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Unsure what is best

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Franklin said:
Yes it’s a slow release insulin
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You may get better blood sugars and flexibility if you had a long acting insulin to cover the background, and a rapid acting insulin to cover the food. It may also be though that you could improve blood sugars with changing the dose of your current intermediate insulin and changes to diet and exercise. Ideally you need to get to see a DSN who can review your blood sugars and talk that through with you.
 
Franklin said:
My insulin is Humulin I, it has a green top on the pen. I do not have a cottage hospital it was closed several years back. just have a two very large hospital to deal with all things. My concerns are my BG has been high for several months 3 at least and I had very little advice on how to deal to reduce it. This site has given me some help and I am doing what most say to reduce my carb intake. I must say my other half is wonderful and she has always tried to keep me eating healthfully. I have lost 6kilo in 8 weeks and its is still going down but the DN over the phone consultation did not feel that was important, I am due another blood test next month that may pick something up, she did say my white platelets were down would that be caused by the diabetes ??.
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Humulin I is isophane insulin (the letter i in its name stands for isophane). That’s an intermediate acting insulin and lasts 12-24 hours - much closer to 12 hours in my opinion. That will be why you take it twice a day - to hopefully provide cover for you day and night. It starts working 60-90 mins after you inject it, has a peak of action usually around 4/5 hours then slowly tails off.
 
I walk each day and average 10k steps per day, I am active and my diet is low carb and I have shown my DN what I eat and I have been involved on a course for diabetes which involved what food and amounts are good, I have smaller portions so that side of things can’t improve much more if at all. I feel the medication needs to be reviewed but as my DN is now leaving next week I cannot see a review happing soon. Sorry to sound negative but I been dealing with these high BG and it’s worrying.
 
You’re obviously working really hard @Franklin I agree that a medication review would be sensible. As @Lucyr says, it might help you to have a fast-acting insulin to cover meals. The Humulin I (isophane) you’re using is a basal/background insulin and can’t really deal with food that well. When I take a break from my insulin pump, I use isophane insulin as my basal/background insulin, but I also use another faster-acting insulin when I eat. That faster insulin stops my food pushing my blood sugar up.

Its not acceptable that your blood sugars are so high and you’re right to be concerned about that. If your surgery aren’t helpful, could you swap to another GP maybe?
 
Have you considered a continuous blood glucose monitor? They are expensive - but the dataset might help you/your DN make more informed decisions about your medication? You can get one for free and try it for two weeks see if it helps.
 
Lucyr said:
Does that mean the profile is the third one down on this diagram? So an intermediate insulin that works gradually throughout the day, but doesn’t specifically peak to cover meals?

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It does have two peaks during each 12 hours, but as you say background use only. SO OP needs to do a load of testing before and after meals plus before bed so he can show his Dr exactly what is going on. If he can not get through to speak to a GP then he needs to send it in via the on line form supplied by his surgery.
 
Hope you can manage to get on a more flexible insulin regime @Franklin

It sounds like your current insulin isn’t working well.

The unintended weight loss is slightly concerning too. Are you speaking to your Dr about that?
 
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