My brother was diagnosed about 18 years ago. He was on a variety of orals yet his numbers consistently hovered around 20. A little over a year ago he was finally given a prescription for the pen to add to 3 other meds. He had 2 hypos in one day and decided to quit it all. I’ve never had a hypo myself so I have no idea. When someone is taking 4 different agents with 4 different actions, how can one possibly decide what to eat when and which drug will kick in at which time? Is there anyone out there who has been successful managing a cocktail?
I’ve never been on a cocktail of drugs (went straight to insulin alone when Glucotrol didn’t work), BUT there is only ONE thing to do when he goes hypo, which is get sugar into him FAST. You can use glucose tabs, Smarties, hard candy, juice or skim milk, but just do it fast.
It also sounds like he needs a talk with the doc. Personally, I tend to be suspicious of TOO many pills. Your brother needs to know exactly WHY he is taking each pill, and whether the insulin will substitute for one or more. For example, he shouldn’t be on insulin AND a sulfonylurea, because the sulf stimulates the pancreas to secrete more insulin, and if he’s taking it by injection, he doesn’t need that stimulation.
Second, maybe the doc put him on a too-large insulin dose, and it needs to be cut down. Better to start with too little than too much!
As far as kick-in times, if he’s taking the drugs according to directions, such as before meals, or once a day, then there shouldn’t be a problem. I’m much more suspicious of too much insulin.
But anyway, do call the office and make an appointment urgently – 2 hypos in one day is unacceptable, but it’s not such a good idea to go off all meds, either.
Thanks Natalie. I think he tossed it all months ago. Maybe I’ll ask him if I can go with him to his next appointment. Maybe together we can find out the correct amount of insulin. He’s a sugar addict and he falls off the wagon often. I really think he should have more control than just a once a day pen.
Your answer was interesting for my situation also. I was offered a small amount of insulin or Januvia as long as I took it along with 2 metformin and 3 diamicron. I was having terrible reactions to both these drugs so I made the decision to ditch the diamicron and not add anything else until I got rid of the terrible side effects. Are you saying that it is probably a good idea not to take the diamicron with the insulin anyway?
Yeah, if Diamicron is a sulfonylurea, all it does is give your pancreas a kick in the pants to try to make it secrete more insulin. But if you need injected insulin, your pancreas is probably pretty well shot anyway. Ask your doc why he has you on both – it really doesn’t make sense to me.
Hmm… I suspect that one of the 3 drugs that my brother was taking must have been a sulfonylurea. I think he has been on one of those forever. If I pass on this information and he will probably let me join him because it will be helping me as well.
I’m just taking the metformin now. I know…like brother like… I was shocked when my numbers dropped from high teens to single digits almost as soon as I stopped the diamicron. I was teaching so it was difficult to keep track but now that I’m off I’m following Jenny’s plan. So far so good …well…better. I know it’s probably a honeymoon so I’m trying to gather as much info as I can before my endo appointment at the end of August. I’ve learned so much on this site. Thanks so much.
I had two hypos in one day and after that I quit insulin. So, I totally understand how your brother feels (at least about that). If you want to know how it feels, check out my blog entry on that experience. In short, being too high is not good, but it leads to a slow death-hypos (and then 2 back to back) feels like you’re going to die IMMEDIATELY.
When I have a hypo now, I just eat fruit, cake, icecream, pie, or whatever else has PLENTY of sugar in it.
Now that I’m no longer on all the medication-I was on too much insulin-things are MUCH better for me.
What an experience you had PennStateDoc! Thanks for the excellent descriptions. Can’t imagine going through all that when first diagnosed. I only had very high blood sugars for a couple of months and I couldn’t stand it. I became alarmed thinking that my brother had been going through that for so many years! It’s strange but he seems to feel better when he is running high. I told him that I was feeling flashes and numbness and he had no idea what I was talking about. “Must be old age”, he said.
I decided to talk to him about this a couple of weeks ago. I asked him about correcting for the sugar he eats. He was clear: " I don’t have enough insulin to do that". So… after drinking so much OJ to correct the 2 hypos, he ran super high until the next morning when he was due to take his next dose. My thinking was that he didn’t have enough insulin to counteract what he was eating during the day and because the pills never did anything before the insulin, if they were kicking in now he would have no idea how to figure all the interactions out. I never thought about the fact that the insulin dose could be too high. Of course that would be logical but there doesn’t seem to be anything logical about this at all.
I don’t understand why the drugs have not worked for either my brother or myself. I think that initially my brother’s numbers went down and he was “stabilized” at around 20.
He said that one more recent drug had helped him to lose weight but then it had suddenly stopped working.
I found that ,with each new pill, my readings went up. I decided it was the side effects but the endo says it’s the “progression of the disease”. Could there be a genetic factor here? I have 2 cousins who took metformin and, as they couldn’t handle the side-effects, they just stopped. With little effort, they both have normal A1Cs. One of them said that she would be allergic to diamicron. Until I was diagnosed, I always had doctors who hesitated to prescribe so I only went about twice a year. When my numbers went down when I stopped the drugs, I started to rant on about pill-pushing. I still do.
What if that’s not the problem? Does my brother’s body fight to maintain a reading of 20? Did my sugars go high because my body was fighting the drugs? Has my pancreas shut down? Is this a honeymoon? I wish one of our doctors would at least try to figure it all out.
It sounds like it’s worth looking into. There is 1.5 diabetes that unfortunately gets misdiagnosed by some doctors. You might want to check to see if you’re not type 1 or type 2, but rather type 1.5. You shouldn’t be running so high on the meds and a healthy diet. Have you ever been on insulin?
Too much insulin can be your brother’s case (it was mine). I was on a fast acting AND a long acting insulin, plus the scale (when I should administer the fast acting) was too low.
Here’s also another example of what could happen:
Your brother wakes up in the morning (normal glucose) gives himself insulin, eats breakfast. A few hours later eats lunch, but 2hrs after lunch checks his glucose and sees that he’s running high-so he gives himself a dose of insulin. That’s one way to get too much of it as well. As you know, after you eat the numbers should be higher than normal.
I’m looking forward to your discovery of what’s going on. Please seek medical advice about your highs (even while on meds) because we know that highs bring a lot of complications-and you don’t want that.
No, I’ve never been on insulin. My endo offered me a small dose for the morning but why? I would rather just take insulin without all the rest. My brother insisted that he never corrected. “Not enough insulin” he said. That would have been my option too.
I have my annual foot appointment next week. I guess I’ll calm down after that. I’m lucky that we have Nel, the rep for the CDA on here. She has provided me with lots of links so I will be prepared for my visit with my new family doctor at the end of the month.
Thanks so much for your input and interest. The good people on this site have literally prevented me from going over the edge.