Fifteen years ago, I was diagnosed T2; through that time, I went through at least 10 medications to control my diabetes. I lost 90+ lbs;I learned to exercise on a daily basis, to journal and keep track of what I ate. Fast forward, 5 years ago, at the ripe young age of 56; I had to start taking cortisone injections in my knees for my arthritis, but cortisone can and will raise your bs's....not good, and my final injection sent me to the 500+ mark. Docs put me on humalog for short term control....the humalog worked and I was even a better controlled diabetic. This past year, with age, (61) my sugars started to fluctuate too much for my liking. I have been begging, doing research, pleading, promising, whatever it took to get the humalog put on as a viable option when my sugars would swing, or as a daily pre-meal injection. After all of this with my doc, with my PA, with the Diabetic Educator, Health Coach, Dietician, last week I had the surprise of my life ---- my doc ordered humalog for me, as a daily pre meal med.!!!!! I can't tell you even after only a week, how great I feel....how changed my numbers are....and this happy camper finally won one battle with the medical squad. And what changed their mind was a night on call nurse at a hospital 200 miles awaym that I had to check in with one night at 2 am because my sugars spiked to almost 350....she asked me about my regime, what works what didn't, and then wrote a letter to my "team" saying that this treatment of Janumet, diet, exercise and an injectable that I can tolerate would be a great way to control things, as my body is changing with the loss of weight, and age. MY moral: If you do your homework, back yourself up with solid medical evidence and personal examples, you can get what you want or need to make your health care better. You are the team captain, this is your body your life, don't give up if there is something that you want to try to take care of you. Happy Camper here! Latest A1C for this period was 5.0 .... now that's a number I can live with,
Thanks for posting this and congratulations on the fine a1C. Your story illustrates why we have to learn all we can and advocate for ourselves. There have been many similar posts by T2's concerning how much better they felt after starting insulin.
I'm curious do you take any basal insulin?
No basal insulin, only the humalog, and despite the rash of comments here, when I tried it after a cortisone injection, it is on a sliding scale according to my readings before meals. This works for me in unison with Janumet, and a well controlled diet and exercise. But what works for me, may not work for others. So as you said, advocate for yourself, become knowledgeable about your own system, and how it works for you,
I'm not sure I've ever heard of that protocol but it's obviously working very well for you.
So far I'm doing fine without insulin but I like reading about other T2's and insulin so I will be well informed if and when the time comes.
Congratulations on your victory. It is not just a victory that you convinced your doctor it is a huge step toward successful treatment.
My transition to insulin was not so hard to come by, I was given no choice by my doctors. It is the best thing to happen to me. I do wish I had know of Tud before, after what I have learned here I would have been much more receptive and probably would not have resisted.
For me insulin was a huge win in a never ending battle. It has allowed me to keep putting up a good fight.
I'm glad you finally got on insulin and it's working well for you… great job on your A1c :)
There have been many similar posts by T2's concerning how much better they felt after starting insulin.
T2 for 15 years. It took getting completely out of control to get me over the "I've failed if I have to take insulin" hump last June.
Changed my life.
I'm a fierce advocate now of insulin therapy immediately for T2's upon diagnosis, for those willing and motivated. With the technology we have available today (pumps, CGM's) it is possible to really, truly manage this disease well, keep BG in a non-diabetic profile.
The benefits in terms of potential complications is obvious. What is less obvious is how much healthier, energetic, happy, motivated, clear-headed, sharp -- I could go on and on -- your feel when your BG is 80-100 all day, instead of 120, 150, or worse.
IMO, "treating" my condition means getting me as close to non-sick as possible. Isn't that what it's all supposed to be about?
Instead, with T2's we take this approach of "good enough", where "good enough" really isn't.
Suzie, that seems like very very little insulin for a T2. Insulin sensitivity is pretty contrary to T2 diabetes.
Also, if the T2 is an undiagnosed late onset T1, they get the insulin they need.
