Pretty new to Type 2 and very new using a FreeStyle Libra 2

T

TonyB

Member
Relationship to Diabetes
Type 2
I am afraid the local Diabetes Dept. is not being very helpful. I know they are very busy but do not have the time to see me.
Moan over.
I am on 2 Metformin and 1 Foxiga a day + 10 -16 units (up to me) of Insulin injections
Started off with 12 units at 2100 hrs and the tablets before each meal ie 3.
By 1600 hrs yesterday the reading was 18. I Do NOT eat anything I should not.
Saturday I changed to 6 units at 2100 hrs and a second injection at 0800. ie splitting my 12 hour dose into 2 injections
Had a reasonable days readings
Did the same today and started the day at 6 ...Injection and Metformin at 0800...Reading 9 by 0930 ...11 after lunch...took Foxiga... down to 8 by 1230...back up to 10 by 1400 hrs ... now at 1500 hrs it is 8.8.
Talk about a wavy line on the FreeStyle screen. It has hovered around the 9.0 mark allday so far.
What else can I do please.
I know I am stressed out and that ain't helpin'

...
 
@TonyB welcome to the forum - and to the experiences of the newly diagnosed.
Is the plan to bring down your blood glucose using insulin but once you can get normal numbers, to go to other medication and perhaps low carb? Or is plan too kind a word for the situation at the moment?
 
TonyB said:
I am afraid the local Diabetes Dept. is not being very helpful. I know they are very busy but do not have the time to see me.
Moan over.
I am on 2 Metformin and 1 Foxiga a day + 10 -16 units (up to me) of Insulin injections
Started off with 12 units at 2100 hrs and the tablets before each meal ie 3.
By 1600 hrs yesterday the reading was 18. I Do NOT eat anything I should not.
Saturday I changed to 6 units at 2100 hrs and a second injection at 0800. ie splitting my 12 hour dose into 2 injections
Had a reasonable days readings
Did the same today and started the day at 6 ...Injection and Metformin at 0800...Reading 9 by 0930 ...11 after lunch...took Foxiga... down to 8 by 1230...back up to 10 by 1400 hrs ... now at 1500 hrs it is 8.8.
Talk about a wavy line on the FreeStyle screen. It has hovered around the 9.0 mark allday so far.
What else can I do please.
I know I am stressed out and that ain't helpin'

...
Click to expand...
Welcome to the forum, would you like to explain how your diagnosis came about and how long ago was it. What was your HbA1C and what insulin is it you have been prescribed as that will help people help you.
It is important to understand how the different medications work. Metformin is usually the first medication that is prescribed and it helps the body use the insulin it produces more effectively and reduces the output of glucose by the liver and in combination with diet will reduce blood glucose but it does not directly work on the food but works away in the background. If that is not successful then a medication like foxiga can be added and that encourages the kidneys to work to remove excess glucose via urine but again does not act directly on the food you eat. Were those tried before insulin has been added to the mix. From what you imply it is a basal insulin which works to keep your blood glucose steady in the absence of food.
You mention nothing about your diet as that is going to be a factor in managing your blood glucose.
People's blood glucose goes up and down during the day and night so will fluctuate depending mainly on what you have eaten.
You may have been advised to take cautious doses of insulin so your blood glucose does not drop too quickly and put you at risk of hypos. You may just need to be more patient.
 
I was diagnosed in Jan this year and put on 4 Metformin a day. 2 am 2 pm
This at the start seemed to doing the job but over the year my Prick a finger monitoring showed
it was alosing battle.
Next step add a Foxima tablet. Incidentially I have never been told how to space the pills out.
About a month ago I was put on Insulin. Shown how to inject 10 units in a n evening and drop
two of the metformin.Also told if my readings did not drom enough increase up from 10 by 2 more units until it did.
That has caused me to have a couple fo Hypos during the night.
So there you ar take 3 tablets and SOME Insulin.
Leaving me to experimkent and so far it is not possible to keep in the Green Band all day.
As we speak it seems that the Foxiga I took around 11 am has now brought it down from over 10 to 7.8.
Its a roller coaster ride nad very stressful. I have to being 85 but a fit cycling still working 85
 
