# New and confused



## cherrycake (Aug 8, 2013)

Hello  all,
I was diagnosed T2 about 12 years ago and put on metformin and glicazide.  Since the last 2 years, glucose readings have been rising due to work stress! I felt exhausted and unwell all the time.  In January this year I was given  Humulin M3 30/70 mix insulin and told to inject twice daily before breakfast and dinner!  My GP?s surgery aren?t the most helpful people and nothing was explained about Insulin, infact I was shocked to be starting it, and I knew Nobody at all who is on insulin 
7 months on my readings are still not within the range they should be and I feel totally alone and lost as far as Insulin is concerned.  The diabetes is now controlling me and not the other way round.  I feel that I only eat to feed the insulin.  Im concerned that for about 2 ? years my glucose readings have not been well controlled.  
Is there anybody else who is on a mixed insulin and has managed to get their glucose readings to an acceptable level?


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## LeeLee (Aug 8, 2013)

OOPS! posted my reply on the other post.  Welcome again!


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## cherrycake (Aug 8, 2013)

Lol... sorry!  Im new to message boards and I posted in the wrong place before


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## lesleyW (Aug 8, 2013)

cherrycake said:


> Hello  all,
> I was diagnosed T2 about 12 years ago and put on metformin and glicazide.  Since the last 2 years, glucose readings have been rising due to work stress! I felt exhausted and unwell all the time.  In January this year I was given  Humulin M3 30/70 mix insulin and told to inject twice daily before breakfast and dinner!  My GP?s surgery aren?t the most helpful people and nothing was explained about Insulin, infact I was shocked to be starting it, and I knew Nobody at all who is on insulin
> 7 months on my readings are still not within the range they should be and I feel totally alone and lost as far as Insulin is concerned.  The diabetes is now controlling me and not the other way round.  I feel that I only eat to feed the insulin.  Im concerned that for about 2 ? years my glucose readings have not been well controlled.
> Is there anybody else who is on a mixed insulin and has managed to get their glucose readings to an acceptable level?



Hello and welcome.   Not surprised you feel the way you do and I hope you get lots of help and support from this forum and will soon be feeling better. I'm type 2 (apparently) and have been diagnosed for two years.   Nasty shock as I had non of the pre-disposing risk factors.   Anyway, the gliclizide and sitagliptin failed to work and I went on to mixed insulin (Novomix) in May - was terrified at first, but now a doddle.   I'm also on two injections a day and the 'dose' depends on my pre-meal reading - the higher the reading the higher the number of units I inject.   This, as well as adjusting units depending on how 'carby' a meal will be, seems to be working v. well for me and readings are only vary rarely in double figures.    Please get more information and support from your doctor - you should not be left to cope alone.   All the best.


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## cherrycake (Aug 8, 2013)

Hello Lesley and thanks for your reply.  I agree its terrifying when we initially start insulin but Im really pleased to hear that youve got it under control 
Is there some sort of ratio.. that enables us to work out how many units to inject? I started on 10 and I now inject 30 units twice a day. thanks


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## Northerner (Aug 8, 2013)

Hi cherrycake, welcome to the forum  Very sorry to hear about the problems you have been having. Your GP and/or nurse should really have got your numbers in a much better range by now, and you shouldn't be being controlled in your eating habits by the insulin  As it happens, we have another member who has just started on the same insulin and is also having similar difficulties. If your GP doesn't have sufficient knwledge to help you, which it appears to be the case, then I would ask to be referred to a specialist. Even if it is only for a few consultations, it will be very useful to finally get to grips with things.

People are put onto mixed insulins initially because it is a cheaper option than the more flexible 'basal/bolus' regime. This entails injecting a slow-acting insulin once or twice a day, and then a fast acting insulin with each meal or snack. The fast-acting inulin is adjusted according to the amount of carbohydrate in the meal or snack. As a result, if you don't want to eat, you don't need to inject. You don't have this option with a mix, especially if you are on fixed doses, as you must eat to match the insulin, and at the times it 'demands'. Some people are fine with mixes, others find them very difficult and troublesome. It is disgraceful that you have been put on insulin and given such little support and information 

So, I would get your determined head on and start demanding answers! This has gone on too long, and it is unnecessary - the NHS might save a few pounds each month by giving you a cheaper insulin regime (and it is only a few pounds), but this is having a profound effect on your quality of life, as well as the fact that it isn't working!


