How stop blood glucose rising???

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Caroline1967

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Relationship to Diabetes
Type 2
Hi I have been using insulin for a couple of months now. For the first two weeks things were brilliant....at least on libre they were. I didn't finger prick and I am now not convinced the libre was measuring things properly. After the initial brilliant levels I have struggled to get below 12... nothing outrageous but my nurse said I should aim to be between 6 and 10 and I cannot get lower than 10. The nurse told me to go up 2 units every 2 days until I got below 10. I started on 14 units of humalin i daily and now am on 28 am and 20 pm so a huge increase of insulin. I am still not getting lower than 10.

I have noticed that I can be quite good over night....so 10 or 11 all night. Wake up at 6 am measuring 10 ish. I don't eat breakfast but my glucose steadily rises from when I get up. Today I hit 15 by 10.30 It then doesn't come down again until the evening, when it gets down to 10 or 11 again. Lunch doesn't seem to make much of a difference...might go up one point but not much more.

I know I should probably ring my nurse for some advice but I can't get a call back for 3 weeks so thought I would ask here first. Is there anything I can do to stop it rising during the day? I am a bit naive but I know that food makes it go up so surely if I am not eating it shouldn't be rising like this!
Thanks
Caroine
 
On a morning when we first wake up and sometimes even before we wake up, our liver starts to release glucose from it's stores to give us energy for the day ahead. This is referred to as Dawn Phenomenon or sometimes Foot on the Floor syndrome because our levels rise as we swing our legs out of bed and stand up and will continue to rise until we eat. If you don't have breakfast then your liver will continue to release glucose and in prehistoric days this was to give us energy to go out and hunt or gather our food, so if it didn't happen we would be at risk of starving because we wouldn't have the energy to go out and catch or find food. Unfortunately for those of us who are diabetic and our insulin production or usage is inefficient or ineffective, we can't deal with that glucose and it causes our levels to rise. Mine will rise by as much as 6mmols in the first hour after getting up unless I inject fast acting insulin to deal with it. You don't have fast acting insulin, just a long acting insulin which won't really be very effective in dealing with it or any food you eat, so your levels rise through the day.

When do you take your morning dose of Humulin I? If you take it after you have got up and perhaps got washed and dressed, then injecting it the moment you wake up may help a little, but you need to talk to your nurse about adding in a fast acting meal time insulin to your regime. In the meantime, it might help to have a small low carb breakfast like a boiled egg or a few nuts or a chunk of cheese as soon as you wake up and this may help to settle the liver down and stop it from continuing to release glucose.
 
Thanks, that is really interesting. I think I will start by having a bit of breakfast. I will book in an appointment with the nurse as although it is 3 weeks until I can speak to them...it will probably be another 3 weeks if I leave it any longer!
Thanks again

Caroline
 
Caroline1967 said:
I know I should probably ring my nurse for some advice but I can't get a call back for 3 weeks so thought I would ask here first.
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Have you at least booked the callback? If not then I would. We can give ideas here but we can’t make recommendations and it sounds like you aren’t confident/experienced in making adjustments yourself yet.
 
Yes I have just booked it....3 weeks though. I am going to check daily for cancellations. To be honest, I am a bit nervous about changing anything. I have upped the insulin like he told me to but have gone from 14 daily to 48 units daily and I am a bit worried about just adding more and more as it doesn't seem to be making much difference!
 
What is your diet like and are you able to exercise at all? I find exercise is a great way of lowering my insulin needs.
The insulin you are using is only designed to mop up the glucose that your liver releases so if you are eating a relatively normal diet with normal levels of carbs, your doses of Humulin I are also having to try to cover this which means you need more of it than you would if you were either eating less carbs or using a meal time insulin to deal with your food, so it may be that if the nurse starts you on a meal time insulin as well, you will need less of the Humulin I but at the moment it is trying to cover 2 jobs when it is only designed for one.
If you can give us an idea of what you typically eat in a day, then we can perhaps make suggestions which will help reduce the amount of insulin you are needing or at least help to bring your levels down into range a bit more, but as long as you are not going up into the high 20s, your levels shouldn't be overly problematic for another 3 weeks, but anything you can do to carefully bring them down a bit more is worthwhile.
 
