Problems with glucose levels

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Country lover

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Relationship to Diabetes
Type 2
Have tried most meds for type 2 so a year ago was put on insulin. It has reduced my underlying levels but from day to day the levels are irratic. I have had several hypos so insulin levels reduced with the expected results. Been refused a cpeptide test in the past and recently the local diabetic nurse specialists said my condition should be managed within my practice by the diabetic nurse there. I really feel that I’m not receiving the help I need. I am very active and not overweight. Any suggestions?
 
Welcome @Country lover 🙂 Sorry to hear about your difficulties and the lack of support you’re getting. Can I ask the name of your insulin (name plus any numbers or letters after the name) and when you take it?
 
Welcome to the forum @Country lover

Sorry to hear you’ve had a bit of a frustrating time with your insulin therapy :(

Are you still taking other oral medications?

Have you been given any advice or information about the level of carbohydrate intake you should aim for (but not exceed) at each meal? Taking fixed doses of insulin can involve aiming for a regular and consistent carbohydrate intake at different mealtimes day-to-day, so that the insulin has just the right amount of carbs to work on to keep levels steady.

As @Inka says, members may also be able to share experiences, if you let us know which insulin(s) you are taking and when you take your doses. 🙂
 
Inka said:
Welcome @Country lover 🙂 Sorry to hear about your difficulties and the lack of support you’re getting. Can I ask the name of your insulin (name plus any numbers or letters after the name) and when you take it?
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Humalin. I take 14 units at breakfast and 16 units with evening meal. Just increased by 1 unit each dose.
 
@Country lover Humulin what? There are various types of Humulin which act in different ways. There should be letters and/or numbers after the word Humulin, eg M3, i, etc.
 
everydayupsanddowns said:
Welcome to the forum @Country lover

Sorry to hear you’ve had a bit of a frustrating time with your insulin therapy :(

Are you still taking other oral medications?

Have you been given any advice or information about the level of carbohydrate intake you should aim for (but not exceed) at each meal? Taking fixed doses of insulin can involve aiming for a regular and consistent carbohydrate intake at different mealtimes day-to-day, so that the insulin has just the right amount of carbs to work on to keep levels steady.

As @Inka says, members may also be able to share experiences, if you let us know which insulin(s) you are taking and when you take your doses. 🙂
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I am not taking other meds as most of them upset my stomach (have had two ulcers so have to be careful). I eat a low carb diet - at most one slice of whole meal bread a day. Eat lentil pasta only. Very rarely eat other carbs but eat lots of legume. I thought the ideology re carbs at every meal was old hat today and diabetics advised to keep carb intake below 100 g.
 
Country lover said:
I am not taking other meds as most of them upset my stomach (have had two ulcers so have to be careful). I eat a low carb diet - at most one slice of whole meal bread a day. Eat lentil pasta only. Very rarely eat other carbs but eat lots of legume. I thought the ideology re carbs at every meal was old hat today and diabetics advised to keep carb intake below 100 g.
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Keeping carbs to the minimum isn’t relevant when insulin is being injected, it can make matching up the profile of the insulin, (whose job it is to mop up the glucose processed from any carbs eaten) with the digestion of the carbs much more difficult. Some people do manage a low carb diet and insulin, but because in the absence of carbs, the body breaks down protein and ultimately fat into glucose, it makes the job of balancing the insulin much harder.
 
Country lover said:
Yes that’s it!
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Ah, so it’s a long-ish acting insulin, that goes on working away in the background. I’m sorry, I don’t have any experience of it, but I know we have some members who use it, so hopefully you’ll get some more useful answers from people with knowledge of it.
 
Country lover said:
That’s it.
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Ok, if it’s Humulin I then that’s an intermediate acting basal (background) insulin. The i stands for isophane. I use an isophane insulin when I take a break from my insulin pump, but I use it in conjunction with another fast-acting insulin to deal with my meals. The job of isophane is really to keep blood glucose in range and steady in the absence of food.

Can you give us an idea of what you eat in an average day @Country lover ?
 
Inka said:
Ok, if it’s Humulin I then that’s an intermediate acting basal (background) insulin. The i stands for isophane. I use an isophane insulin when I take a break from my insulin pump, but I use it in conjunction with another fast-acting insulin to deal with my meals. The job of isophane is really to keep blood glucose in range and steady in the absence of food.

Can you give us an idea of what you eat in an average day @Country lover ?
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I eat one slice whole meal toast yogurt and berries for breakfast. Soup or sandwich or salad for lunch. Dinner is often fish/chicken with vegetables. Try to snack on fruit if hungry. Use recipe books of low carb recipes.
 
So not at all excessive @Country lover The only thing I’d say is to watch out for the fruit. That could push your levels up, depending on what type you have, how much you eat and when you eat it. I’d only be having a fruit snack if my levels needed it. If not, I’d go with a non-carby snack like a Babybel and celery, a hard boiled egg, etc etc.

You mentioned having hypos in your first post. You might need to stick to a routine to reduce the risk of those. That is, stick to the same amount of carbs each day at the same times.
 
Inka said:
You mentioned having hypos in your first post. You might need to stick to a routine to reduce the risk of those. That is, stick to the same amount of carbs each day at the same times
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I agree. And be mindful of differing levels of activity too. You are likely to be more sensitive to the Humulin Insulin of you are more active @Country lover (even if only doing something like walking, gardening, or housework rather than ‘exercise’), and unlike your own insulin production, once it’s in, it can‘t be ‘switched off’.

Are the erratic levels you are wrestling with highs as well as lows? You might benefit from adding a mealtime insulin into your regime to help with any carbs you are eating if your pancreas is missing its first phase insulin release?
 
I am a Humalin I user. You may find the issues you are having @Country lover due to the way it works. I’ve attached an image that shows how Humalin I does not give you a steady ‘input’ of insulin through the day. It works with peak ‘times’ - I have issues with hypos late morning and at around 3am!! If I reduce the bolus I give I then end up too high early evening / first thing in morning. It’s a nightmare to juggle! I now try to take a snack late morning to combat the impending low. I also take some dark chocolate covered almonds before bed to stop the nighttime low.

I hope that might help explain your problem @Country lover.
IMG_7728.jpeg
 
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