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## lesleyW (Aug 8, 2013)

hello again, 
Everybody is different and while some people would prefer to have two different types of insulin (fast and slow) and inject the two types according to their needs, eating preferences etc. etc. I have found the mixed to be absolutely suited to me as it involves only two injections a day and the dose is adaptable.   There is a ratio for upping and downing my insulin - it's on the Novomix website and also with all the gumf I was given with it.   However, as you're on a different type you really need to talk to your doctor about whether this is possible with your type (it may not be) - or, as Northerner suggests, a specialist who can give accurate advice and support.   I also agree with Northerner that you need to start demanding answers - nobody should feel as you do - everybody should feel that their healthcare professionals are taking them seriously and doing their best for them.  I really hope you get this sorted out soon.   All the best.


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## jalapino (Aug 8, 2013)

cherrycake said:


> Hello  all,
> I was diagnosed T2 about 12 years ago and put on metformin and glicazide.  Since the last 2 years, glucose readings have been rising due to work stress! I felt exhausted and unwell all the time.  In January this year I was given  Humulin M3 30/70 mix insulin and told to inject twice daily before breakfast and dinner!  My GP?s surgery aren?t the most helpful people and nothing was explained about Insulin, infact I was shocked to be starting it, and I knew Nobody at all who is on insulin.
> 7 months on my readings are still not within the range they should be and I feel totally alone and lost as far as Insulin is concerned.  The diabetes is now controlling me and not the other way round.  I feel that I only eat to feed the insulin.  Im concerned that for about 2 ? years my glucose readings have not been well controlled.
> Is there anybody else who is on a mixed insulin and has managed to get their glucose readings to an acceptable level?



Welcome to the forum cherrycake......nice name by the way 
I feel your pain!
I myself have just started humulin m3 and like you was shocked and felt lost and alone in the dark.
I was on glicazide for 2 weeks then started on humulin twice a day, you have been on it for some time, how many units are you on in the morning and evening?
My levels are so up and down at the moment, what are your levels like?
The problem I have is that I have to eat the same amount of carbs to match the insulin each day like you, how much carb intake do you have?
I find my levels are high before bed and then drop over night from high 20's to low 10's.
You are not on your own  feel free to chat to me regards treatment and any other aspects you have or want to talk about, we are all here to help each other


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## cherrycake (Aug 9, 2013)

jalapino said:


> Welcome to the forum cherrycake......nice name by the way
> I feel your pain!
> I myself have just started humulin m3 and like you was shocked and felt lost and alone in the dark.
> I was on glicazide for 2 weeks then started on humulin twice a day, you have been on it for some time, how many units are you on in the morning and evening?
> ...



We seem to be in the same boat! 

for the last 2 years my waking readings were averaging at about 9 but this week Ive upped my insulin to 30u in the morning and 30u in the evening and my waking readings this week have been

mon 5
tues 5.4
weds 6.4
thurs 6.7 
fri 8 

Im surprised that they're still gradually going up and up ..  lol
evening readings are still between 10 -14 

You mention that you carb count???  Ive not been told how many carbs to have to match the insulin 
did your GP or DN tell you the amount of carbs to eat at each meal or have you worked out the carb:insulin ratio yourself?  

my DN has not mentioned the amount, except she did say.. in a very matronly manner... 'You Must eat carbs at Every meal' lol
Im really interested in this ... it could be the answer to get our readings down!

btw Im on 30/70 mix.. which mix are you on?


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## Northerner (Aug 9, 2013)

cherrycake said:


> You mention that you carb count???  Ive not been told how many carbs to have to match the insulin
> did your GP or DN tell you the amount of carbs to eat at each meal or have you worked out the carb:insulin ratio yourself?
> 
> my DN has not mentioned the amount, except she did say.. in a very matronly manner... 'You Must eat carbs at Every meal' lol
> ...




