Two insulin’s

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Nadia Robertshaw

Nadia Robertshaw

Well-Known Member
Relationship to Diabetes
Type 2
I’m new to insulin, only been taking it a month. Taking Levemir last thing at night.

On my last hospital appointment with the diabetic nurse, she advised it’s quite likely I’m going to require another insulin injection with my food. So far taking metformin twice a day, and a dose of insulin last thing at night isn’t bringing my levels down enough.

Has anyone got experience of having two insulin’s to take?

Please can someone give me some names of insulin that would be secondary ones?

If you’re in this position have you seen a difference?

Thanks all in advance x
 
Nadia Robertshaw said:
I’m new to insulin, only been taking it a month. Taking Levemir last thing at night.

On my last hospital appointment with the diabetic nurse, she advised it’s quite likely I’m going to require another insulin injection with my food. So far taking metformin twice a day, and a dose of insulin last thing at night isn’t bringing my levels down enough.

Has anyone got experience of having two insulin’s to take?

Please can someone give me some names of insulin that would be secondary ones?

If you’re in this position have you seen a difference?

Thanks all in advance x
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Hi Nadia. I expect your nurse is thinking of adding a short term insulin that lasts about four hours and mops up the carbs from each meal. A lot of people are on something like Novorapid. The correct term is a bolus insulin. The Levemir you are on is called a basal insulin, because it deals with the glucose that your liver trickles out 24/7 to keep your vital organs going. Your nurse should explain all this to you. You may be started off on fixed doses, and told to eat a certain number of carbs at each meal, or you may move straight of calculating your dose depending on what you want to eat. Overall, it should give you finer control over your glucose levels. One of our members, @Ljc , has Type 2 and is on a basal/bolus regime, she may be able to help.
I also wonder if our admin, @Northerner could move this post to the General Messageboard, (it seems to have ended up in Pumping, which is a bit of a niche place for people on insulin pumps.) so more people will see it.
 
Hi Robin,

Thanks for the information it’s much appreciated. It’s such a learning curve going from just tablets/diet now to insulin. You sound like quite an expert , and I must say that’s really reassuring. Well my appointment this afternoon should be interesting, no doubt more things to learn especially if she add’s another insulin to the mix.
 
Hi Nadia, welcome to the forum. I am on a basal bolus regime or MDI multiple daily injections as it’s sometimes called. @Robin has explained it well. I agree it’s highly likely you may be started on a fixed dose till you have learnt how to carb count and adjust your bolus doses, don’t t let that worry you as it’s actually not that difficult ! if your maths isn’t that great you can always use a calculator. Carb counting and adjusting bolus is a very flexible regime.
Whatever regime you are put on the doses of basal and bolus will need tweaking your nurse will help you with that, so keep in close contact with her.

For me MDI has been the next best thing to sliced bread, it leads to far far better control.

Ask as many questions as you need to ok , we’ll do our best to help
 
Good luck with your appointment this afternoon
 
Thank you for your information Ljc much appreciated.

With being on a two insulin regime do you have to monitor your bg levels as well?

Fair play to my nurse said I didn’t need to monitor my bg levels whilst I was away. But it’s become such a routine I continued to do it. It’s enabled me to see a pattern develop.

Myself and hubby want to have a baby, so getting my bg levels reduced and consistent is one of the challenges.
 
Many of us here believe that testing is the only way me included is the only way to find out how the various carbohydrates affect us so you can make informed choices.

Being on insulin or any other medications that can cause hypo’s (Metformin normally doesn’t ) is absolutely necessary also being on insulin you must follow the DVLA rules on testing,I will try to find the link for you, you’ll also need to inform the insurance company, it shouldn’t affect your insurance at all but they do need to be informed.
 
All done the things you mention....I notified dvla, and insurance immediately. On a 3 year license now.
I used to work for dvla, so fully aware of medical stuff prior to being put on insulin.

Nurse hasn’t put me on another insulin yet. She said we’all keep on doing what we are doing for now and reassess in two months. So I guess we’ll see.

My gut instinct says tho, I’ll probably need another as my bg goes up whenever I eat. Only really see a difference after admistered insulin, so last thing at night and in the morning.
 
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Hi Mikey,

I was diagnosed t2 in March 2016. But I’ve never been able to get my bg levels down. Diabetes is also throughout my family, my Nan on mums side has it. T1 immediately for her, mum is t2 but with insulin now. Obviously me t2 with insulin and my sister is currently t2 on medication only.
 
