I have a doc’s appt in one month. I am going to ask about being put on insulin for at least awhile to see if we can get things back to where I want them to be…FBS 120 or within 5 points; daily 130 or at least within 5 points; and an A1C of 6,.2 or lower. I am type 2; swim 4 - 5 times a week for 45 minutes; walk for 15 if my joints will take it three of those days; I have lost over 80 lbs now. I feel good except for the pain, I have arthritis in every joint; I am on Janumet 500’s twice a day; and amaryl 10 mgs twice a day.
I have three arthritic meds, a typertension meds, and cholesterol med, and allergy med. I weigh in every two weeks. See my doc every three months after an a1c…our closest endo is 200 miles away, and I haven’t seen him/her because of finances and distance. I have dropped from 145 carbs a day to less than 80 right now, the idea is to go to 50 and stay there.
Now that you are aware of my situation…please remember the title says BE NICE.
I am NOT afraid of going on insulin, in fact, right now, if she says yes, I’ll be relieved. I have done all that I can do, I have not been consistent in the past, but have done so in the last two years of taking on my own medical care. I would dearly be thankful, if you would share with me the pitfalls and joys of changing from an oral med to insulin injection. Please DO NOT LECTURE ME on why wouldn’t I have done this sooner, we all do things in our own time, when we can. One of my main concerns is weight gain, I have worked very hard over the last five years to lose this 80+ lbs; and to have it all come back on because of the insulin, would be one of the factors NOT to do it. But I am talking about long life here.
Please do not use technical words like post, pre priadial or whatever, cause I am not up on those as yet, bolus, is a foreign word to me also. Use words that are understandable to a non-diabetic. I know it sounds weird that I don’t know those, but that’s another story, and I don’t need it.
This information is very important to me, so please let’s not make it a difficult, Oh My Gosh, She Knows Nothing session, let’s do some over coffee talk about insulin and what I need to be asking the doc for and about. Thanks.
Hi Cathy. I am by no means an expert on insulin or diabetes, so I found the following link useful for myself: http//www.diabetes.org/diabetes-basics/common-terms/ . The two most important basic insulin terms are “basal rate” and “bolus”. The basal, or background slow-acting insulin, needs to be in one’s system all the time; the two basal insulins are Lantus and Levemir. (I love my Levemir!)
The fast-acting insulins used for boluses and corrections are Humalog, Novalog, and Apidra.
Two somewhat old-fashioned insulins, which are available otc without a prescription, are Regular (not as fast as the ones I just listed) and NPH, which is used for basal, but is usually called an intermediate insulin. (R and NPH are probably least expensive at Walmarts.)
I am T1 also, pumping, but when on MDI’s (multiple daily injections) I really believe I gained weight not because of the insulin (cannot live without it LOL!), but because of my own lack of control with MDI’s. So when people talk of weight gain on insulin I have to question what is actually causing you to gain weight - in my case I rode the blood sugar roller coaster - meaning my injections contributed to wide swings in blood sugars (lack of control) so I was chasing highs with more insulin and then chasing lows with food. Make sense? Therefore, I gained weight. Now you are looking on adding insulin to your schedule, I will assume you too will have to get use to the effects and learn how rapidly the injection takes effect, how quickly it lowers your sugars, etc. Back to control. Which for me has been the difference between night and day with the pump and allowed me to lose weight because I am now in control.
I’m sure you know my story. I was diagnosed as T2 back in 2005, and I followed a very low carb diet and exercised aggressively. I tried lots of the medications, eventually taking three medications, but they never worked well and I was unable attain my blood sugar targets. I’ve followed your story as well and you have made great effort to change your diet and lifestyle as well as medications. And it sounds like you are at a similar decision point.
So my experience with insulin has been very positive. I learned a lot about insulin before I ever started. Since starting, I’ve been able to consistently reach all my blood sugar goals. I now take 4-5 shots a day and I have the absolute best blood sugar control ever in my diabetic career. Do injections hurt? Sometimes, but actually it is less than lancing for tests. Is it a pain? Sometimes, but it is really not too bad, just learning some new habits and carrying around some more stuff. Have I had bad hypos? I’ve had only a handful of any hypos that warranted immediate attention and I’ve never needed assistance. Have I gotten fat? I’m actually 5 lbs less than when I started insulin.
Would I do it again? Absolutely, I probably would have been more insistent to start early. I still take metformin, it just seems to make sense.
From what you state, this sounds like a reasonable discussion and a reasonable approach.
Current standards of care (that is, the ways doctors are supposed to treat your medical conditions to get the best results) suggest that doctors consider insulin rather than a second or third oral medication (Janumet is two diabetes medications in one pill – Januvia and metformin – so you’re already on three oral diabetes medications). The current Standards of Care for diabetes is available as a .pdf download on the American Diabetes Association's site.
Also, the fewer the separate medications you’re on, the less likely any one of them will adversely affect the others.
Cathy- I am a T-1 for the past 12 years. I have NOT gained any weight during that time and, of course, I am on insulin. I think that weight gain is from eating too much and your current carb intake will not allow you to gain weight. Congrats on loosing all that weight and on being so active.
What good timing you started this discussion ??? !!!
I have a friend , whose Doc is talking with her about starting insulin …
I suggested to her to become a Tu member . I also asked Tu Admin ,if they could provide me with a discussion group : type 2 on insulin and the answer was sent this morning: http://www.tudiabetes.org/group/insulin_dependent_type2
Your fears about weight gain are real but weight gain need not be too disastrous if you run your sugars slightly higher than perhaps you would like, in other not taking too much insulin! It takes time to put weight back on - it took me 3 years during which I hypoed about 6 to 8 times a day! Partly it was due to being told to inject too much, and partly because I was found (after a long fight) to be allergic to human insulins. When I switched to pork it steadied to maybe 1 hypo a day, and less, and my weight has not gone up dramatically. In fact I am losing! Most people are fine with human insulins, but I am not as has been borne out when I have been in hospitals and they insisted on the human insulin by drip - and they could never get me up. I now have a passport type document stating that I will treat my own diabetes unless I am unconscious and on no account should I be given human insulin. But I digress.
I was on tablets to begin with and it simply did not work. (I had gone down from 15 stones to 6.5 stones without trying and it took 10 years to be diagnosed!) and when I first went on insulin I was bad for quite some time.
The theory is that excess insulin that is not used by the system is stored as fat (I used to have low blood sugars), and also if you have hypos you tend to overtreat them. Natural instinct, but if yo do not inject too much in the first place it should be fine!
In your post you mention excellent weight loss, good exercise and lots of medications. But I could see no mention of diet or testing. By diet I don't mean calorie restriction, I mean a menu tailored for your personal best blood glucose post-meal results.
Please forgive me if my sporadic visits here mean that I missed this information; in that case just ignore me :)
While you wait to see the doctor please consider a brief experiment. All it will cost is some test strips and some time. Begin here: Test, Review, Adjust
Cheers, Alan, T2, Australia Everything in Moderation - Except laughter
