Humilin M3 and Humilin S

[Tina63]

My son has been on M3 for a while in the mornings to cover breakfast and lunch at school, then has recently gone onto Humilin S after school to cover evenings, and Lantus at bedtime (odd regime I know, but there it is!)

He is on fixed doses of all 3. Now he is testing 3 times a day it is obvious the doses are not enough and I appreciate I will need to speak to DSN to alter those (awaiting a call) but we have never been told how many carbs he should be eating.

When he was on MDI before, we just carb counted 1:10 for Novorapid and back then we got sensible figures with relative ease, I don't know now if I should be making sure he only has x amount of carbs with these other two insulins. We obviously eat different meals each day, though his lunchboxes tend to be pretty much the same for a week at a time, but he is still having spectacularly high BGs. We have never been told that he should have a meal equating to x amount of carbs and a snack or 2 for y carbs, so he is just carrying on as before nibbling whatever and whenever and having ridiculously high levels. Nothing anywhere near range yet.

 

[everydayupsanddowns]

When I was on mixed insulins (many years ago) I had a count for each meal that needed to be stuck to. So many grams for breakfast, lunch and eve meal.

So yes, my understanding is that if doses are fixed (on mixed or MDI) then they only work well if carb intake is set to regular amounts of similar GI/GL foods.

 

[Tina63]

That's what I thought. I am upping the veggies with our main meals and cutting carbs down, but unfortunately he is always in and out of the fridge and cupboards and snacks all evening long, even after we have gone up to bed. If I haven't bought something in specially, he has cereals, or a slice of bread, or cheese and crackers, it's all carby stuff. I guess it's a case of either dramatically cutting the carbs or dramatically upping the insulin. He won't cut his food intake, that I can guarantee. MDI worked so much better for him, but he simply won't inject at school or work, so this seemed the only solution. I am certainly not convinced it's doing any good so far though. His lowest reading (fasting) was 11.5, he has been as high as 26 over the past 48 hours. Hopefully his DSN rings soon (its her office day) so we can get adjusting things.

Thank you.

 

[Robster65]

Yes. What Mike said. 🙂

I would imagine the snacking is doing the damage. Especially if it's choc bars and other carb dense stuff.

A mars bar is much the same as a full meal.

Is he now taking the full doses every time?

Rob

 

[Robster65]

You'll find he'll pile weight on rapidly.

When running high, the body can't use the carbs (lack of insulin) so pushes some out through the kidneys (causing damage over long term) and fuels the body by burning fat and muscle. This makes badly controlled T1s thin.

When the insulin adjusts the BG down to normal levels, the calories from the carbs gets either 'burnt' as fuel for muscles or laid down as fat.

If he's taking in a lot of calories, he'll find they just stay around and his resistance will increase. Once he's got the hang of injecting and testing, he'll need to find a sensible calorie intake, which can include snacks, but maintains a reasonable body size.

He may be snacking because his body is craving carbs that it 'thinks' it isn't getting, because there's not enough insulin to convert them.

Once the insulin does its job, his brain won't tell him to eat so much and he can resist the urge.

SOrry it's a bit of a confused post but thinking as I go. Hard work! 😱

Rob

 

[Tina63]

We don't keep chocolate in, but he will literally eat anything he can find (and I do hide food too)! He comes in from school, tests and injects, so as he has eaten his lunch at morning break (10.30) he is pretty starving. He will eat anything from crisps, cereal bars, cheese & crackers, yoghurts, bread, hot cross buns, cereals and milk etc etc (ignores the fruit bowl!) then sits down to a full meal with us around 6, but carries on picking all the above all evening long. I dread to think how much he actually gets through in an evening, but the after school reading should be pretty reliable. Yesterday that one was 17.4! Bedtime was up to 23.0. He woke on an 11.5 this morning. If I hide most of the food, he starts on cups of tea with sugar in, that's what he did the other night before I had been shopping. I suppose I should hide the sugar, but I use it in my bread machine on a regular basis. He refuses point blank to use sweetners, though I do have them in too.

Not easy!

 

[Tina63]

No Rob, I do get it. He was grossly overweight before diagnosis and lost a dramatic amount in the weeks leading up to diagnosis. He is a compulsive eater, I would say that. We are overweight as a family, and I would say 75% of that is down to portion control for me and my husband, but our son just cannot stop eating. He has always had a massive appetite. Even as a breastfed baby (sorry) he piled a pound a week on for the first six weeks of his life. He was never satisfied. I look back and blame myself for feeling the more he ate the more he needed, but the damage is done now.

I do cook a good range of vegetables but he has started to get really picky over them now, so I now disguise them in things like shepherds pies and chillis, in fact tonight we are having a vegetable chilli, but he won't be satisfied with his meal. We just tend to have fruit, and maybe a yoghurt for dessert, then that's it until breakfast the next morning. He just can't stop eating though.

I do sometimes wonder if it is down to him wanting to lose weight. He has put a lot of his pre-diagnosis weight back on, but not all of it, but lately it has gone down a bit again, not that he has ever tested for ketones. He is overweight, so really does need to watch his eating, but he simply won't.

 

[Robster65]

I'm not sure how much cold be down to carb-craving from the high BGs and how much addiction or habit.

I've said it before, but diabetes in general does cause a certain form of eatign disorder to set in. Some control it well, while others can't.

I'm sure he will have an epiphany one day and become a health food freak who weighs everything (who'd do that? 😱) but until that day, he'll probably struggle with control and weight.

Not easy to change overnight, although I sort of managed it at 13. But I was more submissive and it left me with a lot of emotional 'issues' to deal with later.

Maybe rebellion is the way of getting it all out early on. Who knows.🙂

Rob