Thanks for the great advice!! Was it hard to get your insurance to cover your CGM and sensors? Alarm for lows? Thats AWESOME!
CGMs read interstitial fluid, not blood glucose. So you have to get used to the fact that it may show your bg is still dropping after you've treated a low when really it has started to rise again. If you read some of the cgm discussion here, you'll see some of the details. CGMs are amazing technology but do require some skillz (and time commitment) to use effectively. Of course, everyone who notices mine thinks (like the pump) that's it's just push a button and go--hah!
If you're researching pumps and cgms, note the MM Reveal is pump and cgm package. Others are sold separately.
Yes, your endo will start you on less than he thinks you will eventually need, because it's better to work up to what you will eventually need than to throw you into an immediate low!
Novolog and Humalog are rapid-acting insulins that you take right before meals to control postprandial (after meal) rises in BG. Lantus and Levemir are long-acting insulins that cover the basal amount of insulin needed to keep you alive when you are not eating. Some people have reported stinging with Lantus or Levemir, but I was never on those insulins, so have never had that problem.
Either basal or bolus can cause lows if they are not properly adjusted. Since, in the beginning, you will be adjusting because the doc doesn't yet know your needs, lows will probably occur more often than when you are well-tuned. But lows can happen at any time -- if you are LADA, and still have some pancreatic function, sometimes your pancreas just unpredictably decides to shoot out some insulin. For the most part, lows are mild, and simply uncomfortable, but not life-threatening.
For a lot of people, low-carbing tends to even out BGs, but lows are still possible, especially if you are LADA, and the ol' pancreas decides to sputter. I don't know anybody on insulin that has totally avoided lows, but I do think you can minimize them with careful attention.
As far as weight gain, that depends entirely on how you eat and exercise. You need to find the foods that YOU can tolerate -- this may be entirely different from someone else. I have found that increasing my protein fills me up better, and I've been losing weight ever since my coma in September. I'm also trying to eat more low-carb veggies (and I'm NOT a veggie lover!). But other people tolerate carbs much better than I do, and you will have to experiment and find your own level of tolerance.
Keep on asking those questions, and I'm sure you'll learn a lot here! :-)
I'm sorry, I really wish that you had gotten better news. It's perfectly normal to freak out, but those same instincts that are causing you to freak out now are going to help you get through this. From what I recall, you're already putting a ton of effort into this thing, so insulin will just become another tool to manage the disease. Your insulin requirements should be low at first, so that will give you some to adjust to how your body responds. The technology is changing fast, so the tools that you see out there now should be a lot better in the near future!
Early on, it was my experience that taking insulin suppressed my own production, which then became available as needed to maintain my BGs in a very good range. I really didn't need to work very hard the first few years I had diabetes. I don't know if that's true for anyone else.
Thanks for the encouragement :)
Stinging at the injection site or as it travels through your bloodstream???
Are you LADA? What type of insulin are you on?
Thats AWESOME!
You're exercising constantly to keep BG low, which is great, but you'll be able to ease up some with the help of insulin. You'll be fine. You're motivated to learn as much as you can, very diligent & have time to prepare. You're light years ahead of most people who are slammed with a diagnosis out of the blue.
I went into DKA & almost died. I was so ill that I didn't care if I lived. Woke up with tubes in ICU & two days later was told I had diabetes. I flagged down a nurse to show me how to inject the day I was discharged. She gave me some hand-outs that didn't make sense. I was clueless knowing how much insulin to take for meals. One hand-out was on the outmoded exchange system. My endo appointment was three months away. I had to teach myself everything.
Please don't be afraid of insulin.
I know I know lol I guess I feel like I am just tryin to cram it all in and figure it out before I have to do it for the rest of my life, guess it's just my personality. Thanks for all of the wonderful advice, I feel like I am in a foreign country!
Wow...I can't even begin to imagine! What a nightmare!!! You have more than figured it all out! :)
I see this early diagnosis as a huge blessing and I'm so lucky to have this time to educate myself and try and figure it all out with the help of all the wonderful people on this site.
Stinging at the site. I'm a Type Weird, which means that sulfonylureas didn't work, and I went on insulin 18 months after my diagnosis after being very symptomatic, but I've never formally been diagnosed as LADA. My new endo put me down as Type 1, but that's not entirely true either. Suffice it to say, I'm a mixed bag.
I'm on a pump, and I love it. I'm averaging about 35 units a day, and I can bolus whenever I decide to eat (which is only when I'm hungry!), and it takes care of my dawn effect beautifully. But I don't regret being on shots all those years -- once I got on 4 shots a day (NPH at night and Humalog for meals), I did pretty well. However, I would never go back to shots at this point -- I was on shots for a month and a week in September/October because of a coma, and when I got home, and went back to my usual irregular habits, I had 2 lows in a week. I was never so glad as when my new endo immediately put me back on the pump.
When I asked for insulin an Endo told me you do not want to touch that s--t with a ten foot pole. Two years later I was on tonnes of it. A little insulin in the begining can make it a manageable disease instead of your worst nightmare.
Wow...thanks for the heads up...are you LADA? That's horrible that your Dr didn't listen to you!
Bless your heart a coma!?! DKA? Thanks so much for taking your time to give me so much wonderful advice. Seems from what I've heard to start on shots and figure everything out before going on the pump but the pump is so much easier from what people have told me.
Except they are only sort of accurate? It's sort of motivation not to go nuts w/ carbs/ insulin because mine (MiniMed) seems to be very accurate when it's not taxed too much but if I miscount carbs by like 20 and my BG plummets as a result, it seems to run about 20 minutes 'behind' the actual BG, so the CGM will read 76 and it might be like 57? I can tell what's going on and, frankly, usually know when that sort of thing will be going on.
I've had some issues w/ it reading lower than actual when I'm running too, like the interstitial fluid doesn't get enough glucose to register during moderate to high intensity exercise? This is sort of a recent discovery but, in the past, I've just taken like 10G of carbs when it gets into the 80s or 90s when I'm running but it seems like it'll read a lot higher when I get back to my meter. I recently figured out a way to clip my meter into my Amphipod/ Batman Utility Belt however yesterday the meter got too cold to read anyway so I was stuck w/ the CGM.
I'm not saying they are bad at all, just that they are not quite like having a meter going all the time and that they can be inaccurate at times you'd really like to have them be precise? A lot of times though, I'll check my BG before I check my CGM and they are dead on. Knowing the trends and how to read them is really useful.
It is a continuous glucose sensor. I no longer feel when my blood sugar drops low, so Larry (what I named mine) helps me out and lets me know when I am low/high/or falling/rising rapidly. Check out www.dexcom.com
You'll do great! You know so much already. Don't try to digest it all at once & breathe.
Well, I'll ask a dumb question. Did you start by priming the pen, shooting some insulin into the air, so you know you're actually injecting insulin.
I get BD 1/2 marking (3/10 cc, 8mm, 31 G), and I'm told 1/2 markings are also available in other brands. These seem to be very good, since they don't hurt and I use them twice. About your pen, maybe it's defective?