My State Of Being or 2011

**I have had a nagging dizziness problem for more than two years. Blood pressure drops of 40-50 points in the mornings, when I stand up. I am adjusting to it and can actually go out and do things before lunch, but I have to be very careful. The rest of my day is much better.

**I have mild nerve damage all over my body, from 65 years of diabetes. Nerve damage is my only diabetes related complication. It has resulted in weak muscles all over my body, but not so bad in my legs. I do a lot of walking all year long. I joined a club/gym in December, and am using machines to strengthen my muscles. My trainer is taking good care of me. I have a tendency to chomp at the bit, and could do damage to myself. This little gal from Texas is so good at pacing me, and I am feeling the good results.

** I was diagnosed with insulin resistance in 1998, and Avandia has been a wonderful drug for me for almost 12 years. My doctor (an internist) refused to renew my subscription for Avandia in December. It is a drug that has caused some users to have heart problems, but my heart is strong. He insisted that I use Actos, but it is not nearly as good for my insulin resistance. After 3 months on Actos I am using 20% more insulin, and have gained 9 pounds. I have reduced my daily carb intake but it has not helped. My waist has increased 1.5 inches. I know that many type 1 diabetics have had success with Metformin for insulin resistance, but my doctor insists it is not appropriate for a type 1. I am going to see if my endo will permit me to return to Avandia, or use Metformin. She is young, but she has been very cooperative for me for the past 3 years.

**I have been in a group health insurance plan for a long time. In October I learned that the group was going to change providers. Th new provider will not cover a CGM under any circumstances. I used my Dexcom CGM for 8 months in 2010 and then stopped on October. I have saved 10 sensors and will use them this year at times I am on vacation, or am experiencing changes in my normal routine. The sensors have expired, so I don’t know if this will work. The Dexcom sensors are very expensive, and the transmitter and receiver will also expire soon! I was spoiled by my Dexcom and I really miss it.

The above situations involve the problems I am having, but none of them are all that bad. I am still very healthy and my many years of great control continue. I still plan to be the first person to live 100 years with diabetes. Full speed ahead!!!

Dear Richard

Hope Mookie and Dean don’t read this. But insulin is weight gain drug for many people. It is an anabolic hormone used by body builders. It is capital to minimize the amount you use. I though actos was a put on weight drug too. Avandia was not for me. I cannot phantom why your doctor has not put you on met. I have to believe it is monetary reasons or am I wrong? My Endo said it was wonderful for double diabetics.

Cutting carbs well due to a lack of moral fibre I was never able to do it à la Dr. Bernstein so I cannot say that is does not work. One thing Richard that is exceptional about Dr, B is that he uses very very little insulin so it is tempting. I like veggies and an occasional navel orange.

I am eating less that 2000 calories a day and exercising 1 1/2 mile walk with his Lordship and spent 45 minutes weight lifting. I can bench press 175 lb at 60 years of age. But I cannot loose even one 1 kg. could be that a slight amount of fat has been turned into muscle.

Trying fenofibrate now did decrease insulin by 25% for about 40 days but seems to have stopped working now.

What next either Bernstein or metformin or both.

If that doesn’t work you and I start bicycling from New York sate and I will start from Calgary and we meet in Chicago. I was a tooth pick man when I could bicycle 150 miles in one day.

My greatest fear now if of reaching 265 lb and dying at that weight like my friend Bob’s brother-in-law.

Diabulimia is also looking good.

Hi Anthony,

The other day I decided to try a moderately low-carb diet (not Bernstein though, can’t do that!) and the past two days I have used 42 units of insulin instead of the 55-65 I normally use. I am doing it more for control as my numbers have been crazy and I can’t stand it, but I would LOVE if it helps me lose weight, too. I definitely need to lose weight (I’m not insulin resistant but definitely overweight, and yes it’s very hard to lose!!). It’s definitely helped me use less insulin, although my blood sugars are still crazy, though slightly less so. Hoping that will smooth out over the next few days … I blog about it here on TuDiabetes, if you are interested in following my progress.

