New to Diabetes Type 2 Insulin - Very confused!

I believe this is standard anti-spam control for the forum software. Configurable of course for each forum site by the forum admin.
“The maximum number of topics a user is allowed to create in their first day on the site”
“The maximum number of replies a user is allowed to create in their first day on the site”

@MrsNoobie - Who obviously is a real user and not a spam-bot (lol) is probably passed the “first day” threshold so one would assume no longer need be concerned about these.

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I will look into this. Sorry for the site getting in the way of your posting.

@Tim35 - Thanks for additional info.

No problem at all!
Although the wait to post was excruciating!

:rofl:

I understand. I may be unaware of some special “first day rules” for new members. Your membership is only one day old. I trust that you now can participate as often as you’d like!

And how… I am so happy to have found such a wonderful community with a wealth of knowledge and the kindness to share so willingly!

Late to the discussion, but here is my $0.02

I don’t like mixed insulins for one fundamental reason: they are an attempt to apply a one-size-fits-all solution and those simply don’t work worth a rodential fundament when dealing with diabetes.

In the diabetes community, there is a saying: YDMV (“Your Diabetes May Vary”). All it means is that every case is individual and nuanced and very very VERY few cases are a good fit for the average or “standard” guidelines. For instance: one person’s body chemistry and physiological response may mean that insulin A is very effective for them but insulin B is less so, whereas the next person’s reactions may be exactly the opposite.

It also means that each person’s sensitivity to different insulins is personal and individual, and that is the crux of why I don’t have much use for mixed insulins. Mixed insulins represent an attempt to use a fixed ratio of basal to fast acting insulin, and by definition also require them to be administered at the same time.

Now suppose your particular blood sugar behavior responds best to taking a basal insulin once a day, and fast acting insulin with each meal (a very common pattern, by the way). With a mix, you can’t do that. So you’re going to get less-than-optimal results no matter how hard you try.

And suppose the fast acting insulin in the mix is working perfectly but the basal amount is insufficient for you. Once again, you’re stuck. The only way to get more basal is to increase the dosage, which means you’re now getting too much fast acting insulin and must either eat more or risk hypoglycemia. Etc. etc. etc.

As you’ll discover, really good diabetes control is entirely doable, but it requires flexibility and an individually-tailored regimen. That’s awfully difficult to do with a preset mix.

End of editorial. :sunglasses:

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As a noobie I think you may have hit the nail on the head - as nice as it would be to have a one size fits all the reality is that it may just not be possible… one weekend on insulin and I’ve realized it’s a juggling act…

It is, in many respects. But with time and practice you will become a really skilled juggler. Trust me (and the thousands who have been down this road).

One caution, though: with basal insulin especially, rapid changes are problematical. For most people, it takes three or four days for a change in basal dosage to stabilize and give trustworthy results. Changes too close together will simply cause greater confusion. A change needs time to settle down and reveal the true outcome.

I think you have gotten very good advice here. The reason you were not able to post is that the settings on the site “throttle” new users as a way of reducing “spam.” And while it works, it can be a hassle. Quickly, once you have over time read and posted and been on the site all those limits are gone. A spammer will come onto the site and immediately try to spam.

As to your questions. I am T2 and started insulin in 2010. I started with NPH and Regular. Your “Mix” is similar, it is Humalog protomine and Humalog. You generally start at a modest dose (as you did) and then increase the dosing until you see an effect. That would either be a lowering of your fasting blood sugars to a target range or a restoration of your after meal blood sugars at 2 hours to a target range. Unfortunately with a mix you can’t generally reach both fasting and after meal targets.

This is why I chose to start back in 2010 with separate doses of NPH and Regular. The disadvantage is that I had to use vials and syringes. And this will be a trade-off. You were likely started on the mix because it is available with a pen, you could do just 2 or 3 injections a day and it is simple. But it is just not capable of being finely tuned to what you will need. Eventually you will want an upgrade.