Diabetes UK have a free download book about Carb Counting:

https://shop.diabetes.org.uk/store/literature/information-books/carbs-count-e-book.aspx

It can be a bit of trial and error at first because everyone is different in their requirements, plus your ratios can change throughout the day so you need to establish a ratio for each meal of the day. Mixes aren't ideally suited to it, but at least it should help you to determine meals with a similar carbohydrate value and therefore how they might affect your blood sugar levels, rather than ignoring it altogether, which seems to be the (non-)advice given!

Basically, you take a reading before eating, calculate how many carbs are in the meal (by either weighing cereal, for example, or looking at packaging) inject your insulin, then see what your levels are like after eating. The clever bit is working out how much carbohydrate equates to one unit of insulin for you. Most people start with a ratio of one unit per 10g of carbs, so a 30g meal would need 3 units of insulin. If levels are too high afterwards, then clearly this was insufficient, so next time increase the insulin e.g. 1 unit per 8g, which would be approx. 4 units. Conversely, if you go low after eating then there was too much insulin, so you need less e.g 1:12g

Hope that makes sense!


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## cherrycake (Aug 9, 2013)

Northerner said:


> Diabetes UK have a free download book about Carb Counting:
> 
> https://shop.diabetes.org.uk/store/literature/information-books/carbs-count-e-book.aspx
> 
> ...



thanks so much northerner!    the way you've explained it, makes perfect sense.  I didn't have a clue about carbs and insulin ratio but I will start applying it from now on..


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## trophywench (Aug 9, 2013)

Errr - I don't think that's an exact science Northerner - not when you are using mixed insulin!  Because you can't take more fast acting without taking more slow acting, and vice versa.

On mixed insulin, yes you would have to space out whatever amount of daily carbs you settle on throughout the day whereas using fast and slow insulin separately, if I want to completely miss a meal, or have no carbs - say ham salad, no bread and butter etc or spuds, or an omelette, or egg and bacon for brekkie  - then basically, I don't have to take any fast acting insulin for that meal.  But on mixed insulin, you have to inject the fast acting in with it, so if I had that jab this morning, I now need to eat carbs for lunch.  Tedious and inflexible.  And I have to do the same every single day.

Cherrycake, the first thing to do, honestly! - is actually work out how many grams of carbs you eat in a normal day.  If the amount of insulin you take doesn't match that, then your BG will either be too high or too low.

Most people find if they curb the carbs they get far better control over their D.  We don't know (and 'we' includes you!) whether you are eating 30g or 300g, do we?

Let's find that out first !


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## Northerner (Aug 9, 2013)

Yes, TW, I think I did make the point earlier that it's not going to work particularly well with mixes, but understanding how to count carbs will help to know meals of equivalent value. Mixes seem so inflexible to me


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## cherrycake (Aug 9, 2013)

hello trophywench and thanks for the feedback. 
Yes, I'll need to start counting how many carbs I have at each meal because my readings in the evening (before and after dinner) are usually between 10-14! 
the DN said i need to get them below 8 

Northerner, I had a look at the carb counting link.. plenty of great info there to digest!  

Just in the last 24 hours of joining this helpful and friendly site, I no longer feel alone about diabetes and insulin.

Thanks guys for all your support and advice... I truly appreciate it


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## jalapino (Aug 9, 2013)

cherrycake said:


> We seem to be in the same boat!
> 
> for the last 2 years my waking readings were averaging at about 9 but this week Ive upped my insulin to 30u in the morning and 30u in the evening and my waking readings this week have been
> 
> ...



Hello cherrycake 
Sorry for late post I have been very busy at work!
Currently im on 16 units in the morning and 16 units in the evening.
As you im on 30/70 mix as well 
Like everyone has said we have to eat carbs apx 30 mins after injecting and it is hard to no how much to the amount of units we inject, I inject at the same time now everyday but I forgot to eat until one hour today as we were so busy at work but all was ok, I am currently having to increase does every 3 days till I get normal levels.
Im glad you are enjoying the forum and remember no question is daft as I have found up!


