Hello, I’m new here. My name is Joe and I’ve had type II for about 15 years. Currently I’m on victoza, metformin, innvokanna and glimeperide. Recently I’ve been feeling like I was hit by a Mack truck and can’t control sugars. A1c crept up to 12.3 than back to 10.3 a month later. I’ve been following the chip diet as well as dr. Barnard essentially almost 99% vegan. I’m not overweight at all and some say too skinny. I’m due to see an endo for the first time on Monday after my primary told me my pancreas is getting tired. He did the Gad test and it came back at 144!! Primary said lantus will be most likely what I’m going on. I’m frightened but can’t keep feeling this bad either. Any suggestions for my discussion with endo would be appreciated. Thanks
What part of insulin are you scared of? Insulin itself? Insulin causing lows? Doing injections?
I’m not Type 2, but I’ve been taking insulin for 25 years, since I was nine years old, and it has been a lifesaver (literally—I would have died as a child without it). If it’s the idea of insulin itself that scares you, maybe keep in mind that everyone needs insulin, it’s just that most people have bodies that are able to produce enough insulin. From what I’ve read here, most Type 2s who begin insulin feel way better and wish they had started it years earlier.
If your GAD is 144, you are more than likely Type 1. The ‘too skinny’ is probably due to lack of insulin.
In comparison, my GAD was 46, but I make very, very little insulin. My GAD has been positive for a long time, but my diagnosis was Type 1 first in 1999, changed to Type 2 while I was in my honeymoon. Worsening control led to a recheck almost a year ago and the GAD and c-peptide were positive (again) for Type 1.
You need the insulin, especially with that high of a1c. What scares you about it?
I saw a therapist when my diagnosis changed. It was helpful.
As above, you sound like another misdiagnosed adult T1. Same happened to me - but not for so long!! Without insulin you will continue to lose weight and get much sicker. See a highly regarded endocrinologist and get the tests, meds and care you need.
Insulin is scary. The alternative should be scarier. Get the books “Think Like a Pancreas” by Scheiner and “Using Insulin” by Walsh. They will help you understand it all much better. Insulin becomes much less scary over time.
Good luck. You’ll do great.
Thanks. I’m actually looking forward to finally feeling better. Just getting used to the change coming. Thanks for the reading ideas!
Glad you are feeling better. Once I started thinking about my diabetes as having a ‘broken pancreas’, it was easier to deal with. With your high GAD test result, it is indicating that your pancreas is being attacked, and losing it’s ability to produce enough insulin. I think you will find you feel much better once you start using insulin. The book ‘Think Like a Pancreas’ really helped me to accept my broken pancreas and do the job it could no longer do. I’ve been taking insulin for over 50 years.
Hey there. Had ALL the same fears you likely are having. I was diagnosed with type one at 33 in April of is year. I don’t think I was scared of insulin. I was overwhelmed with the new diagnosis and felt like having type one meant the end of ME as a person. I never went to the doctor and had a clean bill of health. After a few months (it seemed to take me 3 to 4) I felt human again and better than I have been in years. Sure…it’s stupid to have to run to my car to check my blood sugar or think of what I eat and inject…but seriously…I feel like a new person and my health has improved immensely. I get the mental aspect of injecting but take it one day at a time. Given that you are sick right now (it comes slowly for some) and you don’t know it…I promise you that you will feel a lot better once you take insulin. And you’ll slowly adjust to “oh crap. I have to do this FOREVER” each day. I’m not completely over the mental part but I can say…I feel so much better. I’m not sure what scale they did for GAD testing but I wa over 1900. Good luck.!
If as suggested by others you are actually a misdiagnosed Ti (possibly slow onset aka LADA), the best thing for you is to be under the care of an Endo. Asking most GPs/Prmarys to manage Type 1 is like getting a blacksmith to fix a Porsche.
On a different note, what is the Chip diet? Does that mean you have to eat a lot of chips? Can you eat fish too?
I think fear of insulin is common. I think there are many people with T2 who delay using insulin because of this fear. Many if not most people with LADA/T1 don’t have the opportunity to think about and become fearful of insulin, they are just hit with the diagnosis one day and walk out of the office one day on insulin. Many have already told you that you really are not T2, but almost certainly LADA/T1, but your primary is not competent to make that diagnosis. As suggested, you really should see an endo. And I have to be honest, you will need to use insulin. So I’d like to take this discussion back to your question.
Fear of insulin.
Why do you fear insulin? Is it because you think it represents failure? Because injections will hurt? Are you worried about cost? Do you think you will have hypos? Please tell us more and perhaps we can help you with our own personal stories.
ps. And I have to advise you that the high carb low fat vegan diet from Barnard is probably the total opposite of what you need to do right now to control your blood sugars. You should be following a low carb diet. Please run away from this CHIP diet.
Victoza is an injection, so you are already injecting Insulin is …the same really and nothing to fear. You weight could also be due to the Victoza, is has a weightloss side effect in some.
From your GAD, you may be TD1, but that’s ok - nothing to fear from it and you can handle it well. You found this site and you now have a great support system.
The chip diet is essentially Vegan. No dairy, meat, eggs, cheese etc. It stands for the Complete Health Improvement Plan…
That CHIP diet sounds like the old fat-is-bad-for-you-carbohydrates-are-good-for-you traditional wisdom that has been relentlessly pushed by popular culture for the past 50 or 60 years and is now being steadily discredited. Depending on how interested you are in this subject, there are some very good references readily available. One of the best starting points is Good Calories, Bad Calories by Gary Taubes.
