I’m the father of a type one, diagnosed five years ago, so I’ve been juggling the algebra for years. I’ve been bouncing around in the 6.0-6.4 range for fifteen years, but came up a 6.8 yesterday. I’d tried metformin in the low sixes four or five years ago, when I was on a round of “turned 50” testing, and went low.
Why not treat with, say 1/4 dose of Lantis and see how the pancreas reacts? The doctor came back with “if you want an injectible I can give you [something with a J]?” I don’t want an injection, I want the organs of my body to do their job and avoid side effects.
I confess, I’m a little sensitive to the not a straight answer to the question I ask. Does anyone know why insulin is the evil product to be avoided? In favor of all these things that monkey with the internal working of the organs that are supposed to regulate BG? Particularly when it is the aging process reducing the capacity of the pancreas to to produce? Why not give the pancreas an assist as first line therapy?
David Schierholz
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Hi,
Low dose insulin maybe the answer you need. I have never heard of anyone regretting starting insulin. Most regretted they did not start earlier. With proper insulin dosing (and probably lower carb eating - depending what works for you) you may be able to get normal blood sugars.
Many doctors seem to see insulin as a lasts resort. Actually, in my opinion and the opinion of many here, it should be first resort. Because it always works.
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I’m confused. You tried metformin and had a low? The typical protocol from say the AACE would have you try diet and lifestyle and then when that doesn’t work you would try metformin which is perhaps the safest and best understood of the diabetes medications. Hypoglycemia is rare with metformin. Most would then recommend that you try one of the GLP-1 drugs (there are a fair number) which are injectible. These have been shown to really help during mealtime as well as being associated with weight loss.
The AACE suggests that a basal insulin such as Lantus is ok as a second line treatment but cautions that it can cause hypoglycemia. I think many doctors are “insulin resistant” about insulin because of the risks of hypoglycemia. They don’t want to be liable if the patient has a serious adverse event. That being said, we as patients also need to give these oral and injectible medications an appropriate chance before demanding insulin.
As a type 2 I moved to insulin 6 years ago, but I had tried many medications and ended up on three medications at the same time and it just wasn’t working. I would urge you to give medications a try. Many find metformin effective and many people also think the GLP-1s work well. There is even some thinking that the GLP-1 drugs “preserve” your beta cells.
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I note that I went low when my A1c was much lower than it is now. My first concern is that if my liver can’t react with a glucose dump when doing a vigorous workout I will not have a vigorous workout. And I think metformin shuts that down.
Insulin resistance is defined as more than 1 unit per kilogram. I weight about 135 kilograms, so if I dose about 20% I shouldn’t go low and the pancreas can still react. Am I wrong on the facts here?
I once came out a cardiac catheterization lab and regained consciousness to a prescription for beta blockers. I was in on what turned out to be a false positive (I had two stenosis elsewhere that were not showing on a stress test and would not have gotten me the surgery). The nurses said that the beta blockers would help with my chest pain. I said “What chest pain?” They said “do what the doctor ordered” but were less than convincing. They also handed me paperwork that said beta blockers will kill you if discontinued.
As the doctor had said (when I was barely conscious) “You’re ours now,” your statement “That being said, we as patients also need to give these oral and injectable medications an appropriate chance before demanding insulin” punched a button.
When I was on my max dose of metformin, yes it did restrict my liver from dumping glucose during hard exercise, which made me run low. Ii discountinued the metformin. And for me solved the problem, but bumped my A1c from 6.0 to 6.3. Which I lowered by now being able to exercise harder, and being stricter on my carb intake.
In my opinion if your looking to give your pancreas a rest, if you are not already, change or diet to LCHF. And if that does not fix it look for other options
High stress year- I will have it back below 6.5 by Christmas.
Worked out yesterday- crashed from 150 to 88 (I have my daughter’s meter). Just exhausted. I’m going to try a morning workout tomorrow before taking the metformin. I just hope it doesn’t kill the day- but black coffee jumped me ten points off the overnight fast this morning, which makes me think the liver function was back after 21 hours.
