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I'm quite new to this only being diagnosed in December and would just like to ask a questions

MikeModelsky

MikeModelsky

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Relationship to Diabetes
Type 2
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As I said, it was only diagnosed in December and was put on Novamix 30

I’m currently at following their advice every three days to raise it by four units on 100 units of a night time and 104 in the morning is this a normal dose and any thoughts on whether it’s safe? I had a phone consultation and was told to just keep up in it even if I had to give myself two injections in the morning too at night, but I’ve had no further contact just wanted to get thoughts and opinions from people, and any help would be appreciated.
 
Hi @MikeModelsky and welcome to the forum

Unfortunately, I am unable to answer your question, but I'm sure someone with the relevant experience will come along shortly with some answers for you from their personal experiences.

Please note that we are not medically trained, so can only give our opinions on any questions asked, that said we do have combined knowledge on most aspects of diabetes

Alan 😉
 
MikeModelsky said:
As I said, it was only diagnosed in December and was put on Novamix 30

I’m currently at following their advice every three days to raise it by four units on 100 units of a night time and 104 in the morning is this a normal dose and any thoughts on whether it’s safe? I had a phone consultation and was told to just keep up in it even if I had to give myself two injections in the morning too at night, but I’ve had no further contact just wanted to get thoughts and opinions from people, and any help would be appreciated.
Click to expand...
I can't help with the insulin question but I'm quite surprised you have been immediately put on insulin unless you HbA1C was extremely high so would you like to say a bit about your diagnosis as it may help people answer you question.
The insulin you have been prescribed is a mixture of slow release insulin which keeps blood glucose even throughout the day and night and a quicker acting insulin which deals with the carbohydrates in your meals but that means you should eat a particular amount of carbohydrates for the dose of insulin.
I assume you must have a blood glucose monitor to test frequently your blood glucose levels as that will ensure you are safe.
I would think you have been put on a conservative dose initially in order to bring you level down slowly but you really need to contact whoever prescribed the insulin for more support, or failing that your GP.
 
Those are quite high doses of insulin and suggest you are experiencing some considerable insulin resistance. Do you need to lose much/any weight? Have you been given any dietary advice along with taking the insulin? Are you able to exercise at all as that can really help insulin resistance. Doesn't have to be overly strenuous, a walk around the block after a meal can help a lot, or chair exercises if you are not mobile.

Hopefully you have been given test strips and given advice about hypos and how to deal with them and told to carry hypo treatments with you at all times including by the bed at night and in all your coat pockets etc.

What sort of readings are you seeing when you do finger prick tests and when are you testing?
 
@goodybags Are you sure about that? Generally standard insulin is 100units per ml and there are 3mls in a pen, so 300 units? I don't have NovoMix but I would expect it would be the same.... as most pens contain 3mls of insulin.
 
Oh and please excuse my bad manners! 🙄 I should really have started by saying "Hello, and welcome to the forum!"
 
goodybags said:
You are correct there @rebrascora my mistake I’ve just checked on my NOVAMIX FlexPen and you are correct, each pen INDEED contains 100 x 3mls units so yes each pen actually contains not 100mls but. 300mls

I shall edit my post .. oops 😱 :D hope I’ve not confused anyone
Click to expand...
No I think the whole pen is 3ml. 300ml is a large drinking glass.
 
@goodybags

Afraid you still haven't got it right..... Each pens contains 3mls of insulin and each of those mls contains 100 units, so each pen contains (3x100units) ie. 300units of insulin in each pen.
 
I would not say that they are high insulin doses. And think it is wrong for anyone to describe them as such.
They are higher than many but it is often said that there is little point comparing insulin doses because there are so many things which can determine your dose such as how much you weigh, what you are eating, how much exercise you are doing, are you drinking alcohol, are you stressed, unwell or injured, how insulin resistant are you, how much insulin is your body producing.

For example, when I had surgery on my broken elbow, I was doing no exercise, I was advised to drink no alcohol, I was stressed and in pain and and my body was healing itself from the surgery. I was also comfort eating. My dose was more than 50% higher than a “normal day” which is typically 30% higher than a holiday when I am chilled and doing lots of exercise.
Plus I am considerably smaller that an average person so even with the broken elbow, my dose is lower than many people.
 
Thanks a bunch for all your answers and the questions!



I’ve got a few things to explain. I’d love to hear any advice you have, too, if it can help me manage my diabetes better.



I was diagnosed with diabetes during the pandemic and started taking Metformin. But it didn’t work well for me. So, I tried a ketogenic diet, which helped with my epilepsy and even lost about 20 pounds. That definitely affected my diabetes, though. My HbA1c was now borderline pre-diabetic, and my doctor told me to stop taking Metformin. But there was no follow-up, and no discussion about lifestyle changes.



