Kind of curious about why I'm not going lower?

[zoombapup]

Hi all,

Been wondering something as I read over my medication side effects list. I'm on metformin (500mg twice a day), semaglutemide (0.25 once a week) and some basal insulin (8 units once a day).

So as I understand it, the insulin could theoretically make me go hypo, which is why I've had to inform the DVLA etc. Or can the semaglutemide do that on its own?

Anyway, if you look at my chart for the last 5-ish weeks..

https://docs.google.com/spreadsheets/d/1cADF0UxEPg0BnxezUyH8vUL7OABOvC_D3_7pdkQI-b8/edit?usp=sharing

The strange thing is that I'm essentially ultra stable at around 5.5 for the last month, with raises just above a 6 and lows just below the 5. But surely if I'm on insulin, I should be potentially going lower than this? Or is it just that with my current routine I'm essentially always in the middle range? I basically do midday lunch and 6pm-ish dinner and nothing with carbs, plus no snacks or breakfast. So I'm being pretty strict food-wise, but I was expecting at some point my numbers would keep going down because of the insulin?

Or is this some natural point where my own system is pulling me back away from the hypo range?

Not that I'm complaining, just wondering about the advice about hypo's and stuff, because it doesn't look like I'm even close to them. Lowest I get is around midday right before lunch.

I know that different people will have a different sort of natural starting point BG wise, but does this mean the insulin isn't being effective?

 

[Kaylz]

your basal insulin shouldn't lower your BG, its designed so that when you get the dose correct for you it keeps you stable throughout the day in the absence of food etc, if it were making you low then you'd need to look at reducing the dose and if you were steadily getting higher throughout the day then increasing it, seems your medication is working perfectly well as you don't want to spend too much time below 5 as this can lead to loss of hypo awareness which I have suffered a few times and its scary, in some you can regain hypo awareness by running a little higher for a couple of weeks, in a way I'd say your re training your body but there are a few members who haven't regained hypo awareness or don't feel hypo until they are below 3 etc so I'd say your medication is pretty effective and you need to chill a bit as diabetes can affect mental health and take over, I've been there too and its not a good place xx

 

[rebrascora]

8 units of basal insulin once a day for a grown man is unlikely to make you hypo but because it is insulin you have to inform DVLA and of course test before you drive etc.
Your liver releases a steady trickle of glucose into your blood stream when there is no food (carbs) providing it and basal insulin is usually taken to deal with that glucose. A proportion of protein and fat can also be broken down to produce some glucose, so even if you are eating very low carb, there is still some glucose being released into the blood stream. Proteins and fats take much longer to be broken down into glucose than carbs so it is a slow low profile rise and fall rather than the obvious sharp spike from carbs.
Maybe consider reducing the insulin by one or 2 units every couple of weeks and see what happens. You can always increase it again if your numbers rise... Maybe discuss it with your HCP first.