Getting Insulin Right

[Abseil]

Hi, I have recently been diagnosed with yet another health condition for which I will have to take steroids for the foreseeable future. I have also (partly as a consequence) been moved onto Insulin and my meds adjusted so I only take 500mg metformin twice a day. I had my first follow-up meeting with the diabetic specialist nurse last week at the hospital where they made all these adjustments and gave me indulin education.
I was taking 22ml NovoMix 30 in the morning and 12ml at tea. I was finding that my morning BG was ok but by the afternoon I would have the muchies, (and binge frequently) such that my tea and pre-bed BG were high. The nurse told me to tweak the morning dose so that it had more effect for the afternoon readings. This I have done over the last few days so I am now on 24ml. The problem is that late morning, I've been have a hypo at about 3.7, and my afternoon readings remain high. I have all the normal symptoms of a hypo the first and main one being the shakes. However, even when my BG increases to the point of being high, I still have the shakes. I don't know what to do - seems the increased dose in the morning is causing the hypo and my afternoon readings are still too high but with the odd situation of having the shakes.
Looking for advice while I wait for a call back from the nurse. TIA

 

[Inka]

That’s the trouble with mixed insulin @Abseil You can’t increase the afternoon without also increasing the morning, hence your hypo. You’ll either have to modify your food intake (count the carbs and adjust as needed, including a carb snack if needed) or ask for a different insulin regime that’s more flexible.

 

[John Gray]

Having been on morning and evening long-lasting insulin, and fast-acting insulin to combat glucose/carbs in food, for very many years you would expect me to suggest that you replace the (IMNVHO) doomed-to-fail mixed insulin régime with one which takes better account of how your body works and how you input food into it. Yes, I'm just sitting on the fence!