And I would echo what @David_dns has said. You should record your results over a couple of days and then make a change to dosing. And a conservative approach is to change by 5%, maybe 10% each time. It is important to understand that the insulin will have no effect until you reach what is called a physiological dose. Your external insulin is to a certain degree “offsetting” your remaining insulin and will only have a visible effect once you reach that physiological dose. Once you reach that dose you will likely see a clear lowering of your blood sugar. So don’t take big jumps in dosing because once you reach that point you do not want a bad hypo (low blood sugar). So I would encourage you to be conservative and check in with your educator and doctor regularly until you are stable.

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Thanks so much Brian! I really do appreciate the in depth feedback. I really hate being hyperglycemic all the time and I must admit that I am truly grateful for not requiring the ER! I am waiting on call from my GP later today and hope that all goes well.

One last thing . . . we’re sorry you had to become a member of The Club No One Asks To Join, but we’re very glad you found us. You’ve come to the right place—welcome to the family!

Please stay in touch and let us know how you’re doing. :slightly_smiling_face:

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Hi All
Quick update…
I chatted with my GP and he asked me to stop increasing my dosage until Thursday this week.
I am on 45 units now and had a very low carb day yesterday and my readings were as follows:

image

Very pleased that there was movement finally!!

Any thoughts on how I am going?

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You are doing great. You see to have reach the point where the insulin is working. This likely means that the further adjustments will need to be smaller and you will have to wait several days to see how things work out. But this is really good news, don’t you think?

I am well happy that there is movement and I am hoping that my headaches, lethargy and general feeling of fatigue will leave me soon…

The psychological impact is still something I am working on…

:blush:

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That may take longer. Fortunately we live in a time when the psychological toll is becoming recognized as just as real and important as the physical issues. Look up the work of William Polonsky, among others.

10.1 on waking up this morning!!!

IMG_4821

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I’m glad you checked that out. Yes it’s 75% longer acting insulin, which is acting as your basal insulin. The 25% fast acting covers your meals. As a Type I from the Stone Age, I was on a 70/30 mix twice a day. In my unprofessional opinion, maybe you and your GP can sit down with your readings and formulate a plan on when and how to increase your insulin and how long to wait until you increase it again.

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I am now up to 50 units of Humalog 75/25 - is that a lot in the grand scheme of things?
I don’t seem to drop below 9mmol\L (even with fasting)…

“Your body size or fat-to-muscle ratio can also make quite a difference. For a larger-than-average person, 1 unit of insulin may only cover 8 to 9 grams of carbohydrate.”

Maybe it is due to the fact that I am defintely “larger than average”?

50 is not terribly high or terribly low, it’s somewhere on the bell curve. Be aware that your insulin needs may vary over time, in either direction, depending on the other steps you are taking such as diet, exercise, other meds, etc., as well as other factors in your life (stress, illness, etc.). It isn’t a test; there is no “right” dosage, except the one that is right for you.

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As several have already said, the right amount is what works for you. My Dr started me on 27-33 units/per day (which seems to be a common starting point). I saw marginal improvement on an 11% A1C until I was taking over 200 units/day of a basal and fast acting insulin. Took a few years to ramp up. Too long in retrospect and it was very discouraging until I read in “Diabetes Self Management” (this was 15 yrs ago) about more concentrated insulin. Found an Endo who would prescribe it. The upside is that after getting enough of a better insulin for me, I’m back down to about 100 units/day and have very good control. So I’m to right of that bell curve that David_dns mentions. You will find your spot too. I also had to stop being the “Queen of De Nile” about carb counting. There is no short cut on that.

Do record your carbs, doses, and BG carefully. You will learn which foods are best for you. Carb counting does become second nature after awhile and you will feel better. Be your own advocate and bug your Dr or change Drs if you must until you see results. The fact that you are actively trying to learn all you can is your best indicator of future success!! And take advantage of a CDE if you can. They can help you personalize your action plan. :sunglasses:

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