TonyB said:
Incidentially I have never been told how to space the pills out.
Click to expand...
What does it say on the box about when to take them? The label on the box and the leaflet inside should have all the timing info you need ie how many times a day and does it matter whether it’s with or without food or not.
TonyB said:
Also told if my readings did not drom enough increase up from 10 by 2 more units until it did.
That has caused me to have a couple fo Hypos during the night.
Click to expand...
Thats normal advice for a type 2. The dose between where you were still too high and where you had hypos in the night (assuming these are real readings below 4 verified on a fingerprick monitor) sounds about right then.
 
TonyB said:
Leaving me to experimkent and so far it is not possible to keep in the Green Band all day.
Click to expand...
You shouldn’t be aiming to stay in the green band all day anyway.

If this is a cgm then ideal target control is 70% of readings between 4-10
 
TonyB said:
I was diagnosed in Jan this year and put on 4 Metformin a day. 2 am 2 pm
This at the start seemed to doing the job but over the year my Prick a finger monitoring showed
it was alosing battle.
Next step add a Foxima tablet. Incidentially I have never been told how to space the pills out.
About a month ago I was put on Insulin. Shown how to inject 10 units in a n evening and drop
two of the metformin.Also told if my readings did not drom enough increase up from 10 by 2 more units until it did.
That has caused me to have a couple fo Hypos during the night.
So there you ar take 3 tablets and SOME Insulin.
Leaving me to experimkent and so far it is not possible to keep in the Green Band all day.
As we speak it seems that the Foxiga I took around 11 am has now brought it down from over 10 to 7.8.
Its a roller coaster ride nad very stressful. I have to being 85 but a fit cycling still working 85
Click to expand...
That looks very much like a need for insulin - unless of course you have been advised that carbs are so healthy - I had that for decades despite my protests so please excuse the eye rolling.
If it is any help - once I saw under 8mmol/l after meals that seemed to be the tipping point and I saw improvements from then on. That was just using diet - I needed to get out from under the cosh of carbs at every meal and snacks too.
 
Leadinglights said:
Welcome to the forum, would you like to explain how your diagnosis came about and how long ago was it. What was your HbA1C and what insulin is it you have been prescribed as that will help people help you.
It is important to understand how the different medications work. Metformin is usually the first medication that is prescribed and it helps the body use the insulin it produces more effectively and reduces the output of glucose by the liver and in combination with diet will reduce blood glucose but it does not directly work on the food but works away in the background. If that is not successful then a medication like foxiga can be added and that encourages the kidneys to work to remove excess glucose via urine but again does not act directly on the food you eat. Were those tried before insulin has been added to the mix. From what you imply it is a basal insulin which works to keep your blood glucose steady in the absence of food.
You mention nothing about your diet as that is going to be a factor in managing your blood glucose.
People's blood glucose goes up and down during the day and night so will fluctuate depending mainly on what you have eaten.
You may have been advised to take cautious doses of insulin so your blood glucose does not drop too quickly and put you at risk of hypos. You may just need to be more patient.
Click to expand...
I will try to answer your questions.
Diagnosis from a routine blood test in January
Do not know what the HbA1C test showed as I was never told.
Isulin is Humulin Isophane.
Six months on tablets until I was put on Insulin
Diet.
I also have CKD and therefore No Meat etc and no Ultra Processed food.. Fish and Foul mainly.
I do not have a sweet tooth so never have needed Cakes and Sweets etc. No Alcohol. Soya Milk.
Very little bread. Lots of Veg. and a moderate amount to Fruit.
As it happens I am seeing a Dietician on Thursday. Take two months for the appointment.
In January I was 88 Kilos and now 76 Kilos. Cost me something in clothing. Waist 38 to 32"
 
Welcome @TonyB 🙂 That sounds sensible splitting your Humulin Isophane. It’s commonly taken twice a day so you’re not doing anything ‘bad’. You don’t necessarily have to split the dose evenly, eg some people need a little less at night and more in the morning dose or vice versa.

