Insulin not bringing down my sugar

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Insulin not bringing down my sugar


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Old 12-19-2016, 09:49   #1
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Default Insulin not bringing down my sugar

Hello everyone,

Please bear with my long post,I am desperately in need of some advice from fellow experienced diabetics.

I am a rebound member here. Last year I conceived, so I was very keen to maintain my sugar levels and worked hard to do so. I cut down carbs and started excercising, also I was on 22 units (twice a day) of novomix 30 insulin. That worked and I was in a good shape, my sugar levels were perfect.

Until I had my miscarriage. After that I just dropped off the radar and stopped testing my sugar levels.
For the most part, I continued eating healthy, and followed a low carb diet, continued with the insulin, but was on and off excerise. I also indulged in carbs quite a few times but that was occassional. But after every high carb meal I tried to balance it by eating low carb for next few days. This continued for a year and I never checked my sugar.

Recently I am back on my fertility meds and since I am trying to conceive again, I started excercising and eating healthy.

Problem is now my sugar levels are very high with the same diet and insulin that I followed last year. My fasting sugar is usually around 140 no matter how low carb I eat. So my pp is also running berserk.

I read a few blogs and found out that my body might have become insulin resistant.
On the blog they said there must have been excess of insulin flowing in my body for sometime now, hence the resistance.
I tried switching injection points but that doesn't seem to have much effect.

I gradually reduced insulin to 16 points testing my fasting everyday. Mostly even with low insulin my fasting came around 140 to 150, so it seems like reducing insulin has no effect yet, nor is my fasting level increasing nor is it lowering.
I am really struggling to keep my sugar levels in check.
If any one has faced this issue, would be very helpful if you could please suggest ways to handle this situation. Please share your insights.

Ps please ignore details in my signature for now, I am yet to update it. I am type 2 diabetic and currently on 16 units of novomix 30.

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First A1c: 11% -> 4-Sep-13
Med: On Amaryl 2mg * 2 -> 5-Sep-13 till date
FBG: 112 mg/dL-> 27-Sep-13

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Old 12-19-2016, 13:56   #2
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Welcome back. So sorry you've had a struggle with your blood sugar. We're here to help and support you as you work to gain control once again.

I'm not on insulin so can't speak from experience, but have been here for a few years and what I've noticed is that the combo insulins may work well in the beginning, but may not later when there may be other issues at hand.

Quote:
NovoMix 30 contains 30% soluble (rapid-acting) insulin aspart and 70% protamine-crystallised (intermediate-acting) insulin aspart;
It might be that you'd do better if you took each type of insulin separately. Basal and bolus. That way you could specifically, and individually, address your FBG and meal-time needs. Another benefit is that you can match your insulin to meal-time carbs without having to reduce the basal.

Could you tell us how many carbs you are eating and when?

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70 yrs. Dx May 2010
Diet controlled: VLC/HF
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I strive to be well into ketosis all the time.
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A1C - 4.9%11/2015
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Old 12-19-2016, 16:32   #3
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Thank you for the reply VeeJay.

Actually since we are planning for a baby, Doctor prescribed Novomix as it safe during pregnancy and doesnt have any side effects. But I will still check with her if she is willing to give basal bolus insulin.

Per meal I try to limit carbs to 35-40 gms, also make it a point to include green salad in each meal. Last year I followed same diet and it was doing wonders but doesnt seem like it is working now.

I actually read somewhere that since I have become insulin resistant I should increase the carb intake, this will counter the insulin in the body and help minimise glucose level. Not sure if this will work, but I am scared to increase carbs. Any suggestions? I am all ears.

__________________
Dx April '13.
First A1c: 11% -> 4-Sep-13
Med: On Amaryl 2mg * 2 -> 5-Sep-13 till date
FBG: 112 mg/dL-> 27-Sep-13

Female 29, 99 lbs
4'10(Best things in world come in small packages)
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Old 12-19-2016, 18:33   #4
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Quote:
Originally Posted by IamSweet View Post
I actually read somewhere that since I have become insulin resistant I should increase the carb intake, this will counter the insulin in the body and help minimise glucose level.
You have been misinformed.

