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Bazzer56

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Hi there my username is Bazzer56 and I thought as I'm a newbie to the group I would just introduce myself and say hello to everyone.
 
Hi Bazzer and welcome.

Have you been diagnosed long?
How do you manage your diabetes? Medication and if so which ones or just diet and exercise?
Is there any particular reason that you have joined the forum ie a particular question or problem or are you just wanting to compare notes with others in a similar situation? Please make yourself at home and feel free to ask whatever questions you have.
 
Hi Barbara I've been a diabetic for 30 or more years now and I take to types of insulin. I have just found this group and thought I'd join to see if I could pick up any thing to help me to get my diabetes under control and help me lose some weight.
 
Good to hear you are on a modern insulin regime with 2 insulins, a basal (long acting) and a bolus(meal time) insulin. What are the names of the insulins you use as each different brand varies slightly in it's activity profile?
Do you have Freestyle Libre or other sensor to monitor your levels or are you reliant on finger pricking to get your levels?
Do you adjust your meal time doses depending upon what you are going to eat or are you on fixed doses? Does your nurse also set your long acting insulin dose and when was the last time it was adjusted? Having your long acting/basal insulin dose set as close to optimum as possible means that your diabetes is usually much easier and less frustrating to manage.

Sadly Type 2 diabetics are not given an intensive education course when they are started on insulin like us Type 1s and are left to muddle along on their own most of the time, which is just so unfair, because knowledge is power with managing diabetes. At least you have taken the step to educate yourself and come here and hopefully we should be able to give you a few pointers, however the more info you can tell us about your insulins and the routine you currently follow with them, the more appropriate our advice will be. If you are not in the habit of adjusting your insulin doses yourself then it is quite difficult to lose weight so learning to do that is probably an important first step. There is an online course called BERTIE which teaches you how to count carbs and adjust doses, if you are interested. I will try to find a link to it...
 
rebrascora said:
Good to hear you are on a modern insulin regime with 2 insulins, a basal (long acting) and a bolus(meal time) insulin. What are the names of the insulins you use as each different brand varies slightly in it's activity profile?
Do you have Freestyle Libre or other sensor to monitor your levels or are you reliant on finger pricking to get your levels?
Do you adjust your meal time doses depending upon what you are going to eat or are you on fixed doses? Does your nurse also set your long acting insulin dose and when was the last time it was adjusted? Having your long acting/basal insulin dose set as close to optimum as possible means that your diabetes is usually much easier and less frustrating to manage.

Sadly Type 2 diabetics are not given an intensive education course when they are started on insulin like us Type 1s and are left to muddle along on their own most of the time, which is just so unfair, because knowledge is power with managing diabetes. At least you have taken the step to educate yourself and come here and hopefully we should be able to give you a few pointers, however the more info you can tell us about your insulins and the routine you currently follow with them, the more appropriate our advice will be. If you are not in the habit of adjusting your insulin doses yourself then it is quite difficult to lose weight so learning to do that is probably an important first step. There is an online course called BERTIE which teaches you how to count carbs and adjust doses, if you are interested. I will try to find a link to it...
Click to expand...
I'm on Toujeo long lasting which I take when I go to bed and Humulin S with meals.
I adjust both depending on what my readings are. At the moment I am still on finger pricking but I have an appointment on the 21st of March with my diabetes nurse to go onto some continuous monitoring system don't know which one it is though.
As you said I was told I had diabetes and how to injected and that was it get on with it and work it your self, I was under the hospital doctors for a bit but when my consultant retired I was slipped off the list. The wife was the same just get on with it our doctors at the time didn't even send her to see the hospital diabetes doctor.
 
Good to hear that you are getting a kitted up with a CGM soon. The extra data can be a bit mind blowing at first so do come back to the forum with any queries you have. Do you know if this is just a trial or if it will be put on your prescription?
Do you mind telling us the sort of doses you need with your insulin and what sort of readings you typically get?
Good to hear you have taken control and adjust the doses yourself. Do you just base any changes on your readings or on the food you are going to eat? ie carb count?
Do you inject your meal time insulin before you eat or after? If before, how long before?
 
