My blood sugar 30 day average is 366 and my doctor just says add 2 units of Levimir and it will start heading down I’m at 94 units at night my doctor doesn’t seem concerned but Iam I feel exhausted my vision is horrible any advice would be apriciated I also take 500mg metformin twice daily
Your doctor not seeming concerned is appalling. You need to get those numbers down and he doesn't seem to be providing you any help in doing so! You need to slowly increase your Levemir until your fasting number gets down into range. What about mealtime insulin? My guess is you are also high two hours after eating? If so you need to start mealtime insulin based on a ratio for the carbs you eat. I highly recommend the book Using Insulin by John Walsh. Also is there a possibility you can see an endo instead of your regular pcp?
Yes, losing weight is important for a type 2 and so is cutting your carbs if you eat a high carb diet, but insulin is the best tool to control blood sugar.
Wow Tinman.
Your Dr. sounds like he's being a bit cavalier about things. An average of 336 will result in complications. It's not a question of "if," but "when."
You have good right to be concerned. There could be quite a few factors contributing to such a high daily dose of Levemir and such high numbers - insulin resistance, medications, diet, weight, sedentary lifestyle. For example, I just recently discovered that my daily nigh time dose of Niaspan (Niacin/B3) was raising my night time insulin requirement by 50%.
Are you only taking Levemir, or are you also covering your meals with a fast acting insulin? Also, are you exercising regularly, and how many carbs are you eating per meal?
Christopher
Levemir is the only insulin I’m taking crb intake is low I don’t eat after 7pm and have dropped 30 pounds since getting diagnosed in January I’ve been taking a vitamin B supplement but only started that last week.
Bill
Which vitamin B supplement are you taking?
I take in as little carbs as possible and when I do they are high in fiber or does the fiber content not matter?
Bill
Good for you; yes, some of us subtract fiber if it's over 5 grams.
Congratulations on the weight loss; that's great! You might try testing your blood sugar two hours after eating. My guess is that average high is based on after meals as well as in between (which is why you would want to start mealtime insulin as well).
It’s nature made B complex with C I started taking to fight fatigue
Bill
My blood sugar numbers are my fasting blood sugar in the morning I use another meter the rest of the day generally 2 hours after I eat the meter says to check my Ketones and is in the upper 400’s to 500’s
Bill
Is there a reason why you aren't on a higher dose of Metformin? The maximum dose is 2,000mg per day--that's 1,000mg twice a day and double what you're taking now.
If your doctor doesn't seem concerned, I'd switch doctors--NOW. An average blood sugar of 366 is too high to be safe. There's a fairly good chance that you're dehydrated because of those numbers. There are also other medications besides insulin and Metformin that might be able to help.
Also, I know that my endocrinologist puts newly-diagnosed people with type 2 on mealtime insulin until their numbers come down to a safe range. Then he takes them off of it. Long-acting insulin might help with the highs, but the truth is that it may be smarter to go on a shorter-acting insulin, as well, until they're under control.
Sounds like you're dealing with some serious insulin resistance. In my experience, taking large shots (>20u) at a time can be inconsistant and ineffective. I've heard it explained that larger dosages provoke greater the immune response. Some have found Levimir more effective if the dosage is broken up into 2 or 3 shots / day.
I would recommend visiting an Endo if you are not already. Good luck.
I would insist on a script for a fast acting insulin and then find a new doctor.
I’ve asked my doctor if I should increase the metformin he just seems to be interested in me getting an operation I think it can be handled with medicine exercise and diet
Run like the wind! Surgery is, by far, not the only option. I'd be rather suspicious of a doctor who's so interested in getting me into surgery that he doesn't want to get me under control.
On top of that, your doctor should know that if you have the surgery with blood sugars that high, it will take you a long time to heal, which can lead to infections and other issues that your body will be too "tired" to fight off because it's so busy with the highs.
I agree with you--it can be handled with meds, exercise, and diet. Especially since you've already lost 30 pounds in the past few months (great job, by the way!), I wouldn't be pushing surgery.
If you're seeing an internist, I'd recommend switching to a good endocrinologist. If this is an endocrinologist, please find a new one.
Tinman - You've received some very good suggestions here. Living life at an average BG of 366 is miserable. Our bodies, however, will adapt somewhat to this new "normal," and it doesn't feel as bad as time goes by. But it still feels way worse than a human normal BG. It causes lethargy, clouded thinking, and depression.
This is nothing to mess around with or delay seeking a solution. I would look for a doctor that is willing and capable taking aggressive action. And I would put that at the top of your "to do" list today.
Good luck. You have a right to feel much better!
Hey Tinman
I would concur with the others who've responded. Based on what you've said, you need to get a different Dr - someone who understands Diabetes and the importance of getting your BG under control.
Regarding your medications: There is no way you can manage this with Levemir alone. You'll find by using a fast acting insulin to cover meals you will probably be able to reduce your basal (Levemir) dosing substantially. And as others have said, there is probably room to up your Metformin dose.
Good job on the weight loss and watching your diet. Also, check out bloodsugar101.com for some great practical advice.
With the right insulins and proper medical advice you should be able to bring your glucose under control immediately.
Good luck!!
Christopher
Yikes, Tinman! And your doctor is not concerned?!? No wonder you feel like crap! Please, please get yourself to an endo and get on fast acting insulin as well as help with dosing of that and your Levemir. You are at risk of a medical crisis with numbers like those!
Hi Tinman - Personally, if I were running such high blood sugars for a prolonged period I would go the the emergency room where they can monitor you, use insulin to bring your blood sugar back to a reasonable range and perhaps refer you to an endo who can begin fixing your treatment regime including figuring out how much insulin you need (basal and bolus) to begin to bring your numbers down. I can't imagine that it is even safe to do surgery until your blood sugars are better controlled.
Your doctor is a health hazard.
Maurie
It sounds like if at all possible, you need a new doctor (I know that's easier said than done), but aside from the mechanics of lowering your blood sugar now so you feel better (you must feel so awful all the time!), you need someone who actually is concerned about your health-- and I would say being "okay" with an average of 366 indicates some sort of medical oath and human compassion oath is being broken.