Dispondish diabetes ... What to do?

In the month of February I was detected the diabetes since then it is totally uncontrolled, the doctors do not tell me anything they only changed the type of insulin and the proportions, now they are giving me alarming results, as I am on vacation I do not know what to do.

In the morning a few days give me 50 to 70 at that time I don't know what to do if walking, breakfast, take sugar and stay at home, other days gives me around 270 in that case breakfast and I'm going to walk.

At night the values ​​are highly always around 300.

They have sent me to put me 40 in the morning and 36 at night.

What should I do especially when it gives me those low values ​​in the morning?

I am 65 years old.

Thank you all!

Hi Aurori

With 50 or 70 it is advisable to drink sugar (a glass of water or fruit juice with sugar and a pair of cookies), rest and at 10 minutes re -measure to see if the blood glucose is above 100.

We would need to know some things to be able to comment more accurately:

I imagine that the units you say are mixed insulin, with names like Mixtard 30 (the clock), Novomix 30, Humalog Mix 25 or 50, Insulatard ... or maybe you put on another type of insulin.

It is important that you also know what you eat, you never have to skip any food or stop eating carbohydrates, carbohydrates is what allows the human body to function, without them and with excessive insulin in the body we have guaranteed hypoglycemia.

We usually explain children:
- Everything that is born from Earth are carbohydrates (fruits, vegetables, cereals ...) And also milk.
- Everything that runs, nothing or flies does not raise glycemia

If you eat excessive carbohydrates for the insulin you get you will have very high values.
If you eat less carbohydrates for the insulin you get you will have very low values.

In summary, and even if it is a vacation, I would ask for an appointment with someone to explain well what diabetes (insulin+food+exercise) is, it can be an endocrine, it can be an educator nurse in diabetes (in many hospitals with unitsThere are diabetes) or even in primary care you can find someone to explain it in depth.

Another possibility is to prove fortune in an association of diabetics, in many of them they have a diabetes educator.

Finally, change the needle after each puncture, never reuse the needles ... If you do it, in addition to doing more damage you have the danger of getting less insulin than marks (if they use them a lot they are embozan, so to speak).

I imagine that instead of clarifying something I have brought you more:-/

Thanks Owash for your answer so fast.

I have to say that the insulin type that I manage is Novomix 30, as I point out in my previous email I put 40 before breakfast and 36 before dinner, also pills one of metformin 850 po the morning and another at night.

I respect carbohydrates I am doing a diet of 1500 calories that the educator nurse indicated, it is very difficult to calculate carbohydrates, but from what I see I take breakfast too many to dinner because the values ​​are always high.

Regarding the low values ​​of 50 to 70, your indications have become clear because as I told you in my first email I did not know what to do.?If the value you indicate to me rises to more than 100 after having taken sugar or juices I can put on the morning insulin 40 u., have breakfast and go walking?If on the contrary they follow the low values ​​that I must do.

Another question: if the values ​​continue so high in the morning and at night around 300 would it be convenient to raise the insulin dose?

I have to tell you that I continued to lose weight in February weighed 83 k.And today 69 k. And I measure 1.60m.
Thanks and cordial greetings.Auriri

With values ​​of less than 70 you do not go for a walk, walk the blood glucose and if you go out with 60 without eating anything you will have an even larcookies)
And whenever you are going to walk in your pockets or in the sugar bag and some cookie, just in case you have a loss of glycemia.

My opinion is that with that insulin you always put it with breakfast and dinner

The insulin you get, mixed, has 2 phases, so to speak, it has a fast insulin (which lasts about 2 hours) and 70% slow insulin (which will last about 10 hours or so).
Fast insulin will make breakfast hydrates very well, the same happens with dinner.

However, the hydrates you eat at noon do not find the insulin they need to function and that is why, you have those high values ​​at night.

Slow insulin acts as basal, as a minimum insulin necessary for the body to work.

I believe that you lack insulin at noon, I don't just convince the metformin+mixed combination ... much less having lost weight significantly.

I would not touch the insulin values ​​at the moment, if you increase the dose you are likely to have hypoglycemia both at breakfast and at dinner.

Try to keep a record of what you eat, the glycemia you do and exercise ... in this way your nurse and the doctor can better adjust the treatment.

Hi Owsh.Thanks again for your comments you are being of great help, the comments you make are completely logical
S Although we do not know if there is logic in this disease.
This next week I will go to the endroquin, at least the nurse attends me, I will be given the results of all the measurements that I have had during the fifteen days, I hope I modify the treatment or me of some satisfactory explication.I will tell you the result.
I hope you do not get tired of me is serving me a great help greetings aurori

Courage, Aurori.
You will see how with the help of the nurse, you soon find the best treatment.
And, of course, having Owash is a luxury in our forum.

