Hi all,
I know something like has been said/asked before…Unfortunately, I’m using 65 units of Lantus units in the evening. My morning numbers are still between 18 - 22. This has been going on for about three weeks. I am not sick. Just tired and nauseous most of the time. In addition to taking lantus- I take the max of Metformin , B12 and iron. I am waiting for a call back to see the doctor sometime in the next month.
Any ideas?
Metformin can cause stomach issues.
65 units seems like a lot to me but everyone is different.
I find that if I exercise after meals, my sugars are remarkably lower and I use less insulin than when I don’t exercise.
The exercise can just be walking, not intense.
I walk or hike or run after every meal generally.
Of course the usuals you know watching carb intake and losing weight always helps too
Have you switched to a new pen (in case your current one for some reason is causing the problem)?
The types of carbs are important as well because long-acting carbs ( anything white like bread, rice, pasta, etc) have a much longer effect on BG than carb that spike hard (sugar) but are quickly out of the system. Protein is another one as the delay in BG rise is far greater with protein than with carbs.
If you are on a CGM, you may find that you can tweak your BG much faster and effectively by dumping Lantus which is long-acting insulin, and replacing it with short-acting insulin such as Humalog.
I would start by skipping all eating after lunch, which would most likely cure your morning highs and then slowly re-introduce snacks or a light evening meal that does not spike your morning BG.
I consider bread and pasta to be fast carb. Pretty similar to sugar,Any refined carb will hit fast.
The “whole food” carbs are healthier and will hit your blood slower. Things like corn and potatoes and whole grain rice.
I only eat whole food carbs I try to avoid refined carbs.
But also fat and protein effects your blood sugar.
When I eat carbs with fat I need twice the amount of insulin to keep my sugar in range.
I eat a modified low fat -high carb diet. It really helps me stay even and in range. It’s also pretty easy to maintain.
Most important for me is if I eat fat, I won’t eat carbs ate the same time.
I avoid foods with oil and fat even avocado and olives and nuts.
My sugars are very stable on this diet and I don’t even follow it super tight.
I use about 45 units of insulin per day in total.
Maybe experimenting with food will help you find a sweet spot
Hi! Thank you for your responses and much appreciated advice and information. I still have not seen the doctor but… I’ve been experimenting with carbs again. Unfortunately, I got my units up 72 and it has made my numbers in the “normal” range for the mornings. I got it in more walking, more water but I can’t kick my pop habit. I’m down to one can every other day. This week I am working with carbs and fat ratios.
I using a new pen and searching whether my insurance will help with a CGM.
Many people split lantus dose in half am and pm.Ask you doctor if you could try that. Nancy50
@Carly2 I am a type 2 diabetic who is currently using an insulin pump. I want to use myself as an example of how T2DM can progress over time.
32 years ago I was diagnosed with fasting BG of 22+ to 25mmol/L. I received timed test strips that needed to be compared to a color chart, was prescribed Micronase, received several sessions with a CDE and dietitians. Within 6 months, I was weaned from the Micronase and had near normal blood glucose levels for 10 or so years through diet and exercise.
Then the progression kicked in. This is caused by insulin resistance which overworks the Beta cells. They begin dying off. I started Metformin. Over time I was up to the maximum dose.
Next Lantus was added to the mix of diet, exercise and Metformin.
November 2020 I notices my fBG and postprandials spiking again. My next HbA1c jumped a full percentage point. Consulting with my doctor, I began multidaily injections in addition to Metformin, diet and exercise and using a Dexcom CGM. I was injecting Lantus for basal and Humalog for bolus. This worked very well.
I really don’t know how I got Medicare approval for a pump. I just wanted to explore the possibility. Suddenly a package came with a T:Slim pump w/C-IQ and infusion sets. I am in my 6 month of using the pump. The Metformin dose is reduced by half.
Now, my experience is my own. I think you really need to get a full evaluation by an endocrinologist. There may be something else going on with you. All of our hormones work together, and when they don’t, things get weird.
Hey Luis, I was wondering what your daily insulin dose is. And does it change much now that you are no longer making endogenous insulin.
I have made diet changes and adjusted a lot of lifestyle in order to reduce my insulin requirements. It seems that the older I get, the more insulin I need. Altering my diet has helped and I’ve always exercised a lot.
I’m not taking any type2 meds to increase insulin sensitivity, but I’m not resistant to it.
I’m am probably still secreting some endogenous insulin, but it seems it is sporadic. My TDD was 32u (25u Lantus, 7u Humalog) when on MDI. With the pump that has reduced to 19u basal/7u bolus.
Whether you did that pun on purpose or not, I love it. I really have had good results with increasing insulin sensitivity with aerobic exercise, although I do some resistance exercises weekly. At 73, I need to keep muscle from vanishing.
Ok cool. You are not taking that much then.
I know it’s different since I am type 1, but I’m using about 45 total units a day, but I was up to 60 before I started eating mastering diabetes low fat diet.
It’s impossible to know why my insulin requirements change. I don’t know if I’m becoming a little insulin resistant as I age, although my doctor tells me I am right where I should be as far as daily dose.
Still I know a lot of people who take ozempic or metformin and are type 1.
I really want a cure but I’m willing to experiment until then.
I’m 56 and I struggle to keep muscle mass too, gotta use it or lose it.
I didn’t realize how much upper body and core I was losing. Cycling is my go to thing and it doesn’t do much for upper and core.
Exactly in your same boat, Tim. I paddle in summer and XC ski in winter to try to keep some upper body mass!