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New diagnosis type2 but meds just dont work.

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Hellybell80 said:
So the last couple of days I've had a bit more carbs. Still under 100g. But my sugar levels are just getting higher again staying around 17 from lunchtime and over 20 in the evening.
Since my fasting sugars have not gone below 10. My nurse has now suggested I take nova rapid with my evening meals. Only 4 units to see if it makes a difference. But she's come to the conclusion that lantus on its own will not work. She kept mentioning type 1 on the call and I would need to control my sugars after meals. I think she was surprised that the lantus didn't control my levels enough. I think she just wants to see what or how it effects my evening sugars. I did say it rises with every meal but she just wants me to take it with either my lunch or dinner depending on what has more carbs. So for now its just the one shot of nova rapid and to continue with the 24units of lantus.
See if I can get below 10.
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Thank god she’s finally got Type 1 in her head! It must be so frustrating for you to be so high. I agree with @rebrascora It’s possible that with the addition of Novorapid - which was what you needed all along - your Lantus might be too high. Be aware of that and test lots.

Perhaps you’ll have more luck with pushing for the C Peptide and antibodies tests now your nurse is considering Type 1.

If you’re going high after every meal, there’s no sense in only having Novorapid before your evening meal. As also said, you could go low during the night. It seems a strange place to start it.
 
Well why don't you ring the nurse up and say to her, you know you kept mentioning Type 1? Why don't you do the blood test for that then? All it involves is extracting some blood out of your arm and sending it off to whatever path lab can do it - eg if you lived near Coventry that's UHCW at Walsgrave in Coventry - not sure whether they do those at Rugby or not. Or were you near Exeter - Exeter Uni hospital definitely do - in fact for several years it was the only place that did them. Yeah the tests themselves take time so you have to wait for the results, but as far as the GP is concerned it shouldn't be in the slightest bit complicated.
 
I had to go to my main hospital to have my Type 1 tests done because they didn't have the facilities to keep the blood stored at the appropriate temp at my surgery or community hospital or in transit from there to the appropriate facility for testing so it may be a little more complex logistically than a normal HbA1c test. I think one of them needs to be frozen immediately and then sent off.
 
It is of course also a lot more expensive than an HbA1c but that is no reason to deny you an accurate diagnosis and appropriate treatment.
 
Apparently it has to be in the lab 1 hour after its taken. I would have to go to Worcester hospital to have it done. I have to be referred first, but the Dr still isn't willing to until I've tried 3 months of treatment.
To be honest I think all the covid issues going on have made it harder to get whats needed. Sad but true.
 
Hellybell80 said:
Apparently it has to be in the lab 1 hour after its taken. I would have to go to Worcester hospital to have it done. I have to be referred first, but the Dr still isn't willing to until I've tried 3 months of treatment.
To be honest I think all the covid issues going on have made it harder to get whats needed. Sad but true.
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Glad you have access to NR now. Frustrated for you that they have set an arbitrary time period of 3 MONTHS before they will request a blood test to establish whether the treatment regimen they are suggesting is actually appropriate or not 😱
 
Hellybell80 said:
Apparently it has to be in the lab 1 hour after its taken. I would have to go to Worcester hospital to have it done. I have to be referred first, but the Dr still isn't willing to until I've tried 3 months of treatment.
To be honest I think all the covid issues going on have made it harder to get whats needed. Sad but true.
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In that case, ask why they can’t treat you as a Type 1 until blood tests prove otherwise. No reason why they can’t, is there?
 
I think they are testing whether the nova rapid will make a difference. At 4 units it hasn't done much, but not going to lie I've had several naughty days on the food front. But unless its at each meal as needed its always going to go high. Unless I match my carbs to that 4 units. My sugars have been around 17-21 in the afternoon right up to me going to bed. By eating around 120g a day. I Will correct that today.

