Diagnosed in January and finally got a result in may as being T2 need some advice

[Scott88]

Hi. I have been giving myself 30 units of long lasting daily and since early part of may when I got diagnosed with T2 they have given me Trurapi to take before meals. I was also told that I am insulin resistant and the values of 1 unit -10 carb more then likely won’t work.

I have signed up to the clarity app via the diabetic team and they have had no contact with me in regard to my levels as they are all over the place, and no contact on when I’m due a review etc.
For instance today I was 6.8 before my dinner ( 7pm ) I gave myself 8 units which pushed me to 13.0 by ( 8:30 ) I then dropped to 10.8 by ( 9:45 ) then all of a sudden I have gone to 18.9 by ( 23:00 ) so I have taken another 8 units of trurapi and at the time of this post it’s only put my down to 15.1

I don’t know if this is making a lot of sense I just don’t know what people would suggest to people that are insulin resistant, I don’t know a safe way to gage my trurapi for situations like this as I don’t want to be drastic and take too much without knowing at this time of night. Should I try to change it to 2 units per 10 carbs for a few days then go 3 if I don’t notice a change. Or is the weather ( 28 degrees til next week ) causing it. Many thanks.

 

[Inka]

Welcome @Scott88 🙂 First thing, are you checking those higher numbers with a fingerprick? The Libre will commonly exaggerate high numbers, eg it might say you’re 15 when you’re 11.5.

What did you eat for your evening meal? What basal (long-acting/slow) insulin do you take and when?

 

[Scott88]

Hey. I’m using the Dexcom one plus which I calibrate every time I have a new one which so far has seem to be only 0.2-0.5 off from a finger prick. Last night I did have to guess because had a Chinese but only had half a portion of egg fried rice and some chicken balls. My long acting is called abasaglar and I generally take it between 7-9am daily

 

[helli]

I’m using the Dexcom one plus which I calibrate every time I have a new one which so far has seem to be only 0.2-0.5 off from a finger prick.

Glucose meter accuracy is typically measured as a percentage. Therefore, the higher the BG, the higher the inaccuracy.
In addition, CGMs are designed to be more accurate at "normal" levels. For this reason, it is always recommended to check highs and lows before making any corrections.
This has nothing to do with how close to a finger pricks reading it is when your finger pricks is 7mmol/l. That is irrelevant when your CGM is reporting 18mmol/l.
I also find CGMs can "drift" during their lifespan. Therefore, I calibrate mine at least once a day when my BG is in range and stable.
I would be incredibly nervous relying upon one finger prick over 10 days for calibration.

 

[Scott88]

Glucose meter accuracy is typically measured as a percentage. Therefore, the higher the BG, the higher the inaccuracy.
In addition, CGMs are designed to be more accurate at "normal" levels. For this reason, it is always recommended to check highs and lows before making any corrections.
This has nothing to do with how close to a finger pricks reading it is when your finger pricks is 7mmol/l. That is irrelevant when your CGM is reporting 18mmol/l.
I also find CGMs can "drift" during their lifespan. Therefore, I calibrate mine at least once a day when my BG is in range and stable.
I would be incredibly nervous relying upon one finger prick over 10 days for calibration.

Oh I do check once a day and currently at the moment it still how’s between a 0.2 -0.5 difference I didn’t check last night but I guess I will have to. Is there another way to lower the blood sugar rapidly?

 

[Inka]

Hey. I’m using the Dexcom one plus which I calibrate every time I have a new one which so far has seem to be only 0.2-0.5 off from a finger prick. Last night I did have to guess because had a Chinese but only had half a portion of egg fried rice and some chicken balls. My long acting is called abasaglar and I generally take it between 7-9am daily

I use the Dexcom G7, which is amazing, but even that will read slightly high at higher levels, so it’s always worth checking.

I always need more insulin for Chinese than I think I will, and I also often need to spread my bolus (fast/meal) insulin over a longer period of time to catch a later rise, so I think the Chinese could well have contributed.

Also, the timing of your Abasaglar could be affecting things. Some people find it works better to inject it in the evening.

Just one thing, I saw that I didn’t reply to your question about increasing your insulin to carbs ratio. No, you don’t go from 1 unit of insulin to 10g carbs to 2 units of insulin to 10g carbs. That would be too big a step, and it’s also back to front. It’s best to look on it as how many grams of carbs 1 unit of insulin will cover. So 1 unit to 10g carbs, or 1 unit to 12g carbs if more insulin sensitive, or 1 unit to 7g carbs if more insulin resistant. Those are just example numbers. The ratio can be anything - 1:10g, 1:12g, 1:15g, 1:18g, 1:25g, 1:5g, 1:3g, etc etc.

 

[Scott88]

I use the Dexcom G7, which is amazing, but even that will read slightly high at higher levels, so it’s always worth checking.

I always need more insulin for Chinese than I think I will, and I also often need to spread my bolus (fast/meal) insulin over a longer period of time to catch a later rise, so I think the Chinese could well have contributed.

Also, the timing of your Abasaglar could be affecting things. Some people find it works better to inject it in the evening.

Just one thing, I saw that I didn’t reply to your question about increasing your insulin to carbs ratio. No, you don’t go from 1 unit of insulin to 10g carbs to 2 units of insulin to 10g carbs. That would be too big a step, and it’s also back to front. It’s best to look on it as how many grams of carbs 1 unit of insulin will cover. So 1 unit to 10g carbs, or 1 unit to 12g carbs if more insulin sensitive, or 1 unit to 7g carbs if more insulin resistant. Those are just example numbers. The ratio can be anything - 1:10g, 1:12g, 1:15g, 1:18g, 1:25g, 1:5g, 1:3g,

I use the Dexcom G7, which is amazing, but even that will read slightly high at higher levels, so it’s always worth checking.

I always need more insulin for Chinese than I think I will, and I also often need to spread my bolus (fast/meal) insulin over a longer period of time to catch a later rise, so I think the Chinese could well have contributed.

Also, the timing of your Abasaglar could be affecting things. Some people find it works better to inject it in the evening.

Just one thing, I saw that I didn’t reply to your question about increasing your insulin to carbs ratio. No, you don’t go from 1 unit of insulin to 10g carbs to 2 units of insulin to 10g carbs. That would be too big a step, and it’s also back to front. It’s best to look on it as how many grams of carbs 1 unit of insulin will cover. So 1 unit to 10g carbs, or 1 unit to 12g carbs if more insulin sensitive, or 1 unit to 7g carbs if more insulin resistant. Those are just example numbers. The ratio can be anything - 1:10g, 1:12g, 1:15g, 1:18g, 1:25g, 1:5g, 1:3g, etc etc.

thanks I have been getting mixed views from the team first time they said have it at night then second appointment they said have it early morning. So maybe try 1 to 7g as resistant

 

[Inka]

Your basal insulin is the foundation of good control @Scott88 If that’s wrong, it makes it harder to get your meal doses right. Think of it like a house. The basal is the foundation on which you build, so it’s important it’s right - ie right dose at the right time. It might be worth thinking about your basal a bit before changing your meal ratio.

If you do choose to try a change of meal ratio, then change it gradually in small steps not big steps. You also need to give any new ratio a few days so you can properly see if it works. Finally, it’s not unusual to need different ratios for different meals - that is, breakfast, lunch and evening meal - so if you find a ratio that seems to work, except for one meal, then you can always have a different ratio for that meal.

When experimenting with insulin changes, it’s easiest to have safe, reliable meals where you know the carbs and there’s nothing about the meals that could mess your experiment up, eg high fat.