Greetings

: Oops: Luckily the compliments are in writing and I can demonstrate it to the unbelievers :))
But completely unreisseed Alea's compliments (they are not worth because we are friends and you are not objective: d) and Aurori's thanks (for that we are ... what a forum it would be if we would answer the questions).

Aurori, it is very important in the diagnosis of diabetes (and in any disease) that teach you to handle the disease, all manuals and clinical guides indicate that at least, that diabetological education must last 1 week in a row (5 classes) and littleLittle by spacing the visits as they learn to control the disease.

Unfortunately, and above all in primary care (outpatients and health centers) or because they don't want or because they can't ... almost nobody does that education ...

If they are taking you in primary care I would ask them to be referred to specialized attention (diabetes unit, or endocrinology service).

Try to point in the notebook the insulin you wear (I suppose that always the same amount), the glycemia that come out, the food (if it can be with quantities much better) and the exercise you do (in duration and intensity) ...And if you put it with the hours when you do all that would be outstanding: D
Shortly that the nurse and/or doctor is a bit competent with that information has more than enough to assess the treatment.

And since when not being objective prevents telling the truth?:(
Well that.:))

Thank you again: Ati Alea I thank you for the dares and surely you are right in relation to the comment you do of Owash.

Regarding the last of Owash I will tell you that for a month I is treating me an endroquin and an expectant nurse, the nurse told me a lot about the disease and especially of the 1500 -calorie diet that put me, and it gave me enough brochures that speakFrom the disease but I see that my problem comes out to put it in some way of the papers, the endroquin was limited to putting the dose of insulin and returned in September. Before the measurements that were giving me fuy again at fifteen days without waitingAs is natural to September, I even made my husband some graphics with all the measurements from the first month, which we presented them showing that every day that passed the results were more alarming, I look at the graphics above and did not make a single oneComment, this time as the dose of insulin uploaded to the previous one, I do not remain the same in the measurements are quite worse, so I have decided to go to consult without having the next Wednesday, I do not know what happened today before dinner hasGiven 430 and I have not eaten nadamas that a rice medication and a fruit at noon, having walked this afternoon for an hour and a half, I put 40/u of insulin in the morning, according to indications of the endroquin
As I see that your help will be fundamental to me will have you up to date, which is certain that we are going to do what Owash tells me to write down everything that is significant for the possible control of the disease daily amounts amounts hours of food etc.PHYSICAL EJRICITIES, INTENSITY etc.amounts of insulin, measurements etc ... thanksssssssss auri

Aurori, with those "mix" insulins it is very difficult to achieve good control.
Here, most use, ultra -grape insulins, either with a slow insulin as basal, or by bomb.
The ultra -grape allow you to correct at the time, in addition to being able to adjust the doses to the meals you are going to do or to the schedule variations.The inconvenience is that the number of punctures is greater, but much better control is achieved.

From what you tell us, it seems that you lack insulin.Speak clearly with the endocrine and eat the possibility of insulin change.

Health

I more than change insulin (which also), if in this next visit the endocrine does not make a minimum effort to understand your diabetes ... I would certainly change their specialist.

One thing is what he puts in the books on diabetes and another very different thing Aurori diabetes (or Owash diabetes, or Celia's ...)

The figures that you put point to a glycosylated hemoglobin above 10%, so it is not surprising that you are thinning if you have been with those figures for some time, it is normal for you to lose weight (which is not good, it is quite bad because the body is not taking advantage ofof correct manwera the energy reserves).

It is also true that there may be other possibilities that we have not contemplated:
- There are certain drugs (for example, corticosteroids) that raise blood glucose.
- In cases of diseases or infections (very common urine infection and now in summer otitis), glycemia are also altered.
- Problems in the injection areas (lipodystrophies), reuse of needles, use of bolis more than 1 month (although with your guideline you will surely consume the ball before)

I guess all this, the endo will have already looked at it.

Since you take out the Owash theme, a corticosteroid ointment to treat an allergic reaction on a finger, can the glycemia upload?

I only use it once a day, and by prescription of the family doctor, not for the endo.

Greetings.

Are your glycemia normal?
Well there you have the answer :))

I imagine that if it is for a finger there will be little the amount you put on, and it is not the same route of administration (and absorption) as the subcutaneous or vein route.