But I am a little confused. If I was type 2 would I need such an intensive regime of NR at each meal? I'm aware later on in type 2 insulin is needed. My family all ended up on insulin. Not as quick as me though. I know ppl think it may be type 1 but can this happen with type 2?
I'm also aware that insulin needs to be adjusted by small amounts at the start so as to avoid hypos. But I am getting a little frustrated I seem to obsessed with what I'm eating. I'm testing my blood sugars around 5-8 times a day. So I can keep good records of my sugar levels.
I take my lantus in the morning as when I started it it was towards mid day onwards I wanted my sugars to level. In the late afternoon I've actually had BS of 7.9 once.Didnt eat much crbs at lunch was before my evening meal. So obviously the lantus has kicked in. But as soon as I eat its high again. In fasting its never below 10.

I'm sorry I'm just trying to get my head around things. As I can't get any definite answers from my health care providers. I know its only been a couple of months since being diagnosed but I don't seem to be getting anywhere and I'm fed up with feeling like cr#p for most of the day.
 
@Hellybell80 Yes, Type 2s can use Lantus and Novorapid - that’s why your doctor waiting for 3 months to see if it works won’t give you a definite answer as to what type you are.

Your Lantus should control your blood sugar in the absence of food. Your Novorapid should deal with your meals. I can only say what I’d do, but I’d use the NR at every meal if needed. It would be daft not to IMO.
 
120g carbs isn’t excessive. It counts as low carb.

The problem seems to be you’re not having enough/appropriate insulin.

“I think they are testing whether the nova rapid will make a difference. At 4 units it hasn't done much, but not going to lie I've had several naughty days on the food front. But unless its at each meal as needed its always going to go high. Unless I match my carbs to that 4 units.”

I’ve edited my post to respond to your above statement @Hellybell80 because I was thinking about it on our dog walk. Novorapid is a short-acting insulin. It works and then pretty much ‘goes away’. Having 4 units with your evening meal will only affect that meal. That’s the whole point of NR and other fast/short insulins. They have a number of names, and are usually called “fast” but their other names are “short” and “mealtime” and “bolus”. All describe their action - a short, fast action.

So your evening NR won’t deal with your breakfast or lunch, and the only matching you need to do is to match your evening carbs to the 4 units because that’s the only carbs the evening NR will be working on - or, far better, match your NR dose to your carbs ie have enough NR to deal with the carbs you’re about to eat.
 
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I am glad that at last your nurse is starting to consider you may have T1 , bout time imo.

When it was believed I was T2 I was put on Insulatard, a long acting insulin then soon after Novorapid. So it isn’t unusual for T2s to be in MDI (multiple daily injections) , it’s more of a case of if you need it you need it, in whatever amounts you need.

When we first go on insulin, though their is a formula they go by, they don’t really know how much we really need as it’s very individual, so they start us on a low dose and gradually build up. Also it’s not good to lower our levels too quickly as it causes unpleasant symptoms and can affect our eyes.

I really don’t understand why they are not referring you to the specialists .
If you have T1 as we suspect then you need the knowledgeable help of the real professionals a DSN
I also don’t understand why you have been told to inject Novorapid for that one meal a day, as has already been said it sticks around for around 4ish hours , deals with your mealtime carbs then disappears .

You are doing all you can to get the right help , I just wish those that should be looking after your health , start doing so properly soon.
 
Afternoon all.
Just wanted to say thanks for all the support that you guys gave me in the beginning.
I'm now taking insulin (nova rapid) with meals. Around 10 units. I don't take it with breakfast as I don't really eat any carbs and my sugar levels are between 6-8 so alot better then before. I take about 44 units a day split between my lantus and nova. And it's worked. Looking at the guidelines this is the amount needed for my weight?
My nurse told me about a month ago to adjust it myself to the needs of what I'm eating. It seems to be working. I've got my hba1c this week so I'll see how that goes. It will probably be higher since my sugar levels were up to 30. Since my first one.
I have to see how these results are before they refer me to the hospital.

