T2 & reducing Insulin (who has experience)

[goodybags]

I know I’ve got to listen to the healthcare professionals on this one, but interested to find out others experience in reducion of and eventually coming off insulin (T2)

So having got my Hba1c down from a spiraling out of control heading for 100 (I’m sure it was over 100 at some point) to a more respectable 48 now (In 12 month)
change of Diet & weight loss (17KG lost in 5 months)
I’m currently still taking daily 200mg of Metformin and now reduced amount of NovaMix insulin (twice daily)

last spoke to Dr a few weeks ago and was advised to reduce insulin to 18 in morning and 14 in evening was previously on a dose of 18 in evening & 20 in the morning
I’ve since then reduced it further to just 12 both morning and evening (still on Metformi max dose)
he advised me to wait for review at Diabetic clinic @ the hospital before any further reduction or looking @ possibly reduced Metformin
im still getting Hypo’s lowest one was woke up in the middle of the night with 2.9 but they are usually low 4’s or in the 3’s

I’m wondering what other T2’s experience was when they reduced / came off insulin
what was their min done they were reduced to (before they stopped taking insulin)
and went back just on tablets
im really hoping for a further reduction in my HbA1c and putt this whole thing into remission I HOPE SO MUCH I CAN
in the next 12 month.

currently I’m taking 12 units of NovaMix 30 twice daily
that is top of the Maximum Metformin 200mg a day (taken breakfast & tea time)

 

[Ljc]

Hi. Tbh I would not wait till your review at the hospital. If you have contact details for your DSN or Consultant then I suggest you contact them urgently as you need proper advise urgently on reducing medications.
Or perhaps your Gp can contact them for further advise, you shouldn’t be left in limbo till a review .
Tbh we are quit rightly not allowed to advise on meds/doses etc but I know what I would do.

 

[Inka]

Why would you need to wait until your review? Your blood sugar results will show whether you need a further reduction and if you do then it’s not exactly complicated.

I wouldn’t want to be so low overnight. I suggest you do something now not wait for your review.

Well done on the weight loss!

 

[SweetGuy]

I take 2000mg/day Metformin SR which is a max dose. Is that what you mean? I also take Novomix 30 although a much (much) larger dose. I vary the dose myself depending on the numbers I have been getting. If i was as low as you on a night time I would certainly reduce it. I think you are better erring towards a bit too high than too low.

 

[goodybags]

I take 2000mg/day Metformin SR which is a max dose. Is that what you mean? I also take Novomix 30 although a much (much) larger dose. I vary the dose myself depending on the numbers I have been getting. If i was as low as you on a night time I would certainly reduce it. I think you are better erring towards a bit too high than too low.

Thanks for the advice @SweetGuy
Never understood about the Metformin SR or standard, on that one I never knew which one it was
but like you I’m on 200mg max dose twice a day
on the NovaMix I was previously taking a lot more like you say you are,
when I was not eating what I’ve since discovered I need to (before feb last year)

think I’ve been on the NovaMix for about 8yrs so was dependent on it but still out of control
at one time I was taking 35 units trice daily
the NovaMix has been previously reduced slowly over the last few months
today I took just 10 this morning and been ok, so will do 20 again tonight

I’m currently testing upon on waking, before & after my three small meals, again before sleep, plus in the night as needed, it’s been a eye opene, for me a lower carb diet & testing has worked
I’m going through strips like crazy (luckily my Dr has upped the prescription on them so I can now get a double lot every month) but I’m starting to feel like a pin cushion

 

[goodybags]

Hi. Tbh I would not wait till your review at the hospital. If you have contact details for your DSN or Consultant then I suggest you contact them urgently as you need proper advise urgently on reducing medications.
Or perhaps your Gp can contact them for further advise, you shouldn’t be left in limbo till a review .
Tbh we are quit rightly not allowed to advise on meds/doses etc but I know what I would do.

Thanks @Ljc
we don’t seem to have DSN anymore, she went when Virgin Healthcare took over my practice they ended up folding as it was a mess, and a neighbouring practice then absorbed all the patients.
I spoke to my Practice today & Dr is going to phone me at some point tomorrow

 

[Ljc]

Thanks @Ljc
we don’t seem to have DSN anymore, she went when Virgin Healthcare took over my practice they ended up folding as it was a mess, and a neighbouring practice then absorbed all the patients.
I spoke to my Practice today & Dr is going to phone me at some point tomorrow

Hi. That sounds awful.
A DSN is normally based at the hospitals diabetes clinic rather than with a Gp practice though some do.
Your Gp should be able to contact the DSN or even the diabetes Consultant . I hope you get some proper help soon.

 

[goodybags]

Hi. That sounds awful.
A DSN is normally based at the hospitals diabetes clinic rather than with a Gp practice though some do.
Your Gp should be able to contact the DSN or even the diabetes Consultant . I hope you get some proper help soon.

Thanks @Ljc
My GP phoned first thing this morning and advised reduced insulin dose again
from 10 down to 6 and see if that works also he’s chasing up previou referral to the Diabetic Clinic

 

[Ljc]

Thanks @Ljc
My GP phoned first thing this morning and advised reduced insulin dose again
from 10 down to 6 and see if that works also he’s chasing up previou referral to the Diabetic Clinic

That is good to hear.
I hope the reduced dose of insulin works well and that you don’t have to wait much longer for an appointment with the diabetes clinic.
Please let us know how you get on.

 

[everydayupsanddowns]

I would also be concerned about those low levels overnight. And be looking to reduce them (as a T1 I was basically given the reins to adjust my own doses almost from the point of diagnosis onwards!)

Am I right in thinking that you are taking a much bigger dose in the evenings... and then going low overnight. When do you take your evening injection? Hopefully it’s before your evening meal?

Novomix is a tricky one, as the action of the two types of insulin can’t be varied separately. It has a fast acting component and a ‘background’ component. It will last up to 24 hours for the background, and have a burst of much stronger activity for the first 4 hours.

Bigger insulin doses tend to absorb more slowly, and last longer than smaller doses... But it feels like your evening injection may well be pushing too hard and sending your BG into hypoglycaemia overnight. And the more frequently this happens the less effort the body will make to do anything about it (eg firing warning signs and dumping glucose from the liver). The brain will physically change to cope better in the future, and it will begin to see these events as ‘normal’, when actually they are quite dangerous. 😱

 

[goodybags]

after speaking to my GP he advised reducing my insulin dosage to just 6 in both morning & evening which I did and seems a better level
waiting on referral to see specialist at diabetic clinic and see how everything goes