Insulin resistance is the result of high blood sugar in that the cells of the body resist the intake of more glucose, leaving more glucose in the blood stream. That triggers more insulin (not less) which is the hormone that causes glucose to be accepted by the cells. But the cells are now resistant to that action by insulin.

The best way to counter insulin resistance is to ensure that less insulin is needed - and that would be where the low-carb diet comes into play. 30-40 grams of carbs, per MEAL, may be just too many carbs for your body to handle, even with the added insulin you take. Most people low-carb for diabetes will eat less than 50g per DAY. That means each meal can be as low as 8-10grams of carbs.

Have you read Blood Sugar 101 It might clear up some gaps in your knowledge of diabetes in general. You might also like to review the section "How To Lower Your Blood Sugar" which is a testing method that will give you the knowledge to make whatever changes you may need.

I would caution you, though. Since you are taking insulin, you should reduce carbs slowly and test to make sure you aren't going low. As long as you are on the combo insulin you can't do much tweaking as you change your carb load.

__________________
70 yrs. Dx May 2010
Diet controlled: VLC/HF
BG steady with no highs or lows.
I strive to be well into ketosis all the time.
A1C - 5.1%10/2014
A1C - 4.9%11/2015
______________________________________
Gluten intolerant, sensitive to dairy & eggs.
Eat no grains
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Old 12-20-2016, 02:01   #5
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It can be very hard to get your post-meal blood sugars under control until you have basal insulin figured out. Your basal insulin is how much insulin it takes to keep your blood sugar steady overnight and between meals.

I have had lots of trouble with my fasting blood sugar and know how frustrating it is to be trying so hard, and not see results! Let's see if we can figure it out.

First off, a mixed insulin which contains both fast acting and basal insulin makes it nearly impossible to manage your blood sugar safely. The reason why is that when you try to increase your basal dose, whether you needed it or not, you are also forced to take an increased dose of fast acting dose of insulin at the same time. You have no control, and end up doing things like "I always get low blood sugar 2 hours after my evening insulin dose, so I eat a snack before bed". So no matter what, I'd recommend asking your doctor to give you a prescription for both a basal and fast-acting insulin.

Next, are you testing your before you go to bed and when you wake up? If you see more than a 30 point difference from when you go to bed and when you wake up (and you didn't eat before bed or take insulin in the middle of the night), then your night time basal insulin probably needs adjusting.

It can help to wake up once in the night (after 4 hours, or in the middle) and check your blood sugar. This can rule out nighttime lows (which can cause rebounds) and help understand when your blood sugar starts rising during the night.

When I went through this, after 3 days if my overnight blood sugar was still rising, I increased my evening dose by 10%. Then tested again for 3 days to see if it worked.

That said, I am NOT a doctor, and cannot give medical advice. So please if you can work with your doctor. Or even better read "Think Like a Pancreas", which is a book written by a diabetic doctor about how to use insulin properly.

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Last edited by Daytona; 12-20-2016 at 02:03.
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Old 12-20-2016, 05:30   #6
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Quote:
Originally Posted by VeeJay View Post
You have been misinformed.

Insulin resistance is the result of high blood sugar in that the cells of the body resist the intake of more glucose, leaving more glucose in the blood stream. That triggers more insulin (not less) which is the hormone that causes glucose to be accepted by the cells. But the cells are now resistant to that action by insulin.

The best way to counter insulin resistance is to ensure that less insulin is needed - and that would be where the low-carb diet comes into play. 30-40 grams of carbs, per MEAL, may be just too many carbs for your body to handle, even with the added insulin you take. Most people low-carb for diabetes will eat less than 50g per DAY. That means each meal can be as low as 8-10grams of carbs.

Have you read Blood Sugar 101 It might clear up some gaps in your knowledge of diabetes in general. You might also like to review the section "How To Lower Your Blood Sugar" which is a testing method that will give you the knowledge to make whatever changes you may need.

