Hi all wondering if you can help. Am on 15 units insultard with breakfast and 14 at tea. Am finding am having to snack on crackers to keep my blood sugar from dropping too low before I have my lunch or tea. Am having to snack even if not hungry which feel like am force feeding and constantly having to test. Also I was at 14.6 at bedtime about 10 ish then did not bother with a snack and then woke up as a 5 at 7 this morning My blood sugar can drop quite fast with in 30 mins so had a couple of jelly babies until got to have some toast. Does anyone else find that they are constantly snacking? I decided to drop my units down to 13 and 13. Is this a good idea? am bored of force feeding myself! Am wondering if my pancreas is starting to work a bit and releasing insulin as only been type 1 for a month.
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Constantly Having to snack. new type 1
- Thread starter astbury1
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Copepod
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Insulatard is an intermediate lasting insulin, so while some people can mange with just one injection in 24 hours, many need 2 doses, divided to suit their lifestyle eg equal or one higher than other; timings depend - people vary in their definitition of breakfast / midday meal / evening meal times (note I avoid using terms lunch / dinner / tea / supper, as people differ in what they mean by these terms).
However, that's not the whole story, as most people combine Insulatard with a short acting insulin with each meal, varying dose according to carbohydrate content of meal, plus other factors such as exercise / physical activity, weather / temperature, stress etc. Such factors may also require adjustment of intermediate / long acting insulin dose.
So, it's worth discussing your overall insulin pattern with your diabetes team. However, it's also worth saying that, early days of insulin use require careful titration of dose with blood glucose levels, as if levels are reduced too rapidly, you will feel "false" hypo symptoms. So, while I understand why you want to get down to single figures, remember it's a marathon, not a sprint, and with work, by you and your team, will turn out OK eventually.
However, that's not the whole story, as most people combine Insulatard with a short acting insulin with each meal, varying dose according to carbohydrate content of meal, plus other factors such as exercise / physical activity, weather / temperature, stress etc. Such factors may also require adjustment of intermediate / long acting insulin dose.
So, it's worth discussing your overall insulin pattern with your diabetes team. However, it's also worth saying that, early days of insulin use require careful titration of dose with blood glucose levels, as if levels are reduced too rapidly, you will feel "false" hypo symptoms. So, while I understand why you want to get down to single figures, remember it's a marathon, not a sprint, and with work, by you and your team, will turn out OK eventually.
Thanks for responding. Yeah I take at breakfast and evening meal. I do not use anyother insulin at present. I have reduced it a bit to see if this helps. It was ok but I think now I have gone back to work rather than sitting around feeling sorry for myself that maybe slightly more active so not needing quite as much. Plus at the start I was very stressed out and anxious at going low so was snacking more. I shall leave at 13 and see how it goes and speak to the nurse. I find the whole thing very stressful but am sure I will get a handle on it
DeusXM
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Something seems very wrong with your treatment, I have to say.
Insulatard is not a frontline treatment for T1 and Insulatard itself isn't even really used very often any more. If your team wants you on an inflexible two-injection system then they should be putting you on Mixtard.
If you need to constantly snack to keep your glucose up, you will mess up your BG control AND you will put on weight - a lot, and very quickly. I think you need to speak to your nurse immediately.
Insulatard is not a frontline treatment for T1 and Insulatard itself isn't even really used very often any more. If your team wants you on an inflexible two-injection system then they should be putting you on Mixtard.
If you need to constantly snack to keep your glucose up, you will mess up your BG control AND you will put on weight - a lot, and very quickly. I think you need to speak to your nurse immediately.
Copepod
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I should declare an interest - since I first heard about basal bolus regime, a few months after being daignosed aged 30 years in 1996, and being put on bimodal, without knowing there was any alternative, I have been using Humalin I (another brand of Insulatard), initially just once in evening, but for several years, at bedtime and getting up time - for my lifetsyle, which often involves shift work, activity at odd times eg manning hilltop check points, establishing registration tents etc at any time within 24 hours, day or night, light or dark, on adventure races & mountain marathons.
