# Hi. Unfortunately I'm here!



## SusieGriff (Feb 25, 2011)

Hi I've recently been diagnosed T1., for 3 months now I have been using Humulin M3 and have been trying to understand the way it works. everyone I seem to talk to uses basal/bolus and cope much better than I do. I'm wondering if there is anyone else here who can explain why I'm on this particular type of insulin?


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## KateR (Feb 25, 2011)

Hi and welcome to the forum. I'm afraid I can't help being type 2 but there will be plenty after me with the answers.


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## Robster65 (Feb 25, 2011)

Hi nomorecakes. Welcome 

Humulin M3 is apparently a mix of 30% short acting to 70% long acting, which I'm guessing you'll be injecting at least twice a day ?

I've been reading that newly diagnosed Type 1s are sometimes put on mixes while they 'settle down' through their honeymoon period but some research shows it is better to be on basal/bolus from the start. 

Rob


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## SusieGriff (Feb 25, 2011)

*Thanks*

Hi, thanks for the welcome note!  Can't say it's nice to be here... lol.  looking forward to chatting to people who understand though.


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## SusieGriff (Feb 25, 2011)

Robster65 said:


> Hi nomorecakes. Welcome
> 
> Humulin M3 is apparently a mix of 30% short acting to 70% long acting, which I'm guessing you'll be injecting at least twice a day ?
> 
> ...



Ah.... no-one told me I might be able to change,  No-one tells you anything, apart from, don't eat this, eat that.. on this particular type of insulin it seems my whole life now is revolving around when I eat and what I eat. 
I am struggling a bit to keep my BG down to a decent level. but I am so frustrated about not having enough information.


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## Northerner (Feb 25, 2011)

Hi nomorecakes, welcome to the forum  I'm not familiar with that particular insulin, but I'm sure we have members here who will be. I've been on basal bolus since diagnosis, although I do know that some clinics start people on other, less flexible routines. Have your healthcare team explained why you are not on Basal bolus? 

It's still very much early days for you. I remember when I was diagnosed I was on fixed amount so fast and slow acting insulin for the first few months and had to call the DSN and tell her my numbers and she would suggest any adjustments. Then I did a carb-counting course and took control of varying the doses myself. Have you been offered any education courses e.g. DAFNE? (Dose Adjustment for Normal Eating) - if not, I would ask about the availability of such a course. Your PCT may run something slightly different, but they should offer something.

I'd highly recommend getting hold of a copy of Type 1 Diabetes in Children, Adolescents and Young Adults by Ragnar Hanas. It will explain all the different insulin regimes and a whole lot more besides - an essential reference! You may find a copy in your local library.

Please feel free to ask anything you are unsure of or that is concerning you - nothing is considered 'silly'!


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## Robster65 (Feb 25, 2011)

I've googled humulin m3 and there's not much info apart from its profile of action which seems to be between about 1 hour and 8 hours so I would imagine you're on a pretty fixed meal regime.

I was for about 15-20 years but then went onto basal/bolus (MDI) and life became much better. I don't know why you've not been offered this, unless there are medical reasons.

Other newly diagnosed members may have answers.

Can I ask for other information such as your age and any other details which may be relevant to advice given (obviously, caution advised on a public forum!).

Rob


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## SusieGriff (Feb 25, 2011)

Thanks 'Northerner',

Unfortunately, I'm not a child, adolescent or a young adult. I was diagnosed straight to T1 at rather a late age compared to most. but I will have a read of the book you suggested. anything to gain more knowledge.  I haven't been offered and educational courses, I've just seen my local Diabetic professonal and my local diabetic nurse at the GP surgery. any adjustments to my insulin are decided between myself and the nurse. I have recently increased it myself as she suggested, only by a very small amount, but still struggle to keep in yoyoing.


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## SusieGriff (Feb 25, 2011)

Robster65 said:


> I've googled humulin m3 and there's not much info apart from its profile of action which seems to be between about 1 hour and 8 hours so I would imagine you're on a pretty fixed meal regime.
> 
> I was for about 15-20 years but then went onto basal/bolus (MDI) and life became much better. I don't know why you've not been offered this, unless there are medical reasons.
> 
> ...



Well, my age.... I am over 55 !! yes, and was diagnosed Type 1.. I was shocked to say the least. but am grateful that I didn't have it as a child. I am slightly overweight, but not so much as you would notice. I have hypothyroidism, and high cholesterol.


