Great advice on this thread. You need to find a new doc.
My Dr. said he wants me to test only twice a day for his own medical analysis. First thing in the morning (fasting) and 2 hrs after my biggest meal of the day (which for me, is lunch). He said this will give him an accurate reading of how my body is handling my current regime and where changes might need to be made. Then, he gave me a additional meter to use so I can test myself randomly throughout the day to keep an eye on things but he wants the one meter to be a clear line of fasting to after a big meal. He did prescribe 5 tests per day which the insurance company didnāt even blink an eye at. He said he would prescribe more if I find i need it. His wordsā¦ āthereās no harm in testingā¦ā.
Iām new here too (yesterday!) and its been such a big relief!! Together we can all do this!!
I never heard of getting generic insulin over the counter! I can check into that but it also sounds scary because I donāt know exactly how much to take considering my body does still produce insulin. I am the odd ball in this diabetic condition. It seems like it anyway. I know Iām not but they think either type 1 at a young age, type 2 at an older age. I do want to eat a better variety some day!
Actually generic insulin doesnāt exist by definition. There are human insulins called Regular and NPH that are available over the counter. They are available under the brands Novolin, Humulin and Relion and they are biosimilars. You can go to Walmart and buy Relion Regular and NPH insulin for $24/vial over the counter.
You sure know a lot! I appreciate everyone on this site. I never have anyone that wants to or even would understand my weird issues! I feel like I have people that actually care and want to help! How will I know how much to use when and if I try it? It is kind of scary! I really want and need to at least have a short acting type if the doctor would let me try it! Thank you sooo much!
Thanks Brian for the clarification.
Dosing insulin is ideally done under the supervision of a Dr. Though it is well described in books like Think Like a Pancreas and Using Insulin by John Walsh.
Ideally you will be prescribed one of the more modern insulins by your Dr. These have much flatter profile (for basal) insulin, and more rapid onset (for bolus). I personally loved tresiba over a 2 month trial (though Iām currently using up my levemir) - which was the flattest basal I have yet found. I then use a fast acting insulin for meals / corrections.
It is not so hard and follows a mostly logical process where one starts low and gradually adjusts the dose over time. There are also testing protocols that can be done to determine appropriate basal (background) and bolus (short acting for meals) dosing. With frequent testing it is as safe as most things in a diabetic life can get (and much better than swinging or high sugars).
I had the same as you. C peptide was normal but low at 1.2 and my GAD was 1930ā¦Yes 1930ā¦my fasting was 168 one time and 174. It was at lunch time too! My PCP said type two but obviously quickly changed to type one. I can say though I feel a whole hellava LOT better on insulin and my energy and body thanks me for it daily. I canāt say Iām thrilled to be a type one (who is?) But I know my body put up a huge fight for me in the months leading up to getting insulin. Iām thankful for that.
@tucsonmo, Iād be looking for a new endo, if this is financially possible. actually weāre not allowed to give dosing recommendations here. itās ok to share what we do ourselves, but you really need to be seen by a qualified endo. and imo the generic walmart insulins are for emergencies or those who have no insurance - the modern insulins have much better action, like @JustLookin says. do you need help finding an endo? I may be able to help you.
Diabetes progresses. Slowly or quickly it is not a moral failing. āyouāre the worst diabetic if you need insulinā. One gets used to feeling the way one feels. One doesnāt try to more aggressively treat diabetes. That leads to complications. A long time with high blood sugar destroys some cells, nerve cells, kidneys, liver, eyes, blood vessels. Doctors find it not worth the effort to train people to use insulin when they are already near a normal lifespan when some people without training get severe reactions, require emergency treatment and become discouraged. So I would suggest staying assertive, not lapsing into constant thirst but updating the treatment as soon as the disease requires.
@tucsonmo Definitely find a new doctor who will work with you. I would not do insulin without some help at the beginning. Insulin is an extremely powerful hormone and support is paramount.
Just thought Iād update this thread I started - my endo still thinks Iām T2 (ā85% sureā) despite the positive GAD test. He put me on 2000mg of metformin XR and it has cut the amount of insulin I need by about half and has helped smooth out some of the peaks. The good news is my last A1C was 5.6!