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## cherrycake (Aug 9, 2013)

Good evening Jalapino   I think if we take on board all the wonderful advice we're getting from here, i feel we can bring our readings down 

I spoke to a very kind man from Diabetes UK careline today.. he said when on mixed insulin regime, we should still be aware of the amount of carbs we have at each meal and monitor our glucose readings regularly.  
we'll be able to tell if we need to increase or decrease our insulin, depending on our readings.. if that makes sense.
Ive been keeping a glucose reading diary and from tomorrow I'll be counting carbs too!
It'll give us a better picture.

Hope this helps you too!


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## jalapino (Aug 9, 2013)

cherrycake said:


> Good evening Jalapino   I think if we take on board all the wonderful advice we're getting from here, i feel we can bring our readings down
> 
> I spoke to a very kind man from Diabetes UK careline today.. he said when on mixed insulin regime, we should still be aware of the amount of carbs we have at each meal and monitor our glucose readings regularly.
> we'll be able to tell if we need to increase or decrease our insulin, depending on our readings.. if that makes sense.
> ...



Evening cherrycake......lol...sorry I nearly put cherrypie ...must have pie on my mind!! 
I also have a diary with what foods I eat and the impact they have on my bloods, I personally don't have a lot of carbs as I try to eat salads but I do have a brown pitta bread with my salad for some sort of carbs, but this week I have had a roast dinner with little carbs and ate some oven chips with fish fingers and beans, my diet is boring to be honest but till I get good bg levels I have to stick with low carb meals, you see when I was first diagnosed I had a bit of weight, and then lost weight then after 6 months put it back on again, now I have lost just over 1 stone, I am 6ft and now my dn says I am a good weight which makes me happy


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## cherrycake (Aug 9, 2013)

I like cherrypie too 
Well done on your weight loss jalapino   If you dont mind me asking, what did you do to lose it?


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## jalapino (Aug 9, 2013)

cherrycake said:


> I like cherrypie too
> Well done on your weight loss jalapino   If you dont mind me asking, what did you do to lose it?[/QUOTE
> 
> Low carb diet! simple as that!! I love salads with pitta bread.... I can and do eat this pretty much everyday
> I would like to shed another stone as this would bring my weight down to when I was 20...but lets not push things


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## jalapino (Aug 9, 2013)

Oh but this week been eating more carbs after insulin, just been having an urge to eat more carbs...not a lot but more than I normally do...maybe the insulin?


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## cherrycake (Aug 9, 2013)

It could well be the increase in insulin... I've been increasing my dose steadily too and I eat to feed my insulin!  I've been told this shouldn't be the case.  
I don't enjoy food anymore, it's like a poison to me and I'm a strict vegetarian .. So food is very restricted 

Keep the motivation going .. Keep posting and you'll soon lose that extra stone!


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## jalapino (Aug 9, 2013)

cherrycake said:


> It could well be the increase in insulin... I've been increasing my dose steadily too and I eat to feed my insulin!  I've been told this shouldn't be the case.
> I don't enjoy food anymore, it's like a poison to me and I'm a strict vegetarian .. So food is very restricted
> 
> Keep the motivation going .. Keep posting and you'll soon lose that extra stone!



I love your attitude! trust me I post more than you think


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## true (Aug 9, 2013)

Hi Cherrycake,  I'm shocked to read that you were given so little guidance or support from your health professionals. It's good that you and I have both found this forum.  There seem to be some very knowledgeable, kind and helpful people here. Hope you don't feel alone anymore.


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## cherrycake (Aug 9, 2013)

true said:


> Hi Cherrycake,  I'm shocked to read that you were given so little guidance or support from your health professionals. It's good that you and I have both found this forum.  There seem to be some very knowledgeable, kind and helpful people here. Hope you don't feel alone anymore.




Hello true.  I agree people here are so very kind and helpful.  Ive had more sound advice on here, and bearing in mind I only joined yesterday 
And no, I don't feel alone anymore, thanks. 

If its ok for me to ask.. How is your sister?


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