You mention getting your diabetes under control @Bazzer56 What kind of blood glucose results are you getting? It sounds like you’re not counting the carbs in your meal and adjusting your Humulin S bearing them in mind, only adjusting it to correct a high sugar. If so, this could be why you’re having problems with control. Clearly, it’s better to avoid actually going high as much as possible, rather than correcting the high after it’s happened.
 
rebrascora said:
Good to hear that you are getting a kitted up with a CGM soon. The extra data can be a bit mind blowing at first so do come back to the forum with any queries you have. Do you know if this is just a trial or if it will be put on your prescription?
Do you mind telling us the sort of doses you need with your insulin and what sort of readings you typically get?
Good to hear you have taken control and adjust the doses yourself. Do you just base any changes on your readings or on the food you are going to eat? ie carb count?
Do you inject your meal time insulin before you eat or after? If before, how long before?
Click to expand...
I adjust my insulin based on my readings and I normally test my blood just before I eat.
Plus I have never been told to count or how to count calories.
 
Bazzer56 said:
I adjust my insulin based on my readings and I normally test my blood just before I eat.
Plus I have never been told to count or how to count calories.
Click to expand...

So you’re high until you correct. You can teach yourself to count carbs - NB it’s carbs not calories you’re counting. It’s not hard. You’ll find it gives you more flexibility and better results. Choose an easily countable meal, tot up the carbs in it and see how your Humulin S copes with those carbs by seeing how your blood sugar is at the next meal. If it’s gone up a lot, you need more Humulin S for the amount of carbs you ate. If it’s gone down too much, you need more carbs in your previous meal or less Humulin S.

There’s some basic information here:

The nuts and bolts of carb counting

When you live with type 1 diabetes, carb counting is a great way of managing your blood sugar or glucose levels. It can give you more freedom and flexibility in what you eat when you're preparing meals at home, grabbing food on the go or eating out. Carb counting does take some time and effort...
www.diabetes.org.uk www.diabetes.org.uk
 
Inka said:
You mention getting your diabetes under control @Bazzer56 What kind of blood glucose results are you getting? It sounds like you’re not counting the carbs in your meal and adjusting your Humulin S bearing them in mind, only adjusting it to correct a high sugar. If so, this could be why you’re having problems with control. Clearly, it’s better to avoid actually going high as much as possible, rather than correcting the high after it’s happened.
Click to expand...
My readings vary during the day it can be like yesterday it was 4.5 when I got up at 6:30 am I had a whisky glass of orange juice and 2 rich tea biscuits plus a cup of tea then at 8:30 I had cornflakes for my breakfast, I took 20 units then at about 13:30 just before I ate a beef sandwich for dinner it was 23.7 soI took 30 units. At 18:00 before I ate boiled potatoes, peas and chicken and bacon pie it was 14.8 so I took 20 units. I then checked my blood at about 21:30 before I went to bed it was HI on my monitor which is more 30, so I took 70 units of toujeo then when I got up at 6:30 my blood reading was 7.7. Then some mornings it can be 10 or more.
 
So you ate the biscuits and orange juice without Humulin S? If you skip the orange juice and biscuits and stick to the cornflakes and milk for breakfast, you’ll be able to calculate the carbs in your breakfast by weighing the cornflakes (look at the nutritional info on the pack) and measuring your milk (200ml milk is approx 10g carbs). Say you had 30g of cornflakes, that’s approx 25g carbs, say you had 100ml milk that would be 5g carbs. 25g plus 5g equals 30g carbs in that meal.

If your Humulin S breakfast dose was 15 units and by lunch your blood sugar was pretty much back to what it was before breakfast, you’ll know that that breakfast and that amount of Humulin S is correct. You’d ideally repeat it for a few days to make sure it wasn’t a fluke.Therefore each unit of your 15 units of Humulin S ‘covered’ 2g of carbs (30g meal carbs divided by 15 units of Humulin S).

Say the next day you want a smaller breakfast of 20g carbs. You’ve learnt that 1 unit of your Humulin S covers 2g or carbs, so you take 10 units of Humulin S for your 20g breakfast.

