Just been diagnosed with Type 2 Diabetes and struggling a bit

[Kingsleyh]

Hi, 3 weeks ago I ended up in hospital with a burst abcess in my leg which required a surgery to clean out and I also found out that I have Type 2 diabetes. They did the 3 month test and it was 131 and my sugar was really high.

I was discharged with a novomix 30 pen and metaformin and told to take 33 clicks of insulin and 2 metaformin (500mg each) in the morning and 22 clicks and 2 more metaformin in the evening. This was going ok for the first couple of weeks but I started getting stressed about pricking my fingers all the time to know my blood sugar, so I bought a libre 3 CGM and this helped massively to see what was going on.

But last week I started having drastic drops in the afternoon and also in the evening before bed and sometimes in the night. I could not get any help from 111 or my GP or nurse as they just kept telling me they had made a referral to the diabetes nurse. I got a text about an appointment in 3 months time. But I complained and said I am struggling with these sudden drops but still waiting on someone to contact me.

The nurse at my clinic suggested we check my 3 month tests again (now about 3 weeks after starting on the meds) and it came back as 97 which is an improvement. I've been reducing my carbs and eating very healthy with protein and veggies.

In the meantime I've dropped my morning clicks to 12 and the evening clicks to 3. But I'm still getting these sudden drops in the day and evening where it drops from 8 or 9 down with a vertical arrow over 5 minutes down to 4 or less. And I freak out and over compensate with lucozade and it shoots up to 10 or higher and then on many occassions drops back down fast again and I freak out again.

I've been trying to instead eat nuts and slow release carb like a huel black and less lucozade but it's hard when you see it going down so fast and feel out of control.

I've started reading through the forum to see other peoples experiences. But I'm not really sure where I should be trying to keep the sugar level and why I keep getting these sudden drops. Also I'm not sure about how much insulin is appropriate and how to find the balance. Im quite stressed about the whole situation.

 

[Inka]

Welcome @Kingsleyh 🙂 No wonder you’re stressed. You’ve had an abscess and a surprise diabetes diagnosis. That must have been hard.

Novomix 30 is a mix of two insulins, a fast one and a slow one. It’s known as a mixed insulin. Mixed insulin is fine but it requires a set schedule - that is, meals at regular/the same times each day and with the same amount of carbs.

I see you’ve reduced your insulin doses a lot but are still having drops. Firstly, do treat any low drops (hypos) with sugar or glucose eg Dextro glucose tablets, jelly babies or full sugar branded Coke. Nuts and the like aren’t suitable hypo treatments.

Your drops in the afternoon could be because you didn’t eat enough carbs for your lunch that day. Your drops before bed could be because you didn’t eat enough carbs for your evening meal. You get the idea. I’d also add that exercise can cause drops too.

 

[jtg1964]

Your not alone it is stressful for a lot of people.
I would suggest you make an appointment with your GP and talk through your concerns.
Try not to worry it takes a few months to get things steady and to adjust.
This forum helped me immensely.

 

[goodybags]

Hi @Kingsleyh welcome to the forum

when you talk about sudden drops in your BS levels, is this just what your Libra is showing ?
or are you checking with a Finger Prick test on your Blood Glucose Monitor
If just (on the Libra) what kind of “lows” are you taking about

your 3 month test (as you call it will be your Hba1c)
although a result showing 131 is quite high hence they’ve prescribed you insulin

FP testing shouldn’t hurt although depending what pricking or as some people call it “finger booger” your using

Ask away you will get loads of advice & support on here

[edit]
I’ve just re-read your original post and you did say you were dropping to 4
Ok not “hypo low” but appreciate it can worry you (until you understand more)
think you will need to establish, if these are true indications as apposed to any kind of comprehension lows
that’s laying on / accidentally applying pressure on are where sensor is easy to do in bed etc..

30+ is in my (non medical opinion quite high dose) I think when I first started on the same insulin as that, but we are all different was on about half that

Obviously you have also changed your diet
and possibly habits since you found out how high your Hba1c was

 

[Kingsleyh]

Your not alone it is stressful for a lot of people.
I would suggest you make an appointment with your GP and talk through your concerns.
Try not to worry it takes a few months to get things steady and to adjust.
This forum helped me immensely.

