Completely muddled.

[Gilly149]

Hi. I have been diagnosed with diabetes for about 10 years. Started diet controlled and then moved on to metformin. My BG was always under 7 and I had no problems.
However I also have Crohn’s disease, had several operations and have had an ileostomy for 33 years.
I had covid in March and although I am fully recovered my body has since stopped absorbing my diabetic oral drugs. ( it has also stopped absorbing. Magnesium and calcium) . My glucose levels were well over 20 , sometimes not even registering. I have a very quick digestion.
I have been on insulin for a few weeks, gradually increasing . My levels are all over the place. I am on 12 units twice a day, sometimes readings are 10 but has been as high as 19. I am still increasing the insulin every 3/4 days.
When I have a reading of 10 it is because I have been really not eating much so am so hungry.
I have lost a lot of weight and was hoping to put some back on, but at this rate I won’t.
So do I eat what I need and keep increasing the insulin until my diet needs and insulin are balanced if you know what I mean.

 

[Ralph-YK]

What insulin are you on?

 

[Gilly149]

Humalog Mix25

 

[Inka]

Hi. I have been diagnosed with diabetes for about 10 years. Started diet controlled and then moved on to metformin. My BG was always under 7 and I had no problems.
However I also have Crohn’s disease, had several operations and have had an ileostomy for 33 years.
I had covid in March and although I am fully recovered my body has since stopped absorbing my diabetic oral drugs. ( it has also stopped absorbing. Magnesium and calcium) . My glucose levels were well over 20 , sometimes not even registering. I have a very quick digestion.
I have been on insulin for a few weeks, gradually increasing . My levels are all over the place. I am on 12 units twice a day, sometimes readings are 10 but has been as high as 19. I am still increasing the insulin every 3/4 days.
When I have a reading of 10 it is because I have been really not eating much so am so hungry.
I have lost a lot of weight and was hoping to put some back on, but at this rate I won’t.
So do I eat what I need and keep increasing the insulin until my diet needs and insulin are balanced if you know what I mean.

You’re on what’s called a mixed insulin - set proportions of slow and fast acting insulin. Have you been told an amount of carbs to aim for at each meal? It sounds like you’re still not at the optimal dose of insulin for you, but that’s not unusual and it’s better to increase it gradually than rush things.

With mixed insulin, I think it helps a lot to have a routine - ie do your injections at the same times each day and eat at the same times and eat the same amount of carbs for each meal.

You mention weight loss - is this because of your digestive problems or is it sudden unusual weight loss? I ask just to rule out the possibility you’re actually a late-onset Type 1.

 

[Inka]

Just saw there was a question in your final sentence. Yes, eat normally and try to eat consistently - ie the same amount of carbs at each meal each day. If you’re struggling to eat enough to put on weight, you could ask about separate insulins (basal/slow and bolus/fast) so you can adjust your meal-time insulin to allow you to eat more.

Your Humalog25 is 75% slow acting insulin, 25% fast/meal insulin. So you can’t increase one part of it without increasing the other. The proportions in this mix might not suit you, as you might need more fast-acting.

Keep good records of what you’re eating (carbs) and your blood sugar and then you can see how your insulin is working.

 

[Gilly149]

Thank you.
I think it’s a mixture of everything that caused me to lose weight, just been gradual over the last year.
I am a creature of habit, get up early, shower then blood and breakfast. Same time every day, and lunch and evening meal is pretty much routine too.
But my digestion, unfortunately , does nt do routine. . It can be really fast one day, losing a lot of goodness, then slower the next. It’s just so frustrating. The diabetic Nurse is really good, but of course I can only have phone appointments. I just feel quite ashamed that I have to tell her on Friday that I have nt managed to get it under control.

 

[grovesy]

Thank you.
I think it’s a mixture of everything that caused me to lose weight, just been gradual over the last year.
I am a creature of habit, get up early, shower then blood and breakfast. Same time every day, and lunch and evening meal is pretty much routine too.
But my digestion, unfortunately , does nt do routine. . It can be really fast one day, losing a lot of goodness, then slower the next. It’s just so frustrating. The diabetic Nurse is really good, but of course I can only have phone appointments. I just feel quite ashamed that I have to tell her on Friday that I have nt managed to get it under control.

Don't feel ashamed you can only do your best, they usally start people on Insulin on a low dose and gradually build up. If she is really good your nurse she understand.

 

[Inka]

Thank you.
I think it’s a mixture of everything that caused me to lose weight, just been gradual over the last year.
I am a creature of habit, get up early, shower then blood and breakfast. Same time every day, and lunch and evening meal is pretty much routine too.
But my digestion, unfortunately , does nt do routine. . It can be really fast one day, losing a lot of goodness, then slower the next. It’s just so frustrating. The diabetic Nurse is really good, but of course I can only have phone appointments. I just feel quite ashamed that I have to tell her on Friday that I have nt managed to get it under control.

Please don’t feel ashamed! It’s not your fault at all. It’s most certainly not your fault you have the digestion issues - that must be hard for you.

You’ll gradually get better control. Slow and steady is the way. Do ask about additional fast-acting insulin though. It can help you eat more and can also be used to correct high blood sugars.

 

[Gilly149]

Thank you , I will speak to her on Friday