Hi I am new to this site. I had an A1C of 12.8 last month. The previous A1C fro Jan 2016 was 6.9 I was taking Invokana till a month ago and stopped because of dehydration and that it is no longer working. I have taken metformin for 16 years, now take 2000mg per day.
I am petrified of insulin because in Germany in 2008 I almost died with low blood sugars. it was the old vials and needle syringe. I don’t want to gain weight and am afraid of the yoyo and low blood sugar.
I also don’t know where this insulin comes from. Is it a pig? or is it synthetic? Insulin is a fat storing hormone. I gained 15 pounds in one month in germany. I am seeing the endo Nov 3 after waiting 5 months for an appt. I previously lived in Durango and there were no endos within 100 miles so I had a GP for 4 years. I eat low carb diet and exercise but at 54 next month, after 17 years of diabetes, and no-one being able to figure out what type I am, moving every few years with the government, I am burned out.
I also feel very tired, especially when I wake up and need strong coffee to get moving. I work full time and am getting burned out.
I need to know what is best insulin for me. I do not trust the doctors. I learn more in the forums than from the doctors. I have seen about 5 endos in my past 17 years dealing with this.
What can you all recommend for insulin that won’t cause weight gain? My sugars have bee 400 fasting and 250 in day sometimes 350. Glipizide prescribed and not working.
My C-peptide was 0.8 recently and I should have GAD65 on Monday. The doc did not even know about this test but wanted me to start insulin! I said I want the test first to figure out what my diagnosis is, Type 1, 2 1.5 or /??
I don’t know that the type of insulin is that much of a factor in whether or not one gains weight on insulin. I think one is much more likely to gain weight if one doesn’t manage one’s eating and insulin dose properly. The most common problem I’ve heard about is with those who give themselves more insulin than they really need causing them to have a hypo. Then they have to treat the hypo with more food. Taking the time to learn how to do proper basal tests, then to calculate the actual need for meal time insulin based upon carbohydrate counting can prevent most of that.
If you need to go on insulin, I strongly recommend that you get either Think Like a Pancreas by Gary Scheiner or Using Insulin by John Walsh. After meeting my endo once, having him correctly diagnose me with LADA (latent autoimmune diabetes of adults), show me how to give myself an injection and giving me starting doses, he was going to then turn me back to my primary care provider. Well, she had misdiagnosed me and treated me as a type 2 for a year and a half even though my initial BG was 289 and A1c was 11.5. I had absolutely no faith in her knowing what she was doing regarding diabetes. So I got the book my Walsh and used it to get my doses adjusted before I even went back to her. Those books really do have enough information in them that one can do that if needed.
Hopefully you will have a better doctor and will get more guidance, but knowing the way my doctor proceeded with things, I knew it would take forever to get my doses adjusted. I felt it was a matter of self protection to do it before I went on a cross-country trip alone.
Insulin doesn’t cause weight gain. Overeating causes weight gain. All that exogenous insulin does is to restore the function that was lost when the pancreas stopped producing. Insulin, whether produced naturally by the body or introduced externally, will allow excess glucose to be stored as fat — but only if it is excess to current energy needs. It isn’t insulin that causes weight gain, it’s consuming more than you need.
I’m glad you came here. There are certainly things about insulin which can make it dangerous or have side effects. But the real thing about insulin is that it is different than just going to a doctor and being prescribed a dose of a medication. You as the patient need to become responsible for making dosing decisions and choosing the right time to take insulin. I would tell that you as someone with T2 (although I believe type actually doesn’t matter), I’ve been on insulin for nearly six years. I tried very hard to learn how to properly use insulin and to use it safely and effectively. While insulin can do things like cause you to gain weight or have hypos, in all those six years I’ve never had a serious hypo and am still within 5lbs of the weight I was at six years ago. And I am about your age.
In the US, all insulins that are available are synthetic. Insulin made from pigs and cows has not been available for years in the US. The best insulins are the “modern analog insulins,” which have better and more predictable effects than older types of “human insulin.” There are basal analog insulins Levemir, Lantus and new ones like Tresiba and there are rapid bolus analog insulins like Humalog, Novolog and Apidra (there are more than these, but these are the main ones). And newer insulins like Tresiba (a basal insulin) have been found to cause fewer hypos. To be honest, having an A1c of 12.8 and running high blood sugars like you have, it is not surprising that you feel bad.
