Go straight to insulin?

Hi ckurpiewski: Is there any possibility that you could get an insulin training session with a CDE? It is possible to figure it out on your own, but a good CDE is...good. And Zoe has given you some good advice; I agree with starting at 1:30, seeing how that works, and fine tuning. Congrats on getting insulin and getting started!

Hey, I like this reply. I anticipate being put on basal insulin tomorrow, as I can't tolerate metformin or Victoza. I bought both books and they are excellent. I believe that insulin is the way to go, for sure.

Thanks for this information David. I didn't know about Joslin putting every newly diagnosed diabetic on insulin--excellent practice they have.

I eat 6 grams of carbs for breakfast 12 grams for lunch and 12 grams for dinner. I read Dr. Richard K Bernstein's Diabetes Diet Solution and that's what he recomends. He is a doc who has had type 1 for 65 years. I also read Jenny Ruhl's Blood Sugar 101 and she also has a website Blood Sugar 101. When I went to the education classes they told me I could eat 45 grams a meal! 45 grams each meal is too much for me! I knew that right from the gitgo so I read the Atkins Diet to learn about carbs. Lo carbing is the only way to go. I had to learn everything on my own because the ADA says to keep A1Ch below 7% and that's way too high. Complications can start at 6%. I'm in the 5% club Type 2 and have never had a hypo.

Katy, I can relate to what you are saying as far as low carbing. But if I ate the amount that you did, I would be on the floor in a heap. My daily intake of carbs is between 80 and 120. There are few days that I get close to 120, it's more like 85 - 97. That has helped me to lose the weight I needed to lose and keep me on my feet, and my A1C at about 5.9 - 6.3. I think what I am trying to say, is this is a fine example of what works for you, wouldn't work for me. And how diabetes treats us all differently. My best gf is my same size, diagnosed about the same time, and she can eat up to 160 and maintain a 6.0 - 5.4 A1C and lose weight...it's a very individual disease in some cases, and that's why we can't blanketly say -- you're doing it wrong, do it my way, Keep up the good work, you're taking care of yourself very well,

I agree completely. Some of us can handle more carbs. Some people are taller and bigger boned and the weight factor has a lot to do with amount of carbs.
In order to lower AiC it is necessary to consider the amount of carbs. It is an indiviudal disease.

There are many ways to help with carbs and A1C. I have had knee and neck problems for about a year now, and I have to make sure that my exercise (swimming and water exercise) doesn't prolong or make the injury worse. I could tell the first week that my carb count was going to have to be adjusted and my A1C wasn't going to be as good as I might have hoped for,
But in the time since the injuries occurred I have been able to adjust my exercise routine, swim more, and thus my carb count has been adjusted, and my weight has gone farther down. Will this work for someone else, I don't know....all we can do it try and see if it's something that works for you,

best wishes Sdkate and glad its working out. For me its like running an old manual steam locomotive where one has to watch everything. fire size, fuel rate, water level in boiler and constantly manually adjusting and tweaking everything.

Isn't that the truth. Good wishes to you, too

Hi ckurpiewski,

Read your story and I am facing some similar situation. I was found as diabetes half yr ago. And was determined as T2 by my doctor. But I expressed my doubt that I maybe LADA and therefore asked my doctor to put me on c-petide test. The result was 1.5 and the doctor said its within normal and thus I am a type 2. I am still a bit not sure about it but decided to live with this now because I am going to see a doctor in public hospital next month anyway (now the doctor is private one, much more expensive). I am having metformin plus gliclazide. And my A1c drop from 11.9 to 6.9.
Fasting is ard 7 (130) right now and having low carb diet.
Let's fighting for our health together anyway.

ADA

T2 is complicated. You can become insulin deficient as a T2. That being said, LADA is diagnosed with a set of antibody tests (GAD, ICA and IA2). If you are positive for any one of those antibodies and have blood sugar control problems your doctor should consider a LADA diagnosis. It is ok to say that you are worried about have LADA/T1 and ask specifically for these diagnostic tests, all they can do is say no.

I am T2. I am apparently insulin deficient as well. So I moved to insulin. But I had to be insistent.