But that’s really an aside. As Brian mentions, eating large quantities of carbohydrate is about the worst thing you could be doing right now. If one’s goal is to achieve high blood sugars, there’s no better way.
On the issue of insulin, I can offer a personal perspective, for what it’s worth. I am a “true” T2 who managed decent control for about 15 years using oral medications (no insulin). When my ability to maintain good control finally deteriorated beyond what I was willing to live with, I started reading everything I could get my hands on, including the books recommended earlier in this discussion as well as others. I concluded pretty quickly that insulin would give me good control again. It has. I feel like I’ve been let out of jail.
You didn’t say exactly what it is about insulin that you fear. If you could be more specific, there are many here who could provide helpful insights.
And last but not least, it seems pretty clear that you have been misdiagnosed. It’s surprisingly (and distressingly) common. Melitta, one of our members, has written extensively about the phenomenon. Check out this link.
Joe, regardless of the ultimate diagnosis of “type”, it really doesn’t matter w.r.t. where you are right now. You are a severely out of control diabetic, and in terms of how you feel, your symptoms, and treating them, the prescription is the same regardless: You need to get your blood sugar under control.
I’m T2, and I’ve been exactly where you are. I understand the “fear” of insulin. If I may, it’s not really the insulin itself that’s scary, but what it MEANS to have to start taking it, how it will impact your life day to day, that it’s forever, and that this says something about failure and deterioration or, a word I’ve used before, you’re more “enfeebled”. Does that about sum up what you’re capturing with the word, “fear”?
I’ve got some comforting words for you. After that first day of taking insulin you will become a convert. Here’s what’s actually going to happen to you, and it will likely be large and dramatic. You will quickly feel SOOOOOO much better!
Your head will clear up and you’ll feel sharper than you have in a very long time.
Your appetite will come back strong, and eating will be a joy, rather than something you feel like you have to force.
You will have a TON of energy.
You will immediately cease being massively thirsty, drinking gallons, then having to pee all the time.
Any difficulties passing urine will go away.
I understand this fear. It feels like you’re crossing a line from “regular diabetic” to “ill diabetic”. Nothing could be further from the truth. Indeed, you’re very ill right now, doing a lot of damage to your body (slowly), and insulin is the way to make you well.
Once you get going, get a routine, and have this under control, you’re going to wish you had started this years ago.
This forum is one of the best places on the planet to learn about how to get yourself healthy and happy with insulin. We can help, and are happy to.
I myself use an Omnipod pump to administer insulin, and a Dexcom CGM to monitor my blood sugar. Start with shots (the “pens” are a great way to go), but don’t be afraid of looking at a pump in the near future. It seems to be another “hurdle” many people are wrongly afraid of, again seeing it as a further step of getting sicker/worse/feeble. Again, nothing could be further from the truth… it’s just a technology for delivering insulin, with much finer control, automation, and convenience. It’s also a lot more complicated, so you have to be willing to take that on.
Best of luck to you, and please report back to us about how you’re doing after you start insulin.
A final note: I’d urge you to discuss starting a basal/bolus regimen right away with your doctor, not just adding a long-acting basal insulin to your treatment protocol. While that approach is logistically much simpler, the best outcome will require bolus injections of fast-acting when you eat to really keep things where they need to be, given what you’ve described above.
if you get back or stomach ache or start throwing up over the weekend, get to a dr ASAP
you should be ok till monday, but sometimes it comes on quick. you can also get urine ketostix from the pharmacy to check
Symptoms of DKA can appear quickly and may include:
breath that smells fruity.
a flushed face.
@Joeasaro, I think I’m of of the “poster kids” for what @Dave26 that management of your BG and you health is paramount to “type” or even choice of treatment. For your long-term health, you need to choose the best available treatment. From the beginning, my diagnosis has been sort of “murky.” Labelled Type 2, but like you, I was not overweight, was very active, and eating a healthy diet… My doctor didn’t even believe the diagnosis he was making! I was not feeling ill and was actually asymptomatic at the time. I was afraid of insulin AND afraid of needles.
I started on oral medications, modified my diet further, upped my exercise level – and got somewhat better control, but felt terrible and had bad side effects from the meds. My doctor didn’t wait too long (just4 months) before suggesting that I stop all the meds and take only insulin (basal and bolus). I did not want to do that, but I’m glad I did. Though it took a little time to get it right, my control improved dramatically. I made mistakes and gained some weight at the beginning (which I’m working hard now to lose), but felt and feel better that I ever did on the diabetes medications.
Today, I’m using an insulin pump and CGM, following a lower carb, moderate protein and fat diet, and have been maintaining A1c’s in the low 5’s (last one was 5.0), with few few low blood sugars - none severe. My own insulin production has continued to decline, but without affecting my ability to manage my BG fairly well. My endo recently decided to change my diagnosis to Type 1 – I’m not sure I agree with his decision or not, but it changes nothing about the way I treat my diabetes or approach a (hopefully) reasonable healthy diet.
From my perspective, the alternatives are much less favourable!
Many of us here find a different diet beneficial: low carb, high fat.
It is similar to Atkins or Paleo diets, but with some adjustments
For instance, I find eating less than 30 grams of carbs per day keeps my numbers in range overall.
Some people are able to handle 120 carbs in a day.
My specific diet is not vegan: I rely on eggs, milk fats, meats, chicken and fish every day.
I also have increased amounts of cream, butter and cheese at most meals.
I wouldn’t know how to eat low carb, high fat within vegan choices.
But I bet there is someone on this site who does.
you must fear of not taking insulin because insulin is necessary for your blood sugar and for cells health
I was afraid of insulin (needles) before I started but insulin is the best thing I ever did. Couldn’t believe how much better I felt.