Its been a long time since I last posted in here but my diabetes has now got to the point where I think demanding insulin at my next Dr. appointment is a must. I’ve had pretty good numbers for the last few years on a low carb diet but the last few months I’ve seen some pretty high numbers (200+) after low carb meals (5-10 carbs).
I’m currently taking 2x500mg Metformin and 1x30mg Diamicron daily. I see my specialist (here in Ontario) every 6 months and the last 2 visits I’ve suggested if its time to start insulin for after meal spikes and hes told me that I’m not at that point yet? If I eat 5-10 carbs I will be anywhere from 180-270 for at least 2-3 hours after. I go to the gym 4 times/week and live an active lifestyle (6’-1" and 150lbs).
Do I “Demand” to be put on insulin? Would I take daily injections or use a pen etc? I’m afraid the Dr. will just “up” my meds and I really dont want that.
@Paul_Curwen I’ve missed you. I hope you know you will always have friends here.
I think you always should think that you are at the “center” of your health team. You should always feel empowered to learn about your diabetes and ask your doctor to follow your considerations. You never fit the model of overweight and you should never think you should think that some treatment focused on you losing a few pounds would make a difference.
Think about what your goals are and what you think you can achieve with different approaches.
Are you type 1 or type 2? You should have been on insulin a long time ago probably with those numbers. Some people who are type 1 just start on a low dose of basal at first. Spiking that high with such a low carb should be a sign to your doctor something is wrong with his treatment plan. I would consider getting a second opinion since this is your body. Change docs if necessary.
At this point I would demand to be put on insulin.
IF the Dr refused, I go find another dr. What is he waiting for? For your Hba1c to reach ADA recommended levels and for complications to set in?
Your body and your diabetes, which isn’t going away, so you need to be integral to the treatment decisions. Sounds like you’ve made the appropriate decision, but your Dr is not on board. Either get him on board or boot him, and then find someone who will get on board.
I find it disturbing how Doctors send people willing to go on insulin away by telling them it’s “not time yet”. How long do they wanna wait? Usually they have to force people on it, because they are scared of it, and here is @Paul_Curwen, educated, informed and willing to learn how to take insulin, and he (the doctor) refuses it.
It blows my mind. Try again, and if you don’t get anywhere, change endo.
good luck
Thanks guys, I really appreciate your feedback. Its 6:15am and I just took my BG reading and its 163 at waking… This has been my average, at waking, for the last month or so… I doubt this Dr will do anything at my next app I’ve told him about my numbers after every low carb meal and his words “that’s ok, as long as its coming down after 2-3 hours”. I asked if there is any danger of complications with these high numbers and he told me no. I’m not sure why I’m having so much trouble with Drs here in Ontario but I have expressed my concerns to 3 other Drs in the past few years (regular GPs) and none of them thought there was a problem. I reached out to the Canadian Diabetes Association a few months ago with my concerns but they just sent me nutrition guidelines.
Here in Ontario you need to be referred to a specialist (Endo) and it took a lot of nagging to get to see this guy so I’m not sure what to do. I guess I need to keep fighting for my health. I just want to be able to attain as normal BG readings as possible and I think with Insulin that would be the best option.
Hi, Paul–When I needed to make some changes in my management, I enlisted help from my CDE. She looked at my data and made recommendations to my doctor–ran interference, so to speak–and that was a big help! CL
I can’t really add anything original to the excellent advice here from Brian and others. I’ll just relate my own experience as succinctly as I can.
After more than a decade on pills, the numbers were making it unmistakably clear that I would never have the control I wanted doing what I was doing. So I did precisely what you are asking about: I marched in and said, in essence, I want insulin and I want it NOW. Before I got to that point, I had done a great deal of self-education (Bernstein, Scheiner, Walsh, others) so I knew exactly what I was asking for and the reasons why.
Insulin has been a total game-changer. I wish I’d done it ten years sooner.
Just to reinforce what Brian said, each of us needs to be the controller for managing our diabetes. Nobody knows your body like you do, and nobody else is there 24x7 to make the choices and live with the results. It’s a job that cannot be delegated responsibly. So if you think insulin is the answer for you—after all, it is the most powerful weapon we have, by orders of magnitude—then do what you think is right.
P.S. Depending on where you live, you may be able to acquire syringes and Regular insulin without a prescription. I actually did that before I even confronted the medical establishment. If memory serves, @Brian_BSC did the same thing.
