Hi everyone

[Seal lady]

Hello, having developed type 2 diabetes around 15yrs ago I have managed my glucose levels well throughout this time with medication ( mainly metformin), however last year I was dangerously ill with covid in intensive care and as a result of this I’m now on insulin 4 times a day. I’ve struggled to keep my glucose levels within range so I decided to join Slimming World hoping shedding some pounds would help, however initially my levels went high which I couldn’t understand but discussing with my diabetic nurse 10 days ago she told me to cut right back on carbs and increase my insulin doses by 15% each time. This has reduced my levels and brought them predominantly within range. My problem now is I’ve started with hypos (3 in past 2 days) which is concerning me and I’m wondering if any members has any ideas or tips as to how I can reduce this happening and level things out. ( sorry it’s longwinded)

 

[Windy]

Hi @Seal lady welcome to the forum. I'm on metformin only, so can't answer your query, but hopefully some of the Type 1 and other insulin treated forum members will be able to advise.
Sorry to hear about the problems you've been having with your BG levels and hypos, and that it was precipitated by covid, that must be particularly difficult for you after you kept it steady with metformin up until then.
From the little bit I've learned from being on the forum, I've got a couple of questions, if you don't mind?
Have you got a continuous monitor fitted, or do you use finger pricks and a BG monitor?
Do you have to inject insulin, if so, what sort(s), or is it a pump?

 

[Lily123]

Welcome to the forum @Seal lady

Slimming World tend to focus more on cutting calories which may explain your struggles with levels. You could speak to your DSN for advice about reducing insulin as this may be the issue causing the hypos What insulins are you on?

 

[Lily123]

Hi @Seal lady welcome to the forum. I'm on metformin only, so can't answer your query, but hopefully some of the Type 1 and other insulin treated forum members will be able to advice.
Sorry to hear about the problems you've been having with your BG levels and hypos, and that it was precipitated by covid, that must be particularly difficult for you after you kept it steady with metformin up until then.
From the little bit I've learned from being on the forum, I've got a couple of questions, if you don't mind?
Have you got a continuous monitor fitted, or do you use finger pricks and a BG monitor?
Do you have to inject insulin, if so, what sort(s), or is it a pump?

@Windy unfortunately it’s in very rare circumstances that Type 2s are offered a pump

 

[Windy]

@Windy unfortunately it’s in very rare circumstances that Type 2s are offered a pump

Oh! Thanks for that @Lily123, I didn't know that. Cheers for letting me know. Sarah

 

[Bruce Stephens]

My problem now is I’ve started with hypos (3 in past 2 days) which is concerning me and I’m wondering if any members has any ideas or tips as to how I can reduce this happening and level things out.

It's kind of the obvious really: you need to inject enough to lower your blood glucose levels, but not too much or you'll go hypo. (There's several reasons the DUK magazine's called "Balance". (Or so I imagine. I've no idea of how the naming came about.))

The details are significant: what insulin (or insulins) are you using? What kind of patterns are you seeing in BG?

And for the details, you should certainly continue asking your DSN for help. Handling varying insulin doses isn't often straightforward.

 

[Seal lady]

Hi @Seal lady welcome to the forum. I'm on metformin only, so can't answer your query, but hopefully some of the Type 1 and other insulin treated forum members will be able to advise.
Sorry to hear about the problems you've been having with your BG levels and hypos, and that it was precipitated by covid, that must be particularly difficult for you after you kept it steady with metformin up until then.
From the little bit I've learned from being on the forum, I've got a couple of questions, if you don't mind?
Have you got a continuous monitor fitted, or do you use finger pricks and a BG monitor?
Do you have to inject insulin, if so, what sort(s), or is it a pump?

Hi Windy, I am still using finger pricks and monitor but when I’m next back in clinic I was going to ask about the monitor instead as my fingers are becoming sore especially having to check so often and extra if I’m planning going out in the car. Yes I have the disposable insulin pens I have a fast release one in the day called lispro for short and my slow night time release is Basal.

 

[Seal lady]

Welcome to the forum @Seal lady

Slimming World tend to focus more on cutting calories which may explain your struggles with levels. You could speak to your DSN for advice about reducing insulin as this may be the issue causing the hypos What insulins are you on?

Hi Lily 123, my insulin doses have been increased due to higher levels since joining slimming world 3 weeks ago and I use Lispro 3 times a day and Basal at night.

 

[Seal lady]

It's kind of the obvious really: you need to inject enough to lower your blood glucose levels, but not too much or you'll go hypo. (There's several reasons the DUK magazine's called "Balance". (Or so I imagine. I've no idea of how the naming came about.))

The details are significant: what insulin (or insulins) are you using? What kind of patterns are you seeing in BG?

And for the details, you should certainly continue asking your DSN for help. Handling varying insulin doses isn't often straightforward.

Hi Bruce, my BG was going up to 20 prior to increasing my dosage of insulin I use Lispro( shortened medical term) 3 times a day and Basal for overnight….

 

[Lily123]

Hi Lily 123, my insulin doses have been increased due to higher levels since joining slimming world 3 weeks ago and I use Lispro 3 times a day and Basal at night.

It may be worth getting in touch with your DSN as that amount of insulin may be too much for you, unless you are doing a lot of exercise before these hypos happen or the same thing every time then going hypo. What basal insulin are you using?

 

[everydayupsanddowns]

Welcome to the forum @Seal lady

Sorry to hear that your brush with Covid has left you with this little present. The pandemic really is the gift that keeps on giving isn’t it 😱

When I first read your post I imagined you might have been put on a mixed (twice daily) insulin, so it is great to read that you are on basal:bolus / MDI (both names for the separate slow acting and mealtime insulins). That is far more flexible and adjustable than a mixed insulin, and the extra jabs are well worth it!

Lispro is another name for Humalog, which is a rapid acting analogue insulin. It gets going over about 20-30 minutes, and lasts for about 4-6 hours after injecting, and some people (I was one) find that it has a bit of a ‘sting in the tail‘ with quite a lot of oomph left at the end of the dose’s expected duration. But these things vary from person to person.

Basal (or background) isn’t a specific insulin so much as a term for the slow acting insulin that is supposed to look after the glucose trickled out 24 hours a day by the liver to keep things ticking over. That is likely to be called something like Lantus, Levemir, Toujeo, Absalgar, Tresiba or similar. These have varying durations amd mostly are taken once a day.

In an ideal world, your nurse will give you skills, techniques and strategies to help you adjust your own doses - particularly matching your meal doses to take account of differing sized meals. This is called ‘carb counting’ and there’s an introduction to it 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

We have T2 members here on insulin who find it just as useful a technique as our T1s.

But in the early days it’s best to get dose adjustment advice from your clinic/surgery 🙂

 

[Seal lady]

Many thanks for your response to my post, I must say you explained the insulin types that I take really well and the article about the carbs I’ve found very useful. Again thanks for explaining..

 

[trophywench]

So, @Seal lady - your bolus insulin is Humalog, what is your basal insulin?

We ask this question because every different insulin has it's own pros and cons, so those of us that know (eg) that Humalog has a sting in it's tail - and suddenly has a little burst of effectiveness at about 4 and a bit hours, just when you'd expect its activity to be almost over and done with - or that eg Lantus has quite a peak after 4 or 5 hours - hence if you ask for assistance with whatever, we can suggest better tailored hints for you personally. That's all - just to try and be helpful ! 🙂