Advise on current results

[Alister]

I am type 2 but on Basal insulin (12 morning & 6 night)
Over the last couple of weeks I have been getting consistently very good results testing before meals, possibly too good as they can be in the mid or even low 4's. as don't want to be getting hypo I am wondering what the best approach should be.

1) decrease my insulin doses -last time i tried this results started regularly hitting the low to mid 6's
2) take it as an indication that I am over dooing it with the low carb diet & start eating a few mor carbs.

3) continue as I am as long as I don't actually go Hypo (A monitor closely)

Obviously I need to make sure I am above 5 before driving but it is fairly easy to bring myself up to this level if I am around 4.5 when I test with half a pack of crisps or similar & I generally feel fine & mostly only drive around town anyway.

 

[trophywench]

Well NEVER change more than one insulin dose at the same time, for starters.

What time of day are the lows happening - change the dose of basal that covers it and nothing else. You absolutely should not eat more or less, to suit the insulin. Well I say that, but I have added a quarter of a teaspoon of sugar to a Weetabix to prevent pre-lunch hypos in the past, because there weren't half-unit pens available back then.

 

[Alister]

Insulin Type - No Idea, just says Insuman basal on the pen & ingredients say Insulin Human. also on 1500mg metformin
Not experienced any Hypos & checking my diary things aren't quite as concerning as I though.
As an example
Wed AM (08:45) 5.5 (bacon sandwich breakfast) 13:05 5.1 (Lunch @ 14:00) 19:15 5.1 (dinner)
I have had a couple of 4.1's for lunch & one 3.9 (but felt fine). I'm happy with the mid 4's but the 3.9 was a little concerning
I have added a Greek yoghurt with honey to my breakfast & had a couple of extra chips with my dinner (still not excessive) so far the figures are remaining good.
5.2 on waking & now 5.6, so I think I am probably doing ok 🙂
Had tried lower doses of insulin previously (10 & 4 as opposed to 12 & 6) but found by figures were higher than i liked, tending towards the mid 6's
from posts here I think the current low values may be due to the weather.

I was concerned that when he figures were high I was reducing my carb intake too much then dropping my insulin doses as the figures became low again which seemed to be resulting in a race to the bottom (not to mention I think I have lost more than enough weight now as I am down from 12ish st last year to 10.5 now and an BMI of around 23).

 

[trophywench]

Don't change both doses, and not by 2 units either. If you happen to need really high doses of insulin (cos we are all different) then maybe cutting by 2u isn't 'that much' but when you only need the levels you do - then 2u is one heck of a lot. They always say 'no more than 10%' but TBH myself I try to get 'no more than 5%' - or as close as possible.

Your type of insulin is in fact what it says on the pen! - but I have no experience of that at all so haven't a clue what its profile is. However having looked it up, apparently there are two types of pen used for it. One delivers in multiples of 2 units and the other in multiples of 1u - so if I were you I'd ask your clinic to change you to the 1u pen. Think the 2u one may be completely disposable where you chuck the whole lot away when you've emptied it (all non recyclable so not at all environmentally friendly) whereas the 1u pen is re-usable, so you just slot a new cartridge of insulin in, once the previous one is finished. The cartridges don't recycle either - but at least it's a smaller amount every time. Don't know about this one, but normally the actual cost of re-usable cartridges is exactly the same as a complete non re-usable pen for other types of insulin.

However - the initial cost of the empty pen will cost the NHS a few quid - but spread that over however many years a person will need it and it's TINY.

 

[Alister]

it is a 1 u pen but not refillable.
Thanks all for the advice. i think i may drop the evening dose to 5 for a few days & see what happens but on the whole I am liking where I am.
Initialy i was hoping to be able to ditch the insulin but after 3 months i am thinking heck this is working well & is no hardship so as I keep telling our customers "If it Ain't broke don't fix it" 🙂
& any other type 2's worried about being moved to insulin don't sweat it there is nothing to it.

maintaining this current regieme should not be a problem day to day, it will be my next trip to Vegas that could be a problem (nothing planed for at least another year though) this is ther idea of a (las)Vegan breakfast https://www.tripadvisor.co.uk/Locat...1342-Hash_House_A_Go_Go-Las_Vegas_Nevada.html

 

[trophywench]

I enjoyed Floridian breakfasts since I could order bacon, one egg sunny side up, tomatoes and 2 hash browns and thoroughly enjoy it. Although some diners poured approx. half a gallon of maple syrup on their bacon - it was not at all compulsory we found!