New insulin user

[Razorb64]

Hi all,
I’ve been type 2 for 13 years although we thought I was mis-diagnosed and was actually suffering from an auto immune disorder.
Anyway, long story short, my meds aren’t working as well as they were and my A1c skyrocketed, I’ve now been put on Basel insulin.
I was toL d by the consultant that tablets sometimes lose effectiveness after about 10 years…haven’t heard this before, but started insulin last night.
I’m a wee bit wary and never had a good nights sleep, kept wakening up to check my libre 2 just in case I went into a hypo.
Are these feelings of nervousness normal when taking insulin for the first time?
Any advice would be welcome

 

[RBZ5416]

You have hopefully been put on a conservative dose to start with, so the risk of hypo should be minimal. Once you have a stable result, you would then usually titrate the dose by around 10% every 3-4 days until you achieve the best glucose levels without going hypo. I would expect all this to be explained by the prescriber but it seems some are lacking in this regard.

I thought Libre had a hypo alarm you can set in any case to save constantly checking?

 

[Inka]

Yes, the nervousness is normal @Razorb64 If it’s easier, think of it as a healthy respect for insulin. Set the Low alarm on your Libre for 5.6 or whatever the highest number is and then you can sleep knowing you’ll get warning of your blood sugar dropping.

If you’ve recently started insulin, you’ll probably be on a dose that’s not quite enough for you, and then this will be gradually increased as needed. This reduces the risk of hypos.

Keep hypo treatments by your bed along with some carby snacks, and keep hypo treatments with you when you go out. It does get easier.

 

[Razorb64]

You have hopefully been put on a conservative dose to start with, so the risk of hypo should be minimal. Once you have a stable result, you would then usually titrate the dose by around 10% every 3-4 days until you achieve the best glucose levels without going hypo. I would expect all this to be explained by the prescriber but it seems some are lacking in this regard.

I thought Libre had a hypo alarm you can set in any case to save constantly checking?

Thanks for this, yes I am on a conservative dose which will be reviewed.
I did have my alarm set but kept thinking…what if I don’t hear it and fall into a coma
Just nerves, I’m sure I’ll start to feel ok with it.

 

[Razorb64]

Yes, the nervousness is normal @Razorb64 If it’s easier, think of it as a healthy respect for insulin. Set the Low alarm on your Libre for 5.6 or whatever the highest number is and then you can sleep knowing you’ll get warning of your blood sugar dropping.

If you’ve recently started insulin, you’ll probably be on a dose that’s not quite enough for you, and then this will be gradually increased as needed. This reduces the risk of hypos.

Keep hypo treatments by your bed along with some carby snacks, and keep hypo treatments with you when you go out. It does get easier.

Thanks for the reply.
Good tip about the alarm. I’ve changed this now. Hopefully tonight will be better.

 

[RBZ5416]

Just in case you weren't advised, you will need to notify DVLA that you're taking insulin. This will result in you having to surrender your licence for one with a three year expiry. If you're old enough to have minibus entitlement by default, you will lose that.

 

[Razorb64]

Just in case you weren't advised, you will need to notify DVLA that you're taking insulin. This will result in you having to surrender your licence for one with a three year expiry. If you're old enough to have minibus entitlement by default, you will lose that.

If I surrender my licence will I still be able to drive in the meantime?

 

[RBZ5416]

If I surrender my licence will I still be able to drive in the meantime?

Yes, unless you're a PSV or lorry driver. Surrender was possibly the wrong term. You're just having the expiry date reduced. You should receive a replacement quickly in any case.

Medical conditions, disabilities and driving

When to tell DVLA about a medical condition or disability - what will happen to your licence, renewing or reapplying for your licence.

www.gov.uk

 

[Razorb64]

Yes, unless you're a PSV or lorry driver. Surrender was possibly the wrong term. You're just having the expiry date reduced. You should receive a replacement quickly in any case.

Medical conditions, disabilities and driving

When to tell DVLA about a medical condition or disability - what will happen to your licence, renewing or reapplying for your licence.

www.gov.uk

Ok Thanks for that.
I knew I had to inform DVLA and my insurance but got a fright there thinking I wouldn’t be able to drive.

 

[RBZ5416]

got a fright there thinking I wouldn’t be able to drive.

Apologies.

 

[SimonP]

You also don't have to surrender your licence at all these days, they will send you a new one in the post and you can keep using the old one until that point - at least that's what happened when I renewed mine at the start of the year.

 

[Razorb64]

You also don't have to surrender your licence at all these days, they will send you a new one in the post and you can keep using the old one until that point - at least that's what happened when I renewed mine at the start of the year.

Thank you, I’ll go onto the website and update tomorrow.

 

[everydayupsanddowns]

Hope your nerves settle soon @Razorb64 and you are able to sleep peacefully again.

The body is pretty good at protecting itself against low glucose levels and has some pretty clanging alarm bells that it will set off, certainly in the early years of insulin use, to alert you to impending hypoglycaemia. And Libre is a great help, because it makes it easy to instantly see your level if you wake in a slightly befuddled state rather than having to faff about with test strips.