*All those figures above are just examples. Do not use them. I chose them just to demonstrate the method. You need to find your numbers*
 
The reason I have the biscuits is when I diagnosed with diabetes the diabetic nurse told me to have the orange juice and biscuits if my reading was under 5.0.
 
Did you test your blood sugar afterwards eg before you had your cornflakes?
 
Bazzer56 said:
The reason I have the biscuits is when I diagnosed with diabetes the diabetic nurse told me to have the orange juice and biscuits if my reading was under 5.0.
Click to expand...
Generally those of us on insulin treat a hypo as below 4 rather than 5 and we have 15g fast acting carbs like your orange juice or in my case 3 jelly babies, wait 15 mins and then retest to make sure we are above 4. Then we might have 10-15g of slower acting carbs like your rich tea biscuits to help stabilize our levels, however it varies from person to person as to how much you need in reality and those are just extra safe guidelines.

For many of us, our levels naturally rise in the morning, sometimes before we wake up or as soon as we get out of bed, so if I was on 4.5 when I woke up, I would not eat any carbs as my liver will release glucose into my blood stream to bring my levels up. If I was say 3.8 I might just have one jelly baby (5g carbs) rather than the normal 3 (15g carbs) because I know from experience that any more carbs than the absolute minimum will send my levels into orbit and even then I have to inject 1.5-2 units of insulin to cover the release of glucose from my liver. If I woke up on 4.5 and had the fruit juice and biscuits you consumed, which amounts to about 40g carbs my levels would end up about 16.5mmols which is obviously far too high and that is without considering the glucose my liver will release.
I don't know if there was a reason why your nurse told you to treat a hypo as anything below 5 instead of 4 but it sounds to me that you are likely overtreating a morning reading which isn't a hypo and may not even warrant treating at all. Testing 15mins after just the orange juice will hopefully reassure you that you are safely out of the danger zone, possibly without needing to eat the biscuits at all, or at least just have one biscuit. rather than 2 and then test again before breakfast to see how your body has responded to those carbs and then consider adjusting it to more or a bit less next time, depending on that prebreakfast reading. Over treating lows, puts you on a rollercoaster where you then go high and need extra insulin to treat the highs which then increases the risk of you going low again, plus yoyoing between highs and lows makes you feel rubbish and isn't good for your body, so treating lows with the minimum amount of carbs to put you in range and treating highs with the minimum amount of insulin you need to bring you down into range is what you are aiming for.

The guidance I was given was to assume 10g carbs will raise your BG by 3mmols. So if you were 4.5 and you had 10g carbs you might expect to end up about 7.5. You had about 35-40g carbs with the orange juice and biscuits so that is likely to raise your BG levels by about 10-12mmols, so starting at 4.5 you would end up about 14.5-16.5 which is clearly far too high. The amount 10g carbs actually raises your levels will vary slightly but that is a ball park figure, to start with and once you. You can test this by eating 10g carbs when your levels are stable and in range and there is no active insulin in your system and see how much your levels rise by from eating 2 jelly babies.

Have you ever set an alarm to check your levels at 2 or 3am, as you may find that you are going too low then, especially if you regularly wake up in the 4s and would suggest that your Toujeo dose may be too high. Getting your long acting insulin dose as close to optimum as you can helps to make your diabetes much easier to manage and makes it so much less frustrating. If people are struggling to manage their diabetes, doing what we call a basal test is the first thing to do to try to put things right.

Good diabetes management is all about experimenting on yourself and testing lots to see how your particular body responds to carbs and insulin and how this differs at different times of the day and different types of carbs and how your body responds may well be different to how my body responds, hence any advice that nurses and doctors give us is just general guidance and our particular body may need more or less. Generally their advice is conservative so that we err on the side of caution to prevent hypos, but if your levels are swinging from low to very high in a day, that is not good at all and it needs fine tuning for your body's individual needs.
 
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Welcome to the forum @Bazzer56

Hope you find the addition of carb counting helps you reduce the variation in your BG levels day to day, and better match the doses you are taking with the food you are eating.
 
rebrascora said:
Generally those of us on insulin treat a hypo as below 4 rather than 5 and we have 15g fast acting carbs like your orange juice or in my case 3 jelly babies, wait 15 mins and then retest to make sure we are above 4. Then we might have 10-15g of slower acting carbs like your rich tea biscuits to help stabilize our levels, however it varies from person to person as to how much you need in reality and those are just extra safe guidelines.

