Hi new to forum been T2d insulin dependant 6 years never been able to maintain stable glucose levels

[John Eccles]

My levels have never been stable regardless of several interventions e.g. strict diet control, negative carbs, and even not eating. Never had an hypo and glucose levels still unstable with a range of 8 to 16.
My biggest query is how can glucose levels rise or have minimal decrease even when no food is consumed.
I am constantly modifying my insulin dose and now after 6 years feel the high constant levels are detrimental to my health and wellbeing

Cheers john

 

[Ljc]

Hello @John Eccles , Welcome to the forum. I am sorry to here your still having problems after going on insulin.
A little more info will help us help you.
What insulin’s are you on.
I am assuming that you are on a basal bolus regime like me ( that’s a long acting background Insulin given once or twice daily, with a rapid insulin for mealtimes) have you been taught how to match your rapid insulin doses to the carbohydrates you eat .

Are you under the GP / GP practice nurse for diabetes or the hospital where the nurses , doctors and dietitians are specialists.

Can you give us an idea of a typical days meals/treats as we may be able to suggest some changes.

Do you test just before you eat then two hours after starting to eat , to see what the difference is

Sorry for all the questions, it’s just that they will help us tract down where the problem may be.

Some of us can be very resistant to insulin, whether injected or our own, which I am wondering may be the case with you. Metformin is often given to counteract this, which is fine if you can stomach it

 

[John Eccles]

Thanks for replying I am at my wits end over this.
I am on novomix 30 twice daily and not been taught how to match insulin v carbs.
I have a diabetic nurse and even she can't give accurate regime despite offering many strategies and numerous alterations to my insulin dosage.
I check my levels before each meal.
I have a relatively good diet and variation . I am not a lover of bread or potatoes but opt for rice or pasta. I generally have cereal for breakfast and a snack and fruit for lunch and always a cooked meal or generous salad in the evening occasionally i do have an indulgent sweet.
I have been on tablets plus insulin previously but was unable to tolerate metformin and glicazide just about worked dropping my levels by 3 or 4 points. Each of the regime's and strategies used over the years have initially worked but but never achieved the 7 or below and 3 or 4 weeks later they rose again.
I am so worried as recently read that readings above 10 start to damage the organs, eyesight, circulation.
I have never had an episode of low blood sugar.
Hope this helps to get me at an acceptable level for optimum health

Regards john

 

[Ljc]

Hi . That’s a big help. I can already see where some more changes are likely to help you.
Metformin is often called Metfartin here for obvious reasons lol.

Ok here goes
Most of us on here find that reducing our carbohydrates improves our control , especially the fast acting carbs, ie potatoes esp mashed, rice, pasta, bread esp white, breakfast cereals , we need to be careful with fruit esp those that originally came from warmer climates, grapes are little sugar bombs , fruit juice is grand for hypo treatmeant other than that we should avoid it, things made with flour esp white.
Now I know that probably sounds horrendous however their are good substitutes.

We often tolerate berries better .
Just to give you a few ideas.
Many here have Burgen linseed and Soya bread or a high protein bread, you may do well on wholemeal bread.
We usually have no problems with protein or good fats, so if you eat meat , it’s fine even high meat content sausage and burgers, eggs, cheese, butter, cream, some nuts are low in carbs , veg that grows above ground .
Cauliflower and broccoli can be or bought riced to have with a curry, chilli etc.
Some here have cauli mash instead of mashed potato.

I am also wondering if mixed insulin is the best option for you but other than what I have read on here I have no experience with them, so I will leave that to others perhaps @Northerner or @everydayupsanddowns can advise.

You will probably find thesethreads and blogs helpful .
what-did-you-eat-yesterday

test-review-adjust. By Alan S

Then take your time reading through the T2 section of this thread
useful-links-for-people-new-to-diabetes.

We all have occasional treats.

Please keep asking question @bout Diabetes, we’ll do our best to help.

 

[everydayupsanddowns]

Hello @John Eccles, Welcome to the forum!

Novomix 30 is a fairly difficult insulin to use if your body is producing little of its own insulin.

The fact that your BGs rise when you are not eating anything might indicate that your own insulin production is limited or almost non-existent. You could have a c-peptide test if your surgery are interested in finding out.

It may be that you were classed as t2 largely because of age, but T1 or LADA (and various other types) can develop at any age. There are also T2 variants where the islet cells in the pancreas 'burn out' from overproducing insulin over the years.

In any respect there are some things about your story that seem to suggest you may be needing total insulin replacement rather than a small additional 'top-up' of your own supply. In which case moving to Multiple Daily Injections (MDI) otherwise known as basal:bolus might be a better, more flexible option for you as you can separate the insulin you need for 'background stuff' and the insulin you need for food, and take the appropriate amounts of each.

This is a conversation you are best having with your Dr and/or the local hospital if your GP is happy to refer you for support there.

In the meantime, you could consider cautiously reducing the amount of carb you are eating (alongside increased BG checks) to see if eating lower carb can help your BGs without going too far and dropping into hypo territory.

Hope you get some answers and let us know how you get on.

 

[John Eccles]

Thankyou for this information especially explaining the rise in BG when not eating will definitely discuss the issues raised as a possible route to control and stability