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Type 2 with insulin - anyone else using this ?
- Thread starter Jenny105
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Jenny105
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Another interesting post. There are certainly a range of approaches and not always the expected one .
Hi I am now on 1,500 mg Metformin plus between 12-20 Novarapid and 9 Lantus once a day. I have had a negative GAD antibody test but fit the profile for T1 at onset. My DSN has put me on the Metformin recently which I am increasing over a 4 week period in an effort to decrease Novarapid. I have found there is some effect but not much in the morning. If I eat carbs it will go well into double figures without Novarapid. Yet in the evening the Metformin seems to have an effect. My time in range has improved overall however, that is the range of 4-10 mmol. Next week my Metformin will be increased again to 1000 in the morning and same at night. I believe that is the maximum?
I am not confident that I will be off Insulin though even at that level. What type I am is still a mystery to me but my DSN is leaning toward T2 as Metformin does appear to have an effect. One thing that has helped me has been participating in a Freestyle Libre trial for free. Without a monitor I would have struggled to get the results I have. In my interpretation of NICE guidelines I should be prescribed but my hospital takes a different view.
I am not confident that I will be off Insulin though even at that level. What type I am is still a mystery to me but my DSN is leaning toward T2 as Metformin does appear to have an effect. One thing that has helped me has been participating in a Freestyle Libre trial for free. Without a monitor I would have struggled to get the results I have. In my interpretation of NICE guidelines I should be prescribed but my hospital takes a different view.
Jenny105
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Hi Jamie thanks for sharing this. Diabetes isn't necessarily straight forward,Jamie. How long ago did you start out on this ? Im on my 2nd week. with insulin but diagnosed 18m ago. Im taking one day at a time on insulin until I speak to the Nurse. I have a theory BUT its no good testing it until the insulin experiment is over.
Keep Going Jamie let us know how it pans out
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If it helps, I was put on basal/bolus after Covid sent my levels sky high (HbA1c 117 & DKA) in May last year. I'd previously managed on 1g of Metformin for 12 years with HbA1c in the mid 40s. I firstly titrated insulin upwards until levels were stable, then Metformin was re-introduced, also titrating up to 2g. Then Empagliflozin was added.
This allowed insulin to be titrated down again. Both basal & bolus were decreased by 10% each time levels were consistently below 6 for three consecutive days. By mid December I had ceased bolus but remain on 9u of basal.
Of course what worked for me won't necessarily work for you, but hopefully shows that the theory is sound.
Jenny105
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Hi Write to your MP about your story o fthe Freesyle Libre, how its helped and that you cant get it locally, Ask why. My MP went to a Diabetes UK Conference. I wrote my story and she has become very interested even writing to the Dept of Health about a query I raised re food labelling -carbs and sugars.
Hi Jenny, so far I have complained to PALS and through them the consultant that I have never met. If still no joy this week then the MP is a good shout. Personally I think who cares what type you are, high and low BGL in any type are the same thing if you are on Insulin. Nobody in the medical profession I have asked can explain this discrimination. Of course the NHS is not a bottomless pit but given the potential complications of diabetes of any kind then why can’t we all benefit from the technology?
Jenny105
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My nurse has said to me there is an alternative to the pen I'm using for insulin. I said I'd stick with this. However if insulin becomes a regular means of treatment I might ask what it is. I am using the same dose each day, but rising every few days until appropriate readings are reached. eg this am reading was 12.1, yesterday 2hr post meal was 10.8. Getting there tho .
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Good to hear that your dose is getting adjusted, and your levels are starting to come down a little @Jenny105 🙂
The NICE guidelines for T2 suggest choosing between basal-only, biphasic (2x a day mixed), or basal-bolus - so it doesn’t seem like 1x a day insulin is all that unusual.
See section 1.7.24 here which covers insulin
1.7.26 Start insulin therapy for adults with type 2 diabetes from a choice of the following insulin types and regimens:
The NICE guidelines for T2 suggest choosing between basal-only, biphasic (2x a day mixed), or basal-bolus - so it doesn’t seem like 1x a day insulin is all that unusual.
See section 1.7.24 here which covers insulin
1.7.26 Start insulin therapy for adults with type 2 diabetes from a choice of the following insulin types and regimens:
- Offer neutral protamine Hagedorn (NPH) insulin injected once or twice daily according to need.
