Holiday, extra food and insulin!

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Caroline1967

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Relationship to Diabetes
Type 2
I finally seem to have got things under control. I have been using insulin since January and have moved onto Humulin M which covers my meals well and the highest I tend to go is about 13 or 13 straight after eating. All good! I am about to go on a cruise and I know I will eat higher carbs and at different times. I am not sure that my dose will cover it. At the minute I take 36 units am and 20pm. Can I take more if I notice I am getting highs? I have a libre so will be able track whether I am going high.
If anyone can help I would be really grateful. I know I could ring my surgery but to be honest I don’t think I have the energy to!!!
Thanks
 
Caroline1967 said:
I finally seem to have got things under control. I have been using insulin since January and have moved onto Humulin M which covers my meals well and the highest I tend to go is about 13 or 13 straight after eating. All good! I am about to go on a cruise and I know I will eat higher carbs and at different times. I am not sure that my dose will cover it. At the minute I take 36 units am and 20pm. Can I take more if I notice I am getting highs? I have a libre so will be able track whether I am going high.
If anyone can help I would be really grateful. I know I could ring my surgery but to be honest I don’t think I have the energy to!!!
Thanks
Click to expand...
When are you going?
Would you have time to swap to a more flexible basal /bolus regime and get used to that.
The disadvantage is by taking extra to cover extra carbs you would also be increasing your basal insulin which may then cause a problem.
I'm sure some others on insulin will be able to comment or ask your diabetic nurse about your concern.
 
Using a mixed insulin makes it more difficult to adapt to bigger meals.
Could you talk to your team about adding in a quick acting bolus which you can then adapt.
 
No you can’t change your doses on a mixed insulin regime to adapt to different kinds of food. You need to stick to the same carb count at the same time each day. The best you can do is some exercise when eating extra carbs to help offset it.

This is why mixed insulin is only really used for those who can’t do their own injections. When are you going? Can you switch to seperate basal bolus insulins in advance?
 
Thanks for the replies. I am going a week on Sunday so may have left it a bit late to do anything. I guess I will just have to hope i can find something decent to eat which isn’t too bad!
 
Caroline1967 said:
Thanks for the replies. I am going a week on Sunday so may have left it a bit late to do anything. I guess I will just have to hope i can find something decent to eat which isn’t too bad!
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My experience of cruises is there is so much choice for meals that you should be able to find things which are suitable. The problem may be more that knowing the carbs in the food will be difficult but they should have that information available if you ask.
 
Caroline1967 said:
Thanks for the replies. I am going a week on Sunday so may have left it a bit late to do anything. I guess I will just have to hope i can find something decent to eat which isn’t too bad!
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You might also have to watch the timings of the meals, particularly lunch. When I was on mixed insulin, I found the slower part kicked in late morning and I’d have a hypo if I didn’t eat lunch at the right time. I also suggest you stock upon snacks in case you need to compensate for a later meal.
 
Thanks. At the minute I have lunch at 12 but I know it will be quite a lot later as a lot of my day trips don’t get back to the ship until 2pm so I will have something to eat then.
I have realised it is actually 2 weeks until I go but I think that is probably still too short notice to actually change insulin. I should have thought of this ages ago! I know going high as a type 2 isn’t the end of the world but I feel rubbish when I am over about 14 and I suspect that will happen while I am away!
 
Mixed insulin can be a bit rigid and inflexible unfortunately :(

Like @Inka I found that the timings as well as the quantities of carbs needed to be ‘adhered to’. Which sounds like it might be quite difficult on the cruise.

With a fortnight to go I’d be half tempted to ask about the switch so that you have the additional flexibility. Though I appreciate it feels straightforward to me as I’ve been on basal/bolus for decades!
 
Your mixed insulin is not going to like the later lunches, so if you stay on these injections you will need to eat at 12 instead of a late lunch

With two weeks to go I would definitely ask about switching or at least taking some rapid acting bolus to deal with extra cabs/late meals. You will still need carbs at your normal times to match the mixed insulin.

If the bolus insulin is not available/possible/seems too big a change at this stage, you can make use of the exercise facilities or deck walks or dancing to reduce your glucose levels post meal.

Let us know how you get on.
 
Breakfast will almost certainly be self-service. There will be rolls, cheeses, cold meats, fruit, yogurts etc available. Make yourself a packed lunch (take a box/bags to put it in) at breakfast time, then you can eat it while out on your trip. When you return, you can always go in for a second lowish-carb lunch eg soup or meat/veg/salad etc if you want.
 
Caroline1967 said:
Thanks. At the minute I have lunch at 12 but I know it will be quite a lot later as a lot of my day trips don’t get back to the ship until 2pm so I will have something to eat then.
I have realised it is actually 2 weeks until I go but I think that is probably still too short notice to actually change insulin. I should have thought of this ages ago! I know going high as a type 2 isn’t the end of the world but I feel rubbish when I am over about 14 and I suspect that will happen while I am away!
Click to expand...

I don’t think it’s too short notice @Caroline1967 If having to eat an early lunch will ruin your cruise, then swap your insulins. Maybe I’m greedy, but I’d hate to have to eat some kind of bread roll lunch at 12 and then miss out on a posh lunch at 2pm. I know you could still nibble non-carby things but it would be a bit sad. You might also resent ‘wasting your money’.

I remember swapping to a basal/bolus regime. The actual insulin amounts were fine. The only thing that freaked me out a bit at first was having to have an injection at lunchtime. But I gradually realised how much more flexibility that gave me re the timing of lunch, as well as the carb amounts.

Ask your GP about swapping. You could still keep the same basal insulin from the Humulin M3 by using Humulin i (isophane) as your basal, then add in a bolus insulin of your choice. Two weeks would give you time to get used to the regime. In fact, I think a week would be enough time to get used to it.
 
Thank you for everyone's help. I spoke to my nurse today and he prescribed Novorapid and Tresiba. These should help me avoid too many highs while I am away.
Just to make you laugh
I was prescribed a novo pen and a pen for theTresiba, insulin of both kinds and a libre.
I went to the pharmacy and they have the novo pen and the insulin, the Tresiba is out of stock and the nurse never prescribed the pen, the libre has gone to some other random pharmacy which I am going to have to trek out to tomorrow as it is not local to me! I know everyone makes mistakes so I am not annoyed.
I phoned the doctor to request the other pen - the receptionist has sent the nurse a note which he will act upon tomorrow.

I have just had an email from pharmacy 2U (which I usually use) to say they have a prescription for novorapid and pen, tresiba insulin and a random trurapi prefilled pen (which I don;t think is my missing pen!!)

Another phonecall tomorrow I think!
I am hoping to start using this all soon so I hope it can all be sorted soon.
Thanks again for your help.
 
Pleased that you have switched. With a bit of sorting out this should be far more flexible and you can now enjoy your meals at times that suit you, so that should make cruising a lot easier.
 
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