Finding it difficult

[Elizabethe]

I have been struggling since February 2021. Assessed as diabetes type 2 and after a period of scans and medication,settled on two metformin and one gliclazide in the morning and one metformin and two gliclazide in the evening.
There was some tension between the diabetic clinic ( I self referred) and my GP about who was to do my blood tests. Eventually after I called to raise a complaint the clinic did the blood tests on the 7th June. My blood sugars tend to be fine during the day but about 12 in the evening. The consultant asked for a C-peptide and GAD antibodies tests.
My referral letter from the surgical team in February did not reach the diabetic service for vetting.
The upshot is the consultant has looked at all my data and I received a letter yesterday to start a low threshold starting insulin. I also have an appointment with the consultant on the 20 th July. I will call the clinic to explain tomorrow
I am 64 years old and underweight
I feel so upset , but require advice about low threshold insulin.
I also hope this makes sense

Elizabeth

 

[everydayupsanddowns]

Sorry to hear what a difficult time you have been having, and how you have been struggling to access appropriate care and support. It has certainly been difficult with the pandemic, and the clinics being so overstretched.

It does sound as though your case needs looking at by the specialists, and I can understand why you are concerned being underweight.

I wonder if ‘low threshold’ just means starting you on fairly conservative doses to begin with? It’s not a term I’ve heard before.

Hope the insulin start goes well 🙂

 

[trophywench]

Hiya - same questions as @everydayupsanddowns really - what actual insulin have they prescribed for you?

 

[DaveB]

Hi. I've been down the same route. There is no such thing as 'low threshold insulin' but merely an insulin injection level that matches your ability to metabolise carbs. Hopefully you will be started on Basal/Bolus insulin which is the most flexible routine. For a while you could just have mixed insulin and change to Basal/Bolus later if needed. You just inject the amount of insulin your body needs which needs some initial guidance.

 

[rebrascora]

I'm wondering if by "low threshold", they mean background insulin ie basal, rather than initial conservative doses which should always be the case anyway. There have been a few people recently who have been started off just on basal insulin only and then bolus for meals introduced later.

 

[everydayupsanddowns]

I'm wondering if by "low threshold", they mean background insulin ie basal, rather than initial conservative doses which should always be the case anyway. There have been a few people recently who have been started off just on basal insulin only and then bolus for meals introduced later.

Ah yes, that’s an interesting thought @rebrascora

 

[Elizabethe]

I haven’t started on insulin yet, I will call the clinic tomorrow. I am dreading it as it has taken me several months to try and control it with metformin and gliclazide. What equipment will I get ?

 

[rebrascora]

Please don't be concerned. The insulin pens are so easy to use and the needles are the thickness of a hair and just about an 1/8 of an inch long so barely anything to see at all. They will show you how and where to use them and tell you how much you need to start with but it is usually a lower dose than they expect you will need and then slowly increase it as they see how you respond to it. You will slowly learn how to adjust the doses yourself with some training, but initially the clinic staff will set your doses.
You will manage fine and the forum will be here to support you through it, so don't worry. It amazes me how "second nature" it has become for me in only a couple of years.

 

[Elizabethe]

Thank you for all the encouraging replies, it is much appreciated x
Elizabeth

 

[pmailkeey]

I haven’t started on insulin yet, I will call the clinic tomorrow. I am dreading it as it has taken me several months to try and control it with metformin and gliclazide. What equipment will I get ?

What does of gliclazide are you on?

 

[pmailkeey]

Assessed as diabetes type 2 and after a period of scans and medication,settled on two metformin and one gliclazide in the morning and one metformin and two gliclazide in the evening.
There was some tension between the diabetic clinic ( I self referred) and my GP about who was to do my blood tests. Eventually after I called to raise a complaint the clinic did the blood tests on the 7th June. My blood sugars tend to be fine during the day but about 12 in the evening.

Please do be more precise with saying what meds you're taking. I'll assume the metformin is 500mg but is the gliclazide 40 or 80mg ?
You can be taking quite a bit more of the pills before insulin comes onto the scene. I'm on 6 metformin and 4 80mg gliclazide.

 

[Elizabethe]

Please do be more precise with saying what meds you're taking. I'll assume the metformin is 500mg but is the gliclazide 40 or 80mg ?
You can be taking quite a bit more of the pills before insulin comes onto the scene. I'm on 6 metformin and 4 80mg gliclazide.

I am on 2 metformin and one gliclazide in the morning and one metformin and 2 gliclazide in the evening. 500mg and 80 mg. the dosage. The update being the clinic are waiting till they have the results of my tests as my hba1c was excellent at 5.8. I did at one stage take an extra metformin but couldn’t tolerate it. Just a waiting game now

 

[pmailkeey]

From my experience, I suspect we get more out of the gliclazide if they're taken 2 hours apart - possibly depending on how well your pancreas reacts to it !
What do you mean - couldn't tolerate the metformin ? I'm taking 2 three times a day - but I also take 30mg codeine with them to keep the bowels happy !
I like codeine - maybe I'm a codeine stalker ! It does wonders for my bowels but the best thing I did for my bowels was stop eating bran flakes* for breakfast.

* But bran flakes are good for you.....yeah, that's what Kellogg's will tell you - in reality, good for their profits !

 

[VickyHW]

From my experience, I suspect we get more out of the gliclazide if they're taken 2 hours apart - possibly depending on how well your pancreas reacts to it !
What do you mean - couldn't tolerate the metformin ? I'm taking 2 three times a day - but I also take 30mg codeine with them to keep the bowels happy !
I like codeine - maybe I'm a codeine stalker ! It does wonders for my bowels but the best thing I did for my bowels was stop eating bran flakes* for breakfast.

* But bran flakes are good for you.....yeah, that's what Kellogg's will tell you - in reality, good for their profits !

Lol, exact opposite on my bowels with codeine although I take quite a bit for chronic pain and restless legs. I’m likely to go onto metformin soon and given the experiences of some I may be quite glad of my current constipation!

 

[pmailkeey]

Lol, exact opposite on my bowels with codeine although I take quite a bit for chronic pain and restless legs. I’m likely to go onto metformin soon and given the experiences of some I may be quite glad of my current constipation!

Codeine is a constipant ! Metformin is the opposite !
I was on tramadol - but new GP has not prescribed it Simply means I'm looking for another new GP.....in a country where meds are easier to get hold of !
First lot of Lantus insulin from new GP was cartridges - not pens ! Had to buy a refillable pen to use the cartridges. I've billed the new 'surgery'.

New GP has also removed pen needles from my repeats ! F T ! (rude words)

 

[trophywench]

I've certainly been to some countries where you can get certain drugs over a pharmacy counter and just pay for them - but nowhere where you can get such strong drugs as tramadol, or insulin of any description, without a proper legal prescription in that country - and of course you've had to pay to see the doctor in the first place. Hence I'm bound to wonder where the country you mention, might be?

 

[SB2015]

Thank you for all the encouraging replies, it is much appreciated x
Elizabeth

Welcome to forum from another late starter (53). LADA in theory but that describes more about how quickly it all gets going and in the end most of us with the basal/Bolus regime with our own tweaks.

For many incorrectly diagnosed with T2 and trying to manage on tablets it certainly seems easier once on injections. As @rebrascora said do not be worried. The needles are tiny and you quickly get used to the management. You will be provided with all that you need. I was given choices at the start but had no idea of what was best so just went with the smallest meter.

There is loads of experience to tap into on here, just ask.