How long have you been a type 2 diabetic? And your GP can’t write a different script for insulins?
I was diagnosed (officially) in late 2017 and was placed on Metformin 1000mg daily (cannot tolerate higher dose) as well as Humalog Mix 25
2019 has been a challenging year and my focus shifted from my physical health to my mental health
A visit to the ER on 29 July changed all that… White blood cell count was abnormally high, CRP (inflammation indicator) was abnormally high, fasting glucose was abnormally high…
Took a 6 day course of Augmentin 800mg x 2 daily and blood tests showed no change.
Cortisol levels too high, so I’m quite sure mental health is definitely affecting all this too!
GP changed Mix 25 to Mix 50 just over 2 weeks ago and still I’m not controlled (and according to GP) taking far too much insulin.
Okay. So this is the thing. You need to keep a watch on the fact you could be a type 1, not a type 2. 30% of type 1’s are misdiagnosed as a type 2 at first. (I was) As a type 1/ LADA, it develops slowly over time so it has all the signs of being type 2 at first. (8 years plus even to develop) One of the key points they say to watch for is a type 2 needing insulin by 3 years of diagnosis. Not responding to medications, fasting levels high, these can all be signs, but they can still also be type 2 problems. I just want you aware as so many of us are still misdiagnosed and it’s something to keep in mind.
I’m not saying you are a type 1 at all, you have to be tested to find out, a GAD test and a C -peptide test and it sounds like financially that might be a problem. The treatment for type 1/LADA is insulin, which you are on already.
Just keep it in mind, I like to make sure everyone is informed. It was a very frustrating experience for me being misdiagnosed for a long time.
If you have an infection (it seems some of your blood test results could suggest that, although I’m not a doctor) then that could also definitely drive up blood sugar levels. It’s a vicious cycle with one making the other worse and vice versa.
I had a C-Peptide year (801 pmol/l) and was told it was “normal”. This was about 5 months ago. The other test is unfamiliar to me - what is it?
Initially it was assumed there was an infection due to my white cell count (neutrophils specifically) being high, however, 6 day antibiotic course ended with no change whatsoever, and no other signs of infection. My GP believed the high count in conjunction with the high CRP count was all linked back to the poor diabetic control. Me, I’m not so sure…
I pulled up for a normal C peptide range on the selfhacked site. If your C -peptide is low, it’s a sign for type 1, if it’s high it’s a sign of type 2.
The normal range for fasting blood C-peptide levels is around 0.8 – 3.85 ng / mL or 0.26 – 1.27 nmol / L ( 260 – 1270 pmol / L ). Ranges vary between laboratories.
Its my opinion that you are running too high and should peruse additional treatment options. I would call your diabetes a bit ‘uncontrolled’ or ‘untreated’ or ‘not properly’ treated. It might be time for a new Doctor. GP not good enough now. Can you see a specialist? This seems to be the fault of the GP, not you. He/she ought to be exploring your treatment options.
Just as a frame of reference, I am a type 1 and I have an a1c = 6.1. You can do better than an 8, especially with the work that you are putting in. You shouldn’t have to resort to the ‘diabetes starvation diet.’ That was how people treated this 100 years ago. Time for a new Doc.
It was stated above by the OP that they have lousy insurance in South Africa. His GP wants to refer them to an Endo but can’t afford it. This is a perfect storm of having no access to an Endo/diabetes specialist, not having good insurance, using an insulin that is not going to control the BG very well.
Totally agree (and I’m to blame as well because I’ve been very bad at ignoring my phantom hunger pangs caused by the insulin dosage increase). I know my GP is trying his best and even he has said he is at his wits end but sadly my financial situation puts me in a bit of a predicament. I can’t go to a state funded clinic as I earn a salary above the threshold, however, cost of living and the terribly high cost of privately funded Endo visits are the only reason I’ve not gone that route. I must admit, however, that my health is now becoming more important than my debt so maybe I need to just find the money somewhere. I appreciate the advice!
Yes, a perfect storm is exactly what it is… I am in the epicenter and I am at a stage where I honestly feel like I should just pretend none of this exists… I sometimes want to stop taking insulin, stop taking readings and take countless anti-inflammatories and headache pills just to get through the day so i can “pretend” this doesn’t exist.
I wouldn’t recommend that approach. DKA is not a fun experience. Instead of taking the mixed insulin, I’d do what @Marie20 suggested and get separate rapid acting and long acting insulins.
You will regret that. Stay tough! Keep trying. If absolutely nothing works out with a Doc, we will help you. Keep in touch.
Thanks for the quick response. My ostrich technique of sticking my head into the sand is not a good idea but I do wish it were as simple as that!
I’ve sent a query through to my medical scheme and they told me that I am restricted on the following insulin’s, so I hope my GP can find something that is suitable.
Trying my best!
Novorapid, Apidra, and Humalog are all fast acting and work similarly. Are there any other insulins listed like Lantus (insulin Glargine)? Biosulin L might be a generic for Lantus in which case that would work fine as a long acting insulin but I can’t find any information on that one, just the R, N and mix.
These are the only insulin’s they (medical scheme) will cover. If I take anything other than what’s on this list then I pay out privately. I am so clueless with these things - are you saying there are no long-acting ones on this list?
Well N is listed but that is a more difficult to dose correctly insulin as it is much shorter acting and has a large peak about 3 hours after dosing which will mean you’ll need to eat at that time or suffer from lows. You would probably need to take 3 smaller doses a day in order to smooth out the bumps enough that you wouldn’t be run ragged trying to keep up with the varying efficacy.
I would ask about the Biosulin L and see what the L means. If it is a Lantus copycat then that will work fine. Edited to add: also if it is like Levimir then that is also fine.
It looks like protaphane might be a long acting. I am not familiar with it at all. It says once a day.
Under clinical pharmacology
Humulin R is an intermediate insulin, it has a trickier peak.
I haven’t found information in the Biosulin L, like @Firenza said, try to find out what that one is.
Have you by any chance asked about a pump? It would probably resolve a lot of your issues since you don’t like taking shots. It would decrease your injections down to once every few days although it does require more attention than shots. Every country is different on what they are willing to provide to diabetics but many countries will fund a pump if you meet their requirements.