I would caution you, though. Since you are taking insulin, you should reduce carbs slowly and test to make sure you aren't going low. As long as you are on the combo insulin you can't do much tweaking as you change your carb load.
Thanks VeeJay. Yes, what I read was contrary to my overall knowledge of diabetes hence I wanted to hear your thoughts. I am ready to just about try anything to maintain my sugar levels.

35-40 gms carbs was not less but earlier with same diet and insulin I was able to have a tight control, hence I sticked to the same diet. But now I think its time to lower my carb intake even more, will try that.

__________________
Dx April '13.
First A1c: 11% -> 4-Sep-13
Med: On Amaryl 2mg * 2 -> 5-Sep-13 till date
FBG: 112 mg/dL-> 27-Sep-13

Female 29, 99 lbs
4'10(Best things in world come in small packages)
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Old 12-20-2016, 06:33   #7
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Quote:
Originally Posted by Daytona View Post
It can be very hard to get your post-meal blood sugars under control until you have basal insulin figured out. Your basal insulin is how much insulin it takes to keep your blood sugar steady overnight and between meals.

I have had lots of trouble with my fasting blood sugar and know how frustrating it is to be trying so hard, and not see results! Let's see if we can figure it out.

First off, a mixed insulin which contains both fast acting and basal insulin makes it nearly impossible to manage your blood sugar safely. The reason why is that when you try to increase your basal dose, whether you needed it or not, you are also forced to take an increased dose of fast acting dose of insulin at the same time. You have no control, and end up doing things like "I always get low blood sugar 2 hours after my evening insulin dose, so I eat a snack before bed". So no matter what, I'd recommend asking your doctor to give you a prescription for both a basal and fast-acting insulin.

Next, are you testing your before you go to bed and when you wake up? If you see more than a 30 point difference from when you go to bed and when you wake up (and you didn't eat before bed or take insulin in the middle of the night), then your night time basal insulin probably needs adjusting.

It can help to wake up once in the night (after 4 hours, or in the middle) and check your blood sugar. This can rule out nighttime lows (which can cause rebounds) and help understand when your blood sugar starts rising during the night.

When I went through this, after 3 days if my overnight blood sugar was still rising, I increased my evening dose by 10%. Then tested again for 3 days to see if it worked.

That said, I am NOT a doctor, and cannot give medical advice. So please if you can work with your doctor. Or even better read "Think Like a Pancreas", which is a book written by a diabetic doctor about how to use insulin properly.
Appreciate your reply Daytona. Yes I understand its difficult to maintain sugar levels using mixed insulin, so I am willing to try basal bolus instead, will talk to my doctor. Just worried if that will have any issues during pregnancy. I dont know any one with pre existing diabetes and pregnant, so was just following doctors suggestions till now.

__________________
Dx April '13.
First A1c: 11% -> 4-Sep-13
Med: On Amaryl 2mg * 2 -> 5-Sep-13 till date
FBG: 112 mg/dL-> 27-Sep-13

Female 29, 99 lbs
4'10(Best things in world come in small packages)
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Old 12-20-2016, 20:09   #8
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Quote:
Originally Posted by IamSweet View Post
Appreciate your reply Daytona. Yes I understand its difficult to maintain sugar levels using mixed insulin, so I am willing to try basal bolus instead, will talk to my doctor. Just worried if that will have any issues during pregnancy. I dont know any one with pre existing diabetes and pregnant, so was just following doctors suggestions till now.
Basal/Bolus is unquestionably safer during pregnancy than mixed insulin. It is the gold standard (sometimes along with a pump), that is used for Type 1 pregnancies.

In fact... if you are able to shop for a doctor to help with a planned pregnancy, I suggest asking around (maybe calling the local hospital) and finding a OB or Endo who has worked with Type 1 diabetics through pregnancy and labor. There are a lot of things to watch out for that a doctor who isn't used to dealing with diabetes wouldn't know about or have experience with real women and safely managing their blood sugar swings during pregnancy/labor.

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