Thanks very much for your reply - very much appreciated 🙂 I will try not to worry as much.

 

[Kingsleyh]

Hi @Kingsleyh welcome to the forum

when you talk about sudden drops in your BS levels, is this just what your Libra is showing ?
or are you checking with a Finger Prick test on your Blood Glucose Monitor
If just (on the Libra) what kind of “lows” are you taking about

your 3 month test (as you call it will be your Hba1c)
although a result showing 131 is quite high hence they’ve prescribed you insulin

FP testing shouldn’t hurt although depending what pricking or as some people call it “finger booger” your using

Ask away you will get loads of advice & support on here

[edit]
I’ve just re-read your original post and you did say you were dropping to 4
Ok not “hypo low” but appreciate it can worry you (until you understand more)
think you will need to establish, if these are true indications as apposed to any kind of comprehension lows
that’s laying on / accidentally applying pressure on are where sensor is easy to do in bed etc..

30+ is in my (non medical opinion quite high dose) I think when I first started on the same insulin as that, but we are all different was on about half that

Obviously you have also changed your diet
and possibly habits since you found out how high your Hba1c was

Hi, thanks for your reply - much appreciated 🙂. I'm basing the information on my libre CGM but I was dropping down to 3.8 where it's alarm was previously set and since I didn't know if it was going to drop any lower than that I immediately tried to get it up again. So I since have set my alarm to be in the 4.5 range so when it goes off by the time I get the sugar needed it's already around 4. You make a good point regarding the sensor readings accuracy - I didn't know it could give me false readings if the sensor gets pressure applied to it - which I'm wondering now if that has contributed to any of the night time drops - I only checked with the finger prick on the ones in the daytime - where I was just sitting at my desk to unlikely to have had any pressure on the sensor. I will try a finger prick test also tonight when it drops. (It drops a couple of times during the night and my alarm goes off usually 21:30 then 2am and then sometimes 5:30am) and in the daytime usually between 3pm and 5pm.

 

[Kingsleyh]

Also in the first week that I started taking the meds (insulin and metaformin) my eyesight got worse and worse until I could not see anything up close - like my phone or my computer screen (and I work with computers so it was super annoying) so I went for an eye test and the optician said no damage and my eyes are ok but I could use with having a prescription for near sight and also one for long sight. So I bought a pair of +1 from Boots on the way home which worked great and over the last few weeks my eyesight has returned to how it was and I no longer need the +1 glasses. But by this time my optician glasses were ready (took over 3 weeks) and I went yesterday to get them and found I couldn't see out of them very well. So I have a retest booked in for next week - hopefully this will lead to a better prescription. The optician says everyone over about 43 needs some kind of prescription and I'm 50 so long overdue. Not that I've really noticed any problems tho until this recent incident.

 

[Lucyr]

This was going ok for the first couple of weeks but I started getting stressed about pricking my fingers all the time to know my blood sugar, so I bought a libre 3 CGM and this helped massively to see what was going on.

Are you outside of the UK? You can’t buy libre 3 from abbot in the uk, only from a few online pharmacies at much higher prices than libre 2+ from abbot

Your drops will be caused by you reducing your carbs without first asking for medical advice on what to change your insulin doses to. If you go back to the diet you had when the doses were set for you you’ll probably have less lows.

 

[Lucyr]

So I have a retest booked in for next week - hopefully this will lead to a better prescription

You shouldn’t be buying prescription glasses for at least 3 months after your blood sugars have settled. Have the test and buy the glasses if you want to but don’t be surprised if you can’t see through them when you collect them.

 

[everydayupsanddowns]

Also in the first week that I started taking the meds (insulin and metaformin) my eyesight got worse and worse until I could not see anything up close - like my phone or my computer screen (and I work with computers so it was super annoying) so I went for an eye test and the optician said no damage and my eyes are ok but I could use with having a prescription for near sight and also one for long sight. So I bought a pair of +1 from Boots on the way home which worked great and over the last few weeks my eyesight has returned to how it was and I no longer need the +1 glasses. But by this time my optician glasses were ready (took over 3 weeks) and I went yesterday to get them and found I couldn't see out of them very well. So I have a retest booked in for next week - hopefully this will lead to a better prescription. The optician says everyone over about 43 needs some kind of prescription and I'm 50 so long overdue. Not that I've really noticed any problems tho until this recent incident.