Almost two and a half years later, I got some blood tests, and my HbA1c was sky-high. I was rushed to the local diabetic centre and started taking the Nova mix 30 insulin in December 2024. I started with 32 units in the morning and 28 units in the evening, and I had to increase it every three days until my blood sugar was between 5 and 10 units per day. It now is at around 7 in the morning and 8 before dinner, and im injecting ow on 104 units am and 100 units pm.

It took about three weeks, and then I got a call to start Monjarro insulin in January. I started that last Monday because I’ve been really sick with Covid for the past six weeks. I’m only just starting to get up and walk around again.



I’ve had a few questions, so I’ll try to answer them below to give you a better idea of what’s going on.



I’m really overweight. I’ve been living a sedentary lifestyle for the past year, more so than ever before, because of a back injury from an epileptic seizure. But I’m feeling better now and can move around, though it’s caused me to gain a lot of weight.



I haven’t really been given any advice on what to eat, other than to increase my protein intake to stay fuller for longer.



If you have any more questions, I’d be happy to answer them in any way I can to give you a clearer picture of my current situation. I’m also open to any advice that can help me manage my diabetes better and improve my overall quality of life in the long run.

I have also added a profile picture which was taken around July. It may not be the best to judge my size but it gives you a visual reference.

Thank you so much for all your replies. This is really appreciated.
 
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MikeModelsky said:
It took about three weeks, and then I got a call to start Monjarro insulin in January.
Click to expand...
I'm sorry I can't help with the insulin questions as I don't take insulin or often work with patients that do.

But, I think it's important for you to be aware that Mounjaro is not an insulin. It's a dual GLP-1 and GIP receptor agonist, meaning it mimics the effects of both incretin hormones (gut hormones that increase insulin secretion after eating).

This dual action helps regulate blood sugar in multiple ways, by enhancing insulin secretion when blood sugar is high, decreasing the amount of glucagon (a hormone that increases blood sugar) produced by the liver, delaying how quickly food leaves the stomach (making you feel fuller for longer) and increasing insulin sensitivity.

Because of these combined effects, Mounjaro lowers blood sugar levels, supports weight loss, and improves metabolic health.
 
mde said:
I'm sorry I can't help with the insulin questions as I don't take insulin or often work with patients that do.

But, I think it's important for you to be aware that Mounjaro is not an insulin. It's a dual GLP-1 and GIP receptor agonist, meaning it mimics the effects of both incretin hormones (gut hormones that increase insulin secretion after eating).

This dual action helps regulate blood sugar in multiple ways, by enhancing insulin secretion when blood sugar is high, decreasing the amount of glucagon (a hormone that increases blood sugar) produced by the liver, delaying how quickly food leaves the stomach (making you feel fuller for longer) and increasing insulin sensitivity.

Because of these combined effects, Mounjaro lowers blood sugar levels, supports weight loss, and improves metabolic health.
Click to expand...

Thank you, that’s much appreciated. I know that it’s not insulin from all the literature I was given. In fact, I was actually given more information about that than I was about diabetes or insulin.
 
Hi @MikeModelsky welcome to the forums and as I only take 1 table of metformin a day (and hopefully none in the near future) I can't really comment on the question of insulins and Mounjaro. However on the subject of food, and beating @rebrascora and @Leadinglights whilst acknowledging that my what to eat advice is based on their advice to me :D the recommendation is to reduce starchy carbs such potatoes, pasta, rice and bread and to limit your intake of other carbs with an aim to keep to 130 grammes of carbs per day. This has certainly worked for me and many others on this site. You probably don't need to go back on to a keto diet although, as that has helped you previously you might feel it worth another try. As others here often warn though, sudden material reductions in carbs can have an impact on other parts of you including your eyes.

Recommended website is https://lowcarbfreshwell.com/ which provides advice and guidance around the move to a low carb diet and the reasons why you may want to do it. There is also an app you can keep on your phone which has the recipe information.

If you are now able to move around a bit more, then a little regular walking will also do you the world of good.
 
Just a warning regarding going back to a Keto diet when you are on mixed insulin particularly but indeed any insulin.... your insulin is supposed to act on the glucose released from carbohydrates in your meals. If you drastically reduce the carbs you eat, you risk going hypo.
If you were on a different insulin regime where your long acting and meal time insulins were injected separately, going Keto would be possible as you would simply not inject the meal time insulin but you would still have the slow release basal insulin to deal with the glucose released by your liver. When it is mixed with the meal insulin. you can't do that and if you don't inject the long acting insulin you risk Diabetic KetoAcidosis which is a potentially life threatening condition which can come on very quickly. It is rare in Type 2 but can happen particularly if your body is very low on insulin production which can happen if you have significant insulin resistance for any length of time.