I am eating about 100g carbs a day .. don’t eat breakfast, lunch and dinner..might snack in the evening but to be honest evenings aren’t so bad as mornings. Today I ate 2 slices low carb bread for lunch with cheese so about 8g carbs, Dinner was chicken and rice which was 24g carbs. Just had a yogurt which was 10g so less than 50g carbs. I think I probably eat more carbs on an average day to be honest. My first post should say I don’t go below 12. I don’t think I want to use more insulin before talk to my nurse but am going to definitely try breakfast and see if that helps. Can’t exercise during the day as I am at work from 7am. I am in holiday next week so will try a bit of exercise too to see if that helps.
Thanks for your ideas.
 
Caroline1967 said:
Yes I have just booked it....3 weeks though. I am going to check daily for cancellations. To be honest, I am a bit nervous about changing anything. I have upped the insulin like he told me to but have gone from 14 daily to 48 units daily and I am a bit worried about just adding more and more as it doesn't seem to be making much difference!
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There’s no maximum dose, most type 2s will be insulin resistant which can mean you need higher doses than type 1s generally do
 
Caroline1967 said:
Today I ate 2 slices low carb bread for lunch with cheese so about 8g carbs, Dinner was chicken and rice which was 24g carbs. Just had a yogurt which was 10g so less than 50g carbs.
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Bear in mind that low carb doesn’t suit everyone, my bgs are worse if I go too low carb. If that’s all you’ve eaten today then it doesn’t sound like you’ll be getting all the vitamins and minerals you need too. It’s important to get plenty of veg in, and a bit of fruit if you like, to make sure all the nutrients are there.
 
The amount of insulin needed varies enormously, but in general T2s need more than T1s, so if you are going by daily amounts reported on here by T1s you may be thinking your 48 units is high. My total daily dose of Levemir (basal or slow acting) is 68 units, plus I take Novorapid (bolus or quick acting) of 35 to 50ish in total a day, and I don't think this is considered particularly high.

It is normal to start on a very low and cautious dose and increase gradually until you hit the sweet spot. If you don't want to continue increasing the dose every 2 days perhaps try every 3 days?
 
Humulin just doesn't suit every human body in the world - eg like mine! I also did fine on it for a couple of years before it all went 'base over apex' and I still struggled to get it changed despite the problems it caused me until I physically moved location from Kidderminster to Coventry so (rather obviously!) saw totally different doctors.

(This can happen with any type of drug whatever the drug is designed to treat - just the same as my sister having glorious thick red hair and deep brown eyes and me having thick but very fine dark brown hair and piggy little hazel eyes - it just happens, is all.) So - you certainly need to discuss this !

Plus I entirely agree with breaking your daily fast - BUT not necessarily with a full 'meal' - try 'gong to work on an egg' whether that's a cold one you hard boiled the night before, or a freshy cooked one, or a piece of cheese, cold meat/fish, a bowl of left over from last night's dinner bolognese/chilli con carne without spag/rice or whatever warmed up in the microwave - just NOT shedloads if any, carbohydrate.
 
trophywench said:
Humulin just doesn't suit every human body in the world - eg like mine! I also did fine on it for a couple of years before it all went 'base over apex' and I still struggled to get it changed despite the problems it caused me until I physically moved location from Kidderminster to Coventry so (rather obviously!) saw totally different doctors.

(This can happen with any type of drug whatever the drug is designed to treat - just the same as my sister having glorious thick red hair and deep brown eyes and me having thick but very fine dark brown hair and piggy little hazel eyes - it just happens, is all.) So - you certainly need to discuss this !

Plus I entirely agree with breaking your daily fast - BUT not necessarily with a full 'meal' - try 'gong to work on an egg' whether that's a cold one you hard boiled the night before, or a freshy cooked one, or a piece of cheese, cold meat/fish, a bowl of left over from last night's dinner bolognese/chilli con carne without spag/rice or whatever warmed up in the microwave - just NOT shedloads if any, carbohydrate.
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Thanks for the reply. I hadn't really thought that different insulins suit different people. I have an appointment with the nurse in the middle of April so will discuss it with him then.
Also thanks for the idea of cold hard boiled egg! I struggle to find time to cook something in the morning....would rather have an extra 10 minutes in bed!!!
 
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