Weaning off of Insulin - Type 2

[Coline]

I was diagnosed with type 2 on 18 August 2021 and told to read my blood three times a day, but I did it 4 times.

I started insulin on 1st of September. It was Sinocare, the long lasting one at 12mg once a day. By the end of January it had got to 44mg.

I then gave up Granary Bread and switched to Nimble and gave up potatoes. Also looked at the sugar labels on everything.

By the 31st of February I reduced this to 20mg then by the 2nd of March. (Just two days of 20mg.)

Then I cut out my insulin all together.

I am now half way through May and still not using it, but I still read my glucose 4 times a day.

I still watch what I eat and once in awhile it goes over but usually its back on coarse by the next reading.

 

[Inka]

Welcome @Coline 🙂 It sounds like your dietary changes have had a good effect. What kind of blood sugar results are you getting now? Do you test 2hrs after your meal so you can make sure you’re not spiking too high?

 

[Leadinglights]

It is unusual to be put on insulin so soon after diagnosis unless you blood glucose is dangerously high.
Is Sinocare an insulin? as it looks as if it is a blood glucose testing monitor.
Were you changing your insulin dose on the advice of your diabetic nurse or off your own bat if so how did you decide how much to reduce it.

 

[Coline]

No. I test when I get up and then about 1pm - 6pm and midnight ish, always before eating.
I am 6 months from 82 and male. Wife is on tablets but she is a ***** for cream cakes ect.,
another thing she is poor at, giving up smoking. I gave up to the vaper but then gave that up too.
2017 Smoking and 2020 Vaping. I can eat 1pk of crisps with a bottle of real ale without going over.
My readings are between 5 and 8.4, peeking occasionally around 9. but then I have been naughty.

 

[Coline]

(Leadinglights) - Was my Diabetic Nurse at the my Dotors. Got the name wrong XXXX, It was Lantus SoloStar.
Went on the FreeStyle site and downloaded the web application to my PC, so you have the averages too.

 

[Inka]

No. I test when I get up and then about 1pm - 6pm and midnight ish, always before eating.
I am 6 months from 82 and male. Wife is on tablets but she is a ***** for cream cakes ect.,
another thing she is poor at, giving up smoking. I gave up to the vaper but then gave that up too.
2017 Smoking and 2020 Vaping. I can eat 1pk of crisps with a bottle of real ale without going over.
My readings are between 5 and 8.4, peeking occasionally around 9. but then I have been naughty.

It would be worth considering doing an occasional post-prandial test to see what’s happening to your blood sugar after food. That way you can check to make sure you’re not spiking too high after your food.

 

[leonS]

You got the units wrong too - insulin is measured in IU not mg - this confuses simple minded folk such as I.

I agree with @Inka, you would be better off with a test before a meal and one two hours after it and just use 2 tests a day on different meals.

 

[Coline]

You got the units wrong too - insulin is measured in IU not mg - this confuses simple minded folk such as I.

I agree with @Inka, you would be better off with a test before a meal and one two hours after it and just use 2 tests a day on different meals.

Sorry but my pen was marked in Mg - Conversion is possible but " In converting human insulin from conventional (units, ml) to SI units (pmol, l), there are 2 (maybe even 3) conversion factors, but only 1 is right. It is not the one most used in online conversion calculators and tables, and it is not necessarily the one recommended in some journal’s style guides. This issue is open to widespread use of incorrect values in research, analysis, and care."

 

[rebrascora]

With insulin we generally talk in units rather than anything else because it makes things simpler. As you will see on the label you posted for the Lantus Solostar, it is 100units per ml and your pen will usually hold 3mls or 300units.
I would imagine you started off on 12 units and gradually had that increased to 44 units, but thanks to the power of following a low carb way of eating, it sounds like you have managed to reduce that down to zero and you are getting pretty good results with that, so you have done incredibly well.
Congratulations on a fantastic achievement!

 

[everydayupsanddowns]

Sorry but my pen was marked in Mg - Conversion is possible but " In converting human insulin from conventional (units, ml) to SI units (pmol, l), there are 2 (maybe even 3) conversion factors, but only 1 is right. It is not the one most used in online conversion calculators and tables, and it is not necessarily the one recommended in some journal’s style guides. This issue is open to widespread use of incorrect values in research, analysis, and care."

I’m afraid you lost me with the SI units stuff

100u/ml as shown on your leaflet is the conventional strength (100th of each ml of insulin being creatively called a ‘unit’)

There are also 200u/ml and 500u/ml strengths, which allow people on very large doses to only inject a smaller volume of fluid. But it’s fraught with risk as they must be administered with their own devices which are configured for the higher strengths.

Glad you’ve been able to make some changes to your menu and adjust your insulin downwards. 🙂

 

[Inka]

Sorry but my pen was marked in Mg - Conversion is possible but " In converting human insulin from conventional (units, ml) to SI units (pmol, l), there are 2 (maybe even 3) conversion factors, but only 1 is right. It is not the one most used in online conversion calculators and tables, and it is not necessarily the one recommended in some journal’s style guides. This issue is open to widespread use of incorrect values in research, analysis, and care."

I’d be very surprised if your pen is marked in mg. All insulin is specifically measured in International Units. Dialling up a dose of, say, 12 on your pen, simply means 12 units.

I vaguely remember the reason behind this being explained to me at diagnosis, but that was a long time ago and I don’t remember the details. Possibly it was to do with the difference strengths of insulin that were available many years ago.

When I was first diagnosed, we used syringes, and I do remember the importance of checking you had been given the right syringe. Again, the syringes were marked in units because they were insulin syringes. So drawing up insulin to the number ‘8’ meant you had 8 units ready to inject.

 

[Bruce Stephens]

When I was first diagnosed, we used syringes, and I do remember the importance of checking you had been given the right syringe. Again, the syringes were marked in units because they were insulin syringes. So drawing up insulin to the number ‘8’ meant you had 8 units ready to inject.

I remember having to (occasionally) do a bit of mental arithmetic when the pharmacy gave me a different strength insulin.

If I remember correctly the story I heard was that it was hard for some reason to produce animal insulin at high strength, and the artificially made stuff was an opportunity to simplify things so that almost all of us use U100 all the time. (I seem to remember at least one crime story (Agatha Christie?) where the murder method involved substituting a stronger insulin. Much easier when someone was used to use 20 strength (or even 10 strength) but when 80 strength was fairly easy to get.)

 

[Inka]

I googled and found this:

“Historically when insulin was discovered at the turn of the 20th century by Banting and Best, they did not have the advanced technological luxury we have today to readily measure the weight of an insulin molecule. Furthermore, insulin was available in various strengths and concentrations so it was difficult to measure the mass or volume of insulin.


Scientists in the past however were smart people and they came up with creative ways to do things. Therefore, an indirect model was used to quantify a standard amount of insulin. Like most historical scientific studies, we used animals to test a hypothesis. In the case of insulin, we used rabbits. One international unit of insulin was the amount of insulin required to lower the fasting blood sugar of a rabbit by 2.5 mmol/L. With the advanced technology nowadays, we now know one unit of insulin is equivalent to 0.0347mg of pure crystalline of insulin.


Now is it easier to dose insulin based on 0.0347mg of insulin or 1 unit?”

 

[rebrascora]

Now is it easier to dose insulin based on 0.0347mg of insulin or 1 unit?

I did think the OP's mention of a dose of 44mg of insulin would probably be enough to kill an elephant let alone a human but wasn't sure of the actual figures. It would be well over 1000units! 😱