Way to go! Thanks for sharing the story! I agree w/ Bad Moon that there are many of these story out there, people having to fight with docs to get insulin. That doesn't make sense to me at all. There seems to be an "insulin is a defeat" paradigm in the medical industry. Obviously, no one really wants it but, if your BG is high, it usually works to bring it down. I'm glad it worked out and that you were able to talk some sense into them!
Insulin resistance is very common for T2s but it is not universal. Some of us are quite sensitive and don't need very much. My case is a double whammy -- I am extremely sensitive to both insulin and carbs. So I live by the "Laws of Small Numbers" (Bernstein).
I guess I'll jump on this bandwagon, too.
I am a long time T2 whose control with diet, exercise, and pills was gradually deteriorating. Eventually it reached the point where I said (like the character in the movie), "I'm mad as hell and I'm not going to take this any more." So I started studying the disease in earnest. One of the first (of many) books I read was Bernstein's. He convinced me quickly that insulin was part of the answer, and he was right. It has been life-changing. My A1c's are routinely in the 5s now, and that was never possible before.
Of course this is hindsight, but I don't see why anyone should be afraid of insulin. Everyone is insulin-dependent. Everyone. Without it you'll die. The only difference between me and other people is, I can't make my own. So I need to get it from another source.
When something is the right tool to fix a problem, then that's what you use. If you had a broken leg, would you try to "get along" without a cast for as long as possible? Of course not -- you'd want it and you'd want it NOW.
BTW, the world renowned Joslin clinic now starts newly diagnosed T2s on insulin right away. Perhaps they know something? :)
Huh, I always saw the insulin resistance as a defining component of T2 diabetes, and if insulin resistance isn't there, I think that the diabetes resembles T1 more (some T1s still produce a bit of insulin). T2 generally is seen as a metabolic disorder while T1 is mostly beta cell damage due (due to immune response).
That has always been the traditional wisdom, yes. However the science is beginning to cast doubt on whether the matter is that cut and dried. You can dig into this as much (or as little) as your time and interest permit. A good starting point is here.
The article casts doubt as to whether insulin resistance is the causal agent, but it also states in the conclusion...
"The fact that insulin resistance may be largely an acquired problem in no way lessens its importance in the pathogenesis of type 2 diabetes."
Hey I'm a fan of Dr B's book, and supportive of the law of small numbers. In my copy of his book, he seems to describe T2 as a metabolic disorder with insulin resistance. Diseases/disorders are defined by their symptoms, causes, and traits, and at some point outliers are placed in other groups or seen as something different. To me a diabetic who is very sensitive to insulin has a condition that more closely resembles T1 than T2 because they aren't going to have the problems related to insulin resistance, and their response to insulin as well as treatment more closely resembles that of a T1.
Yes. No one is saying IR doesn't exist or isn't a factor. Simply that it's not a one-size-fits-all equation. IR is the principal issue for some, but not for others.
But getting good/great results with 1/2 unit per day is going very far in the opposite direction and IMHO is a level of sensitivity very rare among T1s.
I do think we have to remember that what works for one of us doesn't always work for everyone, nor is one plan a plan for everyone. 15 years ago, I said NEVER, NEVER will give myself an injection. Well, when the time came to go on humalog or another insulin, I was the first one to be surprised that I fought so hard for it, So well controlled for one of us is not the same for another....the worst thing I think we can do for each other is to downgrade a plan that has worked for another, or down grade a doc and patient relationship unless that is the specific problem or question a responder has. I left here for about a year because I had a plan that at that time was working and two members helped to undermine my confidence in the plan, in myself and my care team...so let's be careful about judgement calls
Mainly, I was thinking that I wouldn't describe diabetes as T2 if someone is insulin sensitive. I do agree that there is a lot of gray between the (T1 and T2 lines), and there may be a few more types.
But I'm in the same camp with treatment. ADA carbs recommendations are way too high. Low carb intake simplifies BG management, and it's generally a good idea to get on insulin early.
Also, I'm pretty horrified over the standard protocol for diabetes. They assume that everyone is a T2, and give them 3-4 meds before trying insulin. Then once they are on insulin, they keep them on the other meds. Couple that with 50+ grams of carbs at every meal and 3 test strips a day, and how the heck does a T2 maintain good numbers?