Please do not try diabulimia. It may sound good but if you actually read about it, it doesn’t work (unless you want to die eventually you need to take insulin at which point you instantly gain back any weight you lost). Plus, it’s just very unhealthy and tempting death and not something you want to do.

We’re all counting on you to be the first 100 year old diabetic. Don’t let us down!

I don’t blame your internist for refusing Avandia & I hope your endo will agree to Metformin. It has a safe track record. The way I’ve convinced a very resistant doc to change my insulin was as an experiment for a couple of months. If I didn’t see an improvement, I’d go back & admit he was right & I was wrong.

Richard, I have been wondering how you are making out with your BP problems - I have that same issue. My mornings are the worse also. I am glad you have someone pacing you!

Glad to hear you are taking such great care of yourself Richard! Great job!! So glad your dizziness is getting better too, I have vertigo problems and low bp problems so I know how scary and what a pain it can be. My father who is a type 2 was taken off of Avandia after I demanded his doctor too after researching the heart attack risks (he is overweight and doesn’t take care of himself or his diabetes so I thought that in addition to Avandia was not a good combo!). He was switched to Metformin but still swears none of the other meds work as well as Avandia.

Someone deleted their question asking if mine & Richard’s BP problems were diabetes related – thought I would go ahead and answer. Yes, both Richard & I have autonomic neuropathy. Most people are familiar with peripheral neuropathy that affects your feet (along with other body parts). Autonomic neuropathy affects stuff like BP, body temperature and internal organs like your heart.

Hi Anthony, I don’t think Mookie and Dean will be visiting this discussion. Lol! I am eating only 120-130 carbs per day and still gaining about 2 pounds per month. I don’t think I can cut down any more on my carbs, I need the energy for my walks and workouts at the gym. I wish I could ride a bicycle, but that is impossible at my age, and with my dizziness.

I do not have the guts to do the Dr B routine. I think it would wear me down and would not be worth it. I believe my endo will prescribe Met and that will solve my weight problem. I am sorry to hear that you have a weight problem now, and hope you will find a solution for that soon.

Suggesting that I can use Met as an experiment sounds like a great idea, Gerri. Thanks!

Hi Kelly, I just sit and post most mornings, but I can go grocery shopping in the morning. A grocery buggy makes a good prop while I walk the aisles…well…there are some aisles I avoid. Lol! I can go to the gym after lunch, my dizziness is much better then. The evenings are best, I do not feel dizzy at all then.

Lil MaMa, it is probably best that your father has stopped Avandia, but I used ir for 12 years and my heart is very strong. I would use Avandia again in a heart beat (lol) if I could.

Kelly, I am not at all convinced that I have autonomic neuropathy. My neurologist diagnosed that after I had been through more than 2 years of testing of many types. The diagnosis was kind of a process of elimination and some guessing, combined. I have the big drop in BP, but only in the earlt part of the day. I do not have any problems with internal organs. The other side effects of autonomic neuropathy are very mild, or non existant. If I DO have autonomic neuropathy, it is not so bad. I can put up with the dizziness, and hope it does not get any worse.

Do you have a headache that never goes away? I have had that since janurary, 2010. It is not bad like a migrain, but it is always there. Has your doctor prescribed a med to restore damaged nerves, to help your autonomic neuropathy? My internist did, but my neurologist insists that there is no med that will help. The cost of the drug prescribed is not helped much by my insurance and would cost me many hundreds of dollars per year. I tossed the prescription, and cannot remember the name of the med now. You should see the the list of potential side effects of the drug. One of them is dizziness. Lol!

The Met actually sounds like a good idea. I have to express some caution on the Actos. Avandia has been implicated in heart problem which apparently occur concurrent with edema. It really sounds like the Actos may be giving you some edema as well, not a good sign. Edema can evolve into congestive heart failure. Metformin sounds like a quite safe and resonable approach.

