I was dx type 2 this past September (BG 330, A1c 8.4) at age 41 by PCP and re-dx as type 1 in January (GAD level 500) by Endo . I’ve been taking Januvia and Metformin since then. It seems to be working fairly well (last A1c 6.2) as long as I keep my carb intake moderate/low. I’m worried though, because I’ve read that it may be causing stress to my pancreas and therefore burning it out faster. Anyone else taking only oral meds? How do you feel about it?
For Clarification; My endo wanted to start me on insulin right away but I was so caught off guard and confused over the diagnosis that I got nervous and refused insulin. He suggested it again at my last appointment and I stated my case - that the oral meds seem to be working and I just wanted to keep up with them for now. He agreed again with the understanding that I be very strict in monitoring my bg. After reading up and researching I’m beginning to think I should have listened to my Endo right from the beginning. My next appointment is in a few weeks and I want to be prepared to state my case for continuing oral meds or prepare myself to begin insulin.
Currently my fasting bg averages about 145 and my post meal averages 180 (with occasional spikes to the high 200’s if I eat too much of something I shouldn’t (crackers…). I eat moderate amounts of carbs (a 15 carb snack, 30 carb meals).
Becca - I think once you get a handle on insulin, you’d be able to get even tighter control over your BG levels. Your numbers aren’t horrible, and I know tighter control can be harder with the unpredictability of T1 vs. T2, but 140 is the level where minute amounts of damage start to happen to the body, so you really don’t want to be hovering above that number all the time.
Personally, even as a T2, I’m a fan of insulin over drugs like Januvia. Drugs like Januvia are associated with an increased risk for pancreatitis, pancreatic cancer, and thyroid cancer. Insulin can be scary for some people, but it can also be very freeing in that once you do get a good handle on how to use it, you have so much more control than you do with a set-dose oral medication.
I was diagnosed as T1 nine years ago at the age of 57 and went on insulin immediately. Using insulin has preserved - or at least slowed the decline of - my beta cell function and has made the disease easier to control all these years.
One advantage of using insulin is that you will be less dependent on your medical team once you’re up to speed. Balancing multiple oral medications takes a physician; managing insulin doses is something that you’ll learn to do yourself.
As the young resident said when I was first seen in the emergency room, insulin is the best medicine.
Ugh - yes, the possible risks associated with Januvia are particularly worrisome. I also frequently forget to take my morning dose (I’m taking it twice a day - one pill in the morning and one at night). Actually, now that I think about it, I’ve been forgetting it so often at this point, I could probably just cut it out of my routine all together and stick to only one dose before bed. Of course, I’ll keep a very watchful eye on my bs if I do that.
First, I think that it’s important to always remember that what is working for you is the most important thing. It may not work for others and what works for others may not always work the best for you, but if your management plan is providing you the results that you and your healthcare team are happy with, then that’s all that matters.
In addition to that, my endo had recently discussed with me that a lot of Type 1’s are being put on Metformin along with their insulin because the Metformin is helping with insulin resistance.
Insulin can seem like a very scary transition, but with practice and experience of how it affects your body, you become a professional at all very quickly.
I wish you the best and hope that you can have an open conversation at your next appointment about what the best mix of medication is for you.
Eventually the oral meds will lose their effectiveness (it sounds like they are starting to already or you would be closer to 100) so I think it is time to bite the bullet and start taking insulin. It really does not take long to get the hang of it! You are already testing and counting carbs so that is half the battle right there…
Becca, I won’t repeat the excellent information provided by others above. I’ll just add that if I were in your shoes, I’d have switched to insulin as soon as I was correctly diagnosed with Type 1. With the BG numbers you’ve been having, I wouldn’t think twice about being on insulin. I couldn’t be comfortable with BGs that weren’t a whole lot closer to 100 a whole lot more of the time…
Hey there. I think insulin is the way to go and I’m still learning the ropes. Your body will thank you for it and you will feel a MILLION times better once you’re on it. Don’t waste anymore time. There are a lot of questions I still have but the folks on here are great. I was lucky to be put on it right away. It’s scary yes but once I started that fear was erased with motivation. I am almost three weeks into insulin (4 weeks from diagnosis) and I feel so much better. It’s night and day. Your body is doing a great job fighting but needs a little help is all. Good luck.
