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Is my dose, high or low?

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Seansmit17

New Member
Relationship to Diabetes
Type 2
I am T2 but my HBA1C has always been 70+

I was on all the pills for my BS but nothing got it to be below 10 consistently. Activity and diet wise I had to be walking or my case working but walking about 14 miles a week or about 3 a day along with eating next to nothing for my BS to stay below 10.

After years and years and years of this I have finaly been put on insulin and taken off all but one of the pills (Empagliflozin).

I am now on Toujeo once a day and NovoRapid with meals.

I am still adjusting the dose to suit my needs but so far I am taking 26 Units of Toujeo at night and then 10-16 units of NovoRapid depending on what I eat.

The thing I want to know is how the dose compares to a T1. I have looked about on google but cant seem to find an answer.
I would hope the does I am taking is much lower than what someone who is T1 taking.

I have been on the Toujeo for 6 ish weeks and the NovoRapid for 2/3 weeks. My August HBA1C was 83, last week it was 77. I am hoping after a full 3 months on both inulins my HBA1C will come right down. Fingures crossed.

Cheers
 
Seansmit17 said:
I am T2 but my HBA1C has always been 70+

I was on all the pills for my BS but nothing got it to be below 10 consistently. Activity and diet wise I had to be walking or my case working but walking about 14 miles a week or about 3 a day along with eating next to nothing for my BS to stay below 10.

After years and years and years of this I have finaly been put on insulin and taken off all but one of the pills (Empagliflozin).

I am now on Toujeo once a day and NovoRapid with meals.

I am still adjusting the dose to suit my needs but so far I am taking 26 Units of Toujeo at night and then 10-16 units of NovoRapid depending on what I eat.

The thing I want to know is how the dose compares to a T1. I have looked about on google but cant seem to find an answer.
I would hope the does I am taking is much lower than what someone who is T1 taking.

I have been on the Toujeo for 6 ish weeks and the NovoRapid for 2/3 weeks. My August HBA1C was 83, last week it was 77. I am hoping after a full 3 months on both inulins my HBA1C will come right down. Fingures crossed.

Cheers
Click to expand...
It does vary greatly between individuals as said above, but in general T1s take less, often much less, than T2s. Your present doses of both basal and bolus insulins (assuming the NR is per day not per meal) are less than half mine. It is common to start people on low doses, to minimise the risk of hypos, as they can make an educated guess based on your weight what you might need but their guess may be way out! Don't be surprised if you have to keep increasing your doses (with advice from HCP) before your levels are roughly where they should be. It is best if this is done gradually.
 
Our insulin doses vary hugely.
It depends on things like how much we weigh, how many carbs we eat, how much exercise we do, whether we have insulin resistance, how much stress we have, whether we are ill, how much alcohol we drink, ...
My dose varies day to day depending on many of this criteria (apart from my weight which doesn't change much). I could take anything from half your total daily dose (TDD) to about half as much again of your TDD.
 
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Type 2s tend to need much more insulin than type 1s because they have insulin resistance, most type 1s don’t have that. But you need however much you need to keep your blood sugars under control, what anyone else takes is completely irrelevant to you, everyone is different.
 
My total dose used to be about 90 units but has dropped to 80 as I have converted fat to muscle. I believe percentage body fat is an important marker often ignored by health professionals who obsess about BMI with a simple equation that is incorrect for both the short and the tall!
 
The thing I want to know is how the dose compares to a T1. I have looked about on google but cant seem to find an answer.
I would hope the does I am taking is much lower than what someone who is T1 taking.

Why? Are you thinking that a smaller dose than a Type1 would mean more of your beta cells were working? I don’t understand why you’re asking. Most Type 2s take more insulin than Type 1s due to insulin resistance. Type 1 and Type 2 are two very different conditions. I’m Type 1 and take less insulin than you - but it doesn’t matter at all!

You need the right amount of insulin for you as an individual. Your doses aren’t huge so concentrate on continuing to improve your control. That’s what’s important.
 
Yes, no right or wrong, just what is right for you, right now
 
Fiar enough.


I am now also using a FreeStyle Libre 2 sensor to help monitor my levels and its been very helpful.

I totaly forgot my insulin does tonight and thought I felt a bit off, reading is 21.. opps lol

Taken both shots and its already coming down only 15 mins after.
 
I see from your other post that you have had diabetes for a number of years and you are only 39 now, which makes me wonder if you might actually be a misdiagnosed Type 1, especially as your insulin doses are more in line with Type 1.
Would you mind telling us how you came to be diagnosed? How old were you and did you develop symptoms or was it just picked up through a routine blood test?
Unfortunately some GPs and nurses believe that Type 1 only develops in children and young adults, so they assume it must be Type 2 if you are a mature adult. Unfortunately this is not true and some of us here were diagnosed Type 1 in our 50s and older. It sounds like you are reasonably fit and active. Was that the case at diagnosis too? Were you carrying much/any excess weight at diagnosis and did you lose any quite easily or unintentionally?
 
Im defo T2.

As I stopped taking Gliclazide my BS was going up while we was adjusting the insulin dose.

I have been on pills since 2011. But my A1C was always high. My BS spikes high when I eat and takes an age to come down with just the pills.

When I was diagnosed they were a little confused as to if it was T1 or T2.

My ketones where sky high, my BS was 47 and I was really not well at all. My BS came down way to fast with insulin they told me but T1 symptom is high ketones but the fact my BS was dropping so fast with inulin was a T2 thing. I was overweight at about 16 stone at the time and my diet was bad and activity was non exsistent.

I soon got my weight down to 12.5-13 stone (85ish kg) and thats where my weight has stayed ever since. My activity level has been up and down depening on my job. My current job is not so active any more. I also had a heart attack back in 2016 and that has made it hard for me to keep as active. I had a job doing room service walking a good 2-7 miles a night depending how busy it was. I did that for a year and my doc at the time still told me to do more walking! I was like, na mate I am absolutley exhuasted after work, My days off are not going to be spent doing more walking. Ever since the HA keeping active has been tricky as I get tired so easy and it adds even more stress to the job.

So, the pills did work but not as well as I would of hoped. So it took 12 years but I got insulin. I wanted fast acting for years to help with the spikes when I eat but it was decided to just stop the pills and get me on a long and fast acting insulin instead.

My predicted A1C is currently 63. Better than the 77 I got last month
 
DKA and sudden very high BG levels of 47?? shouts Type 1, which often has a slower onset in adults. I would expect your body to respond quickly to insulin if you were Type 1 but be more resistant if you were Type 2, so the opposite of what they were saying. Did they ever do tests to check for Type 1? GAD antibody and C-Peptide tests?
 
Good to see that your levels are coming down now that you are on a basal/bolus insulin regime ie. both fast and slow release insulin. Just a shame they weren't introduced sooner. Having high BG levels for a lot of years could well have contributed to your heart attack.
 
Couldn't tell you tbh.

But if I was t1 then the pills would not of done anything surely?
 
Seansmit17 said:
Couldn't tell you tbh.

But if I was t1 then the pills would not of done anything surely?
Click to expand...
T1 comes on much slower in adults, so it’s possible that T2 medication may have an effect while you still have some beta cells working. Once they are all gone though, only insulin will work. There are several people on this forum who were diagnosed as T2 purely because of their age, who found that T2 medication did work for a short while but then not any more and they were eventually reclassified as T1. You don’t change from one to the other though, it just means they were T1 all along.
 
Friend was diagnosed Type II because if age desire being both slim and fit. Really suffered with ever increasing doses of Metformin until re- diagnosed Type 1.5 and put on insulin. Hasn't looked back since
 
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