Help - type 2 new to insulin

[GXT]

I’m a 10+ year Type 2 - previously using Metformin and Jardiance - posted a couple of months back that I’d been taken off Jardiance due to high ketones, following that my Hb1Ac readings that would normally vary from high 6 to 8 have now been 10.8 and 11 last two months - I’m now taking insulin for the last month and it is having no effect - slowly increasing the dose every couple of days but my morning BS is high 13-15 (every morning) and it doesn’t reduce much during the day and never going below 10 - I’m up to 50 units Ryzodeg before dinner and from today an additional 15 units before lunch - I’m not eating many carbs at all and I’m increasingly feeling frustrated that I can’t control my BS - any similar experiences?

 

[Inka]

First time I’d heard of Ryzodeg @GXT Are you on the 70/30 mix? Are you taking it at breakfast too? If it is the mix you’re taking, the proportions simply might not suit you, and it could be you’d be better off on two separate insulins - slow/basal and fast/bolus/meal. That way you could adjust each insulin type separately, hopefully leading to better control.

But as you’ve only been on this insulin a month, personally I’d give it a little longer to try adjustments to see if you can find something that works. If not, ask about the regime I’ve described above, which is known as basal/bolus.

 

[GXT]

First time I’d heard of Ryzodeg @GXT Are you on the 70/30 mix? Are you taking it at breakfast too?

Hi Inka, thank you for replying - I am on 70/30 mix and no just before lunch and dinner - generally I skip breakfast - I had a banana today for lunch (I’m desperately trying to lose weight as I’ve put weight on since coming off Jardiance) BS was 14 before the banana and 2hrs later it was 13.7 and that’s with 15 units of Ryzodeg. I’m not spiking above the current base level after food as I’m being very careful it’s just I can’t seem to get my base level down to a reasonable/good level. In the past (on Jardiance) I would wake and the highest it would be is 9 max and during the day would come down to low 5s or even high 4s sometimes - it’s so worrying and frustrating.

 

[Lucyr]

I’d been taken off Jardiance due to high ketones, following that my Hb1Ac readings that would normally vary from high 6 to 8 have now been 10.8 and 11 last two months - I’m now taking insulin for the last month and it is having no effect

Were you eating low carb whilst on the jardiance or have you only started that since switching to insulin?

Low carb is not recommended whilst taking jardiance (empagliflozin) because of the ketone and DKA risk, so it may be that the jardiance would have been ok for you with more carbs. Low carb can also make you more insulin resistant so it could be that low carb just doesn’t suit you and a few more would allow your body to better use the insulin?

 

[Docb]

Hi @GXT and welcome to the forum. I see you are posting from Singapore. We are a UK based forum and welcome members from other countries but it is often sensible to clarify things up front because differences in medical protocols can lead to confusion if not recognised.

Is Ryzodeg insulin commonplace in Singapore? It is the first mention i have seen of it on the forum although I am not an insulin user and might have missed something.

 

[Inka]

It’s good the food isn’t raising your blood sugar @GXT but a banana doesn’t seem much food. I’d speak to your nurse about the possibility of a further insulin increase, and see how that works before considering asking for a change of insulin/regime.

 

[trophywench]

A mixture of insulins degludec and aspart, from Novo Nordisk, hence in UK terms 70/30 of Tresiba and Novorapid.