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Struggling

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Gardener1

New Member
Relationship to Diabetes
Type 2
Everything seems to have gone wrong my sugar levels are through the roof. I am constantly craving sweet things something I have never done before. I have other health problems and I feel unwell. Don't know what to do, our doctors are still in lockdown.
 
Have you rung your GP surgery? - ours are operating a telephone triage system where they arrange for a GP to ring you back and talk to you, and if they need to see you to try and sort it, they will then ask you to come in to the premises at a specific time.

If they are not answering the phone, ring 111 and say so.
 
Yes several times, I have managed to get a phone appointment, they have told me to increase my once a day insulin and take novorapid at tea time but it doesn't seem to have made much difference. I am struggling with other health problems as well which I think maybe making things worse
 
Ah did they tell you by how much to increase? Or just to increase it by a small amount?

I'm not sickly usually, just colds occasionally and general stuff and admittedly I am Type 1 but I was gobsmacked at how much more insulin I needed when I broke my kneecap a couple of years ago - I finished up on approx 3 times the amount of basal insulin, and nearly half as much again, mealtime insulin.

Any other health problem does cause BG to increase, especially if it involves 'inflammation' generally. Certain drugs given for other things, can also do this. Every person is different though, but anyway best if you can keep your fluid intake high too, because you then encourage your body to pee some of the excess glucose out but you don't want to be doing that for ever so long else you'll have problems in the waterworks equipment.

I'm not suggesting you increase your doses by such a huge amount - it took me a while to increase mine up to that and you just have to keep testing and keep a close eye on your BG - I was safe - a) I felt perfectly well in myself anyway and understood everything that needed doing and most importantly - b) I was in a hospital bed! so 100% safe since they were also regularly checking my BG too.

Ring them again anyway tomorrow, say it doesn't appear to be working, so what now?
 
Hope you get sorted, keep ringing till they sort you out, you need help. This lockdown is horrendous, an absolute nightmare for the doc. I phoned for my daughter yesterday, you're lucky to get a telephone consultation these days. Is there some sort of walk-in clinic at the hospital?
 
Yes several times, I have managed to get a phone appointment, they have told me to increase my once a day insulin and take novorapid at tea time but it doesn't seem to have made much difference. I am struggling with other health problems as well which I think maybe making things worse

I think you should ring them back and say that the dose increase isn’t working. They might put it up more gradually. Did they explain how to adjust the Novorapid? Did you get a chance to speak about your other health problems? If they’ve flared up in any way, that might need managing alongside your diabetes.

Can you give us an idea of an average day’s food and blood sugars for you? How high are you going?
 
@trophywench you just answered my concern, after breaking my ankle in January, diagnosed with MRSA in June my highly erratic diabetes seemed uncontrollable, I couldn’t get professional advice due to lockdown but increased my Novarapid and Lantus a bit at a time. I’m now on 2-3 times the amount I needed this time last year but think I have better control. Still waiting/hoping to see the diabetic Consultant, my last ‘annual’ appointment was May 2019
 
I think you should ring them back and say that the dose increase isn’t working. They might put it up more gradually. Did they explain how to adjust the Novorapid? Did you get a chance to speak about your other health problems? If they’ve flared up in any way, that might need managing alongside your diabetes.

Can you give us an idea of an average day’s food and blood sugars for you? How high are you going?
My fasting blood sugar level as 11.4this morning I had not eaten or drunk anything for 13hours. Yesterday they started off at 7.4 were 7.3 at lunch time 13.3 before evening meal about 5.30pm when I took 5 units of novarapid, then up to 19.3 at bed time. I took 27 units of Abasaglar in injection at 9pm my usual time. The highest my blood sugars have been is 28 that was before bed. I don't know if I feel rubbish because of my High sugar levels or if my sugar levels are high because I am feeling unwell. I think I may have found the reason I am having these mad sugar cravings, it is because I have cut down on my carbohydrates at lunch time.
 
Ok, those are high - particularly the 28. You’re quite right that it’s hard to tell what’s causing what - ie is illness causing your highs or are your highs making you feel ill.

High sugar can make you crave sweet things and feel hungry.

If this is a sudden change in your sugars, I’d say illness was most likely to be causing the highs rather than the other way around.

