what do i do now?

[crystalangels]

I would agree with the GP that you do seem to be using a lot of insulin for your body weight and it not being effective. I wonder if it is a problem with the insulin delivery somehow. An error in your technique perhaps or problems with site absorption. I know I made one or two mistakes in the early days and didn't realise for a while that I wasn't doing it right, particularly with the air shot and on my DAFNE course the educator said she had come across one person trying to inject through the needle cover which explained why their levels were in orbit. Have any of your medical professionals watched you do an injection.... apologies if I am teaching my granny to suck eggs here, but just seems like the insulin is not . Can you talk us through the procedure you follow each time you inject to see if we can spot a mistake in your technique. Getting consistent readings in the 30s is very dangerous and you really should be seeking urgent medical assistance via A&E.

thank you for replying. my husband delivers my insulin as i am needle phobic. we follow the technique as told by the diabetes nurse and consultant to gently pinch skin around my middle and then inject. i usually bleed and bruise even though using the finest needles. the hospital gave me a phone appt last week and i sat by the phone for an hour and a half just to make sure that i had got it right or they were late but they never phoned. the hospital don't know how to bring my readings down. i consider that i have been dumped. my readings have been 30 and over for about 2 yeas now. i am careful with my diet. i can have the insulin before bed as advised and after meals but most times my readings do not budge all night.

 

[crystalangels]

How are things going now @crystalangels ?

Have your doses been increased? And have your BGs reduced?

It certainly sounds like your treatment is not working for you at the moment, and those high BG levels are quite worrying for you.

What happens to your BGs if you skip a meal? Do they still rise?

Perhaps you should ask for a referral to the hospital clinic to be seen by a specialist diabetes consultant who may have more experience in cases like yours?

thank you for replying. yes my levels still rise if i skip a meal. Appt with diabetes clinic only telephone appt last week they failed to contact me with a prearranged appt and did not ring me. no one here is giving face to face appts. the same for my Rheumatoid Arthritis- 15 months since i have heard from them 4 appts for telephone appts have been cancelled. they term appts moved not cancelled. but i call it disgraceful. so glad my daughter is getting appts for hers. sorry to moan am afraid my kidneys are in trouble with diabetes as they ache. GP doubled tiny white pill but keeps forgetting to put it on repeats so hassle every time i phone PODS. have now run out while they decide if it has been doubled or not and need to contact GP. try to ring them back to check but may take up to forty mins. on phone. ridiculous system.

 

[rebrascora]

Does your husband do an air shot every time and see insulin coming out of the needle before he injects? I would be particularly concerned if an "untrained" third party was giving me my injections when I wasn't responding to treatment. I really feel this may somehow be an insulin delivery problem. Does your husband also dial up the dose or do you do all the prep with new needle and dose and taking the cap off and then give him the pen to inject it. Is he holding the needle in long enough after releasing the dose?
I don't want to sound like I am putting blame onto him by any means, I just know how easy it is to develop a technique which isn't correct because I did, particularly if you have only been shown how to do it once or twice by a nurse.... and usually at a time when your head is in a spin with the diagnosis and all the other information. It is just easy to go home and not get it quite right and then continue with that incorrect technique, thinking you are doing it right.

 

[rebrascora]

Also where is he injecting it ie which part of your body? Do you have any scar tissue in that location. Does he inject in a different spot every time?
Sorry to ask so many questions, but something isn't right and it needs fully investigating. Do you hear the pen clicking as the dose is injected?

Obviously, if your diet isn't good then that that won't help and only you can do something about that but finding lower carb snacks that I enjoy really helped me, particularly in the first few weeks/months. Things that I could just pig out on without worrying that it would raise my BG levels excessively.

 

[Inka]

thank you for replying. my husband delivers my insulin as i am needle phobic. we follow the technique as told by the diabetes nurse and consultant to gently pinch skin around my middle and then inject. i usually bleed and bruise even though using the finest needles. the hospital gave me a phone appt last week and i sat by the phone for an hour and a half just to make sure that i had got it right or they were late but they never phoned. the hospital don't know how to bring my readings down. i consider that i have been dumped. my readings have been 30 and over for about 2 yeas now. i am careful with my diet. i can have the insulin before bed as advised and after meals but most times my readings do not budge all night.

Have you tried different insulins? You’re on Apidra and Toujeo, yes? Could it be the kinds of insulin you’re using? Have you tried a different basal insulin in particular?

Also, as you’re on big doses are you/your husband splitting the dose between a couple of injection sites to help absorption?

And have you tried injecting in other places than your stomach? Eg your thighs or top of bum?

 

[everydayupsanddowns]

thank you for replying. yes my levels still rise if i skip a meal. Appt with diabetes clinic only telephone appt last week they failed to contact me with a prearranged appt and did not ring me. no one here is giving face to face appts. the same for my Rheumatoid Arthritis- 15 months since i have heard from them 4 appts for telephone appts have been cancelled. they term appts moved not cancelled. but i call it disgraceful. so glad my daughter is getting appts for hers. sorry to moan am afraid my kidneys are in trouble with diabetes as they ache. GP doubled tiny white pill but keeps forgetting to put it on repeats so hassle every time i phone PODS. have now run out while they decide if it has been doubled or not and need to contact GP. try to ring them back to check but may take up to forty mins. on phone. ridiculous system.

It all sounds very frustrating and worrying for you @crystalangels

If your BG levels rise or remain high even when you skip a meal then it feels like it’s not just food-related - your body’s background insulin needs are not being sufficiently met either

Hopefully you can either work with your GP, or ask for a referral to a hospital clinic for more specialist advice and support to explore your options. Alternative insulns (maybe even u200 double strength) may be more appropriate for you.

But of course Covid is making all of this much more difficult to organise and arrange. Which is making things so much harder for you.