But a question I have... my insulin amounts I'm taking are what they would normally advise for type1 . I think.. I dont seem insulin resistant as I'm not taking excess amounts.
44 units seems to about right for my weight, so does this push more towards type 1 ? I know how ppl feel about me and think I'm more of a type 1 but I need more of an argument to push for more tests etc with my GP and nurse.
Can you have an idea of which type by how much it takes to bring it under control?
I've had no hypos which is a bonus so far. Lowest I've been is 5.
 
I don’t think Type can definitely be determined by insulin usage @Hellybell80 You’ll find that Type 1s take varying amounts of insulin - yes, even Type 1s of similar weights. The weight formula thing just gives a rough starting point. You then need to find the amounts of insulins that work for you as an individual. Carb counting is crucial - that is, counting the carbs you’re about to eat and adjusting your Novorapid as appropriate.Do you know your meal time ratios?

How long it takes to control it isn’t an indicator of Type either. The C Peptide and antibodies tests are far more useful.
 
I take about 10 units of nova with my meals. Sometimes a little more if its higher carb. It seems to suit me so far. Around the 100 give or take carbs per meal.
 
Just to make life interesting , we all need different amounts of insulin. It literally depends on how insulin resistant we are . Their are a few folks with T1 who are on Metformin as well as insulin as their insulin resistance is high , Metformin helps reduce this.

It really is only the C-peptide and antibody tests that can determine
Which type we really are . Many Gps and practice nurses unless they are really on the ball don’t know that T1 can occur at any age not just in childhood.
 
Unfortunately my GP has said you don't get type 1 at my age... so yup its one of those. My nurse won't do anything without the Drs say-so. I was aware that people do take all sort of amounts of insulin, but was just looking for something I could use to help with the GP.
 
How about our ex Prime Minister Teresa May being diagnosed Type 1 in middle age.... if your Dr wants evidence that age is not relevant to diagnosis.

www.diabetes.co.uk

Theresa May is a British politician for the Conservative Party and the current UK Home Secretary. She was appointed in May 2010 when David Cameron became Prime Minister.

Theresa May is a British politician for the Conservative Party and the current UK Home Secretary. She was appointed in May 2010 when David Cameron became Prime Minister.
www.diabetes.co.uk www.diabetes.co.uk
 
Hellybell80 said:
Unfortunately my GP has said you don't get type 1 at my age... so yup its one of those. My nurse won't do anything without the Drs say-so. I was aware that people do take all sort of amounts of insulin, but was just looking for something I could use to help with the GP.
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NICE has recommendations on diagnosis and treatment of adult Type 1 diabetes. This is the diagnosis bit:

Recommendations | Type 1 diabetes in adults: diagnosis and management | Guidance | NICE

www.nice.org.uk www.nice.org.uk

Must admit I find it odd that someone nowadays would dismiss the possibility given that we've recently had a Prime Minister and currently have a Speaker both diagnosed as adults. (It's possible I watch too much political news coverage.)
 
Hellybell80 said:
I take about 10 units of nova with my meals. Sometimes a little more if its higher carb. It seems to suit me so far. Around the 100 give or take carbs per meal.
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You have 100g carbs per meal for which you take 10 units of Novorapid? Did I understand that correctly? If so, your ratio is 1:10 ie 1 unit per 10g carbs. That, on the face of it, would be more like a Type 1 ratio, but there is a big overlap. Just to add more difficulty, some Type 1s can also have insulin resistance and some can have what’s referred to as ‘double diabetes’.
 
Inka said:
You have 100g carbs per meal for which you take 10 units of Novorapid? Did I understand that correctly? If so, your ratio is 1:10 ie 1 unit per 10g carbs. That, on the face of it, would be more like a Type 1 ratio, but there is a big overlap. Just to add more difficulty, some Type 1s can also have insulin resistance and some can have what’s referred to as ‘double diabetes’.
Click to expand...
Yea give or take. Its working out to 1:10 ratio.
 
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