Evening,
I will be talking through my concerns with my diabetic clinic at my next appointment however, I'm looking for advice from anyone who has been in a similar position and a feel for whether I need to try and bring forward my next appointment. Happy to be told to chill out and go with the flow too!
I started insulin on 8th June. A follow up appointment was supposed to be two months later but no appointment has come through yet. At my first appointment I was given long acting Semglee starting at 12 units daily and fast acting Novorapid with an initial carb ratio of 1:15.
For the first 2-3 weeks this seemed to be making a big difference and my numbers dropped from high teens to 10-13 range. I generally eat a keto/very low carb diet so wasn't needing any NovoRapid. My morning readings have always been high due to DP so after a call to the nurse we agreed that I would use an insulin sensitivity/correction of 2.8 using NovoRapid to deal with DP. We also agreed to increase my basal by 2 every few days until my readings were coming down to within normal range.
In the last 8-9 weeks since then I've had a few meals out with family and friends plus a holiday where I relaxed my diet and tested my carb ratio. It became apparent very quickly that a ratio of 1:15 wasn't cutting it. I'm now using a ratio of 1:3 and I can imagine that might have to lower even more. This is causing issues alone as although I don't go off plan often I do allow myself something I wouldn't normally eat on special occasions. I went to Wagamama for a birthday recently and sharing a couple of sides and an order of ramen meant a bolus of 56 units, both apps I've tried throws a warning for anything over 50 and refuses to calculate (MySugr and Diabetes.M) I also find injecting this amount is often more uncomfortable and more likely to dribble back out of the injection site, no matter how long I leave the needle in.
It become clear that an insulin sensitivity/correction of 2.8 wasn't enough, I've lowered that all the way down to 0.7 currently. My basal is also still not correct as I'm constantly having to correct with bolus (26 units of NovoRapid in corrections today, for example). My basal is currently at 48 units and still increasing every few days. Achieving a blood sugar of under 7 is rare. I generally hover around 11-12 in the morning and 8-9 the rest of the day.
I know we are all different and will all have different insulin needs and sensitivities. I also know I need to remind myself I'm only 3 months in. I'm just massively frustrated and don't know if I should be concerned with how quickly I've had to increase and how little difference it seems to be having on my numbers. I appreciate I also need to get my basal right as my bolus will likely change. I can speak to my nurse by phone, however after the first few times of calling and getting the same answer (increase basal a couple, decrease carb ratio a bit, see what happens) I started adapting my doses on my own. I'm comfortable doing so and very much want to have control as I've always done. I also haven't had a single hypo to worry about because my numbers just aren't low enough yet. However now I'm reaching almost 50 units should I be discussing this with her again and asking for a more urgent appointment? Is there anything specifically I need to raise as a concern? Is this an unusual progression or do I need to relax?
Apologies for the ramble!
I will be talking through my concerns with my diabetic clinic at my next appointment however, I'm looking for advice from anyone who has been in a similar position and a feel for whether I need to try and bring forward my next appointment. Happy to be told to chill out and go with the flow too!
I started insulin on 8th June. A follow up appointment was supposed to be two months later but no appointment has come through yet. At my first appointment I was given long acting Semglee starting at 12 units daily and fast acting Novorapid with an initial carb ratio of 1:15.
For the first 2-3 weeks this seemed to be making a big difference and my numbers dropped from high teens to 10-13 range. I generally eat a keto/very low carb diet so wasn't needing any NovoRapid. My morning readings have always been high due to DP so after a call to the nurse we agreed that I would use an insulin sensitivity/correction of 2.8 using NovoRapid to deal with DP. We also agreed to increase my basal by 2 every few days until my readings were coming down to within normal range.
In the last 8-9 weeks since then I've had a few meals out with family and friends plus a holiday where I relaxed my diet and tested my carb ratio. It became apparent very quickly that a ratio of 1:15 wasn't cutting it. I'm now using a ratio of 1:3 and I can imagine that might have to lower even more. This is causing issues alone as although I don't go off plan often I do allow myself something I wouldn't normally eat on special occasions. I went to Wagamama for a birthday recently and sharing a couple of sides and an order of ramen meant a bolus of 56 units, both apps I've tried throws a warning for anything over 50 and refuses to calculate (MySugr and Diabetes.M) I also find injecting this amount is often more uncomfortable and more likely to dribble back out of the injection site, no matter how long I leave the needle in.
It become clear that an insulin sensitivity/correction of 2.8 wasn't enough, I've lowered that all the way down to 0.7 currently. My basal is also still not correct as I'm constantly having to correct with bolus (26 units of NovoRapid in corrections today, for example). My basal is currently at 48 units and still increasing every few days. Achieving a blood sugar of under 7 is rare. I generally hover around 11-12 in the morning and 8-9 the rest of the day.
I know we are all different and will all have different insulin needs and sensitivities. I also know I need to remind myself I'm only 3 months in. I'm just massively frustrated and don't know if I should be concerned with how quickly I've had to increase and how little difference it seems to be having on my numbers. I appreciate I also need to get my basal right as my bolus will likely change. I can speak to my nurse by phone, however after the first few times of calling and getting the same answer (increase basal a couple, decrease carb ratio a bit, see what happens) I started adapting my doses on my own. I'm comfortable doing so and very much want to have control as I've always done. I also haven't had a single hypo to worry about because my numbers just aren't low enough yet. However now I'm reaching almost 50 units should I be discussing this with her again and asking for a more urgent appointment? Is there anything specifically I need to raise as a concern? Is this an unusual progression or do I need to relax?
Apologies for the ramble!