I am a T2 doing very well on minidiab and metformin for 12 years. Then suddenly my bg shot up and I needed insulin shots - Lantus and Novorapid - with increased metformin, 500mg twice a day. I was alright with metformin for the past 2 years until now. During the past few days I have been getting sharp stomach and chest pains with a lot of gas. I also feel like throwing up every time after taking metformin. My stools are dark, which I suspect might be stomach bleeding. I’ve stopped the metformin for now and am taking antacids. I can’t get to see my endo until next week. I know that T2 can’t be on insulin alone as they need drugs to help the body cells counter insulin resistance. What type of questions should I be asking my endo? Thanks for any input.
I’d contact your PCP ASAP- you symptoms sound like what my Mum had, and it was her gallbladder. She had it removed 5 days later. Don’t wait for your Endo- something is up NOW. Call your PCP and let them know your symptoms, they can discuss with your Endo- YOU DON’T HAVE TO WAIT!!! This is a prime example of why doctors have OnCall services and After Hour phone lines. Please take advantage of it, or at least give them a call in the morning and tell a nurse what is going on. That’s what we pay them for.
As for the Endo portion: I’d ask about an extended release form of Metformin if you aren’t already taking one, and you may need to up the dosage even more. I myself take 1000 mg twice daily. For the last 3 years, I’ve been doing insulin alone, and I recently started Metformin and my insulin needs have decreased SO dramatically I have no idea why no one caught it years ago. I’m type 2.
Seriously though, give your doctor a call and tell them about your symptoms. It doesn’t sound like something that should wait.
No you can be on insulins alone not a problem except for possible weight gain. Metformin and my body do not get along well. I was told by McGill’s best tummy doctor that dark blood in the stools is to be worried about. Could be bleeding ulcer. Metformin may not have anything to do with that but I have no data if it is good to take when the GI system is suffering.
PS I agree that the metformin is a good thing to fight the insulin resistance and possibly you should resume after your GI issues are resolved.
While every diabetics milage may vary, here’s my current diabetes regiem:
I’m 6 foot, 215 lbs
Lantus 23 units 1x/day
Onglyza 10mg 1x/day
Normal diet paying attention to healthier carbs and elimintaing things like HFCS, refined sugars and of course portion control
BG results prior on Metformin, Avandia and Onglyza (max doses):
150-200 fastings, before meals a bit lower and 1 hr post meal 250-300
BG results on Insulin and Onglyza only:
100-120 fasting, 80-100 before meal
I’d call my PCP as something else sound to blame and my not wait a week.
Thank you Varena. I suspect that while a lot of T2’s take copious amounts of insulin (even with pills) it isn’t alway’s neccessarily true. Plenty of T2’s I’ve spoken to use way much more basal insulin that I do. People I’ve met in person or online tell me their taking as much as double to 4 and 5 times as much or more. I’ve heard figures of 100-200 units per day. I’m pretty sure that amount of Lantus would ruin my day (not to mention my week). I say this because Onglyza doesn’t do anything for basal insulin levels, mealtimes only. It fools the pancreas into producing insulin for an extended period of time after meals.
I say all this because prior to this regiem I was taking plenty of metformin and avandia and it didn’t put much of a dent into my overall control. The reason I’m off both of these drugs is with the addition of Diovan 160/12.5 for two months my kidneys decided to take a vacation and I spent 4 days in the hospital.
Doc put me on a basal insulin and the onlglyza only changing the pressure meds to something less stressful. What does this all mean to me? I’m enjoying great control at the moment with a minimal amount of drugs (1 pill/day) and insulin which technicnally is not a drug at a level that suggests I’m either one of the most insulin sensitive type 2’s out there or . . .I’m not really a true, classical type 2 considering I take NO drugs for insulin resistance . . .nada.
It would be an interesting experiment to drop the Onglyza to see what happens, however that would most likely mean the addition of mealtime insulin. If D is truly progressive I’ll get to that point eventually and it will be interesting to see what happens to my insulin requirments.