Having said that, if you sleep on your sensor arm you can get a fake ‘compression low’ where the interstitial fluid cant get to the sensor properly, so if you wake to a Libre alarm it can be worth double checking with a BG meter before you start necking Jelly Babies 😛

 

[rebrascora]

It is very normal to worry about nocturnal hypos particularly. Interestingly, what helped me was to experience a few. I had a week in November about 8 months after diagnosis when I started doing more exercise and my levels started dropping overnight and I had one or two hypos nearly every night for a week. My body woke me up (I didn't have Libre then) and I learned to deal with them and since then I have also learned to adjust my basal insulin to try to prevent me hypoing after exercise, but dealing with it is so mundane now that I can do it whilst half asleep and be back to sleep within a couple of minutes if not less. As I have got used to and confident with treating hypos, I very rarely get the adrenaline rush that I used ti get when my body went into panic. I still get hypo signs but very very rarely, the horrid, heart pounding sweating and feeling faint reaction which is in response to the adrenaline release, so getting back to sleep is easy as I hardly even wake up, just enough to scan my Libre reader which is under my pillow, reach for the JBs on my bedside table, pop one or two in my mouth and chew and drop back off into deep blissful sleep again. I know I should stay awake for 15 mins and retest but I love my sleep and my body wakes me back up if I need to treat again. I am back to getting really good sound sleep after that initial period of anxiety and it really is heaven! Not wishing night time hypos on anyone, but you fear the unknown. Once you have faced your enemy and realise that you can conquer them, the anxiety goes. In many respects, that week of nocturnal hypos did me a favour in that it made me face my fear and learn how to manage it and gave me the confidence that I needed not to be frightened anymore. I should say that I live alone so it is up to me to keep myself safe and I do everything I can to prevent nocturnal hypos but they do still happen occasionally and I no longer sweat them physically or metaphorically.

 

[Razorb64]

It is very normal to worry about nocturnal hypos particularly. Interestingly, what helped me was to experience a few. I had a week in November about 8 months after diagnosis when I started doing more exercise and my levels started dropping overnight and I had one or two hypos nearly every night for a week. My body woke me up (I didn't have Libre then) and I learned to deal with them and since then I have also learned to adjust my basal insulin to try to prevent me hypoing after exercise, but dealing with it is so mundane now that I can do it whilst half asleep and be back to sleep within a couple of minutes if not less. As I have got used to and confident with treating hypos, I very rarely get the adrenaline rush that I used ti get when my body went into panic. I still get hypo signs but very very rarely, the horrid, heart pounding sweating and feeling faint reaction which is in response to the adrenaline release, so getting back to sleep is easy as I hardly even wake up, just enough to scan my Libre reader which is under my pillow, reach for the JBs on my bedside table, pop one or two in my mouth and chew and drop back off into deep blissful sleep again. I know I should stay awake for 15 mins and retest but I love my sleep and my body wakes me back up if I need to treat again. I am back to getting really good sound sleep after that initial period of anxiety and it really is heaven! Not wishing night time hypos on anyone, but you fear the unknown. Once you have faced your enemy and realise that you can conquer them, the anxiety goes. In many respects, that week of nocturnal hypos did me a favour in that it made me face my fear and learn how to manage it and gave me the confidence that I needed not to be frightened anymore. I should say that I live alone so it is up to me to keep myself safe and I do everything I can to prevent nocturnal hypos but they do still happen occasionally and I no longer sweat them physically or metaphorically.

Thank you for taking the time to reply.
This was very helpful and reassuring. I hope it all settles down, last nights sleep was better, so hopefully I’m getting over the nerves.
Best regards.

 

[Razorb64]

Hope your nerves settle soon @Razorb64 and you are able to sleep peacefully again.

The body is pretty good at protecting itself against low glucose levels and has some pretty clanging alarm bells that it will set off, certainly in the early years of insulin use, to alert you to impending hypoglycaemia. And Libre is a great help, because it makes it easy to instantly see your level if you wake in a slightly befuddled state rather than having to faff about with test strips.

Having said that, if you sleep on your sensor arm you can get a fake ‘compression low’ where the interstitial fluid cant get to the sensor properly, so if you wake to a Libre alarm it can be worth double checking with a BG meter before you start necking Jelly Babies 😛

Thank for this. I didn’t know about the fake compression lows. I do try not to sleep on whichever side my sensor is on, but now I know, I’ll make even more of an effort.

 

[DaveB]

Thank for this. I didn’t know about the fake compression lows. I do try not to sleep on whichever side my sensor is on, but now I know, I’ll make even more of an effort.

I've never had this compression problem but I gather some do.

 

[helli]

Thank for this. I didn’t know about the fake compression lows. I do try not to sleep on whichever side my sensor is on, but now I know, I’ll make even more of an effort.

I think there are parts of our arms where we are more likely to apply pressure. I find the higher up my arm I place my sensor, the less likely I am to get compression lows. Usually my sensor is on the back of my arm in line with my arm pit. It is hard to lie on that area.
I have to think this way as I am nearly as much of a fidget when asleep as i am when awake. I can never avoid lying on one side. I favour my left side but that doesn't mean by right doesn't get a try out.