Anyone Else?

Type 2
1

I have been following some of the posts here via twitter for several months before I joined and I have yet to see anyone with a similar situation as mine. I would like to know if there is anyone out there who has dealt with type 2 diabetes as a result of other illnesses. Let me explain:

I was diagnosed with asthma when I was 6 months old. I'm currently 53 years old, have had COPD since I was 23, and have been on corticosteroids (such as Medrol and Prednisone) all my adult life. I was diagnosed with Type 2 diabetes around 2006 (if I remember right). At first, I only had to watch what I ate, and my A1C remained at or slightly below 6. Except when I was on steroids. But I didn't require medication at all until the last three years or so.

As I no longer have much of an immune system left, I get sick very easily and I get much sicker quicker than I used to. I've been intubated (on a respirator) and in ICU more times than I can count. The prednisone is a drug I'd rather not take at all, but I have to take it to survive. The bad thing is, steroids causes Blood Glucose Levels to go sky high.

I was never told this by my doctor, he wouldn't even give me a BG meter. I had to go buy one myself and monitor my levels on my own. But even then, I didn't know what to do when I was sick recently and my BG shot over 600. After that, an emergency doctor gave me Novolog.

I currently take Metformin 500mg. twice a day, along with Lantus 30 units daily and Novolog 15 units which my doctor told me to use "only if your BG goes over 300". I feel like I'm not managing very well, and often times will avoid eating at all just to keep my BG levels from going nuts.

I know if it wasn't for the steroids, I wouldn't have developed diabetes. My doctor hasn't given me the information I need to take care of myself and I'm very discouraged. I'm tired all the time, and have to go lay down if I eat and I fall asleep at the drop of a hat. My BG rarely goes below 140, but normally stays in the 170-240 range.

This isn't living. I no longer have the strength to stand, walk, grocery shop or even take a shower without assistance. I watch what I eat, drink only water or sugar free drinks and steer clear of almost all carbs.

I'm sick of being sick! Is there anyone else who has/is going through this?

2

High BG is cause for exhaustion, along with everything else you're dealing with. No, that's not living, but things can get much better.

Insulin is best used based on your before meal readings & on the carbs you will be eating. Telling a patient to take 15 units Novolog if over 300 isn't the way! Of course, the strategy is to pre-empt the highs with proper doses of insulin before meals & a ratio to correct highs. I'm so sorry for the lack of appropriate care you've received. Please get a referral to an endo.

I second Sally's suggestions to get Dr. Richard Bernstein's book Diabetes Solution & Using Insulin. Know how cliche this sounds, but Diabetes Solution changed my life.

4

AS one who is 64 and almost rotted out and had horrible numbers BG running 180 up and a1c at 13.3, it is good that you wrote in and shared your experience.

Regarding Doctors and endos, I must share that even with my bad experiences, my take on the problem is the approved mis-guided cures and play books Doctor's/endos must follow to ensure "quality" nee - read lack of legal law suits.

I was on actos and 26 units a day of 75/25 insulin. Today I am on metformin multiple doses and 3 units of humalog lispro at am and smaller doses at lunch, dinner and midnight. STarlix, actos and 26 units of humalog 75/25 all gone and not needed and weight down from 330 to 260 and dropping.

There are many good web responses so far for you. I with my excellent Doctor's understanding patient help was able to get mess under control.

I am not Doctor nor qualified to recommend approach or cures except to share what had to be done in my case after stroke in 2007.

The end game is as follows:

one needs to really get average BG down to sub 155 - preferrably 140 and A1c sub 170.

Unfortunately the human body does not worry about excess glucose from food eaten and energy balance from energy expended. It is only optimized to prevent starvation and extend ones life a smuch as possible when food unput stops.

To this end carb control is extremely critical and why low glycemic diets are vety important. See Steven Harper's MD Mediterranean diets et all. Portion size here is the key. I see Bernsteins excellent work was also suggested here.

Not knowing what level of actual hearty exercise you can get or can do is critical in guessing carbs input from meals during a day.

For me that was 1 to 2 miles a day slowly walking and 1200 calorie a day diet. I am a big person 6 ft 260 pounds.

Unfortunately, nobody really states that human body needs regular exercise to help burn off the liquid energy and keep it moving out of system. Insulin DOES NOT do that contrary to the stories out there.

