried any of the others though I have heard a few bad stories about lantus.

When you first go on it you will have to check your sugars before bed, once or twice through the night (to make sure you are not going too low and to see if you're having a 'symogli' - is that how you spell it?) and adjust the dose as necessary.

Are you finding your sugars slowly rising through the day? If not, this is probably why they are relutant to give you basal insulin at it s much simpler then just to correct the morning highs with some extra rapid acting insulin.

Obviously as I'm not a doctor this is just my thoughts, so make sure you discuss everything thoroughly with your specialists to get the most appropriate regime.

Good luck!

 

[anna29]

Hi...
I used to be on levemir insulin it made me feel drugged up in my head, mentally weary and sluggish.
Since changing to animal porcine insulin am with clearer head and thinking, loads of energy and focus !
Wish I had been on animal porcine from the beginning ... Its great suits me so well and works a treat !
Plus with the levemir it is known and can give injection site lipos which it "did" with me.
I am on basal only, no bolus due to the fact I am so weight gain phobic [gave both my DSN and consultant hell with this fact]
Bolus, I am told just swallows up the calories and then fat stores, you need to be very active to fat burn afterwards using a bolus regime.
Am tiny in frame always have been , had heart surgery so it was decided this was the best plan for me was to use a basal background insulin only.
Why did they decide you on a bolus therapy only?
Anna.

 

[noblehead]

Problem is, our surgery have a view that until I hit 10 - 13 range there isn't a problem.

I wouldn't be happy with that I'm afraid, it's your diabetes and your life so tell them you want to be prescriped a basal insulin to bring your levels within your own personal targets.

 

[bigpapalazarou]

The most common long acting insulins are Levemir and Lantus, but there are others - I've been using Humalin I for over 15 years, in 2 doses for the past 8 years. I can't understand why the NHS doesn't try the cheapest option first (Humalin I costs half of Levemir or Lantus) and only go to more expensive medications if the the cheapest isn't suitable.

I have been placed back onto actrapid and insulatard as the useless novorapid and glargine just didn't work!
The human insulins are cheaper, DSN told me this. Though they wanted to give me a shed load of tablets to help the analog insulin, would that not mean a greater cost to the NHS for something that doesn't work?