Hubby Stuck In His Ways

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Lynne888

Lynne888

Well-Known Member
Relationship to Diabetes
Type 2
Hubby was diagnosed type 2 over 25 years ago. He was given humalog and told to inject twice a day morning and evening. He still does this. Even if he’s not having breakfast he will still inject. This hasn’t been a problem as his BG would be quite high in the morning but now I’ve taken over with carb counting, his BG is more stable. It was 6 this morning and he’s taken humalog and not eaten. He just doesn’t see the wider picture of not needing to take it until he eats. He doesn’t understand the concept of injecting for the amount of carbs he’s going to eat because no diabetic nurse or consultant has ever told him to do this and he will always believe them over me of course. I’m not even sure Humalog is the best insulin for him now. What’s the best move here? The diabetic nurse left our GP practice a few years ago and had never been replaced. No one there seems well educated regarding diabetes. When I was diagnosed I was given an envelope with some websites to look at, told I didn’t need to count carbs and that I absolutely didn’t need a finger prick monitor so I don’t think he will get up to date advice there. Hoping if someone replies with good information he will take it on board.
 
Lynne888 said:
Hubby was diagnosed type 2 over 25 years ago. He was given humalog and told to inject twice a day morning and evening. He still does this. Even if he’s not having breakfast he will still inject. This hasn’t been a problem as his BG would be quite high in the morning but now I’ve taken over with carb counting, his BG is more stable. It was 6 this morning and he’s taken humalog and not eaten. He just doesn’t see the wider picture of not needing to take it until he eats. He doesn’t understand the concept of injecting for the amount of carbs he’s going to eat because no diabetic nurse or consultant has ever told him to do this and he will always believe them over me of course. I’m not even sure Humalog is the best insulin for him now. What’s the best move here? The diabetic nurse left our GP practice a few years ago and had never been replaced. No one there seems well educated regarding diabetes. When I was diagnosed I was given an envelope with some websites to look at, told I didn’t need to count carbs and that I absolutely didn’t need a finger prick monitor so I don’t think he will get up to date advice there. Hoping if someone replies with good information he will take it on board.
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Are you sure it is Humalog as I'm surprised that he is not having hypos if he does not eat after the morning injection.
Injecting just twice a day implies the insulin is either just a basal insulin or mixed insulin rather than a rapid acting insulin.
Are there any numbers/letters after the name which would suggest it is actually not rapid acting.
 
Lynne888 said:
It’s Humalog mix 25.
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Yes that would be a mix of fast and slow acting insulin.
Best to keep a good eye on his blood glucose if he is not eating. Usually people are advised to eat a certain about of carbs.
Not taking it would mean he would not be getting the slow acting basal part which is keeping him steady in the absence of food.
Maybe a chat with the GP or clinic to get a basal insulin and a separate bolus insulin so he could then choose not to eat and therefore not need to inject.
But if he is not having hypos then it may be working OK for him.
 
I’ve no practical help to offer as I’m not an insulin user but I just wanted to offer virtual hugs and sympathies as it must be hard to see someone you love not ‘own’ their medical condition.

I’m the sort of person that likes to know the nitty gritty of everything but my mum buries her head in the sand and it drives me crackers!! She takes the GP word as sacred and never does her own research or tries to help her own condition by changing lifestyle choices for example.

Keep getting the support on here. It’s a lovely group and a smashing place, even if you just want to vent a bit. Take care xx
 
Deb_l said:
I’ve no practical help to offer as I’m not an insulin user but I just wanted to offer virtual hugs and sympathies as it must be hard to see someone you love not ‘own’ their medical condition.

I’m the sort of person that likes to know the nitty gritty of everything but my mum buries her head in the sand and it drives me crackers!! She takes the GP word as sacred and never does her own research or tries to help her own condition by changing lifestyle choices for example.

Keep getting the support on here. It’s a lovely group and a smashing place, even if you just want to vent a bit. Take care xx
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I know just what you mean. Hubby thinks because the doctor told him it must be right and as we all know that’s not always the case!
 
He doesn’t understand the concept of injecting for the amount of carbs he’s going to eat because no diabetic nurse or consultant has ever told him to do this and he will always believe them over me of course. I’m not even sure Humalog is the best insulin for him now. What’s the best move here?

@Lynne888 He’s not on Humalog, he’s on Humalog 25, which is a mixed insulin. Although I sound like a pedant, it’s really important to give the full name of the insulin as they are quite different in the way they work and what they contain. Humalog 25 is mainly slow-acting insulin mixed with a smaller amount of fast-acting insulin. All the mixed insulins vary slightly in their modes of action but the graph below gives you a rough idea:

7B0C93D8-D062-4E69-B10E-3100E2B279E4.jpeg
If your husband reads the information about Humalog 25, he’ll see it says to inject within 15 minutes of a meal or straight after the meal. He shouldn’t be missing breakfast and injecting it. As you can see from the graph above, the fast bit of the mix starts working quickly (see that first peak). The slow part of the mix kicks in around late morning to help cover his lunch. He then injects again for his evening meal, with the fast bit releasing very quickly to cover his meal and the slow bit kicking in late evening to help control his blood sugar overnight.

If he misses meals, he’ll have insulin working with nothing for it to work on, so to speak, and he’s at risk of a hypo.

Show him the graph and get him to read the Humalog 25 info about injecting before/immediately after a meal.
 
Here’s a direct quote from the Patient Info Leaflet:

“You should normally inject Humalog Mix25 within 15 minutes of a meal. If you need to, you can inject soon after a meal.”
 
Inka said:
He doesn’t understand the concept of injecting for the amount of carbs he’s going to eat because no diabetic nurse or consultant has ever told him to do this and he will always believe them over me of course. I’m not even sure Humalog is the best insulin for him now. What’s the best move here?

@Lynne888 He’s not on Humalog, he’s on Humalog 25, which is a mixed insulin. Although I sound like a pedant, it’s really important to give the full name of the insulin as they are quite different in the way they work and what they contain. Humalog 25 is mainly slow-acting insulin mixed with a smaller amount of fast-acting insulin. All the mixed insulins vary slightly in their modes of action but the graph below gives you a rough idea:

View attachment 28951
If your husband reads the information about Humalog 25, he’ll see it says to inject within 15 minutes of a meal or straight after the meal. He shouldn’t be missing breakfast and injecting it. As you can see from the graph above, the fast bit of the mix starts working quickly (see that first peak). The slow part of the mix kicks in around late morning to help cover his lunch. He then injects again for his evening meal, with the fast bit releasing very quickly to cover his meal and the slow bit kicking in late evening to help control his blood sugar overnight.

If he misses meals, he’ll have insulin working with nothing for it to work on, so to speak, and he’s at risk of a hypo.

Show him the graph and get him to read the Humalog 25 info about injecting before/immediately after a meal.
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Thank you. He’s never had a hypo in 25 years. Amazing isn’t it. I don’t think his BG has been well controlled enough to ever get a hypo or for it to cause a problem not having breakfast.. no one from the surgery or hospital has told him any different but we are on it now.
 
Lynne888 said:
Thank you. He’s never had a hypo in 25 years. Amazing isn’t it. I don’t think his BG has been well controlled enough to ever get a hypo or for it to cause a problem not having breakfast.. no one from the surgery or hospital has told him any different but we are on it now.
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Hypos are (or absence of.) not a “symptom” of great management or a standard of “poor” steering of his diabetes. Does your husband use a CGM/flash monitor?
 
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