Hit a wall?

[Doddy]

Me again Im afraid!

I feel like i have hit a wall. I am now on 34u twice a day, and I don't seem to be getting any lower BS's The only time it goes lower (7-8) is if I don't eat. It's been the same since i hit the 30u mark. It lowered it, but now it's stationary.
Do I just keep going up again now till I find the level that lowers it that little bit further?

 

[Phil65]

Me again Im afraid!

I feel like i have hit a wall. I am now on 34u twice a day, and I don't seem to be getting any lower BS's The only time it goes lower (7-8) is if I don't eat. It's been the same since i hit the 30u mark. It lowered it, but now it's stationary.
Do I just keep going up again now till I find the level that lowers it that little bit further?

.....I would push to go on MDI....your current treatment is obviously not working...you must feel constantly exhausted with your continual high levels!?

 

[Copepod]

The right insulin dose is what gives you the right blood glucose levels, so do ask whoever is managing your care to help you find the right dose.

I agree with Phil - MDI is much more flexible than twice daily bimodal insulin, so you should discuss that, too.

 

[Doddy]

Can I ask the GP to go onto MDI? I just worry she will think I am telling her how to do her job if I suggest it. At what point will she think this regime isn't working tremedously well for me. Don't get me wrong, from where I started, my figures are a lot better..I wouldn't go below 17 before, and now am waking on 10, and don't really go above 17.

 

[robofski]

Doddy, I'd agree with the other posts, push for MDI, I went straight to MDI as my DSN suggested it would suit my lifestyle and whilst I've still not got my levels right I do think it gives me much greater freedom in what I eat and when I eat.

Now if only I can get my basal right so I'm starting at a good level and get my carb:insulin ratio figured out I'll be there!! Like you I seem to get my best numbers if I skip a meal!

Chin up, you'll get there 🙂

 

[Doddy]

OK, I have emailed her, so I shall see what she says. Haven't asked directly about MDI, but have made it clear I am not happy, and feel very down about it all. It feels like I am injecting twice a day for nothing at the moment...I know it's no big deal, but I think my honeymoon period is over, and things are beginning to get me down a little

thankyou xx

 

[Northerner]

OK, I have emailed her, so I shall see what she says. Haven't asked directly about MDI, but have made it clear I am not happy, and feel very down about it all. It feels like I am injecting twice a day for nothing at the moment...I know it's no big deal, but I think my honeymoon period is over, and things are beginning to get me down a little

thankyou xx

It IS a big deal - you want to feel happy with your diabetes management and blood sugar levels, and I am sure it is achievable. As has been said though, it's likely that this particular regime isn't best suited to you since it gives you little flexibility. Far better if you can separate the tow components of your mixed insulin so that you can tailor each to the element it needs to control i.e. the slow-acting element to your basal/non-food related needs and the faster acting element to match your food more closely. So, another vote for MDI and don't be afraid to ask for it - it's a very common regime chiefly because of the flexibility and control it provides. The disadvantages are that it requires more injections and probably costs the health service more, but in my book you shouldn't just 'half treat' the patient because it's half the price! 🙂

What I would say is that the fact you are dropping into the 7s when you don't eat would suggest that you are not yet at the dose you need, but approaching it. However, your needs can vary through the day, as many of us know - I need considerably more insulin in the morning than I do later in the day, and it's only really on MDI that I can tweak things sufficiently.

 

[Copepod]

Can I ask the GP to go onto MDI? I just worry she will think I am telling her how to do her job if I suggest it. At what point will she think this regime isn't working tremedously well for me. Don't get me wrong, from where I started, my figures are a lot better..I wouldn't go below 17 before, and now am waking on 10, and don't really go above 17.

Not sure how your GP will react, but a few months after my diagnosis, about 15 years ago, a pharmacist in Tasmania, the mother of a friend of mine, sent me an article about basal bolus insulin regime. So, I went to the hospital clinic where I was being treated, and asked about changing to what I felt would suit me better. The doctor seemed happy to help me change over.

The main advantage of MDI / basal bolus over bimodal insulin isn't so much overall blood glucose levels, more the flexibility to eat what and when you want, by varying insulin doses and times, instead of being limited to set meals at set times. So, if set meals don't suit you, then you could rightly say that the regime isn't working for you.

 

[Doddy]

I don't eat at set times of the day. Most days I miss lunch, and I have only just started to eat breakfast since dx.
I wouldn't mind the extra injections if it means I have better control. I have noticed I have much higher readings in the evenings, before i have my evening jab. I still then go to bed quite high.
I have only been seeing my GP, not seen any other specialist.

You guys always speak a lot of sense, and make me realise I am not alone in this, although it feels I am. I think I am heading for a bout of depression...

 

[Northerner]

Don't lose faith Doddy, you really have made a lot of progress and learned a lot since we 'met' you. These things do take time, not just getting the levels down, but understanding what is going on - and you will have absorbed and learned so much! 🙂 The high levels will be affecting your mood, perhaps obscuring the light at the end of the tunnel, but I've seen how far you have come 🙂

 

[robofski]

I think outright asking about MDI should tell your care team something, it should tell them you CARE and WANT to treat this condition to the point that you've done your own reserch about the various treatments around. Your showing that you understand things or at least trying to understand how insulin works with you and your routine or indeed how it doesn't.

I understand you thinking they may look at you as if you're trying to "teach your grandmother to suck eggs" but they should look at you as someone who actually is going to be an easier paitent becuase you want to get on top of this.

Hope all works out well for you.

