Confused With Treatment Plan

#1

I just got diagnosed however I was a little concerned about my doctor’s treatment plan. Instead of trying me on metformin, she wants me to go straight to insulin and this seemed a bit odd to me. And was wondering if this is normal.

#2

Without more details, it’s impossible to answer. Were you diagnosed with Type 1? if so, insulin is mandatory sooner or later—usually sooner. No other medication has the ability to lower or control blood sugar directly as insulin does.

Some doctors (a growing number, actually) prescribe insulin for newly diagnosed Type 2 on a temporary basis until blood sugar is normalized, then continue with metformin or other meds.

Without knowing a lot more specifics about your situation, it really is not possible to give a succinct answer to your original question. Just too many variables and unknowns.

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#3

As David suggested, if your blood sugars were very high (consistently over 200 mg/dL), it’s pretty normal these days to start on insulin regardless of type of diabetes (which they might not even know early on). Consistently high blood sugars do a lot of damage to the body, and so a “normal” treatment plan these days is to bring those blood sugars closer to “normal” as quickly as possible. Then, if you’re Type 2, MODY, or some other variety besides Type 1, you might have a diet, exercise, and oral medications plan suggested.

Insulin is the right tool for the job in many people after early diagnosis. Almost all Type 1s (I happen to be one of the weird exceptions, although that was due mostly to being initially misdiagnosed as Type 2) start on insulin immediately as do many Type 2s.

I honestly wish I had been started on insulin immediately: it took a couple of months to get my BG down, and now they’re going up slowly but surely, so I’m going to end up on insulin anyways. That is, sometimes, an issue with being diagnosed very early in a progression: my symptoms and bloodwork were so close to normal that my doctor didn’t think it was a big deal, and gave me persistently wrong and harmful advice. Had to get a new doctor and find out about diabetes from other sources, which I wish wasn’t the case.

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#4

Something I learned early on after coming to TuD in 2007—Fear Not Insulin! When my time comes, I plan to skip metformin and go right to insulin—if insulin is what my body needs, that is what I will give it! Besides, I am a petrie dish for side effects. From what I have read here, the possible side effects with metformin would overlap with my fibromyalgia difficulties, magnifying them…

Go forward and keep careful, detailed notes so you can adapt boluses and food choices!..Good Luck and keep us posted…

#5

Insulin is just one among a collection of tools. If it’s the right tool for the job, you use it. If it isn’t, you don’t. No mystery and no mystique. In my case, when nothing else was giving me the control I wanted, I figured out it was the only thing that would. So I requested it. That’s the only criterion the choice should be based on. You figure out what works, and that’s what you use. Forget the myths, forget the stereotypes and forget the propaganda. If it’s what fixes the problem, then it’s pretty foolish not to welcome it.

End of editorial. :sunglasses:

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