Hello

[geordie]

Thanks for letting me join.
I have been type 2 for 14 years and "beat" it for 10 years with exercise and weight loss.Eveventually put on metformin and gliklazide. Figures have got much worse lately and metformin increased to 1000mg.Retestested after 3 months and figures worse again. Taken of gliklazide due to liver problems and looks like insulin is next step.
Very useful reading other people's experiences on the forum

 

[Inka]

Welcome @geordie 🙂 There are a number of Type 2s on insulin here, so you won’t be alone. Do you have an appointment to discuss it?

 

[rebrascora]

I would be considering whether you really are Type 2 or may actually be a slow onset Type 1 if levels are not responding to standard Type 2 medication and lifestyle regimes anymore.

I expect that insulin will improve things but it is a big step and there is a lot to learn as it is a bit of a balancing act. I don't think any of us realised just how clever that little organ, the pancreas actually is until we had to take over one of it's functions.
Anyway, we are here to support you with that, so please ask whatever questions you have. You may find that there are a range of right answers to questions you ask and you have to try different things to find which is the right one for you because diabetes is quite individual as are human bodies so they all respond in slightly different ways and you need to learn to become the expert in how your body responds to food and insulin and exercise and stress and illness and alcohol and ambient temperature and lots of other factors, although food and insulin are the 2 main ones to get your head around at first and then perhaps add in exercise once you can mostly balance the food and insulin. It is a bit like like juggling, you have to start with just a couple of items until you are experienced and competent enough to add in a third and eventually a 4th.

Do you know which insulin(s) they are considering?
To put you in the picture, there are various types.....

Mixed insulin is a mix of slow release insulin which deals with the glucose trickled out by the liver 24 hours a day (the liver is like a rechargeable back up battery which keeps us fueled when we are not eating/digesting food.... during periods of fasting etc) and a fast acting insulin which releases more quickly to deal with the glucose release from food we eat. It is premixed at a set ratio... I think something like 60/40 and you inject it twice a day, usually before breakfast and before your evening meal. This mix means that you need to eat regular meals of a particular size to balance the insulin and skipping a meal or eating much later than usual upsets the balance so you have to be quite regimented. It works for people with a very fixed routine but not everyone's life is like that.

Basal/Bolus regime.... This is where the long acting and faster meal time insulins are in separate pens and you inject them as and when you need to. The basal insulin is generally once or twice a day depending on the brand and usually morning and evening. The fast acting bolus insulin is injected just before each meal and once you know what you are doing, the dose is adjusted according to what you are about to eat. If you skip a meal, you obviously don't need any. If you want to eat late you can because the meal time insulin is separate of the long acting one. Another advantage is that if your levels go high for some reason, you can inject a bit of the fast acting bolus insulin to bring them down. This can be particularly useful at times of illness when levels often rise sharply and wont come down and you are not well enough to exercise or drink lots of water. It is therefore a much more flexible system and allows you to be more fluid in your lifestyle choices but it involves extra injections, usually a minimum of 4 a day and some headspace in calculating doses etc. Most of us would say that that it is well worth those drawbacks, but some people find mixed insulin suits them better.
You can also reduce doses to take into account exercise, so that you are less likely to hypo during a bike ride or football match or whilst swimming etc

Sometimes the doctor/nurse will start you off on just a basal (long acting) insulin and see how that goes before possibly introducing a meal time insulin later and very occasionally, they will give a short acting insulin just for meals when your system needs extra help.

You should have an element of input as to what is prescribed if you understand what is available, hence explaining this now. For me, I would never manage to stick to a routine, so mixed insulin would be very difficult for me, but I am happy to put the effort into working out what I need for each meal and injecting it as and when I need it, so a flexible basal bolus system works well for me and in fact most of us here, be they type 1 or Type2, but there are some people who don't want to give any thought to their diabetes and just do what the doctor tells them and muddle along. Their diabetes may be less well controlled but it is mostly adequate although with minimal finger prick testing they probably don't see a lot of peaks and troughs which largely cancel themselves out to produce a reasonable HbA1c, whereas modern CGM systems might show that their BG levels are much more variable than would be ideal.

Anyway, I am well aware that I am waffling, just wanted you to have some understanding of the different insulin options before your appointment so that you can discuss them with your Dr or nurse and have some input into what is prescribed because you will know your lifestyle far better than the person prescribing it.

 

[everydayupsanddowns]

Thanks for letting me join.
I have been type 2 for 14 years and "beat" it for 10 years with exercise and weight loss.Eveventually put on metformin and gliklazide. Figures have got much worse lately and metformin increased to 1000mg.Retestested after 3 months and figures worse again. Taken of gliklazide due to liver problems and looks like insulin is next step.
Very useful reading other people's experiences on the forum

Welcome to the forum @geordie

Glad you’ve found it helpful to read experiences on the forum.

Do ask away with any questions you have when you start (and once you know which insulin(s) you’ll be starting on. We have lots of members (of various different diabetes flavours) who have been on various different insulin regimen over the years, so there will definitely be someone to compare notes with. 🙂