It is important to get on top of your diabetes. I would urge you to face your fear. Take action to avoid hypos. Get the books that @Uff_Da recommends. Read and post in these forums. And talk to your doctor, tell your doctor that you fear hypos and weight gain and ask him to help you with a treatment that help you avoid hypos. But that being said, I would urge you to start to get your head around insulin. For me insulin was like a miracle, drugs didn’t work. Properly used it can really do an amazing job controlling your blood sugars.
Since I have posted my original thoughts about the fear of going on insulin, I’ve gotten many responses back that are very encouraging. I guess I was just fearful of the progression. I have my first endo appointment on Monday and will be getting Lantus. Everyone says how much better I’ll feel almost immediately that I can’t wait to get there. I still feel like crap with bf’s all over the place, ears ringing etc etc…My attitude is getting better knowing that it will be fixed. Also, gaining a bit of weight back will be good as I had dropped to 161. In addition I downloaded think like a pancreas and am amazed at what I am reading. Thank you all for the encouragement here!!!
Thanks so much. Do you recommend all those insulins as “safe” for basal? and do i need a bolus? am afraid to take any insulin at night.
i see primary on Tuesday morning. I would like to get some insulin and not wait till Nov 3. I am feeling really tired. I think my body is wearing down from months of running high like 300-500.
What you you suggest I ask the GP for or do I wait 3 more weeks till Nov 3 to see endo?
I have to be honest, with blood sugars in the 300-500 mg/dl range you could walk into an ER right now and likely be given immediate insulin and IV treatment to normalize your blood sugar. As soon as you were stabilized , they would likely hand you a basal insulin and tell you to follow up with your doctor on Monday. Blood sugars as high as you are experiencing not only are doing cumulative damage but you risk very serious health crises like DKA or HHS. And this is beyond making you totally feel bad.
So yes, I would personally advise you to see your GP as soon as possible and request (perhaps even demand) treatment and that treatment would typically start with a basal insulin. A doctor will typically start you with a small safe dose and work up. They can immediately give you a sample or a prescription and a starting dose. You can then call in every day or so and report your readings and have your doctor adjust your dosage. Many people find that a diabetes center with diabetes educators can help with insulin adjustment. And insulin treatment is a continuum. You may start with a long acting basal insulin with one or two shorts a day, but eventually many of us end up on an intensive regime where we bolus, taking rapid insulin for meals and correcting high blood sugars. If I had blood sugars in your range I would be take a bolus (repeatedly) until I brought my blood sugar into range.
And as to safety. The three modern basal insulins (Levemir, Lantus and Tresiba) that are mentioned above are quite safe. If you worry about overnight you can take your basal insulin first thing in the morning, then any “peak” will occur during the day when you will be awake and can take care of it. If you have good insurance and it is covered, Tresiba is really what I would consider the best. It’s effect is extremely flat and last a really long time, thus it is the least likely to cause hypos because of this. Your insurance may or may not cover it, but many doctors have samples that they can give out free to patients. During the insulin conversation with your doctor it is perfectly ok to ask about certain treatments such as Tresiba.
And in the meantime (until Tuesday), I actually ask that you consider restarting the Invokana for a couple of days and make sure you drink lots of water (with electrolytes). Both of these things can help bring down your blood sugars (yes just drinking water helps). Make sure you have recorded all your blood sugar readings in a log or on your meter to make sure you can vividly demonstrate to your doctor your blood sugars and how serious this is. And finally, I’d ask you to look in the mirror and remind yourself of how tough a time you have gone through. You have braved very serious things and although starting insulin may be a bit scary, you really can do this.
You can do it, I ran 400s and higher and my doctor drug his feet 35 yrs ago. I am lucky to be here really, Fear is lack of use or knowledge and you will be fine. It shows the other meds are doing nothing for you, what do your daily test shows. Orals do not work for me and never have it is only insulin that has worked.
[quote=“Joeasaro, post:25, topic:56705, full:true”]
Since I have posted my original thoughts about the fear of going on insulin, I’ve gotten many responses back that are very encouraging. I guess I was just fearful of the progression.
[/quote]Like I said Joe, I’ve been there, and I just knew this was a part of what what giving you knots in your stomach. It’s an irrational fear – a true phobia – and you’ll think about this so differently when insulin has actually made you stronger, healthier, sharper, happier, and all the good things you can think of.