The other things I’d like to ask you is about your exercise regime. Exercise can have a dramatic effect on insulin resistance, and in some cases it can drop you insulin needs by half. Have you need able to keep up with exercise? Simply taking a good walk every day can make a difference.

Richard, I do believe that I have it. I had 2 doctors tell me I did but one said “maybe” you have it. I do have gastroparesis, which is one of the things listed for autonomic neuropathy. Two years ago, I flunked my stress test and had to have a heart cath. The cardiologist said my veins were really clean & to keep up whatever I was doing. No one said why I flunked the stress test, but I am guessing neuropathy. Gustatory sweating is also listed and I have that. They said that if your pupils are slow to dilate, that is also a sign. I had some minor laser surgery to clean off the film on the lens they put in my eye and they had a hard time getting my eyes to dilate enough. My doctor said it brought back memories of the day he did my cataracts. No one ever said before that day that my eyes took forever to dilate. It does seem like I have a bunch of stuff on the list.

Believe it or not, I don’t have a neurologist. The one I went to just did not seem interested in doing anything. I have that on my list to call and make an appointment someplace else. I haven’t taken any medicine but I do take alpha lipoic acid.

I have some days that it doesn’t bother me at all & other days, it lingers until mid-day. You are right, evenings are the best!

Thanks Jennifer

No I will not do diabulimia. I would be counterproductive as it is my belief that high blood sugars make IR worst. And they will kill my low remaining endogenous insulin production.

Yes I would love to follow your progress.

I am trying fenofibrate in desperation. dinosaur on Diabetes daily had lost a maximum of 15 lb before the action stopped. I don’t like the idea since the drug has similar nasty side effects to statins. My lipids were actually better on a high saturated fat diet that on a low one. LDL was the same but HDL was 30% higher and triglycerides 25% lower. I wonder if the ghost of Dean Ornish is going to get me for this heresy.

Dear Richard.

It will be nice to have a discussion based on facts instead of self righteous emotions. I will use my Excel spread sheet to see how many carbs and calories I am eating at present. I think I am eating less than 100 g if metamucil does not count I think it is non-caloric and a necessity for low carb. I will report back.

I am experimenting with fenofibrate. It does seems to cut my appetite to normal via the reduction in insulin requirements. Not sure if the effect is sustainable or just transitory.

Being older does hinder our ability to exercise on a massive scale. I took his Lordship for a 2 mile walk and went to the gym for my 3/4 weight lifting routine. Not sure that if that is sustainable on a daily basis.

For sure the Endo will prescribe metformin mine was keen on it. I will try it again if the fenofibrate fails. I fall apart after 3 weeks on it and have no idea why. I don’t think it is the liver the white of my eyes were still blueish not yellowish. I was taking vitamin B-12 supplements to counter act alleged deficiency caused by the drug. Too bad the endo just said to cut the drug out instead of trying to find out what was happening. GP remembered lactic acidosis as a rare problem with met. Not sure waht the symptoms of that are.

That is a thought I actually never asked the new GP for Avandia, I didn’t dare too with all the bad press.

Thanks bsc, I am going to research Edema and mention it to my endo when I ask her if I can start taking Met.

I am using machines at a gym that involve lifting weights to exercise and strengthen my weak muscles. I do that 3 days each week. The gym sessions last 90 minutes. On the other days I walk outdoors for an hour, or use a treadmill in my house. That has not decreased my IR, I don’t know why. I am going to continue with my exercises indefinitely. I have a lot of repair projects to do on my house this spring/summer too. Thanks for asking.

Kelly, it does sound like you have AN. I don’t have any of the symptoms you mentioned. I have only two of the symptoms in the list when I researched AN, and one of them dates back 21 years ago. The drop in blood pressure when standing up is the only other symptom. I think my neurologist jumped to conclusions because he had done all the tests he knew to do and didn’t know what else to do.