I wonder whether your rising sugars in the afternoon are due to your Abasaglar not lasting the full 24 hours. You could ask about splitting the dose to see if that helps. You could also ask about using the Novorapid to do correction doses. That is, when your blood sugar is above a certain level, you inject a small amount of Novorapid (without eating) solely to reduce your blood sugar. You would be given a formula to help you do this. That would be a really helpful tool for you.
 
Hope you get sorted, keep ringing till they sort you out, you need help. This lockdown is horrendous, an absolute nightmare for the doc. I phoned for my daughter yesterday, you're lucky to get a telephone consultation these days. Is there some sort of walk-in clinic at the hospital?
No unfortunately not they closed our walk in clinic a couple of years ago to save money. It takes about half an hour to get through to the doctors, then you only get to speak to the receptionist, who might if they think it is serious enough get the practice nurse to ring you back, which is as far as I have got. I have asked to speak to the diabetic nurse, but only got someone from the practice ring me back. After a fairly long conversation she ended the conversation saying You really need to speak to the diabetic nurse about this. I said I thought that's what I was doing at which point she went quiet, then said you can ring back if you need more help and ended the call
 
Ok, those are high - particularly the 28. You’re quite right that it’s hard to tell what’s causing what - ie is illness causing your highs or are your highs making you feel ill.

High sugar can make you crave sweet things and feel hungry.

If this is a sudden change in your sugars, I’d say illness was most likely to be causing the highs rather than the other way around.

I wonder whether your rising sugars in the afternoon are due to your Abasaglar not lasting the full 24 hours. You could ask about splitting the dose to see if that helps. You could also ask about using the Novorapid to do correction doses. That is, when your blood sugar is above a certain level, you inject a small amount of Novorapid (without eating) solely to reduce your blood sugar. You would be given a formula to help you do this. That would be a really helpful tool for you.
Thank you for listening it has made me feel better just speaking to someone. This is the First time anyone has mentioned High sugar levels might be causing these very strong sugar cravings, I have been hungry but have never had cravings like this before. Up until recently I was not a person who liked sweet things. I have spoken to doctors again and I have asked for more help they are going to see if they can arrange some blood tests. They did say not to take novara'id without food but I will ask again
 
Ah did they tell you by how much to increase? Or just to increase it by a small amount?

I'm not sickly usually, just colds occasionally and general stuff and admittedly I am Type 1 but I was gobsmacked at how much more insulin I needed when I broke my kneecap a couple of years ago - I finished up on approx 3 times the amount of basal insulin, and nearly half as much again, mealtime insulin.

Any other health problem does cause BG to increase, especially if it involves 'inflammation' generally. Certain drugs given for other things, can also do this. Every person is different though, but anyway best if you can keep your fluid intake high too, because you then encourage your body to pee some of the excess glucose out but you don't want to be doing that for ever so long else you'll have problems in the waterworks equipment.

I'm not suggesting you increase your doses by such a huge amount - it took me a while to increase mine up to that and you just have to keep testing and keep a close eye on your BG - I was safe - a) I felt perfectly well in myself anyway and understood everything that needed doing and most importantly - b) I was in a hospital bed! so 100% safe since they were also regularly checking my BG too.

Ring them again anyway tomorrow, say it doesn't appear to be working, so what now?
Thankyou have rung the surgery again they are going to try and arrange some blood tests although they are not generally doing face to face at the moment. As I said in another post just talking to others who understand and have given me advice I can follow has made me feel better.
 
How long have you had T2 @Gardener1 ?

Just wondering if your pancreas is still producing as much insulin generally as it once did?
I was diagnosed about 2 years ago. Unfortunately my doctor's surgery was undergoing major changes and apparently dispute having had several blood tests they failed to pick up the diabetes. I have struggled ever since to get much help especially since covid when they closed down. How would I tell if I am producing insulin?
 
Good morning @Gardener1

There is an expensive test that can be done to check the amount of insulin you are producing, but in general the indicator that we have at home is by measuring our BG regularly before and after meals to see how our bodies deal with the glucose from what we eat. Are you able to test your levels. If so keeping a record of these can help them make decisions about any changes needed to your doses.
 