- Consider starting both NPH and short‑acting insulin (particularly if the person's HbA1c is 75 mmol/mol [9.0%] or higher), administered either:
- separately or
- as a pre-mixed (biphasic) human insulin preparation.
…. and then goes on to discuss other variety of insulins and when those might be more appropriate
Jenny105
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Hi folk the daily readings continue to fall a little each time the insulin dose rises. 19.3 on waking is now 11.3 n 20u of insulin.
By phone I managed to get my DN to say sugars should be 5% , 5gms per 100g BUT what i didnt get is this 'is this per meal ' or 'per day' . If anyone has experience of Type 2 with insulin (16u - 22u) I'd love to hear.
By phone I managed to get my DN to say sugars should be 5% , 5gms per 100g BUT what i didnt get is this 'is this per meal ' or 'per day' . If anyone has experience of Type 2 with insulin (16u - 22u) I'd love to hear.
Jenny105
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DN said nothing about carbs,
The 1800 cal diet uses about 120 - 160 ish carbs. 1800 cals. As Im trying add about 4-7 lbs or 2-3kgs is it ok to increase the carbs,. Bread , potatoes, rice, pasta dont features oftemn (Weight loss reasons or carbs control reasons ?) I probably need 200 - 400 more a day in carbs to gain this weight
Ive gained about 1kg on this diet , but i can lose it again - what would U suggest ? Thanks
The 1800 cal diet uses about 120 - 160 ish carbs. 1800 cals. As Im trying add about 4-7 lbs or 2-3kgs is it ok to increase the carbs,. Bread , potatoes, rice, pasta dont features oftemn (Weight loss reasons or carbs control reasons ?) I probably need 200 - 400 more a day in carbs to gain this weight
Ive gained about 1kg on this diet , but i can lose it again - what would U suggest ? Thanks
Leadinglights
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I think there is a confusion that is caused by nurses using the terminology 'sugars' when they mean blood glucose or carbohydrates because they thing that people won't understand the words glucose and carbohydrate.
This can lead to huge misapprehension. So using the phrase 'have no more than 130g per day sugar' when they really mean 'no more than 130g per day carbohydrates' is very dangerous.
What your nurse said really makes no sense.
This can lead to huge misapprehension. So using the phrase 'have no more than 130g per day sugar' when they really mean 'no more than 130g per day carbohydrates' is very dangerous.
What your nurse said really makes no sense.
Been on basal insulin since December but with gliclazide along side dapagliflozin as I can’t take metformin as has pushed me in hospital twice previously with my GI disorders and rapid dehydration. Still trying to get the dose right and balance with my GI disorders but getting there slowly.
Jenny105
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@Leadinglights. OK point taken....... As I had a reading of 6.6 pre lunch and 4.7 pre supper. I reckon I'm doing OK. Those readings were in the 20s a month ago.
I'm afraid I don't always use the correct terminology, nor explain myself well as a result. so let's try this. For 3 months I've used the D UK 1800 meal plan as a Base ( not rigidly). A good guide to carbs and sugar, protein etc, tasty recipes easy to prepare. I want to branch off a bit and anyway it's a diet former losing weight. So
I'm afraid I don't always use the correct terminology, nor explain myself well as a result. so let's try this. For 3 months I've used the D UK 1800 meal plan as a Base ( not rigidly). A good guide to carbs and sugar, protein etc, tasty recipes easy to prepare. I want to branch off a bit and anyway it's a diet former losing weight. So
Interesting. Glad to here you are progressing. Its certainly a challenge
Thank you, hope you’re not having too many side affects?@Leadinglights. OK point taken....... As I had a reading of 6.6 pre lunch and 4.7 pre supper. I reckon I'm doing OK. Those readings were in the 20s a month ago.
I'm afraid I don't always use the correct terminology, nor explain myself well as a result. so let's try this. For 3 months I've used the D UK 1800 meal plan as a Base ( not rigidly). A good guide to carbs and sugar, protein etc, tasty recipes easy to prepare. I want to branch off a bit and anyway it's a diet former losing weight. So
Interesting. Glad to here you are progressing. Its certainly a challenge
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