To be honest, it sounds like you’re doing well 🙂 You mention your weight loss - is this something you needed, or are you finding it hard to eat enough to keep weight on?
 
Thanks for that information, I'm not sure why you were told to take the metformin at those funny times as it is usually taken twice a day once with breakfast and once with dinner, if slow release they can be taken all at the same time usually with the evening meal.
It is always tricky to balance dietary requirement when you have the complication of additional conditions, but fish and chicken, eggs are all options.
Hopefully some others will be along to make some suggestions.
It would be a good idea to ask what your HbA1C result is then you know what you are dealing with.
I hope your dietician appointment goes well, I is a good idea to make a note of any questions you have and jot down the answers.
 
TonyB said:
Leaving me to experimkent and so far it is not possible to keep in the Green Band all day.
Click to expand...

Welcome to the forum @TonyB

Sound like you are doing amazingly well. sorry to hear you don’t feel very supported by your Diabetes nurse / clinic. Unfortunately diabetes can be contrary, obstinate, and fiercely individual, so personal experimentation is pretty much par for the course I’m afraid.

Just to add a little detail to @Lucyr ‘s suggestion - blood glucose will vary through the day. even people without diabetes see significant variation - so chasing a ‘flat line’ isn’t very realistic. What we have to aim for, really, is to reduce the dramatic wobbles, and see if we can aim for more gentle undulations 🙂

A panel of experts put together this recommendation for Time in Range, which you might find helpful 🙂

everydayupsanddowns

Thread 'Time In Range - useful for Libre / CGM wearers'

I've been meaning to post this for ages, but kept forgetting!

At the ADA this year the international consensus paper on TIR (time in range) was published by a panel of experts with a huge amount of knowledge and expertise in supporting people to use continuous data to help manage their diabetes.

Different targets are suggested for general T1/T2 users, and those who are pregnant or who may be older or infirm.

Hope people find this helpful and that it gives folks something to aim for. Particularly useful to recognise that you have have a reasonable chunk of readings about 10mmol/L and...
  • Like
 
Leadinglights said:
Thanks for that information, I'm not sure why you were told to take the metformin at those funny times as it is usually taken twice a day once with breakfast and once with dinner, if slow release they can be taken all at the same time usually with the evening meal.
It is always tricky to balance dietary requirement when you have the complication of additional conditions, but fish and chicken, eggs are all options.
Hopefully some others will be along to make some suggestions.
It would be a good idea to ask what your HbA1C result is then you know what you are dealing with.
I hope your dietician appointment goes well, I is a good idea to make a note of any questions you have and jot down the answers.
Click to expand...
Thanks for the replies. Have settled into a sort of routine now.
Metformin and 6ml Insulin an hour before breakfast If possible (depending if it is a start work at 0900 or 1000 day)
Forxiga an hour before lunch
Metformin an hour before evening meal
4 to 6 ml Insulin before bed.
Even with this routine I usually get a 13 /15 spike after meals.
The Dietician answered all my questions and myths. She was really helpful.
My weight has settled down at 75 KG in the last few weeks. It was not a planned weight loss. Worry about Diabetes and CKD I suppose and not long after a divorce. Not fun in your 80s.
The only way is up.
 
Still very erratic readings.
Went out for lunch yesterday. Nothing very evil to eat. Mostly Chicken but my Libra Link went mad. Shot up to 15.6.
Today I thought I will try another approach.
9pm last night 10ml Insulin
5am this morning one Metformin .............Reading 6.2
8am ...8ml Insulin
8.30 Breakfast...Porridge and Coffee........Reading 8.0
10.00 .........................................................Reading 10.2
12.noon......................................................Reading 7.4
.....................NO LUNCH
12.30 Up it goes ???
12.45 1 Forxiga Reading 11.6
For the last two hours up and down between 9 and 11.
Now have a headache. Just take Blood Pressure. Top end of normal.
Not going to eat again today until it gets down to 5-6 (If it does)
.
Was going to book a holiday today but wondering if I am firt enough to go.
 
