Type 2 and starting insulin, any advice?

[samanthag46]

Hi Everyone, as the title says I am new here. I am type 2 diabetic an have been for nearly 3 years. Up until recently my HB1 and overall diabetes has been well controlled with diet and exercise. But seemingly over the last few months my sugar levels have risen, I am not sure how as I feel my diet has been good. However, I had a hip operation last April but have still been in a lot of pain and as a consequence am unable to do much exercise because of this. I have also been having steroid injections into my hip joint so not sure if this has an effect.
Over the past month or so I have been unable t control my sugar levels and ended up in A&E on Tuesday this week after a phone consultation with my GP. This was because my sugar levels were not dropping below 30 even after taking my medication.
I saw the diabetic team and they started me on 0.25mg Ozempic to be increased after 1 month. So I have just received a call from the diabetic team and they are still not happy with my sugar levels which are ranging between 18-25. She then spoke with the consultant and now I have to start on daily Insulin injections.
Does anyone have any advice? obviously this is all new to me and has all been done over the phone as they are not allowed to make appointments so I am feeling a bit out of my depth.
Do I still eat low carb and low sugar? can I drink alcohol? (mothers day on Sunday) so many questions I do not know where to start.

Any advice would be very much appreciated
Many Thanks
Sam

 

[Ljc]

Please try not to panic. I’ve been on insulin for a couple of years and tbh I am glad I am in it. Yes it’s a bit scary initially. You are lucky in so much as you are under the specialists, rather than Gp practice nurses .
They will guide you through everything you need to know and you also have us too.

As you are probably aware , steroids inc injections can cause high BGs , pain won’t be helping either but readings of 30 in my non medical opinion seem rather high for someone with T2 , I am wondering if you may not have LADA instead, (latent auto immune diabetes in adults) it’s often mistaken by GPs as T2 and may initially respond to T2 treatments, but sooner or later insulin is the only way, when you next speak to your DSN or consultant to test for T1 .

 

[Vicsetter]

What insulin are you being given?
its generally not a problem with insulin injections (unless you are needle phobic), injection sites are the front upper thighs 2 rows of three sites and tummy area to rows of three sites either side of the navel (avoid the navel area).

While a consultation with a consultant or diabetic specialist is ideal, it will probably be difficult at the moment, and any blood testing is not going to happen due to the labs being overwhealmed.
The good news is there is little chance of a side effect from insulin and the only effect on your life will be if you drive (do look up the rules about driving) and also the need to test your blood glucose levels regularly.

P.S. Its useful to put your meds and status in your signature.

 

[Inka]

Get some hypo treatments just in case; test your blood sugar lots so you can see what’s happening; don’t drastically alter your diet because if you suddenly cut your carbs down, you could have a hypo; keep in contact with your team so they can adjust your insulin as necessary.

And, as said above, don’t discount the possibility of not actually being Type 2.

Notify your car insurance company and the DVLA too.

 

[samanthag46]

Thanks for the replies so far.
I have been given Tresiba 100ul/1ml 3ml if that makes sense.
I also take 2x80mg Gliclizide with breakfast as well as 2x 500mg metformin, lunchtime I have 1x40mg of Gliclizide and teatime I take 1x80mg Gliclizide.
The diabetic nurse said today that these will probably have to reduce within a few days once I start injecting.
I will be doing my first injection tomorrow morning as I didn't get my pen until 5pm this evening.
I have just been reading up on it and is it true that you cannot have any alcohol at all? I don't drink very often at all but as it is mothers day on sunday I was going to have a glass of bubbly but if I cannot then I wont.
Wow this is so much to take in and learn.
Is there anything else I need to know?
Many thanks
Sam

Forgot to add the diabetic nurse is phoning me Monday morning to see how I am getting on with it.

 

[Inka]

Do you mean 3 units of Tresiba? Insulin doses are measured in “units”.

 

[everydayupsanddowns]

I have just been reading up on it and is it true that you cannot have any alcohol at all? I don't drink very often at all but as it is mothers day on sunday I was going to have a glass of bubbly but if I cannot then I wont.

No that isn’t true.

But there is a complex relationship between alcohol and insulin, which is why you have to be a little careful.

Alcohol keeps the liver so busy that it no longer trickles out the amount of glucose it usually does while it is processing the alcohol. Which can mean you have a net excess of insulin and you are at higher risk of hypoglycaemia. An added complication being that hypos can look a lot like being drunk... and you could have alcohol on your breath.