Sorry to hear you’ve been having a bit of a whirlwind time with your diabetes @Kingsleyh

Blurry eyesight when your levels improve as you start taking medication is pretty common. As your BG levels have been increasing the pressure in your eyes will have pulled them slightly out of shape, but this will have happened very gradually, and your brain would have adjusted to keep things in focus. With the insulin, and rapid reduction in your BG levels, the osmotic pressure will have normalised, and your eyes will have bounced back much more quickly. It can take the brain a little while to adjust to the new focal length!

Sorry to hear you’ve been on a bit of a rollercoaster with your BGs. Mixed insulin can be a bit of a blunt implement for diabetes management, because the 2 different parts of it (background and meal insulins) can’t be separated ot adjusted independently, and once it’s IN you have to act to its schedule.

In general terms you should be aiming for:

4-7mmol/L before meals and
No higher than 8.5 by 2hrs after meals.

Readings below 4.0 should be treated with the 15 rule. Eat 15g of fast acting carbs, wait 15 minutes and recheck BG (with a fingerstick meter, not CGM to avoid ‘sensor lag’). If levels are still below 4.0 repeat the cycle. It can be hard to resist Eating All The Things when hypo/near hypo, but bouncing from hypo up to high and back again is grim.

You may find that 10g or so of slower acting carbs (eg a plain digestive biscuit, or crisp bread) helps to reduce the risk of a ‘double dip’

 

[Kingsleyh]

Are you outside of the UK? You can’t buy libre 3 from abbot in the uk, only from a few online pharmacies at much higher prices than libre 2+ from abbot

Your drops will be caused by you reducing your carbs without first asking for medical advice on what to change your insulin doses to. If you go back to the diet you had when the doses were set for you you’ll probably have less lows.

Thanks @Lucyr for the reply 🙂 When the nurse gave me the medications it was at the hospital after my surgery and nobody asked me at all what my diet was like - they told me to start eating lower carbs which I've been trying to do but since then I've been trying to get an appointment with the diabetic nurse unsuccessfully so far - they did put one in for 3 months time and my GP told me to wait for that and to reduce the dosage a bit if it seems too high which I have been doing gradually. I'm in the UK and I bought a batch of the libre 3 sensors from an online chemist - I have no idea how much they normally cost.

 

[Kingsleyh]

You shouldn’t be buying prescription glasses for at least 3 months after your blood sugars have settled. Have the test and buy the glasses if you want to but don’t be surprised if you can’t see through them when you collect them.

I see that's very helpful - the nurse told me to have an eye test and during that eye test the optician told me I needed to buy glasses - and since I couldn't see for my job I thought they would take like a couple of days to get them and then would be ok. The optician said that he didn't think my prescription would change also - I guess that was bad advice because it's totally changed back to how it was and I feel like I bought the glasses for no reason.

 

[Lucyr]

I guess that was bad advice because it's totally changed back to how it was and I feel like I bought the glasses for no reason.

You did buy them for no reason, if you told them about the diabetes you should go back and complain as the optician shouldn’t have sold you glasses

 

[Kingsleyh]

Sorry to hear you’ve been having a bit of a whirlwind time with your diabetes @Kingsleyh

Blurry eyesight when your levels improve as you start taking medication is pretty common. As your BG levels have been increasing the pressure in your eyes will have pulled them slightly out of shape, but this will have happened very gradually, and your brain would have adjusted to keep things in focus. With the insulin, and rapid reduction in your BG levels, the osmotic pressure will have normalised, and your eyes will have bounced back much more quickly. It can take the brain a little while to adjust to the new focal length!

Sorry to hear you’ve been on a bit of a rollercoaster with your BGs. Mixed insulin can be a bit of a blunt implement for diabetes management, because the 2 different parts of it (background and meal insulins) can’t be separated ot adjusted independently, and once it’s IN you have to act to its schedule.