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## Northerner (Feb 25, 2011)

nomorecakes said:


> Thanks 'Northerner',
> 
> Unfortunately, I'm not a child, adolescent or a young adult. I was diagnosed straight to T1 at rather a late age compared to most. but I will have a read of the book you suggested. anything to gain more knowledge.  I haven't been offered and educational courses, I've just seen my local Diabetic professonal and my local diabetic nurse at the GP surgery. any adjustments to my insulin are decided between myself and the nurse. I have recently increased it myself as she suggested, only by a very small amount, but still struggle to keep in yoyoing.



Hey, I was diagnosed aged 49! The book is just as useful whatever age you are so the title is a little misleading really 

I would be a little suspicious about the level of knowledge your GP practice nurse may have, if she is not a fully qualified DSN (Diabetic Specialist Nurse). Most practice nurses will only ever deal with Type 2 diabetics not on insulin. I would ask to be referred to a consultant - your GP should not have a problem doing this for you. How were you diagnosed?


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## Robster65 (Feb 25, 2011)

Just to back up what Northerner's saying, many GP nurses have limited and/or out of date knowledge and may not be giving you the best that you can get.

As for the book, I have today recieved a copy of it and even after 30 odd years of injecting (I'm now 45), and several months on this forum, I'm learning plenty from it, so would recommend it for any age.

Rob


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## SusieGriff (Feb 25, 2011)

Northerner said:


> Hey, I was diagnosed aged 49! The book is just as useful whatever age you are so the title is a little misleading really
> 
> I would be a little suspicious about the level of knowledge your GP practice nurse may have, if she is not a fully qualified DSN (Diabetic Specialist Nurse). Most practice nurses will only ever deal with Type 2 diabetics not on insulin. I would ask to be referred to a consultant - your GP should not have a problem doing this for you. How were you diagnosed?




I was feeling ill, very ill for about 2wks, went to my GP, he tested me, and whisked me off to hospital, my BG was over the top of the scale! my eyesight went fuzzy and I had  keytones. so then after 4 days on a drip I was discharged, frightened to death and on insulin... 3m later I feel SO much better but somewhat baffled by this regime.


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## shiv (Feb 25, 2011)

Hey, welcome to the forum! Whereabouts are you based?

From personal experience, I would want to get off Humilin M3 (which I was on for 10+ years as a child) ASAP and get in to see a consultant ASAP - don't stick around with a GP practice nurse!


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## SusieGriff (Feb 25, 2011)

shiv said:


> Hey, welcome to the forum! Whereabouts are you based?
> 
> From personal experience, I would want to get off Humilin M3 (which I was on for 10+ years as a child) ASAP and get in to see a consultant ASAP - don't stick around with a GP practice nurse!



Hi, I'm in the east midlands. and I wasn't even given a follow up appointment for the consultant!!!!  am still chasing them up to get an appointment. I want to know so much!!


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## Steff (Feb 25, 2011)

hi and a warm welcome to the forum


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## shiv (Feb 25, 2011)

Ring your GP everyday until you get a referral to a consultant. Sometimes the only way to get things done is to stamp your feet until someone listens!

You'll see that as soon as you come off mixed insulin - which is considered very old fashioned nowadays as you have to 'feed' the insulin, rather than taking insulin to match what you are eating - you'll be able to eat cakes  I hope you get that referral soon - keep us up to date - and we'll all be here to lend a hand when it comes to carb counting and everything else MDI (multiple daily injections - basal/bolus regime ) involves!


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## ypauly (Feb 25, 2011)

Hi and welcome, I can't add anything as the others have done so well. It is daunting at first and I learned more from this forum than any doctor/DSN would ever be prepared to teach me. When I go and see them now I now what questions to ask and it is all thanks to this place.


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## SusieGriff (Feb 25, 2011)

Wow, what a great relief to find you all. thank you so much for all your help. I'm off to bed now .


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## Northerner (Feb 25, 2011)

nomorecakes said:


> Wow, what a great relief to find you all. thank you so much for all your help. I'm off to bed now .



Sleep well!