Theoretically corticosteroids excite the liver to produce glucose (glycogen) and also the damn annuls the use of circulating glucose in the plasma: Evil:

Hello everyone: as I indicate last day 21 today I have gone to the endocrine again the nurse has attended me, the endroquin did not want to talk to me and he has limited heDO.
It coincides quite a lot with what you tell me, that is, they send me the values ​​before the midday food and they tell me that if the value is greater than 250, that I put 5 units of insulin and if it approaches 400 that I put aUnit more, of the same insulin that I am getting (novo mix 30), with respect to the rest it remains the same is to say in the morning 40/u and a pill of metformin, at noon if it passes from 250 I must put 5/u, ifOne more unit and an adiro pill, at night 36/u insulin and a metformin pill and the needle change will be daily will be approached.
I have also been told that I point out what amounts and elements eat at each meal and that it drinks quite liquidThe view of them will modify the treatment
The nurse points to me that you have to go step by step until you get the desired values, I do not know what to do if asking for the change of endroquin now or waiting later?What do you think

Daily needle change?: Shock ::?: ((: Evil: :(: |: x

Let's see, the needle is used only, 1 puncture and undo, as the manufacturer says ... the law says that users are obliged to use pharmaceutical products as the manufacturer indicates ... if they tell you to beYou can use more than 1 time they put it in writing and with your name ... you will not be by chance of the Valencian Community, right?(Alégrame the day: Mrgreen :)

I honestly do not understand that insulinization pattern ... In my view it is a guideline of the year 3 BC :(

With 10 glycosylated and do not put ultra-grape insulin: !: !:!so that?If you have the basal, and it only gives you 1: Shock: ...

With 10 glycosylated you will drink to the water of the vases ... if you must be drinking all day (and on top of this heat)

Glycosilada does not fall every 15 days: shock ::-it is absurd to make it every 15 days ...

So now you get:
40 Novomix 30 units to breakfast
If in the food you have + 250, you put another 5: shock:
36 Novomix 30 a dinner

Let me guess it, they have given you a diet of 1800 calories ... and on top you are losing weight ...

Adiro is "aspirin", acetylsalicylic acid ... There is a current that advocates the prevention of heart attacks by taking this drug ... which by the way is also from Bayer.

Please tell me that you have nothing in the kidney ...

And one last thing, I am not a doctor, and it is very easy to comment on the sitad behind a PC ... so that it is possible that I am wrong so you do not take anything that I say as absolute truth.

That said, I changed my doctor now.

Well here we are: after the last thing you tell me Owash I stay in the painting, I need to know so much to get calm that the comments you make to me, being so different from those that the nurse tells me I do not even take me to take them.
What is true that I have a mental empanada that I do not know what a way, I am very grateful to you Owash for your comments, for what I ask you even though you are not a doctor and in view of what I expose you to tell meWhat treatment should I segir until my vacation ends and I can return to the endocrine again.The last Wednesday moves me from my holiday place to visit it.Endocrine change will be necessary
Since the diabetes told me in the month of February I have been completed six complete analyzes between emergency services and the header, in none of them they located any anomaly.Therefore I have nothing to kidney.
The current endroquin has asked me to do an analysis for the month of September that I have an appointment with him.
By the way I am not from the Valencian Community and I do not want to drink water.The diet they have given me as I put in other emails is 1500 calories.And what I wear is what you point out

The guideline you must follow is the one that the doctor has marked you, in no case you must change insulin on your own or because someone puts it in a forum.

Putting 5 extra units (with respect to the initial guideline) in the food only confirm that you lack insulin ... but above all you lack ultra -granted insulin.

My opinion is that you should go to a bolus-base pattern ... in Christian, basal insulin (lantus or levemir) + ultra-granted insulin in each meal ... more than anything because it is the most similar way to how a pancreas and pancreas worksBecause it is the way to try to return the balance to the pancreas (this only applicable to type 2)

Sometimes it happens that the pancreas cells turn toilets to the production and/or use of insulin ... If for a time insulin is supplied externally, it has been seen that this lost functionality is partially recovered ...

Glycosylated hemoglobin measures the glycemia of the last 3 months ... It is how if all the glycemia of the day were added and divided by that total number of measurements ... We would get an average of all those days (this is not entirelyThus because 50% of that average is responsible for the last month ... and technically it is not an average but a median, but well it is worth) ... 140 mg/dl equals 7% (more or less and the laboratory depends)
That is, as much, and for it to be significant, glycosilada should be done not before the month and a half ... but it is impossible to draw conclusions from the figures

I believe that you have the right to a diabetological, dignified and minimal education to get your diabetes well, and that is why you have to fight.
Without teaching you everything that requires diabetes (exercise-food-drugs) it is impossible to carry this disease well.

Aurori greetings, I with values ​​of 400 would go to the emergency room without hesitation, stop experiments