Your numbers suggest to me that body is showing signs of glucose saturation.

Many times adding large doses of insulin with numbers you have suggest that the insulin will simply circulate around your body doing nothing as skeletal muscle cells temporary glucose storage is already filled up. Been there done that.

Unfortuantely many of the current theories on type 2 diabetes are short new and more advanced thinking nor has that data made the rounds all over.

The fact you are on metformin should be helpful as it is the one drug that can slow down excess liver glucose release.

If it was me, I would cut to low glycemic diet and reduce carbs/calories signifigantly till numbers back in control but this all requires assistance and help of a good Doctor and do not do without that supervision and help.

Insulin can be most helpful when the body can absorb more glucose but when its full aready, the insulin is useless.

Best Wishes and good luck in days ahead and I see many good folks have responded with excellent comment and thoughts.

You honestly do not want to stay at these elevated BG numbers.

5

Dear Granni

Boy you have an diabetically unfriendly doctor. I feel the same way even without the COPD and prednisone.

I think you would feel much better in a BG range of 100 to 140. I certainly do.

Get a book called using insulin by John Walsh. That will explain how to get your insulin dosage in the right range.

6

Granni,

Too many doctors try to put all diabetics in a little box. You must live inside that box and do nothing else. That never works.

Each diabetic is different and responds to medications differently. I had oral meds that did nothing at all for me. I have been on most of them. I have even been on U500 insulin.

I saw an endo here in MS (who left private practice, darn it) who put me on byetta and lantus (100u before breakfast) and my BG has been stable ever since (with the occassional bump in the road from chocolate cake).

You and a doctor have to work together to get what works for you. You and the doctor are supposed to be a team. You listen to the doctor and the doctor listens to you.

Remember...you are paying the doctor not the other way around.

7

Nice to meet you Granni Annie.........

Since you're feeling sick and fatigued all the time, it's obvious your current therapy is not working. Steroids is big time medicine, and an endocrinologist is the person to see. Juggling meds, insulin, and steroids is a balancing act that isn't working for you. Treating a 300 sugar when only necessary with insulin is already too late. The trick is to find out what got you to 300 in the first place. See a specialist in diabetes care and log your food, BG readings, and therapy for a week or two to bring with you to the doctor. Let us know how it works out.

8

Welcome! You've come to the right place!

Read as much as you can on this site, in Dr. Bernstein's book, and also have a look at Jenny Ruhl's Blood Sugar 101 site. Give yourself time to digest all the information that you're finding. Ask tons of questions here! You will get better support and more accurate advice from folks here than you're likely to get from a doctor. Most GPs know very little about diabetes. Endocrinologists know a lot, but may not have the time you need to explain things. In the end, there is only one expert on your type of diabetes: you.

Keep a log of your BG readings. Test when you wake up in the morning, before every meal and two hours after you've eaten. Test when you go to bed. Keep notes about what you've eaten, exercise, how you feel, unusual stress, etc. Record your insulin doses and when you take other medications. After a week or two, you should start to see some patterns. For example, it may be that your BG rises easily in the morning, whether you eat or not. Or it could be that your BG takes a long time to come down after meals. Once you start seeing patterns like these, you can figure out what to do about them from your reading or from asking questions here.

If you go on a very low carbohydrate diet you will soon find that you have a lot more energy and that your BG readings are lower. A lot lower! You may not want to eat low-carb all the time, but it might be worth trying it for a month or two. Carbohydrates produce glucose. Less glucose in your system will make you feel much better, fast!

9

You didn't mention if you are overweight or not. On Byetta (about 5 years), I have lost 65 lbs. over the last few years (slowly), and now my asthma seems to have gone away.

I go to a good endo, who specializes in diabetes, and is a type 1 diabetic himself.

I take 1000 mg. of metformin twice a day, but am starting to cut down on it since my last A1c was 5.1. I have been able to stay under 6 for several years now. I now take byetta only once a day.

I have had 5 steroid shots in my back and two in my knees over the past years and they do send blood glucose levels high for about a week. I'm not sure my regular asthma steroids raised it much over the years. I haven't taken any asthma meds for about 8 months now.

I agree with everyone reading Dr. Bernstein's book, the 2011 edition. You can learn a lot.

Good luck!