A few questions for the diabetics here that are on insulin.

[jodaer]

I'm a t2 diabetic and have been for over 20 years. Mostly I've kept it under control with A1C around 6, give or take a few. This was with metformin. My CKD has progressed to where I had to stop the metformin. My doctor tried a few other meds but they didn't work. A couple of weeks ago I started on insulin. I'm finding this is a whole new world now.

I started on fast acting insulin with 4 units, breakfast, lunch and dinner. Then it was 4 at Breakfast and lunch and 6 at dinner. Now it's 4 at breakfast, 6 at lunch and 7 at dinner. I'm also taking 4 units of long lasting at bedtime.

Question 1 is, is this a lot or not very much.

Question 2 is, where do you learn to adjust the amount of insulin you take based on your meals. Or do you?

[Bassetmommer NKF Ambassador]

HI Jodaer,

Good that you are off metformin. As far as your questions, question 1... no, it is not a lot. My husband takes 3 times that for meals. I only take long lasting at night and I take 28 to 30. The doctor is adjusting according to how you react, which is great because he is trying to give you the lowest dose possible. At some point, you will hit the sweet spot where your glucose will stay steady. That is why it is so important to use your meter to record your glucose levels.

Question 2, you will find certain foods will raise your glucose. Pasta, bread, cereal, sugary creamer, obviously sweets, some fruits, and much more. Sometimes, you can eat a bowl of pasta, and no problem. And then other times it might be high. It depends on what you eat it with...for example, eating protein with carbs helps to mitigate a spike. We discovered certain brands of pasta affect us differently. We buy a good product like Dececco pasta and it does not raise our glucose. Giving up pasta was not an option for us. The only way to learn what effects you is to test you level about an hour and half after you eat. Exercise will affect your numbers too. If you go for a walk after dinner, your spike will be less. Staying hydrated will help too. Sugar is eliminated through the kidneys. It will take time, trial and error to learn what works. For now, follow your doctor's orders with the titration of the shots.

[Darlenia]

Hi Jodaer. My hubby is on a short and long lasting insulin regimen too. When you're on a combination of these, it's definitely hard to figure out and forecast what one needs to do. We learned a lot after my hubby passed out from low blood sugar. Our doctor immediately flipped the percentage of long lasting and short term amounts. He explained that long lasting slowly and methodically addresses glucose over a 2-24 hour time period. However, short lasting acts quickly over a brief period of time of 30 mins to 6 hours. Short lasting, if taken at the wrong time and in too high a dose, will rapidly take out the sugar in your body and...one passes out; the potential to die is high if not found. (Maybe you remember the murder stories where someone deliberately kills someone by injecting them with insulin - that's likely rapid or short lasting insulin.) So, when calibrating your short term dosage, look very carefully at the foods you're eating or will eat, the amount of exercise you intend to do, and so on. Diet is incredibly important - remove as much "white stuff" as possible and read labels. The lower the sugars and carbs, the fewer the drops. We try to arrange our day so that hubby doesn't need to take any short term insulin at all. Sure, a cheat meal is possible, but then we address that with short lasting insulin. Looking at your schedule and dosages, it's my personal opinion that your long term insulin could be increased a little bit and your short term lowered if not mostly eliminated depending on your daily life decisions. I suspect you'd be a lot happier and safer that way. If you think so too, I would highly recommend you chat with your doctor before doing anything. I'd like to stress that I'm drawing on our personal situation, what we've discovered, and these are my observations and opinions only. I'm definitely not a medical doctor. So please don't do what my hubby is doing unless it's cleared by your own professionals. Insulin is exceptionally powerful, I respect it a great deal. I sense that you'll see your way clear soon...asking questions is good!

[ling in reply to Darlenia]

What you say makes a lot of sense. Thank you

[jodaer]

Thanks, Bassetmommer and Darlenia. Good info and very helpful. My doctor isn't that good about answering questions. I've been thinking about switching but now that I'm on the insulin path I feel like I should stick with her. At least until I get to that "sweet spot". It seemed to me like I was taking a lot of insulin and not seeing great results. Now I can be patient a bit longer.

[darkstar1974]

This book was very beneficial to helping figure things out

amazon.com/Think-Like-Pancr...

And these folks have good resources, they lean toward T1 type info but also have things geared towards T2.

integrateddiabetes.com/

[jodaer in reply to darkstar1974]

Thanks, I'll check them out.

[Alexie90]

I use to be on insulin and took long acting insulin 1-2 time a day. if one time then 15 units at bedtime. if twice then 6 units AM and 6 units PM, about 12 hours apart. but was also taking short acting for lunch and dinner (my glucose was fine at breakfast) trying to remember... mealtime dose varied. it was suppose to be in part based on my glucose prior to eating and maybe # of carbs in the meal. I think my dinner time once was 7-8 average. but it never seemed to help. the long acting worked better

[jodaer in reply to Alexie90]

What are you using now if not insulin?

[Alexie90 in reply to jodaer]

originally I was on Metformin 1000-1500mg/day plus insulin. then a new Dr changed me to Metformin ER 2000mg a day. I can tolerate the ER variation better plus insulin. it brought my A1C down far enough, so I was taken off insulin. was only on Metformin ER (plus blood pressure and high cholesterol pills). and then had a recent small medication change

[jodaer in reply to Alexie90]

Got it. Good luck with the metformin, I wish I could still take it.

[AndrewT]

Dear jodaer,

I too have Only Just 'Started' Insulin, so maybe I can 'Help' you? I'm On "30% Soluble Insulin Aspart And 70%Insulin Aspart Crystallised With Protamine" Taken via an EpiPen, twice a day (using Disposable Needles). Morning is 8 units and Evening is 6 units, which appears to be Working Well.

I 'assume' that, if the Results became Regularly 'erratic' then these Values could/ will be adjusted.

I assume that you, like me, are being 'Monitored' regularly and any Anomalies will be 'Picked Up'.

AndrewT

[jodaer in reply to AndrewT]

Thanks Andrew and I am being monitored. I send a report to my doctor weekly for my testing 4x a day. Last night she upped me by 1 unit at lunch and dinner.

[jodaer]

My last A1C was 7.8. I was on jardiance and Trulicity. I couldn't go up any on the trulicity and that lead to the insulin. I didn't lose any weight on either one and now on the inulin I'm gaining about .5 a day.

[jodaer]

I get it, I'm way past post-menopausal and can'at exercise due to COPD and pain, mostly pain. I can't walk very far without extreme pain. I don't eat veggies either.

[CuriousCKD in reply to jodaer]

Hi! I have a very bad lower back problem in the L5 region. One leg is about 16mm shorter than the other, and I have been having to sleep in a recliner for about 2 years because of the horrible pain when arising from lying flat in a bed. I was so inactive because of not being able to stand for more than 10 minutes, that I suffered a lot of muscle loss. I could not step up on a curb without help. I have found the most effective tool that has brought me much joy. It is called an UpWalker. It has adjustable height with pads to rest my arms on, and supports my back. (I also have painful neuropathy in my feet.) This Walker has been like a small miracle. I’ve only had it for a few months, but I am up to walking over a half mile in about 20-25 minutes, about 3-4 times a week. I can’t say enough about it, because I am stronger, and can go short distances without a cane. It is not inexpensive, ($695) but it has been worth the money. It is collapsible, weighs about 18 lbs, and has a seat to sit on, when you need it. It also comes with a rechargeable light on each side, if you are out in the evening. The website is UpWalker.com. There are 4 different models and weight bearing up to 350 lbs. I hope this info may be helpful to you. I wish you well!