Acceptable numbers?

Former queen of denial, I reigned from 2007 (diagnosed) to last December, when a routine exam uncovered stenosis of the carotid arteries-way too much for my age-likely caused by high cholesterol, poor (actually non-existent)control, and years of smoking (I quit-1 year this April). I finally got serious about accepting my disease. So even though I've been diagnosed for years, I am really just learning. My concern is that my numbers don't ever seem to go down into what I keep reading is the "acceptable range". The only med my PCP has me on related to the condition is 1000 mg metformin SR, which I take 2x day-breakfast and dinner. I appear to have the "Dawn Effect" phenomenon, as I consistently wake with my levels anywhere from 175 to 200. My doc keeps blaming my high A.M. numbers on my eating in the evening-that snack for me consists of a piece of fruit-usually an apple-so I don't really believe that's the cause. She put me on Januvia, which she said would lower the morning numbers. Didn't happen. I went off the Januvia because the possible side effects are way too frightening. I have now started taking my metformin immediately upon waking, and before eating-always around 7 a-to try get my numbers down before I even attempt to have a bite to eat. To my knowledge, I have not had a C-Peptide or GAD antibody test, so I am going to request one at my next visit. My concern is that my numbers seem to always hover in the 150-200 range, no matter what I do or how careful I watch my carb intake. Doc doesn't seem to think anything of it, but then again, nothing seems to raise her level of concern (shopping for a new doc-specifically an endo). I guess my fear is that insulin is in my near future. My apologies for the long post, but any input appreciated!

Testing to confirm type is a good idea, though 7 years would be a long time to go without insulin if you are LADA/Type 1 and you would be much higher than that most likely.

However, whichever type you are, insulin may be in fact the best bet. Please don't think of it as a "fear" or a "punishment". Those who have struggled and gone on insulin quickly say it was the best thing they could ever do. And yes, I would leave a doctor who shrugs at you staying continually between 150 and 200.

Thank you for the feedback, Zoe. Then you agree that I should be experiencing lower numbers? Your thoughts 're the possibility of actually being LADA/type 1 occurred to me as well, and I agree-not likely. I will insist on the additional testing. Just checked again 2 hours after eating, and I am at 165. Very frustrating because I think I am doing all I can to achieve some decent control, and its just not happening.

Zoe, Count me as one that says going to insulin was the best thing I ever did. You are dead on correct that it is not a punishment or something to be feared.

I cannot say if it is time for Judi to start insulin but I do agree that 150 to 200 is not acceptable. It may be to soon for insulin and there are still other things to be tried but I believe that doctors withhold insulin from T2s for to long.

Insulin is a powerful tool and I like having the best tools in my tool kit.

Yes, that is too high, Judi. It's not extreme by any means, but you just don't want to stay high on an ongoing basis. I'm sure you are doing all you can, it isn't your fault! You obviously need some change in treatment to manage your BG and you are not getting support in doing that!

Count me in as well. As a 30 year type 2; I found pills( not metformin) but the pills that push on the pancreas as great pain in the rear. Liquid Insulin was a god send and allowed me to get proper control.

I have to tell you as a T2, almost without exception T2 drugs do little to help your fasting numbers. I have tried nearly all of them and finally made the decision to move to insulin as Gary did. In practice, a constantly elevated fasting blood sugar and large Darn Phenomenon (DP) does indicate that you just don't make enough insulin. Period.

The one medication you may consider is of the new class SGLT2. It is called Invokana. Pretty much all the rest of the drugs work mostly be helping your response to meals. But a low carb diet is much more effective. The only problem is that Invokana is new and likely quite expensive. You can ask your doctor about it.

In the end, this is really your decision. I talked extensively about moving to insulin with my doctors. You can read about my decision in my post from 2011. There is no failure in using insulin, it is just another treatment. We all deserve the opportunity to treat our diabetes within our means to achieve the best outcomes.

Sincere thanks to everyone who responded-all of your valuable opinions will broken into consideration when I see my doctor again. Your validation of my concerns makes me feel less alone in dealing with this disease on a daily basis!

I like to aim for pretty normal BG. I don't by any means hit it all the time and, occasionally, it'll get pretty out of whack but I figure I'm more likely to hit normal if you're aiming at it, if that makes sense.

Unfortunately, I only know what I've read about T2 Meds but the Ominous Octet article kind of lays out the different options that are out there for T2 pathologies and meds to address them more precisely. The article is pretty heavy scientifically and I only read through it all the way once a couple of years ago but I like the way it breaks things down.

Thanks for the link-I'll check it out.


Wish I had done it ten years sooner. Life-changing.

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