My endo has been gradually cutting my insulin dosages but acknowledged that if my BG gets out of range to stop cutting, so that seems pretty reasonable to me.
In the end I suppose it doesnāt really matter if Iām T1 or T2 since the treatment is basically the same for me at this point (with the addition of metformin to lantus/humalog) and my BG stays in control. My only little niggle is now I get fewer test strips!
The real risk that you have is that there is a significant chance you are T1 and simply in a honeymoon. Having your insulin reduced and then being pushed to stop insulin can put you at risk of a serious adverse event. Your honeymoon could simply end and suddenly that āoptionalā little bit of insulin isnāt optional anymore. It is all to common to have someone diagnosed with T2 be told that their diabetes is just progressing and that they just need one more medication or they just need to fix their lifestyle. Being told this and sent on your way for another three months could land you in the hospital. Iām just sayin, the prudent thing would be to diagnose you as LADA/T1 and keep you with prescribed insulin. Please donāt think the medical system and insurance will treat you the same whether you are diagnosed T1 or T2, they wonāt.
It actually can matter quite a bit! With a T2 diagnosis, I am limited in how many test strips I can get a month, and insurance wonāt cover a CGM or insulin pump. The treatment may be the same but how much you have to pay for that treatment hinges on the diagnosis.
Whether youāre T1 or T2 is going to make a huge difference if/when a cure is found. A cure for T1 is incredibly likely ONLY to work for T1, and a cure for T2 only for T2 because of the very different mechanisms of operation.
Knowing which type you are will also help you get better emotional support, since T1 and T2 deal with different stigmas and reactions to stigmas.
Knowing which type will also help your treatments, particularly with exercise. Exercise helps both T1s and T2s because the more insulin sensitive you are (whether you were insulin resistant or not) the better! But a T2 is unlikely to exercise to the point that theyāll get a dangerous low and collapse cause their pancreas still functions well enough to tell their liver to barf up some stored glucose when needed. In a T1, we canāt trust our livers and need to take extra precautions when exercising. Also, having one autoimmune disease (which T1 is) makes you more likely to get other autoimmune diseases. Lastly, you could have something really strange like adult onset cystic fibrosis and your pancreas could be filling up with mucus and you donāt even know because your doctor has decided to do the minimum amount of work to keep you alive. You are worth more than the minimum.
Iām so happy to hear your A1C is now 5.6! You are totally right that, in the short term, since everything is under control, it doesnāt matter. But it will matter in the long term and youāll want to find out BEFORE the long term. You seeā¦ if I have a sore throat, coughing, and sneezing and then I find that rest, hot tea, and a fever reducer make me feel betterā¦ thatās great! If itās a cold, thatās just fine. But if it is strep (which will look better with the same treatment in the beginning), it could turn into scarlet fever and more dangerous things. Itās important to know what it is, because youāre important.
And actually, itās even worse than that, because T2 is really a collection of several different varieties of diabetes, or subtypes if you like that term better. So if and when there IS a cure, it wonāt be āaā cureāit will be several cures, one for each type of T2.
I had a gestational diabetes that didnāt go away, tested roof-top positive for GAD antibodies, A1C of 6.1 and failed oral glucose test (194 after 2h). My endo commented on these results that its pre-diabetes and āwe need to make sure it doesnāt turn into full diabetesā. Then he started on about exercise and bla, bla. Didnāt mention anything about LADA or type 1 until I pressured him. I also forced him to prescribe me insulin for meals. If I didnāt research the subject before doctorās appointment Iām sure I would be ārelievedā that I donāt have diabetes and if I do a little run everything will be just fine. So your endo is exactly in the same denial as mine
With a T2 diagnosis, I am limited in how many test strips I can get a month, and insurance wonāt cover a CGM or insulin pump. The treatment may be the same but how much you have to pay for that treatment hinges on the diagnosis.
A cure for T1 is incredibly likely ONLY to work for T1, and a cure for T2 only for T2 because of the very different mechanisms of operation.