Levels between 7 and 8 before meals are not too bad at all, so it may be that your doses are somewhere near right and the Covid infection you have had has caused your insulin needs to rise, so do watch out for levels starting to drop and perhaps needing to start reducing those doses. Those of us on insulin have to learn to adjust our doses as needed to try to balance our levels. It is an ongoing challenge to get the dose right so we are not too high or too low.

In your position I would ask for a referral to a diabetes dietician because you need specialist advice particularly because you are using a mixed insulin.
You might also benefit from a 15 day free Libre 2+ trial if you haven't used Libre before. It may help you to spot foods which are causing you particular problems and help you to reduce portion size or cut those foods out whilst being able to keep a close eye on your levels not going too low.
 
JimmyBlue said:
Hi @MikeModelsky welcome to the forums and as I only take 1 table of metformin a day (and hopefully none in the near future) I can't really comment on the question of insulins and Mounjaro. However on the subject of food, and beating @rebrascora and @Leadinglights whilst acknowledging that my what to eat advice is based on their advice to me :D the recommendation is to reduce starchy carbs such potatoes, pasta, rice and bread and to limit your intake of other carbs with an aim to keep to 130 grammes of carbs per day. This has certainly worked for me and many others on this site. You probably don't need to go back on to a keto diet although, as that has helped you previously you might feel it worth another try. As others here often warn though, sudden material reductions in carbs can have an impact on other parts of you including your eyes.

Recommended website is https://lowcarbfreshwell.com/ which provides advice and guidance around the move to a low carb diet and the reasons why you may want to do it. There is also an app you can keep on your phone which has the recipe information.

If you are now able to move around a bit more, then a little regular walking will also do you the world of good.
Click to expand...
I don't believe I suggested to the OP they should adopt a low carb regime as in the Freshwell program as they are taking insulin. The suggestions for 130g carb is for those on oral medications NOT insulin.
 
Hi @MikeModelsky I was going to post earlier today, in-fact thought I did but looks like having started the reply, I hadn’t hadn’t pressed the blue reply button and not posted the comment.. oops

Mike, I’ve been on Mounjaro since June last year & previously other medications that are whilst not the same (are similar)

the first time I was taking these kind of weekly injections, I’m sure that was when I was referred by my DSN or maybe 🙄 my GP - to a dietitian (ok it was only a phone consultation but was very worthwhile)
I see @rebrascora has already recommended that to you

also as she suggested, I would recommend it’s worth trying a CGM (if you haven’t ever asked before) as both DexcomOne+ & Abbott Freestyle Libra2Plus, are available to all diabetics, on free trial (Dexcom the sensor if free but they charge £4.99 P&P)

Regarding Mounjaro (whilst taking insulin)
incase you weren't already aware Mounjaro for a minimum of the first month, you will be the introductory dose of 2.5Mg PW
but as you increase, sometimes this can be after a month or for some people it can be longer between increases, you will most likely need a reduction of the insulin infact I think I retry much as soon as I started on MJ was reducing my insulin
plus
as you will be loosing weight so will most likely require less insulin anyway
P
the second stage Is after the introductory dose of 2.5mg
Is on to 5mg
then 7.5mg
then10mg
the maximum dose is actually 15mg PerWeek
(which my GP still says he would like me to move up to possibly in a month or 2 (I’m currently just transitioning to the 10Mg from the 7.5mg) we are all different also now taking almost half the insulin I was in May/June last year

I know other people who were ready to increase their MJ dosages on the 2nd then 3rd month, equally I know others who stayed on the lower doses at 2.5/5mg

whilst I’m posting 😳 my apologies for any confusion
yesterday I responded to your original post @MikeModelsky, I got confused between units (units and ml) and the total contents of a NovaMix30 pen, my mistake :thankyou: hope I didn’t confuse anyone

anyway I have since deleted that post, yes … sometimes I waffle & ramble, im not an expert myself, but happy to share my experience 🙄 hoping to help someone else
hey - as they say, everyday is a school day
 
Just wanted to apologise for taking such a long time to reply unfortunately I’ve been slightly unwell and in hospital so this has been my first opportunity, I was placed on 5 mg of MJ around two weeks ago and I’ve seen a significant drop in the amount of insulin needed, however I have noticed a side-effect of severe dizziness, it’s almost like having a hypo but my blood is still at 7/8 mmol/L.

I wanna thank everybody for their help and advice as it’s all been really useful and informative especially as contact with my diabetic nurse is in frequent and an appointment at my GP. I may literally have to pay an arm or a leg for, I will definitely look into the continuous blood glucose monitor, once I’m slightly more back on my feet.

I would be interested to know if anyone has experienced severe dizziness with their Mounjaro?
 
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