So alcohol is fine, but like most things diabetes-related it’s best in moderation.

Enjoy your Mother’s Day bubbly!

 

[samanthag46]

Do you mean 3 units of Tresiba? Insulin doses are measured in “units”.

Sorry for the confusion I have to take 6 units of insulin
hanks

 

[rebrascora]

Hi Sam

The odd glass of wine is OK so enjoy your celebration on Sunday.

As regards injecting insulin, there are You Tube videos which show you how to do them, so watch a few of those before you inject and don't forget to do a 2unit air shot before each injection to prime the needle with insulin. It won't kill you or anything serious if you forget and a little air goes in with the insulin but it means you will not be getting the full dose.
I find injections below the level of the navel are more comfortable than above and I also use the outside of my thighs and make sure to rotate injection sites so that you are not using the same spot all the time.

Make sure that you always have something to treat a hypo with you.... Dextrose tablets, jelly babies, a small carton of orange juice or those small cans of full sugar coke. Keep some in the car (if you have one) and some in all your handbags and your pockets and in the bedroom next to the bed etc. With such a low dose you should be ok but we all have different sensitivity to insulin, so it is best to be safe and if you drive, always make sure you are 5 or above before you hit the road, although I guess you know that since you are already on Gliclazide..... Oh, and you will also need to inform your Insurance company and DVLA that you are using insulin.

 

[samanthag46]

Hi Sam

The odd glass of wine is OK so enjoy your celebration on Sunday.

As regards injecting insulin, there are You Tube videos which show you how to do them, so watch a few of those before you inject and don't forget to do a 2unit air shot before each injection to prime the needle with insulin. It won't kill you or anything serious if you forget and a little air goes in with the insulin but it means you will not be getting the full dose.
I find injections below the level of the navel are more comfortable than above and I also use the outside of my thighs and make sure to rotate injection sites so that you are not using the same spot all the time.

Make sure that you always have something to treat a hypo with you.... Dextrose tablets, jelly babies, a small carton of orange juice or those small cans of full sugar coke. Keep some in the car (if you have one) and some in all your handbags and your pockets and in the bedroom next to the bed etc. With such a low dose you should be ok but we all have different sensitivity to insulin, so it is best to be safe and if you drive, always make sure you are 5 or above before you hit the road, although I guess you know that since you are already on Gliclazide..... Oh, and you will also need to inform your Insurance company and DVLA that you are using insulin.

Thanks so much for your reply. I have just done my first injection so lets see how this goes. I will get some dextrose tablets today when I pop out. On Monday I will also inform the DVLA and my car insurance. I wasn't aware of this so thanks for informing me.
Now what food to get when I go shopping !!!

 

[rebrascora]

Well done! That first one can seem a bit daunting but you get used to it pretty quickly. I was shown how to do it by the nurse but there were things about it that I didn't properly take in and a few weeks later I was having problems with an air bubble building up in my pen. Stupid me was doing my air shot without the needle pointing upwards. So it can be worth watching a few videos a few weeks in to make sure you are doing it right.
I was just told to inject in my stomach but I found I was more comfortable doing them into the front outsides of my thighs in the house or if I was wearing a dress or a skirt, whilst eating out, as I could discretely lift my skirt on one side and inject under the table without anyone noticing. I guess for you at the moment that will not be an issue as you are just using basal insulin once a day.

I would agree with @Ljc that you may well be LADA and may eventually go onto a bolus/basal system if they test you for Type 1 diabetes and you should ask for testing when all this craziness is over and normal service is resumed. Those are GAD antibody and C-peptide tests. In the meantime, just take it steady and if you have any problems just ask.

Just to confirm, you need to keep your stock of unused insulin pens in the fridge but the one that you are using stays at room temperature and is good for 28 days kept like that.... injecting straight from the fridge can cause it to sting more and just not necessary to keep the in use pen cool, but it does need to be protected from excessive heat, for instance when holidays abroad are eventually an option again.

 

[rebrascora]

Food wise, it is best to continue eating as you have been as the dose of insulin you have been started on is based on your current BG levels which are of course influenced by what you eat, so try to keep things the same for now and once you become more experienced with using insulin and perhaps go onto a slightly different regime (basal/bolus or mixed insulin) and perhaps learn how to carb count, you will then be in a position to experiment with your diet.