read that most type 2’s will need insulin on average in 7 years after dx. some say that we should be started
earlier than that. I live alone and worry if started on insulin would get it wrong have a hypo and die in a coma.
any thought’s about insulin therapy vs. med therapy.
1 Like
I would imagine it all depends on what kind of Bg readings they are getting over that time as they rise it is a clear indicator of what is or is not working. Starting on insulin, they are no different that anyone, it is a learn as you go thing. Endo would more than likely start a very modest amount of insulin to be on the safe side and you make adjustments after some time.
2 Likes
As a type 1 I’ve never had a choice, but dying or going into a coma from hypoglycemia is extremely rare and not worth worrying about. It’s equivalent to the fear some people have of using insulin pumps because of DKA - it’s theoretically possible but unlikely if you are testing frequently, in control and know your body. I have lived alone, travelled alone, drank more alcohol than I should have many nights in university and travelling, and I’m still here to talk about it and was never in any danger. Plus, with continuous glucose monitors the risk of these things happening is even less likely than ever.
2 Likes
It was closer to 20 years for me, and then it was at my request, not a medical recommendation. Cases differ.
1 Like
My mother had Type 2 for over 22 years and was only on insulin when in the hospital (for reasons completely unrelated to diabetes) during her last year – and that was for the hospital’s convenience, NOT because orals were not working for her.
1 Like
Also, when type 2s go on insulin, they initially usually go on just a basal insulin, at least at first. A lot of them never need to go on the meal time insulin, provided they are willing to limit the carbs in their diet. Hypos from just the basal insulin are much less common than those from miscalculated meal time insulin, so any risk is pretty low.
Any good doctor would have a patient starting basal insulin start at a very conservative level, then gradually titrate the dose up to a level that keeps the BG at a decent point fasting and before meals. Patients can sometimes get themselves in trouble if they get too impatient and try to increase the dose too much at a time.
And if you should ever need to go on meal time insulin, it can be used quite safely if one takes the time to learn what one is doing. At that point, just ask on these boards and someone will give you some of the best current resources to check out and learn the ropes. But I’m assuming that could be years, maybe even decades from now.
4 Likes
thanks for info .
2 Likes
Your worries are valid but not the only consideration. Insulin is a powerful tool but is not the dragon that many perceive it to be. It is a tool that must be respected but not feared.
Insulin can be used safely, it is used successfully out of necessity by millions of T1s and many T2s every day of their life. It is possible to be insulin dependent and be comfortable with it. Knowledge and diligence is the key, you cannot be successful with out paying close attention to what your body is doing, knowing your blood glucose levels and how to take action based on your readings is of utmost importance, it is what will keep you safe.
3 Likes
@nats1 - Have you considered using a CGM? There are a few although I do believe the Dexcom G5 is the best. Certainly biased as we use it and like it. In any event, a CGM can be set for alarms for various conditions such as low, critical low, drop rate, etc… You may find this not only helpful in your overall treatment plan but useful to alleviate concerns over being alone while you sleep.
3 Likes
I would make an effort to not be alone when you start insulin. Insulin is great, but you might want to camp out at a buddy’s house or a relatives place (preferably one that is bigger than you - on the off chance that they need to drag you or fight you). Do you have any old drinking buddies from college that you trust?
2 Likes
I am on drug 3 now along with bps. Insulin must be next.
2 Likes
I eat low carb to keep my blood sugars low. Have been on Metformin for 6 or so years and have not increased my dose of drugs. For T2s I think low carb is really important.
2 Likes
I was DXd T2 6 months ago with FBG ~400 & A1c = 13.2(!). ER doc started me on glyburide. (After watching my roommate live in the bathroom for 6 months on metformin, I didn’t want to mess with it. Explosive diarrhea just isn’t my style so I went with the other option.) Glyburide & avoiding carbs got my A1c down to 8.2 by April but my primary doc (who was amazed) had already told me I’d probably need insulin & referred me to an endocrinologist.
I saw the endo in April & we talked about the various options. I told him I’ve been watching my roommate shoot insulin twice a day for the last 7 years & needles don’t bother me. (Yeah, I’m that weird person who watches her blood being drawn.) We did discuss Victoza but that requires extra authorization since I’m on Medicaid. We decided to go with Toujeo, which I’ve gradually increased to 32u/day & I’m thrilled with the results so far. Still limiting the carbs, average BG is hovering around 110-115, estimated A1c ~5.5%. I’ve lost 12 lbs & am feeling pretty good.
Long story short: Toujeo has definitely been worth it!
2 Likes