To be honest I’ve never asked my Doc if I’m really a type 2 as I’ve been more concerned with getting the D under control.
I take metformin 1000mg 2x a day and 20 units of nph and regular acording to my meal and premeal BS. average of about 5 units regular with meals. metformin made me dry heave so doc had to prescrib another med to control that. W/O metformin my fasting BS was around 135 and post meal about 165. W/O any med my fasting averaged about 160 and post meal as high as 350. Addtionally, b4 starting insulin I had horrible muscle cramps usually at night but increasingly common during the day. It was interfering with my sleep. The day after starting NPH my cramps went away and never returned unless I stopped insulin for 3 days. My doctor is clueless about the relationship, but I wuould use insulin if no other reason than to stop the muscle cramps.
rest well
danny
I was a insulin resistant type 2 that was on shots only with out oral medications. The oral medications make me sick to my stomach so my doctor switched me to injections only. I was on injections only within about 6 months of being diagnosed. I was on both Lantus and Novolog. You might have to up the amount of insulin that you inject but that is about it.
I am now on a pump and have been told that I am a type 1 diabetic. Just ask your Endo how they feel about you doing injections only or changing the kind of insulin you are on. They should be open to the idea.
The difference between oral medications and injections only is like night and day for me. I could choose when and what I wanted to eat instead of having to eat the same thing all the time. My glucose levels became more stable. I was not nauseated all of the time.
I was using 90 units of Lantus and I was on a sliding scale for the Novolog. I think I was on a 1:10 ratio with Novolog. I split up the Lantus into 2 shots because I kept having lows after taking the Lantus and highs before it was time to inject again.
One of the things that I learned from this website is that if your doctor does not listen to you and is not on your side then look into getting a new doctor. Not every diabetic reacts that same way to the same medications. You will not react the same way to the medications from day to day. You need to be willing try new things and so does your doctor. A good endo is willing to to whatever it takes to get your glucose levels under control.
Hi Varena -
I am an “insulin dependent T2” - that’s what I call myself. I managed with orals, diet, and exercise for nearly 20 years. After that, I did injections for about a year (Lantus & Novolog, then Lantus & Apidra). Now I have a pump - I love it. I still take metformin - it does help resistance a bit and helps with weight a bit.
I would much rather be on insulin than any of the oral medicines - I believe they helped “burn out” my beta cells .
The best advice I can give you is to learn as much as you can - diabetes is a disease that we must manage, to a great degree, ourselves - medical folks are just the support team. The best resource I know is Jenny Ruhl’s web site http://www.phlaunt.com/diabetes/ and book - Diabetes 101: What They Don’t Tell You About Diabetes. I believe it saved my life. My A1c went from 8.9 to 5.5 and my cholesterol & blood pressure returned to normal without additional drugs.
I hate to say this but your A1C should not have gone up that drastically because of menopause. Sounds to me like your medications are just not working for you. How much are you injecting a day? Are you insulin resistant?
Actually, I disagree. Menopause can impact your entire hormonal system - including BG.
I thought you were Type 1…
Yes, I know you are a Type 2… but I thought Unicornzzz was a Type 1.
Lantus and novorapid and weight gain is a big problem now that I am old.
You seem to be getting a lot of good advice here, including a reminder that what may work for one diabetic won’t necessarily work the same way for another. I too can’t tolerate metformin. I am using lantus and novalog. I have not found it necessary split my Lantus dose. The number of units that provides effective results for you may seem like a lot, but you have to go with whatever works. Using insulin isn’t the end of the world; it’s just another tool that can be used to manage your diabetes.
I was originally diagnosed as a type 2. My doctor has since ran tests on me and found out that I am now a type 1. I was on injections for over 2 years while I thought that I was a type 2. I started fighting for a pump while I was still supposed to be a type 2. It was not till after I had received my pump that we found out that I was a type 1.
I take metformin 2x 1000mg per day &nph 10 units twice a day.
W/o any mess my BS ranges 150-325. On them it is 95-135.