In general terms you should be aiming for:

4-7mmol/L before meals and
No higher than 8.5 by 2hrs after meals.

Readings below 4.0 should be treated with the 15 rule. Eat 15g of fast acting carbs, wait 15 minutes and recheck BG (with a fingerstick meter, not CGM to avoid ‘sensor lag’). If levels are still below 4.0 repeat the cycle. It can be hard to resist Eating All The Things when hypo/near hypo, but bouncing from hypo up to high and back again is grim.

You may find that 10g or so of slower acting carbs (eg a plain digestive biscuit, or crisp bread) helps to reduce the risk of a ‘double dip’

Thanks very much for the advice 🙂 - I think this is excellent advice regarding the 15 rule and using the finger prick and not the sensor for this. My main problem is that I totally freak out when my blood sugar drops as I feel out of control and very not used to dealing with trying to balance things. Hopefully this will improve - I really want my next 3 month blood test to be much lower so I can move to meds that don't cause these drops. Its gone from 131 to 97 and hopefully lower on the next ones.

 

[Kingsleyh]

You did buy them for no reason, if you told them about the diabetes you should go back and complain as the optician shouldn’t have sold you glasses

I will complain for sure - because I asked several times if my blurry vision was going to correct and the prescription would be still ok and the optician proceeded to sell me 2 pairs of glasses!

 

[everydayupsanddowns]

My main problem is that I totally freak out when my blood sugar drops as I feel out of control and very not used to dealing with trying to balance things.

Perfectly understandable. It is literally messing with your brain, and that can make it hard to think straight.

Plus if your levels have been running above range for a while, your symptoms at the lower edges of the recommended range (eg mid/low 4s) can be fairly full-on. Because the contrast with where your body is ‘used to’ is quite marked. It can take a little while for your internal glucose thermostat to reset.

 

[everydayupsanddowns]

I will complain for sure - because I asked several times if my blurry vision was going to correct and the prescription would be still ok and the optician proceeded to sell me 2 pairs of glasses!

That is really wrong. They should have absolutely known not to sell you glasses that they knew would be no longer appropriate in a few weeks 😡

 

[Kingsleyh]

Welcome @Kingsleyh 🙂 No wonder you’re stressed. You’ve had an abscess and a surprise diabetes diagnosis. That must have been hard.

Novomix 30 is a mix of two insulins, a fast one and a slow one. It’s known as a mixed insulin. Mixed insulin is fine but it requires a set schedule - that is, meals at regular/the same times each day and with the same amount of carbs.

I see you’ve reduced your insulin doses a lot but are still having drops. Firstly, do treat any low drops (hypos) with sugar or glucose eg Dextro glucose tablets, jelly babies or full sugar branded Coke. Nuts and the like aren’t suitable hypo treatments.

Your drops in the afternoon could be because you didn’t eat enough carbs for your lunch that day. Your drops before bed could be because you didn’t eat enough carbs for your evening meal. You get the idea. I’d also add that exercise can cause drops too.

Thanks for the advice 🙂 I'm definitely struggling to find the balance. I'm hoping it will improve soon. I will try to focus on my diet a bit more to see if making some changes affects it. I've also found out that squashing the sensor at night can cause false readings. I'll keep an eye on that also.

 

[Lucyr]

I will complain for sure - because I asked several times if my blurry vision was going to correct and the prescription would be still ok and the optician proceeded to sell me 2 pairs of glasses!

Here’s a (random from Google but looked authoritative even if American) link to help

Diagnosed With Diabetes? Seeing Your Eye Doctor Is Essential

If you’ve been diagnosed with diabetes, it’s essential that regular eye exams are part of your healthcare routine. According to a report from the Centers

www.optometrists.org

 

[Kingsleyh]

I'm also not very happy with the Libre 3 app! I can't zoom in on the graphs to see better what has happened and I can't set alarms between time periods, and I can't set percentage drop alarms, and I can't also see my reading on my phone when I use it as a night stand - which would be really nice. Also it doesn't rotate when I turn my phone which would make the graph easier to read. They seem to use some kind of smoothing on the graphs as well.