So, hope you find a suitable insulin regime, astbury1 - it's what suits you that matters, not what others think you need.
So, hope you find a suitable insulin regime, astbury1 - it's what suits you that matters, not what others think you need.
Hi yes i will speak to the nurse. Just out of interest are youtrainied in diabetes? Or is this coming from your experience as a type 1?
I have a feeling at present they treating me as type1 however I am sitting on the middle line of type 2 and 1 and they are watching and waiting
I have a feeling at present they treating me as type1 however I am sitting on the middle line of type 2 and 1 and they are watching and waiting
DEUSx- Thanks for your advice. However just to let you know telling someone that is new and anxious about diabetes already that thye are not on the right medicine makes the anxeity worse. I have also just read they are discontinuing mixard.
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I'm another who was a little surprised at the regime you mentioned in one of your other threads. To me it seems like there might be something going on 'behind the scenes' in the minds of your team. Strictly speaking there is no 'middle line' between t1 and t2, just as there is no middle line between apples and oranges. However diagnosis is diabetes is often done by evaluating a number of factors in the hsitory/appearance of the patient (weight, age, speed of onset of symptoms, presence or lack of ketones etc), rather than by commissioning some of the more expensive lab tests which exist (in your case a GAD antibody and/or c-Peptide test would ascertain whether your immune system was killing off your beta cells and how much of your own insulin you were still able to make).
Matters are further complicated by the existence of other types of diabetes (which some HCPs are reluctant to agree exist) such as LADA, sometimes called 'slow onset T1' or T1.5.
It would seem that your team are using Insulatard alone as they suspect you may well still have some insulin production of your own going on.
Can I ask if you have tested to see what happens after you eat a meal? For example test before lunch or eve meal, then again every hour until 4 hours after eating. It would be very interesting to know those results. Insulatard is not able to provide a 'boost' of insulin to match food intake so if you are producing little of your own insulin you would expect to see a significant rise in BG levels in the hours immediately after a meal. With a more 'standard' basal: bolus pattern a different insulin would be used at mealtimes to keep these rises under control.
The short answer though is 'no' you shouldn't have to eat to feed your insulin. Long term this is not healthy or convenient IMO.
Matters are further complicated by the existence of other types of diabetes (which some HCPs are reluctant to agree exist) such as LADA, sometimes called 'slow onset T1' or T1.5.
It would seem that your team are using Insulatard alone as they suspect you may well still have some insulin production of your own going on.
Can I ask if you have tested to see what happens after you eat a meal? For example test before lunch or eve meal, then again every hour until 4 hours after eating. It would be very interesting to know those results. Insulatard is not able to provide a 'boost' of insulin to match food intake so if you are producing little of your own insulin you would expect to see a significant rise in BG levels in the hours immediately after a meal. With a more 'standard' basal: bolus pattern a different insulin would be used at mealtimes to keep these rises under control.
The short answer though is 'no' you shouldn't have to eat to feed your insulin. Long term this is not healthy or convenient IMO.
Thanks everyday.Yes they do believe producing some i think and they have said that I will be doing the multiple injection soon. I went into ketoacidosis so they have been bringing my levels down gradually as they said this is safer. I will have a look into my blood sugar. I do know that I was 5this morning had 2 jelly babies then had toast and marg and about hour and half later I was 11 but if I didnt have a snack before lunch i would be too low
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Mixtard 30 was discontinued in 2010, but many other mixed insulins still exist including 'Novomix 30' by the same people that used to make Mixtard. They consist of a blend of short and long-acting insulins which is intended to try to cover meal and 'background' doses. For some people the lower number of injections a day is a powerful motivator, though mixed insulins are usually acknowledged to be more restrictive and less precise in terms of BG control - as with all things D though... everyone is different and what works for one person will not necessarily suit another 🙂
Hi there, just thought I'd chip in with my experiences....
