From pills to insulin

I have been on various pills for 6 years with no luck. my “normal” numbers run in the 200’s. I am 97% positive that I will be put on insulin at my next visit in a few weeks, and very worried about this. Any pep talks? Pro’s and con’s to insulin over pills?

If your normal is in the 200’s, you definitely need something to help get those numbers down. Insulin isn’t as scary as you think it is - we all went through that fear (well, those of us old enough to remember it at least) and once on insulin, you realize it’s not so bad. It’s actually quite nice, really. After getting insulin, I was bouncing off the walls with crazy energy. You really have no idea how awful you feel in the 200’s all the time until you get down to normal numbers.

As for the orals not working - if you’ve been exercising and eating correctly (meaning lower carbs and choosing the right carbs), then you may have been mis-diagnosed. Many of us who developed T1 as adults were originally (and incorrectly) diagnosed as T2. No pill is going to help when your pancreas just isn’t producing enough insulin. It’s something you may want to discuss with your doc.

No nasty GI side effects with Insulin. The needles are tiny and you usually don’t feel them when injecting. Fingersticks are much worse and you already do those! Good luck!!

Insulin has advantages–better control, being able to dose according to carbs at meals & insulin doesn’t have the side-effects of meds. A big plus is that insulin protects your beta cells.

There’s nothing to worry about because you’ll be healthier & feel better with lower numbers. Injections don’t hurt at all.

Get these two books. If you order through TuD (see Best Diabetes Books on the bottom right side of the page, under Diabetes Resources), TuD gets a donation.

Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin by M.S. Gary Scheiner M.S.

Using Insulin, Everything You Need for Success With Insulin by John Walsh

Thank you for all of your responses! Has anyone ever been able to come off insulin?

You know your feelings are very common. It can be scary thinking about moving to injections. It can give you a sense that you have “failed.” You can be worried about bad stuff happening like hypos. But in truth, if you have been diabetic for 6 years, you have been thinking about this for a while. There was a show on the discovery channel that you might find helpful, it was on about 9 months ago. It highlighted a number of diabetic patients who are going through just what you are going through now. You can watch it online at (…). The show actually was partly filmed from patients that I know and have meet through my local diabetes education center.

Personally, I’ve been going through similar progress with my condition, not finding any medications that work. I long ago “came to terms” with insulin and actually would prefer to move directly to insulin. I already inject, so all that stuff is behind me. Injecting although it initially seems scary, becomes very routine. It actually is less painful than lancing for blood tests. I don’t consider moving to insulin a failure, it is just one of the treatments available, and clearly if you are running in the 200s, you need more aggressive treatment. When I looked at the safety of insulin, I actually came away feeling that it was pretty darn safe. Even the risk of hypos is manageable with informed use of insulin.

What I might suggest you do is sit down with a pad of paper. Draw a line vertically down the center. One the left write the pros and on the right write the cons.

Here are some of the pros: Will normalize your blood sugar. Will feel better. Will feel more in control. Will avoid high blood sugars/complications.

Here are some cons: Could get hypos. Could gain weight. It is scary. It could hurt. Could have less freedom.

When you have written out all that you can think about you can look at everything at once. I bet that when see the list you are going to feel better about the transition. Many of the cons that you will write down are things that are unknown that you fear. In the end, it is very important to get control of your blood sugar. You know that.

Look at the discovery show, I think it may help you think through things.

That’s a good question. I don’t know, but my guess would be probably not. Since meds didn’t help, you need the extra support of insulin. There are T2s who’ve been able to maintain great BG with a very low carb diet & exercise & some without any meds.

I’ve seen other people on-line that have come off insulin, but most fall into two categories. Some are newly diagnosed and insulin is able to get them back normalized and then with an appropriate diet, exercise, and medication regime they are fine. The others are people who have made marked changes in their profile, typically their diet and exercise regime, adopting a strict low carb diet or losing marked amounts of weight/becoming fit.

Let me ask you. Exactly how much have you devoted yourself to changing your lifestyle? You do realize that oral medications and insulin are just secondary treatements. If you don’t eat right and exercise, you are still not going to be in the best shape.

Answer these three questions:

Are you following a strict low carb diet?

Do you aggressively exercise three or more times a week for an hour or more?

Are you thin and lean?

If you answer yes to all these questions, it is unlikely that further lifestyle changes would markedly change your diabetic status. If answer no to all three areas, you should see some improvement but coming off insulin is by no means a guarantee. Should that be the case I would heartily recommend you immediately try and improve all three areas and see what happens.

On insulin as a T2. My thought is that insulin is not a failure but a much better way to treat MY diabetes. Come off insulin - me - likely never. I have freedoms in my food choices that I never had not on insulin (not bad food choices, just carbs I couldn’t eat all all off insulin). I like having those freedoms and MUCH better control of my numbers while carb counting.

Pro - could have more freedom (freedom of the food choices you have - within reason) too!

check out the top 5 insulin myths blog post I wrote a couple of days ago in the blog section and what everyone said about them, it might be insightful…
and good luck
Ronald Gregory

For me it was a no brainer. Pill made me feel awful and my glucose levels were still all over the place. I asked to be put on shots. I loved the fact that I did not have to eat so many carbs to cover the pills. I could eat as few carbs as I wanted to and just give myself insulin accordingly. I am now on a pump and I love that even more.

Guess again. 8^) I am a type 2 and I was on insulin for a year and then things got a little more normal. I went to nothing for 2 years and then on oral after that and now I am having to reduce the oral.

I will tell you it was not easy accomplishing that. I dropped a lot of weight, quit my high stress job, worked out like a mad man, completely changed what I ate. I could only maintain that for about 2 years and then i started to relax on the diet and excercise and then numbers went back up and got put on oral.

But i have told my self if metformin quits I will not try any other combo of drugs, i want insulin because I hate the weird side effects from oral. I have been on insulin and it was not that bad compared to oral meds.

anyway take care