For many of us, our levels naturally rise in the morning, sometimes before we wake up or as soon as we get out of bed, so if I was on 4.5 when I woke up, I would not eat any carbs as my liver will release glucose into my blood stream to bring my levels up. If I was say 3.8 I might just have one jelly baby (5g carbs) rather than the normal 3 (15g carbs) because I know from experience that any more carbs than the absolute minimum will send my levels into orbit and even then I have to inject 1.5-2 units of insulin to cover the release of glucose from my liver. If I woke up on 4.5 and had the fruit juice and biscuits you consumed, which amounts to about 40g carbs my levels would end up about 16.5mmols which is obviously far too high and that is without considering the glucose my liver will release.
I don't know if there was a reason why your nurse told you to treat a hypo as anything below 5 instead of 4 but it sounds to me that you are likely overtreating a morning reading which isn't a hypo and may not even warrant treating at all. Testing 15mins after just the orange juice will hopefully reassure you that you are safely out of the danger zone, possibly without needing to eat the biscuits at all, or at least just have one biscuit. rather than 2 and then test again before breakfast to see how your body has responded to those carbs and then consider adjusting it to more or a bit less next time, depending on that prebreakfast reading. Over treating lows, puts you on a rollercoaster where you then go high and need extra insulin to treat the highs which then increases the risk of you going low again, plus yoyoing between highs and lows makes you feel rubbish and isn't good for your body, so treating lows with the minimum amount of carbs to put you in range and treating highs with the minimum amount of insulin you need to bring you down into range is what you are aiming for.

The guidance I was given was to assume 10g carbs will raise your BG by 3mmols. So if you were 4.5 and you had 10g carbs you might expect to end up about 7.5. You had about 35-40g carbs with the orange juice and biscuits so that is likely to raise your BG levels by about 10-12mmols, so starting at 4.5 you would end up about 14.5-16.5 which is clearly far too high. The amount 10g carbs actually raises your levels will vary slightly but that is a ball park figure, to start with and once you. You can test this by eating 10g carbs when your levels are stable and in range and there is no active insulin in your system and see how much your levels rise by from eating 2 jelly babies.

Have you ever set an alarm to check your levels at 2 or 3am, as you may find that you are going too low then, especially if you regularly wake up in the 4s and would suggest that your Toujeo dose may be too high. Getting your long acting insulin dose as close to optimum as you can helps to make your diabetes much easier to manage and makes it so much less frustrating. If people are struggling to manage their diabetes, doing what we call a basal test is the first thing to do to try to put things right.

Good diabetes management is all about experimenting on yourself and testing lots to see how your particular body responds to carbs and insulin and how this differs at different times of the day and different types of carbs and how your body responds may well be different to how my body responds, hence any advice that nurses and doctors give us is just general guidance and our particular body may need more or less. Generally their advice is conservative so that we err on the side of caution to prevent hypos, but if your levels are swinging from low to very high in a day, that is not good at all and it needs fine tuning for your body's individual needs.
Click to expand...
Thank you Barbara I will certainly try what you suggested. I don't know if my liver is producing glucose because I have liver cerosis and kidney failure, ( not on dialysis yet). I also have rheumatoid, osteoarthritis osteoporosis so I'm on allsorts of medication and don't know if any of them could affect my blood sugar readings. I am going to ask my diabetes nurse about this when I see her on the 21st March.
Barry
 
My jaw dropped reading what you ate and your numbers - it is so unlike the low carb way of eating many type 2s follow these days.
Can you perhaps get back into being seen by a consultant as you must be taking quite a battering from those blood glucose levels swinging so high and then down again.
 
Drummer said:
My jaw dropped reading what you ate and your numbers - it is so unlike the low carb way of eating many type 2s follow these days.
Can you perhaps get back into being seen by a consultant as you must be taking quite a battering from those blood glucose levels swinging so high and then down again.
Click to expand...
It sounds as if the OP hasn't been given particularly good advice for balancing their insulin with the food they eat.
 
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