I was put on Insulatard at first as (5 years ago) as like you, they thought I was still producing some insulin and wouldn't need much. Also 2 injections a day sounds like plenty to be starting with! So I think it was used as a means of getting BG within range without overwhelming me with info or hypos.
However, like you I found I did have to eat a lot to avoid hypos and quickly gained a stone, also I was 26 and all my friends were having weddings or christenings and they were really stressful as you don't know when or how much you'll be eating. I'm also into exercise which wasn't easy on insulatard.
So after about 4 months I asked to change to multiple daily injections (MDI) and have never looked back - but I thought I would speak up in defence of your team as I found Insulatard fine to start with. i did have to tweak the doses a lot though as the initial doses were too high.
The other thing was initially I wasn't given any info about carbs, and so I thought it was just sugar which was bad. So I'd have something like cheese and crackers for pudding then wonder why my BG was raised. But after a few weeks I went on a course run by my clinic for newly diagnosed people which covered basic carb counting and things made a lot more sense then - don't know if you have been to anything like this?
Basically on insulatard you need to eat the same amount of carbs at the same time every day - whether that is starch or sugar. Then if you exercise you need to eat more carbs - even things you might not think of as exercise, like hoovering or decorating! Once I started counting carbs, I realised that if I had toast for breakfast that was 35g carbs, whereas my typical porridge portion was 70g carbs - so no wonder my BG was all over the place! So I modified portion sizes to try to be consistent, but that took some of the fun out of eating.
On MDI you adjust the quick acting insulin to the food, so I'd take 3.5U for toast and 7 U for porridge, much easier to get variety in your diet!
So if your insulin doesn't suit your lifestyle then speak to your team, but if you find the injections a problem then maybe stick with 2 for now... whatever's right for you, basically!
I was put on Insulatard at first as (5 years ago) as like you, they thought I was still producing some insulin and wouldn't need much. Also 2 injections a day sounds like plenty to be starting with! So I think it was used as a means of getting BG within range without overwhelming me with info or hypos.
However, like you I found I did have to eat a lot to avoid hypos and quickly gained a stone, also I was 26 and all my friends were having weddings or christenings and they were really stressful as you don't know when or how much you'll be eating. I'm also into exercise which wasn't easy on insulatard.
So after about 4 months I asked to change to multiple daily injections (MDI) and have never looked back - but I thought I would speak up in defence of your team as I found Insulatard fine to start with. i did have to tweak the doses a lot though as the initial doses were too high.
The other thing was initially I wasn't given any info about carbs, and so I thought it was just sugar which was bad. So I'd have something like cheese and crackers for pudding then wonder why my BG was raised. But after a few weeks I went on a course run by my clinic for newly diagnosed people which covered basic carb counting and things made a lot more sense then - don't know if you have been to anything like this?
Basically on insulatard you need to eat the same amount of carbs at the same time every day - whether that is starch or sugar. Then if you exercise you need to eat more carbs - even things you might not think of as exercise, like hoovering or decorating! Once I started counting carbs, I realised that if I had toast for breakfast that was 35g carbs, whereas my typical porridge portion was 70g carbs - so no wonder my BG was all over the place! So I modified portion sizes to try to be consistent, but that took some of the fun out of eating.
On MDI you adjust the quick acting insulin to the food, so I'd take 3.5U for toast and 7 U for porridge, much easier to get variety in your diet!
So if your insulin doesn't suit your lifestyle then speak to your team, but if you find the injections a problem then maybe stick with 2 for now... whatever's right for you, basically!
Thanks Pigeon you have made me feel a bit better! I thik also I may have started to honey moon which is a pain as I was getting used to my blood sugars being vaguely consistent! Started on 8 units 2 times a day and then as then up to 15 units and 14 units. Now I have adjusted it to 12 units again as I seem to be struggling to keep blood sugars up! I have a feeling it might end up going back to 8 at this rate!It is nice to hear that someone had a similar experience and it is not just my body being odd!
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