Hello!

[Stooriedee]

I was diagnosed as Type 2 16 years ago (I am now 66 years old). I am on Metformin and also inject Humulin M3 insulin twice daily. For several years until November 2023 I also injected Victoza once daily. Due to the Ozempic ‘craze’, Victoza could not be sourced. This possibly played a part in my HbA1c rising from low 60s to 72 over the year. Hitting 72 jolted me into self funding CGM and I am currently using Dexcom One +. This was a revelation as it showed that the 30% ‘fast acting’ component in the Humulin M3 was not ‘fast acting’ at all. CGM has allowed me much greater control of my diabetes and, in the first 6 months, I have reduced my HbA1c from 72 to 64.
In the past month I have started on Jardiance (empagliflozin) 10mg daily, in place of Victoza. I am already noticing a smoothing out of my high spikes and anticipate a further reduction in my HbA1c.
Whilst my lifestyle and diet may not be perfect, I take my condition seriously as, to be blunt, the thought of being a blind amputee does not appeal. My experience with diabetes is that if you treat it with respect you can lead a perfectly normal life.

 

[everydayupsanddowns]

Welcome to the forum @Stooriedee

Glad that you’ve found the Dexcom One+ useful, and it has had a positive impact on your blood glucose management. Is that something you are planning to continue using? In my early days of self-funding I found it pretty cost-effective to spread out my stock of sensors with some gaps in between. Using the extra information as a means of ‘resetting’ my approaches every month or two.

Good to hear you have been seeing positive impact from Jardiance - but frustrating that it is shortages and supply issues rather than clinical factors which have prompted the change

Since you’ve seen how the mixed insulin works (or fails to!) through the sensor data, are you tempted to ask to switch to MDI / basal:bolus, where you take meal insulin each time you eat, and your ‘background’ insulin separately once or twice a day? Several of our T2s on insulin have found that a much more flexible and accurate way of managing their insulin doses - and it can help in getting sensors funded in the NHS

 

[Stooriedee]

Thanks for your reply. I see (privately) an endocrinologist on a yearly basis and she has written to my GP practice suggesting the basal bolus approach. My Practice Nurse started me on the Jardiance just before I left for a 7 week break in Australia. She has forwarded the endocrinologist’s letter to NHS Fife’s Diabetic Centre. I would not have considered a major regime change just before departure. Back home early December and hopefully things will progress then. A move to basal bolus would allow me to meet NHS Fife’s criteria for funding.

 

[rebrascora]

Good to hear that you have wheels in motion to go onto a basal/bolus system.

If you are seeing spikes after meals, the thing to consider is how far in advance of that meal that you inject your insulin. Breakfast is a particularly tricky time and many of us find that injecting a significant time before we eat breakfast helps. For me it is quite important that I inject before I get out of bed because my liver starts to release a flood of glucose as soon as I get up, so the sooner I can get that insulin into me on a morning the better. I then make my breakfast and potter on getting washed and dressed and have my coffee whilst I keep an eye on my CGM and I eat my breakfast when I see the insulin starting to bring my levels down. For me that used to be over an hour after injecting with my old insulin but just 30-40 mins with my current one which is one of the faster ones. In the evening I don't need nearly so much time between injecting and eating, usually 10-15 mins but in the morning I need much longer. I appreciate that with a mixed insulin you have less flexibility but keeping your insulin by the bed and injecting before you get up can be a useful strategy as long as you don't take the dog out for a long walk straight after you get up etc. You might only need 20 mins prebolus time, but it is helpful to experiment with extending the time if your levels still spike high when injecting 20 mins before breakfast.