Just seen your other thread about being tired all the time, Nadia, and I am wondering what I think Mike is wondering - whether you might be LADA (ie late onset, slow developing, type 1) rather than type 2. Being tired all the time can be a sign of untreated type 1, and with diabetes including type 1 in your family and the fact that you've never been able to get your levels down and they only go down when you have insulin, it is a bit suggestive of type 1.
 
Hi Juliet,

I think you and Mikey maybe on to something. Now that I’m under the local hospital maybe they will be able to confirm that. I’m not seeing my nurse until the end of September now, after today’s appointment she’s told me to keep on increasing the insulin by 2 units until I get my bg readings into single figures in the morning. Whether that is actually gonna happen tho is another matter. Currently on 22 units at night, and it’s hit & miss in the morning as to whether it’s under or over 10bg level.
 
Hi Nadia

I would agree with others that you are sounding very much like a T1. I was diagnosed with T1 when I was 53. I got thinner (list 1 1/2 Stine in a week), was very thirsty, very tired and on the toilet a lot (I could not get through a 1 hour lesson without using the loo). Once diagnosed and on insuiln problems were solved (although that was only the start of all that I have learnt.

If you are now in the care of the hospital, you could ask them to check this. A Gad antibody test can give an indicator of T1, as with T1 it is antibodies in you that gradually destroy your beta cells in the pancreas that make the insulin.

Either way you clearly need insulin and it sounds as if you are beginning to get things sorted. Keep in touch and let us know how you get on.
 
Thank you SB2015

Prior to my next appointment with the hospital nurse she wants me to have blood tests. These will be my first blood tests under the hospital, so hopefully they will establish whether I am t1 or t2. Secondly, could they help the nurse decide if I need to have more insulin apart from my nightly dose.
 
That's good, Nadia - hopefully they will do the GAD antibody test and also maybe a C-Peptide test (another test for type 1) and not just your HbA1c and blood count. It's worth asking when they do the tests, to find out which ones have been requested - or if you have a phone number or email address for the nurse, you could ask her beforehand if they will include tests for type 1 in case you have LADA. They don't always think of testing for type 1 with adults because type 2 is so much more common, but quite a few people here have been misdiagnosed as having type 2 and then turned out to have LADA or type 1.
 
Hi all,

I trust everyone is well? Well I got to meet the consultant today for the first time. As expected I’ve been put on a fast acting insulin. Novo Rapid.....it all seems rather daunting at this point in time.

I’ve been advised to inject 4 units with meals, been advised it can drop down to 3 units and 2 units if necessary. They have also advised to continue with the Levemir last thing at night and not to increase beyond 30units.

The consultant also advised I need to lose some weight, and do more exercise. I did my first dose of new insulin earlier bg was on 8. Then had my meal about 40 mins after doing insulin, unfortunately meal was lots of carbs . So on checking bg 2 hrs after bg was on 14.7. So I’m hoping when I do night insulin it will bring it into single figures in the morning.

Would be really grateful for more help and advice. Thanks all xxx
 
The main thing you need to do is reduce your carb intake. Now you are on insulin, you will eventually learn how much insulin you need for a particular meal. This is called dose adjustment for normal eating, DAFNE for short. Your diabetes team should organise a course for you.

It sounds like your meal rather overwhelmed the insulin you injected before the meal, so if you have been told to stick to certain doses with meals, you will have to change the meals to match the insulin better. As I said, reduce the amount of carbs in meals, and your numbers should come down, as well as helping with the weight loss.

It is daunting at first, there is so much to learn, but it does become second nature after a decade or two. That’s not a joke, but you learn more each day, and it gets easier every day when you get to know how your body responds to insulin, and your food intake.

And the more you post, the more convinced I am that you’re T1. Don’t worry, being T1 means that you can have closer control of your BG. Eventually.🙂
 
Hi Nadia. Thank you for the update. Snap i am Novorapid . I know it seems daunting to you at the mo. Please don’t be frightened of insulin, we are just having to give ourselves a hormone that our bodies can no longer make correctly or enough of .

Did you have a high carb meal because you were worried about h@ving a hypo (low blood glucose) ?
When we first start on insulin they are quite conservative about the doses as they need time to find out what amount works best for us , you see just like everything else to do with diabetes the amount of insulin we need. Varies so much, so they usually start us off on lowish amounts and then tweak as necessary .

Initially going on insulin is a rather like learning to drive, ie you don’t have enough hands or feet to be able to do everything at once and it’s scary too , but then with more practice it begins to get easier, you will be supprised just how quickly you’ll learn .

Keep in close contact with your diabetes team , they are there to help you , we can help too
 
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