I have taken my first ever forxiga tablet this morning. I was told I was likely to pee a pint of urine but not how quickly that might happen. I took it at 7.30. I have to take a relative to the doctors am Monday so am checking so I can decide if lunchtime is better. I also take 2 metformin which I would like to take together. Until yesterday I was taking two lots of two but it's halved with the addition of the new drug. I am still not clear how low, low carb becomes a problem. I would like to start eating porridge again next month but will try and do a finger prick test.

I realise you are in your eighties when appetite lessens and metformin has dulled my appetite but I would have thought some food should be taken midday eg soup or an omelette or a snack. Obviously many snacks are carb heavy.
I was told before i had a diabetes test that my cholestral had crept up so increased the fish in my diet. I had local crab yesterday Maybe someone who knows about using insulin can give you more positive advice in relation to your latest post. I've actually been given keto sticks to test my urine if I think I've had too few carbs. I'm told ketoacidosis is very rare but as this still so very new to me it is a bit stressful.
The prescription for forxiga just says take one a day. As I don't know how soon I may urinate I took it first thing ( 730) but nothing has happened yet. So will have a cup of tea and breakfast

I hope things improve and you feel well enough for a holiday.
 
Last edited:
saffron15 said:
I have taken my first ever forxiga tablet this morning. I was told I was likely to pee a pint of urine but not how quickly that might happen. I took it at 7.30. I have to take a relative to the doctors am Monday so am checking so I can decide if lunchtime is better. I also take 2 metformin which I would like to take together. Until yesterday I was taking two lots of two but it's halved with the addition of the new drug. I am still not clear how low, low carb becomes a problem. I would like to start eating porridge again next month but will try and do a finger prick test.

I realise you are in your eighties when appetite lessens and metformin has dulled my appetite but I would have thought some food should be taken midday eg soup or an omelette or a snack. Obviously many snacks are carb heavy. Maybe someone who knows about using insulin can give you poor positive advice. I've actually been given keto sticks to test my urine if I think I've had too few carbs. I'm told ketoacidosis is very rare but as this still so very new to me it is a bit stressful.

I hope things improve and you feel well enough for a holiday.
Click to expand...
I think how low on carbs people can safely go on the 'flozin' meds may be quite individual. The general guidance is keto or very low carb isn't advised but I have struggled to find anywhere what is regarded as a 'safe' amount. The suggested around 130g per day which counts as low carb not very low carb is OK but there are a few people who have 80-100g per day and don't seem to have any problems.
You should make sure you drink plenty otherwise it may put more stress on your kidneys and be more likely to cause UTIs as the excess glucose will be more concentrated in the urine.
 
@Leadinglights thank you. I think 8 weeks in I need to become more organised. I haven't been counting carbs though I do check food labels. I initially cut everything out apart from bread. The reason for keeping bread which I have cut down is I'm retired and live on my own. I like going to the cafes in the village. It is a short walk with changing people. I sometimes go to one at breakfast time, they open at 8 and have coffee and a teacake. The other alternatives are cake, scones or crumpets. I occasionally go at lunchtime where they do freshly made sandwiches. All cafes serve them with crisps which I decline. The other cafe opens at 10. I can eat frittata there.
I might have one or two lunches a week and one breakfast. In winter they do soup. There is another cafe with more variety.
It wasn't until I was diagnosed in July I realised how many choices in cafes rely on bread pastry or potato.
I have now checked out the carb count for my flat white and toasted tea cake!
I need to lose weight and low carb means I'm losing steadily.
I'm considering having a small portion of pasta with the second crab I bought that my sister has declined. There are still so many things to consider.
 
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