Queries about insulin

[Caroline1967]

Well I started my insulin on Friday and have managed fine! I was really nervous on Friday using it but I think I did ok!
My nurse said to aim for between 10 and 14 which I am not quite understanding as surely the idea is to get it down to normal, but I will go with what he said. I have started with 14 units and he told me to go up 2 units every 4 days until I am in the range of 10 -14. This is the bit I don't understand. I am using 14 units and waking at 9 (never woken that low before!) During the day it ranges from 7 - 16. So 16 is more than the high of 14 he mentioned but if I add 2 units surely the lower number will be lower than the 10-14. Does that make sense? It is quite nice not spiking up to 20 in the evening so I think the insulin is doing it's job. Just not sure whether I should up the dose or not. I will try to get an appointment to ask him what I should do but they are a bit like hens teeth so not sure when i will manage it!!!

 

[Inka]

Hi @Caroline1967 I guess the range you were given was so your blood sugar could be brought down gradually and also to avoid hypos by building up slowly to the right dose for you.

Which precise insulin are you taking?

 

[DaveB]

Hi. It sounds like you are on twice-a-day mixed insulin - quite common for T2s. If you need better control in the longer term ask to be changed to the 4/5 times a day 'Basal/Bolus' regime where you have two different insulins. It's easier then to adjust your Bolus insulin to your carb intake. With mixed it can still help if you keep your carb intake under control to avoid big spikes.

 

[Caroline1967]

Hi @Caroline1967 I guess the range you were given was so your blood sugar could be brought down gradually and also to avoid hypos by building up slowly to the right dose for you.

Which precise insulin are you taking?

Hi I am on Humulin I
Having just looked that up I see I am supposed to see my nurse to review medication in 3 weeks (don’t remember him saying that!)

 

[Inka]

Hi I am on Humulin I
Having just looked that up I see I am supposed to see my nurse to review medication in 3 weeks (don’t remember him saying that!)

Ok, that’s a basal/background insulin (i stands for isophane) See how you go with it. You might find it better to have less of that and add a bolus/meal insulin so you have more flexibility with your meals and better control.

 

[Caroline1967]

Hi. It sounds like you are on twice-a-day mixed insulin - quite common for T2s. If you need better control in the longer term ask to be changed to the 4/5 times a day 'Basal/Bolus' regime where you have two different insulins. It's easier then to adjust your Bolus insulin to your carb intake. With mixed it can still help if you keep your carb intake under control to avoid big spikes.

Hi
I am eating low carb still. I use 14 units am and still taking gliclazide. I need to make an appointment in 3 weeks which I hadn’t realised, so will chat with him more then. Thinking back I do remember him saying something about maybe needing it to go with meals too. I guess time will tell!

 

[Inka]

Hi. It sounds like you are on twice-a-day mixed insulin - quite common for T2s. If you need better control in the longer term ask to be changed to the 4/5 times a day 'Basal/Bolus' regime where you have two different insulins. It's easier then to adjust your Bolus insulin to your carb intake. With mixed it can still help if you keep your carb intake under control to avoid big spikes.

Lots of Type 2s are started on a basal insulin rather than mixed. I think that’s in the guidance? As @Caroline1967 has confirmed, she’s on isophane.