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Sands123

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Type 2
Hi everyone my name is Sandra and new to this site. I was diagnosed with type 2 diabetes about 2014, I am on 2 insulins(1 slow release and one fast release) also metphormin and still struggling to get my blood sugars regulated. I was due to have a hip replacement but they have delayed it to my high blood sugar levels being high. I am really struggling as I find if I am stressed or feeling down I eat, which I probably don't need and this does not help my blood sugars. Open to any advise anyone has
Thanks
 
Welcome @Sands123 🙂 How high exactly is your blood sugar? Are you on fixed doses of the fast insulin at meals or do you adjust the dose according to what amount of carbs you’re about to eat?
 
Hi from a blood test recently it shows 70 the fast insulin in the morning (12) and then the evening (12) (Apidra) I take them before my meals. I wasn't aware that I could adjust with the amount of carbs I eat
 
If you have 2 separate insulins ie a basal/bolus system.....basal is the slow acting and bolus the "quick" acting that you have before meals) then the only reason your levels are too high would be that you haven't been given the support and education to use them effectively.
I wonder if you would benefit from the BERTIE online carb counting course. Learning to adjust your doses according to what you eat is the most important aspect of using 2 separate insulins.

Welcome - BERTIE Key Learning

www.keylearning.bertieonline.org.uk www.keylearning.bertieonline.org.uk
 
Do you not eat lunch or have you just not been told to take insulin with your lunch?
 
Thank you Barbara, can I join the BERTIE Key Learning if I am type 2 Diabetic?
 
Yes I do eat lunch usually a sandwich or salad but no mention to take insulin at this time only told to take both in the morning and fast in the evening
 
Sands123 said:
Hi from a blood test recently it shows 70 the fast insulin in the morning (12) and then the evening (12) (Apidra) I take them before my meals. I wasn't aware that I could adjust with the amount of carbs I eat
Click to expand...

Ok, so you’re on fixed doses of fast/mealtime insulin. In that case, you’d need to make sure you ate the right amount of carbs for that fixed dose. If you ate too many, your blood sugar would be too high, too few and you risk a hypo.

The slow insulin is supposed to control your blood sugar in the absence of food, then you use the fast/meal insulin to cover the carbs in what you eat so that they don’t push your blood sugar up too much. Most people prefer to adjust their insulin according to what they eat as it’s more flexible. You might need support to do that initially.

How often are you testing your blood sugar each day?
 
I appreciate that it is directed towards Type 1s and so you may need to keep that in the back of your mind with some of the information, but the basics should be the same in that it teaches you how to manage your diabetes with a basal bolus system. I believe @Lucyr is Type 2 and may have educated herself through BERTIE.
Sadly there is a real 1st and 2nd class system in diabetes care and whilst Type 1 diabetics are offered intensive education courses and better tech to help them, Type 2s seem to get much less input or sympathetic support/encouragement and are often left to muddle along, even more so now in the current climate where the NHS is struggling. If you can educate yourself and take control of your diabetes management then you will find it beneficial.

Which basal (long acting) insulin do you use and how much of that do you take and when?

Bolus (Apidra in your case) is designed to be taken before each meal to deal with the release of glucose from the carbs in that meal. So your lunchtime sandwich likely has 2 slices of bread which will be about 30g carbs. (roughly 15g carbs per slice if they are medium wholemeal slices. A large roll will be more) For me that would need 3 units of insulin because I have a 1:10 ratio... so 1unit of insulin for every 10g carbs. If I didn't take insulin for that meal, my levels would increase by about 9mmols and stay there, so by tea time I would need a lot more insulin to bring them down. It may be that your evening dose of 12 units of Apidra is partly to bring down those higher levels but you will have spent nearly half of the day with your levels well above target which will of course increase your HbA1c result.
Do you test your levels on an evening before your meal and if so, do you consistently see above target readings?
 
Sands123 said:
Hi everyone my name is Sandra and new to this site. I was diagnosed with type 2 diabetes about 2014, I am on 2 insulins(1 slow release and one fast release) also metphormin and still struggling to get my blood sugars regulated. I was due to have a hip replacement but they have delayed it to my high blood sugar levels being high. I am really struggling as I find if I am stressed or feeling down I eat, which I probably don't need and this does not help my blood sugars. Open to any advise anyone has
Thanks
Click to expand...
It looks as though you need to refer back to whoever is looking after your medication.
As a type 2 - unless you are not making or responding to your own insulin, the usual way to reduce blood glucose levels is to remove high carb foods from the menu and track responses after meals so adjustments can be made in what is eaten.
You seem to be on fixed doses of insulin and are eating 'ad lib' which appears to be failing to meet your requirements.
 
Sorry to hear you are having a difficult time with balancing your insulin doses and food.

I’m slightly confused by the doses you have described. Usually with background and meal insulins you would take fast acting insulin (apidra) alongside each of your meals, and either adjust the doses to match the amount of carbs in your meals... or keep the doses the same, and eat a fixed amount of carbs at each meal.

I’m not quite sure how you would balance food with the system you have described!
 
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