You have my agreement about the docs. Part of their reasoning, or the ones I have been in contact with is they don't think that people will be as vigilant as they need to be or the docs think they should be with insulin. Gimme a break! This is our health, our bodies, our lives. Teach us the whole story, and we usually get it, and can make it work. None of us wants to do more harm, but physicians have to be willing to take the time and teach us what to do with the insulin, when to take it, how to chart it....and that can't be done in a 15 minute appointment. So I agree, the crime is they won't give us what we need until damage is done, and almost always irreversible. But God bless the ones that do take the time, so far I haven't met one,

My question is WHY do we have to FIGHT for what we need and want. It appears that most of us feel as if we are addressing the Supreme Court judges when we suggest a different treatment or ask for a different medication. We are not stupid, and I am tired of being treated like that by some medical professionals. Thank fully, I do have a CDE and a PA who will listen, take consideration, do some homework and then we meet to exchange information....and then we come to a mutual decision, but that's not all of my team. I'd rather ignore the others and do it myself.

My first recommendation to every diabetic, no matter what type or how recently diagnosed, is to go on a pump and a CGM immediately. I'm not a doctor, just a T2 success story. IMO it's cruel, and unethical, for the health care industry to deny a covered client the best treatment available to make them as healthy and "normal" as possible.

I just don't think this is possible for the vast majority of people without the aid of pump and CGM technology. My own story is a poster-child for this theory.

Now, realistically, it's very, very hard to get a pump and CGM approved if you are T2, and haven't been at "crisis" levels of out of control BG. While I would never advise someone to go nuts for 3 months and send their A1C soaring up to 11% or more, this sort of situation will get doctors, and insurance companies attention.

That said, start with MDI and carb counting. Test often -- before putting anything in your mouth, and again 2-3 hours after. Work, work, work on understanding your own personal response to insulin, carbs, etc. It's easier than it sounds, and even without a CGM, MDI can be effective in getting close to normal BG profiles.

Most of all, DO NOT COMPROMISE. Be your own strong advocate. Be polite, but insistent with your endo. Tell them your goal is to get under 6% A1C, and stay below 140 mg/dl at all times. This is very achievable with MDI but a bit of work, much easier with a CGM, nearly effortless with a pump and CGM.

Way to go Sdkate. You right on target.

For those of us needing more strips, tools we have to fight like hades through all the crap and nonsense from the non diabetics and there stupid policies to manage our disease.

In the end we end up saving ourselves and the system big cups of money. But hell no, we get put through all sorts of crap like a drug addict to get our tools, strips etc - not fixes and drugs.

I keep asking, who is the dam fool and what incredulous arrogant science justifies this policy? Answer - Silence. Let the creeps and idiots and non diabetics come forward now with the scientific rational data supporting this policy to harrass the sickest of us into hades.

Dave - If you read a bit more on this site you'll see that "nearly effortless" is a stretch, especially with regard to staying under 140 at all times.

I'm glad you're doing so well.

Maurie

Yea, totally agreed...In my place, there are too many patients with not enough docs, which leads to very short and rush appointment that cannot have much done. Diabetes is a life-long war, we need very thorough preparation and not just 15-20 mins per month...

Hello,

Just wanted to give a little update. I have know been taking both basal & bolus insulin for a few months now. I have had my ups and downs but getting better. It's really tough during Halloween and having candy everywhere! It's going to be worse after Thu. when my kids come home with tons of candy! I have read both Think like a Pancreas & Using Insulin by John Walsh. I had a panic attack because I am was constantly paranoid about being low or being in DKA. I had to stop reading for a little while. I enrolled in the Trialnet study last month because I wanted a 2nd opinion on the antibody tests and I have an Uncle with Type 1. Just got a call from a nurse. She said I tested positive for the Insulin Autoantibodies which I assume is because I was taking insulin at the time of the test. I told her my background and she said yes it was probably because of that but she has been a diabetes nurse for 20 years and because of my history she still thinks I am probably LADA. It felt good to have a health professional acknowledge this and actually know what it was! Thanks for reading & I appreciate everyone's advice :)

I'm so glad you are educating yourself and making such good progress. I wish you a long healthy life. Read Dr. bernstein's books if you get a chance.