Gardener, in your shoes, if I was seeing blood sugars in the high 20s, despite following the instructions of my diabetes care team, I would be calling 111 for advice.

As a T2, I doubt you have blood test strips to test for ketones, but at 28 and feeling rubbish, personally, I want to check.

I don't know what you're eating for your evening meal, but I wonder if a few days of seriously low carb might help show up if your numbers are being very much influenced by what you eat, but your long acting insulin not lasting long enough, or another underlying case - like an infection, or whatever the other conditions you mention are.

Are you taking any additional, or different medication for your other conditions? Things like steroids can send blood sugars very high, for example.

Just a bit of a brain dump from me. I'm not an insulin user myself, so just being clear about that, but just trying to think inthe bigger picture.

Fingers crossed for you.
 
Some of the blood glucose results are 7s. It’s never a good idea to go “seriously low carb” when on insulin. Even if someone is having high sugars, they can still get a bad hypo if they cut carbs too low, especially when it’s not clear what’s causing this and what’s going on.
 
Some of the blood glucose results are 7s. It’s never a good idea to go “seriously low carb” when on insulin. Even if someone is having high sugars, they can still get a bad hypo if they cut carbs too low, especially when it’s not clear what’s causing this and what’s going on.
I would relax this statement. It can be ok to go seriously low carb when on insulin but only if you know what you are doing - are confident with your insulin dosing and able to change it.
It is NOT ok to go seriously low carb if you are on fixed dose insulin.

I know of a number of people with Type 1 who eat less than 50g carbs per day and do not hypo.
 
I would relax this statement. It can be ok to go seriously low carb when on insulin but only if you know what you are doing - are confident with your insulin dosing and able to change it.
It is NOT ok to go seriously low carb if you are on fixed dose insulin.

I know of a number of people with Type 1 who eat less than 50g carbs per day and do not hypo.

I agree with you both @Inka and @helli

While it is technically true that some insulin users prefer a lower-carb approach (we have some on the forum) these are people who are experienced insulin users who have a good understanding of the way their body reacts to carbohydrate, and the need to carefully balance insulin and carb intake (along with other factors).

I don’t think ‘going seriously low carb’ is a very sensible or safe strategy for @Gardener1 until they have a good deal more experience and training in dosing and adjusting insulin - which is after all a potentially lethal substance if misused.

However it is also true to say that regular readings in the 20s are not ideal (or safe) either! And it is clear that @Gardener1 needs a good deal more help and support from their HCPs than they are currently able to access.

As this sudden change is happening only 2 yesrs after diagnosis I am wondering like others about the current state of insulin production, and whether @Gardener1 might be LADA rather than T2, which would need a much more comprehensive insulin regimen than basal-only with ad-hoc Novorapid.

I would speak to NHS111, your Dr or rhe Diabetes UK careline (number at the top of the page) about how to correct these very high BG levels safely.

It may also help to begin keeping notes of the carbohydrate content of meals and snacks (a reasonable estimate is accurate enough) to see of there are patterns, and whether some cautious carb-reduction might help - not immediately canning all carbs, but just carefully reducing portion sizes to see if better numbers result.

Hope the other illnesses and health problems improve, along with the high BG cravings.
 
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I asked what I asked for the simple reason it struck me immediately from what you'd already told us, that you could actually be LADA, not Type 2, too! So, it's not just me wondering that.

The tests they need to do to ascertain how much insulin a person is actually producing, only used to be done at one laboratory in the UK - Exeter University Hospital. Exeter Uni Medical School do a lot of diabetes research and do all sorts of genetic testing too. It's a subject that Med schools seem to take turns at specialising in; years ago it used to be Warwick Uni which specialised. then Newcastle, then Exeter. They've all made different breakthroughs and contributions to our particular cause, and continue to do so thank God.

However more recently the test has become much more available - eg where I live, Uni Hosp Coventry & Warwick Lab does them, and not just restricted to people presenting at A&E, all the GP surgeries can arrange them the same as they do any other blood test. Hence they are not as restricted as they once were and importantly, the price of doing them to the GP surgery has reduced ! I don't know the actual price but do know all tests are priced properly on a commercial basis by the labs hence based on time taken for the number of different actions and different machinery needing to be used etc., whether for the NHS or otherwise.
 
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