You’ll look back and maybe even be angry with a health care system that didn’t put you on insulin much earlier in your disease, so you didn’t have to have suffered what you have already.
Please report back and let us know how you’re feeling after a few days, and your BGs have come down under 200.
One more important thing: Go easy on bringing the BG down. You’re likely to suffer from a harmless, but very uncomfortable phenomena called “false hypo” – feeling hypoglycemic at normal or high blood sugars – because your brain has been marinating in syrup for so long. It takes some time to adjust.
So, when you get your insulin, target getting your BG under 200 in the first 24-48 hours. After that, work it down to normal (under 100) over 1-2 weeks.
Or, you can slam it down to normal ASAP, and tough out the false hypo. That’s what I did, but I wouldn’t recommend it.
Finally, plan something you really like to eat for your first “BG relatively in control” meal… you are going to enjoy eating again like you haven’t in a long time.
And to follow up with what @Dave26 has mentioned, most diabetologists will take special care to ramp down the blood sugars from the 400s for two important reasons. The first is that as @Dave26 points out you become accustomed to having your blood sugars in the 400s and suddenly having a blood sugar of 200 or lower can feel like really bad hypoglycemia. The other thing is that sudden lowering of very high blood sugars can also trigger retinopathy so it is prudent to bring down very high blood sugars over a period of a week or two. You won’t likely get this type of ongoing care from an ER visit and a GP may not necessarily be aware of these concerns, but an endo should.
Brian and Dave26, I hadn’t even thought about this issue. When I did sit down to think about it, I remembered how when my blood sugar crept into the 120 range I would start to feel shaky. I will now be aware of it and insert this subject into the discussion with the endo tomorrow. I do know that I am feeling really crappy right now. I am looking forward to the cells getting the nutrients they need so I can DO stuff again. Thanks—Joe
You’ll have a pack of new friends with you in spirit
Assuming you get started on insulin in next few days, I look forward to hearing how you’re doing in another week.
As @David_dns says, insulin per se doesn’t cause weight gain, overeating does. HOWEVER, someone in your situation, regardless of whether or not you’re overweight IS overeating right now, because you’re spilling a lot of sugar in your urine at those BG levels. In other words, you’re peeing away a lot of what your eating.
So be careful when you start insulin to adjust your overall food intake, especially carbs. Once you get your BG in line and your kidneys heal a bit (they, like many organs, are very stressed right now at your high sugars), plus with the action insulin has to cause fat tissue to take up sugar from the blood and convert it to fatty acids, you’ll start gaining weight if you keep eating the same calories post-insulin treatment vs. now without insulin.
Don’t get too hung up on this for the next few weeks. Just get better, feel better, and enjoy it. One thing not often mentioned in your situation is appetite and eating, and how much that will change too. I’ll bet most of the time you feel kinda sick, maybe even actually get sick once in awhile; you have a weird appetite that feels sort of nauseated-hungry, and when you eat you never feel good and satisfied, but rather more like you have to force it down sometimes. You’re drinking GALLONS of fluid all day long, urinating a lot. The thirst and the peeing will stop on a dime when you get your BG down.
The first few days after you start to get your BG in control will like being gastronomically reborn. You’ll be hungry like the old days, food will go down so satisfyingly, and you’ll feel full and good at the end of a meal.
And don’t be discouraged. It takes you awhile to feel normal again. In my case…I felt human again after 3 to 4 months. You will feel better each day but a hard part for me when getting back to my baseline. Test a lot and remember that each day your body is getting better and adjusted. I’m used to a routine now and it doesn’t phase me anymore. To be quite honest it has motivated me to get moving on things I was too sick to do before. It’s a GREAT thing I promise. And I had all the same feelings you have had. Trust me when I say you’re not alone.
thanks to everyone here. i look forward to feeling better. I am almost 54 have raised 5 kids and have my granddaughter living with me since July. I feel really beat. I will try for Tresina if my insurance will cover it. If not lantus or leviteamer or however you spell it. so tired. i see the gp tuesday but want to call tomorrow and see if he will call something in. i doubt it he will make me go in tuesday. i see the endo for first time since our move in april i see endo Nov 3 can’t wait. feel horrible.
why is my personal email posting on this site? can someone help me?