 

[melissaf]

Hi Doddy. Im in the same position as you. I was diagnosed Type 1 seven months ago (Im 34) and have been on 2 injections a day since diagnosis. My DSN and consultant keep on telling me Im not ready for MDI as I am still in honey moon period (I take 12 units of insulin in morning and 10 units at night) but I too feel I have no control and am very seldom below 10 and my last HBA1C was 10.3. After speaking to Northerner (Alan) and others at the Glasgow meet last month (which was a great afternoon) I realised I need to to be more assertive with my DSN and tell them this is not fitting in with my lifestyle. When I was first diagnosed there was so much information to take in that I was fine with just doing as they told me but now I feel I need to take more control of it all. So I have made an appointment for this Thursday with my DSN and dietician to request a change to MDI (and am filling out my food diary to prove I can count!!!) and hopefully they will listen to me this time. Will let you know how I get on - and if successful - report back on the hopefully positive affects of being on MDI. Take care and chin up 🙂

 

[Northerner]

Hope they agree Melissa! 🙂

 

[Doddy]

Hi Doddy. Im in the same position as you. I was diagnosed Type 1 seven months ago (Im 34) and have been on 2 injections a day since diagnosis. My DSN and consultant keep on telling me Im not ready for MDI as I am still in honey moon period (I take 12 units of insulin in morning and 10 units at night) but I too feel I have no control and am very seldom below 10 and my last HBA1C was 10.3. After speaking to Northerner (Alan) and others at the Glasgow meet last month (which was a great afternoon) I realised I need to to be more assertive with my DSN and tell them this is not fitting in with my lifestyle. When I was first diagnosed there was so much information to take in that I was fine with just doing as they told me but now I feel I need to take more control of it all. So I have made an appointment for this Thursday with my DSN and dietician to request a change to MDI (and am filling out my food diary to prove I can count!!!) and hopefully they will listen to me this time. Will let you know how I get on - and if successful - report back on the hopefully positive affects of being on MDI. Take care and chin up 🙂

Good luck...I didn't realise T1's could just be on the twice a day stuff...I thought you always had to inject with every meal. Your figures are very much like mine. I hope they listen to you xx

Thanks robofski...you have given me some confidence!
Thanks Northie...I have come a long way haven't i...all thanks to you and the other lovely people on here.
I know I am heading for a bout of depression, I knew it would happen, it was just a question of when...but it doesn't make it any easier. I was even tempted to throw the towel in earlier, and not take my insulin or meds tonight...jeeez, i hate these dark times

 

[Copepod]

Just hang in there, Doddy - one meal, one injection, one sleep at a time.

What helps you usually when you're heading towards depression? I'm sure others will be posting through the night, so keep talking 🙂

 

[Doddy]

Just hang in there, Doddy - one meal, one injection, one sleep at a time.

What helps you usually when you're heading towards depression? I'm sure others will be posting through the night, so keep talking 🙂

What helps me get thru the depression?....usually having someone to talk to. I have lost the people who i used to turn to...they are fed up with me and don't seem to want anything to do with me. And I will not go running to them beggin for them to listen. Im not even going to tell them how I am feeling. They don't care..its plain to see.

I am normally depressed after a run of seizures, but i haven't had any for a while, so I can't blame that. I feel I am getting no-where with the diabetes...i have got my numbers down from what they were which is fab, but I feel like i have hit the wall now, and there is no-where else left to go. It's the fluctuations that are getting to me...can be low, then they go high.
I know there are people out there far worse off than me, and I should stop wallowing in self pity, pick myself up, dust myself off, and be happy...but i can't.

 

[Copepod]

Sorry you don't have people you can talk to in person. How about Samaritans?

In the UK dial 08457 90 90 90.

Calls from BT residential lines will be charged as follows:
Mon-Fri 7am-7pm:
4.032p per minute including VAT
Connection charge 12.5p

Mon-Fri 7pm-7am and all day Saturday and Sunday:
1.021p per minute
No connection charge

So, actually cheaper to phone now than during weekdays.

Unfortunately, the reality is that managing blood glucose levels with diabetes is tough, especially in the honeymoon phase, but it does get easier with experience, and it's more flexible with MDI than bimodal, so hope your doctor can help you change over. Be easy on yourself, though, as even with years of experience, some of us get unexpected results. And also ask about treatment for mental health - talking therapies often have long waiting lists, but medication can help in a shorter timespan.

 

[Doddy]

Sorry you don't have people you can talk to in person. How about Samaritans?

In the UK dial 08457 90 90 90.

Calls from BT residential lines will be charged as follows:
Mon-Fri 7am-7pm:
4.032p per minute including VAT
Connection charge 12.5p

Mon-Fri 7pm-7am and all day Saturday and Sunday:
1.021p per minute
No connection charge

So, actually cheaper to phone now than during weekdays.

Unfortunately, the reality is that managing blood glucose levels with diabetes is tough, especially in the honeymoon phase, but it does get easier with experience, and it's more flexible with MDI than bimodal, so hope your doctor can help you change over. Be easy on yourself, though, as even with years of experience, some of us get unexpected results. And also ask about treatment for mental health - talking therapies often have long waiting lists, but medication can help in a shorter timespan.

I am already on anti-depressants, and quite a high dose too I think I jsut have a depressive nature, and I fall quite easily into it ;(
I think I will make an appointment with my GP to discuss going onto MDI and discuss how I am feeling with her. Talking therapies have never worked with me...I had a counsellor once that just sat there...didn't say a word. Needless to say I found her useless. I am not the sort of person who blurts out everything without being prompted!

Im sure in a few days, life will look brighter.