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## Steff (Feb 25, 2011)

Nights sleep well


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## macast (Feb 25, 2011)

hi Nomorecakes.... welcome to the forum .... sorry you have to be here.... but it is an informative forum and also fun


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## Sheilagh1958 (Feb 25, 2011)

Welocome to the forum


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## Nicky1970 (Feb 26, 2011)

Hi and welcome to the forum


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## Deborah Batton (Feb 27, 2011)

Hi I was diagnosed on 10 February.  Wont forget it.  I notice you have only been diagnosed recently.  Does it get any easier?  I see one of your interests is your dog, mine too, I have a german shepherd.  What have you got?


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## chrismbee (Feb 28, 2011)

Hi nomorecakes and welcome to the forum. 

I notice that nobody else has actually explained basal/bolus yet? Apologies if you already know this (now!) but basal refers to your background insulin requirement, due to the glucose that your liver trickles into the blood; bolus is the additional insulin required to process food, as it enters the blood stream (MDI = Multiple Daily Injections).  Basal is slow-acting and bolus is the fast acting insulin.
As others have suggested, using a mixed insulin means that you need to eat controlled amounts at set times, to match the insulin that is already in your body.  It is not unusual for newbies to start on this regime, even today, as it lets you get accustomed to the new world of diabetes (blood tests, carb counting, good/bad foods etc), especially if you have a "honeymoon" period during which your pancrease may have odd spurts of producing insulin.
MDI gives you greater flexibility and lets you alter your insulin to match what you expect to eat - and, yes, cakes are possible! 
There's a lot of stuff to learn, but none of it is particularly difficult.
Just keep testing, analyse the results and ask lots of questions.
Good luck.

PS. my auntie was diagnosed T1 at 65, after a lifetime of struggles with weight.  Although she was perplexed by the barrage of info, she has now settled into it and lost some weight!


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## SusieGriff (Feb 28, 2011)

Hi Chrismbee!

Thanks for your kind reply, I have had several explanations re the different types of regimes, and it's good to know I'm not the only one diagnosed at a later age.! I have been struggling a bit with this mixed insulin - having to eat at certain times, as I have a good lifestyle and am not staying in just to feed my insulin which is having to happen right now, so I'm seeing my DSN sometime this week I hope and discuss something better suited to my lifestyle. I hope she will help me.  
Yesterday I had visitors for lunch and we walked before hand, I came back - cooking dinner mid-way I had a hypo!! and my lunch wasn't even due, I suppose it was all the exercise and the excitement, but there must be another way?? even if I'm new. It seems it makes new people even more confused.


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## SusieGriff (Feb 28, 2011)

Deborah Batton said:


> Hi I was diagnosed on 10 February.  Wont forget it.  I notice you have only been diagnosed recently.  Does it get any easier?  I see one of your interests is your dog, mine too, I have a german shepherd.  What have you got?



Hi Deborah,

I've got a little jack russell terrier! she's our life, we love walking and playing with her. great aren't they?

I was diagnosed in Nov 10.  and I am on mixed insulin and my life is very restricted, I have to eat at certain times and eat practically the same each day. I hate it, and am trying to get to see my DSN (diabetes specialist nurse) soon to get it changed.  I dont mind the injections at all, that's not what bothers me, it balancing all the food to the insulin. hopefull I can change this and get something where the insulin works for the food I'm eating.

Keep in touch! we can help each other along with this.!


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## shiv (Feb 28, 2011)

nomorecakes said:


> we walked before hand, I came back - cooking dinner mid-way I had a hypo!! and my lunch wasn't even due, I suppose it was all the exercise and the excitement, but there must be another way??



It probably was the walk & excitement that caused the hypo  if you're burning up extra glucose in your body, in a person with type 1 this needs to be replaced - in that instance I would have had a little something to eat or drink (full sugar drink!) at some point to stop me dipping low later on  you'll learn over time what sends your levels up and down - ie the excitement of having friends round etc!

You sound really motivated to get onto a better regime and that's the best way to be! Life is so much better on MDI/not on mixed insulin, in my opinion!


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## Northerner (Feb 28, 2011)

I must admit, I can't imagine how restricted my life would have been on mixed insulin. I don't know how I could have handled getting back into training for running, for example, if I could never be sure that I had enough carbs on board to counteract the exercise - being able to finely tune my insulin doses to the food I _wanted_ to eat prior to a run made it realatively simple to adapt to.


