Oral Meds and Insulin

Are there a lot of people on both medications?
I currently take 45mg of Actos in the morning and a 70/30 novolog mix with Breakfast usally 12 units, then at lunch depending on what I eat I use novolog 4 to 6 units and at dinner time it’s 1500mg of Glucophage XR and another dose of the Novolog 70/30 mix 12 units, my last A1c was 5.8 while there are times I expierence a low in the morning about 3 hr’s later and I am normally around 70 to 80 for lunch. I am also suppose to use the novolog on a sliding scale for dinner and breakfast mostly for dinner if i see that I am a little carb heavy. I’m guessing that with my A1c now under 6 I should just keep doing what I’m doing but worry about the spikes both high and low even thou they don’t last very long.

Now am I the only one that takes oral meds and insulin?

Thanks Cathy, it’s a tough battle win some and lose but hopefully we’ll win the war angainst this disease. good luck to you also

Since you’re type 1, why glucophage and actos? Does the Dr. suspect some resistance to insulin? I was just recently diagnosed, first type 2, now type 1.5 (i’m fairly young, fairly thin, and have no family hx of diabetes). My endo has been trying different oral drugs, but I’m not seeing any difference. In fact, my BS continues to gradually rise (from fasting 130 to now at 150). The glucophage worked for about maybe 2 days, enough time for me to get excited, but it didn’t last.

You know I’m not really sure, except my A1C is down below 6 I orginally was type two and only on oral meds, Actos, Amaryl and the Glucophage however my numbers remained high and A1C was above 7 so I started the insulin first the Novolog 70/30 and then adding the Novolog on a sliding scale. I did ask the Dr if this meant I was a type 1 and he indicated since I am now insulin dependent that I was considered a type 1.
This will be a topic of discussion at my next appointment.
I am also not over weight and no family history.

John,

If your doctor thinks “Type 1” means insulin dependent, maybe you need to look for a doc who knows a bit more about diabetes!

Novolog 70/30 and Actos is a bizarre set of meds for someone who is truly Type 1. If you have Type 2 and need insulin, it’s still not the meds that the current practice recommendations say doctors should be prescribing.

And the sliding scale is WAY out of date too.

Can you get an appointment with an endocrinologist who could diagnose you properly and put you on a more modern regimen? Your doctor’s choice of drugs has “does not usually treat Type 1” written all over it!

Hello John. I am a type 1 diagnosed in 1945. I used insulin exclusively for 54 years. I gained weight when I started using Humalog in the 1990’s. By the late 1990’s I had gained 57 pounds. The extra weight caused insulin resistance. A type 1 with insulin resistance is sometimes referred to as a double diabetic (a type 1 with type 2 symptoms). My insulin dosage had increased 40% because of the insulin resistance. I started taking Avandia and in a few days I was able to reduce my insulin dosages to normal levels. I have now taken Avandia for 9 years and it has not caused me any harm despite the reports that it may cause heart problems. My endo feels that it will not cause me any problems since I have used it safely for so long. Your Actos serves the same purpose as Avandia. I tried Actos for 6 weeks and it made my blood sugar go high for that period of time. I resumed taking Avandia and I was back in control very quickly.

John I suggest that you talk to your doctor about using carb counting instead of a sliding scale. It is a much more effective way of obtaining very good control of your diabetes. When I started using carb counting my control improved tremendously and I soon had A1c’s below 6.0. Good luck to you!

Thank you Richard for the information and maybe I have some of the terminolgy wrong when I mean a sliding scale I mean I look at what I maybe having for lunch and how much carbs or sugar is involved and adjust my Novolog dose for that meal, I usally only take between 3 and 6 units and it also depends on my bs at the time.
As far as breakfast and dinner I take the novolog 70/30 and have been successful with 12 units and very rarely have I had to add the novolog to this dose which was suggested if I was having continous high spikes after the meal.

Thanks Jenny for input and as I explained to Richard above I may have not used the terminology of sliding scale correctly (or maybe I did) all I know is that when I was first treated I had an A1C of 7.8 and my last visit in March was a 5.8 so something is working, I was on strickly oral meds for approximately 3 yrs with some improvement in the A1C but high blood sugars and I was always starving, anything I ate raised my sugar level, I have been on the combination I have mentioned for 1 1/2 yrs now and feel a lot better and am able to eat what I call normally. So maybe I am not a “true” type 1

I will discuss this further with my current Dr and a second opinon with a endocrinologist might not be a bad idea.

Thanks again for your input

I also forgot to mention that I work a rotating work schedule 12hr shifts, 4:30 am till 4:30 pm and 4:30 pm to 4:30 am so I am no where’s near regular. every week is different as far as what days I have off or I’m working days or nights.
In the end I “think” I’m managing pretty good.