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## MargB (Feb 28, 2011)

Hi Susie, welcome to the forum.  I can't help as I am Type 2 but I am learning more about Type 1 from this thread.  

I have never seen a DSN but do see the practice nurse who believes every bulletin she is sent from the PCT.  She sees diabetes as a condition and thinks everyone can be treated exactly the same way.  Since joining this forum, I see things differently!  Congratulations on finding this forum - they are brilliant and no question is too basic or stupid or timewasting - you have found a very good supportive bunch of people.


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## Liz! (Feb 28, 2011)

Basal and bolus will be much better if you can get that! 

But you still might have unexpected hypos. Certainly cooking dinner for others after a walk...  It's a good idea to test your blood sugar before, during and after exercise, if it was lowish I'd have something to keep me going to get the meal cooked!


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## SusieGriff (Feb 28, 2011)

Hi, and thanks for the message..

I am learning all the time!  I thought as I was on mixed insulin it would last a bit until lunchtime, but I know now!!   I have been speaking to my DSN this morning and she is going to arrange for me to go onto the basal bolus regime!! YEAHHH. I hope I can manage the maths involved working out carbs etc...  But I'm sure it'll be better than what I am taking now.


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## shiv (Feb 28, 2011)

nomorecakes said:


> Hi, and thanks for the message..
> 
> I am learning all the time!  I thought as I was on mixed insulin it would last a bit until lunchtime, but I know now!!   I have been speaking to my DSN this morning and she is going to arrange for me to go onto the basal bolus regime!! YEAHHH. I hope I can manage the maths involved working out carbs etc...  But I'm sure it'll be better than what I am taking now.



Great news!! Carb counting is daunting to begin with but gets wayyyy easier over time. A calculator comes in very handy!!


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## Northerner (Feb 28, 2011)

nomorecakes said:


> Hi, and thanks for the message..
> 
> I am learning all the time!  I thought as I was on mixed insulin it would last a bit until lunchtime, but I know now!!   I have been speaking to my DSN this morning and she is going to arrange for me to go onto the basal bolus regime!! YEAHHH. I hope I can manage the maths involved working out carbs etc...  But I'm sure it'll be better than what I am taking now.



That is such good news! I can't imagine that basal/bolus will prove any more complicated than trying to match your life to mixed insulins, so I don't think you need fear it 

A lot of people find it easier in the beginning if they weigh food so they can be more accurate with their carb counting - this is a good set of scales:

Salter 1406 Nutri Weigh Slim Dietary Computer Scale

Also, a very popular book (also available as an App, I believe) is Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting for People with Diabetes 

or the new version which also includes proteins and fats: Carbs & Cals & Protein & Fat: A Visual Guide to Carbohydrate, Protein, Fat & Calorie Counting for Healthy Eating


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## Robster65 (Feb 28, 2011)

Just catching up and that is excellent news ! 

You'll be fine with the calculations I'm sure. 

I know I found the mixed insulins very restrictive and was on them for 15-20 years. When I was offered MDI, it enabled a whole new freedom.

I'm really pleased the DSN is going to help you.

Rob


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## SusieGriff (Feb 28, 2011)

*Thanks*

Thanks to all for your information!!
 I was armed to the teeth when I called my DSN,  I had downloaded and printed a sheet from the insulin type page, had a whole speech ready in my head, and she just said, "Yes I agree with you, but we start people on ito begin with to get them ued to injecting etc.." so I felt a little humble, and she then went on to say she'd phone the nurse that could give me al the information and training etc. it may take a couple of weeks, but at least I wasn't refused.  great news.

The scales look excellent, I might just invest in those.

Boy! am I glad I found you guys!


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## Northerner (Feb 28, 2011)

Ah! Good news Susie!  I'm still not entirely sure that it's necessary to 'start you off' on mixed insulins as it sounds more difficult to deal with to me and basal bolus is only a couple of injections more  Still, it will give you a little time to get geared up for it


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## Robster65 (Feb 28, 2011)

As with most medical types, they probably aren't very good at assessing the patient as a person and therefore treat everyone as a bit simple and incapable. 

Rob


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## SusieGriff (Feb 28, 2011)

Robster65 said:


> As with most medical types, they probably aren't very good at assessing the patient as a person and therefore treat everyone as a bit simple and incapable.
> 
> Rob



Hah! well, they've met thier match here then. I ain't no simpleton or incapable!!


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