Sadly a pump is not covered with my medical insurance, and the pumps are few and far between here in SA (not sure why) so the cost privately is quite steep.
I think I may have to speak to the Endo (if I can ever afford the private consult) and get him to take me through this list one by one… a registered nurse who I am friends with recommended discussing the potential treatment of a tri-therapy with Biguanides, Sulphonylureas and Thiazolidines as I do fall into a range that could be viewed as “medium risk” with my HbA1c readings never being greater than 10.7% (pre-insulin)
A CBC blood test is very cheap.
I would suggest a follow-up CBC w/diff.
If it was me, I would absolutely demand the doc provide the order for a repeat CBC.
Maybe the elevated neutrophils just took a few extra days to come down and now are at normal levels. However if not and still elevated for an unknown reason then you should have that looked into as a priority.
A normal c-peptide result isn’t normal with type 2 diabetes. Type 2’s usually present with elevated c-peptide as the body is making too much insulin but it just isn’t being used properly. The insulin resistance you are experiencing could be from any number of factors including stress, infection, the nature of the mixed insulin you are using and poor diet.
If I were you I’d try to get another c-peptide run to see if your levels have changed. If they have dropped then you would be more likely to be type 1 than type 2 which may have an effect on what insulins and technology your insurance is willing to provide.
IMO it’s been 2 years since you started insulin and even large doses aren’t keeping you in control. Type 2 meds are not a substitute for insulin, they can only help you better use the insulin you are making/injecting in conjunction with diet and exercise and for many the side effects can be disrupting.
I just found the packaging for Biosulin L on Google images and It’s zinc bio-synthetic human insulin and it as marketed as an intermediate insulin by Ascendis Pharma. Have you tried getting the cash price per vial of Lantus from your pharmacy? I just looked it up online and it shows that it is R 665.96 or $43 USD. At one or 2 bottles a month you would be paying less than what many of us here in the U.S. pay with insurance.
I’m on board with that plan. You might not even need much Lantus. I bet you could get through a month with one bottle (although, I think Lantus is a little unstable and gets old and ineffective quickly compared to other insulilns. Is that true, guys?) Talk to a Doc, but maybe you just need to take a shot of a few units of Lantus in the morning or at night before bed to get things back in shape. Check the over the counter (no insurance) price for us.
If you still have a high white blood cell count then you definitely have an infection of some sort. Could be a persistent and quiet urinary tract infection (UTI), which is quite common, or something else having nothing to do with diabetes. And I still say that a mixed insulin is never a good choice.
So just an update (in case anyone is still tracking this one)!
First of all I’d like to say THANK YOU! As usual you guys are really proving yourselves to be the best diabetic community out there!!
All the response, guidance, advice and even the $ to ZAR conversions are appreciated!!
So let me just tell you this first off-I successfully stopped the mixed insulin late August 2019… my edema only the lower legs disappeared after 4 days and I’ve felt a whole lot better since… I continue to use Glucophage XR (1 x 500mg morning and 2 x 500mg before bed) and have now added (after consultation with my GP) Glycomin (Glibenclamide from the sulphonlureas family (1 x 5mg morning and 2 x 5mg early evening) and there has been some, but not nearly enough, progress.
I’m very happy to report that my numbers are constantly low-teens now (I now consider a “high” at 15 mmol/L whereas prior to this I regularly had 18 mmol/L and higher after meals) but I’m very disappointed that, even with my change of eating habits (I now fast for a minimum of 15 hours per day) that I’m never lower than low-teens.
Essentially it does not matter how long I fast, (or not fast) I will always, always be higher than 10 mmol/L (I’ve been monitoring for 2 weeks now and it doesn’t matter if I test upon waking up, or upon fasting from 7pm the previous evening to 2pm current day it’s never less than 10 mmol/L).
Before I give up and go back to insulin’s I do want to consider tri-therapy and my option is to add a pioglitazone to the mix. What are your thoughts guys? Do you have experience with them? Just in case you were wondering I have appointment with GP soon to discuss and get his opinion too…
I’ve done some research and found that pioglitazone has been shown to reduce the risk of heart disease and the first-ever diabetes drug shown to reduce the risk of strokes(which is always good)but at the same time I’ve read that it has become less popular with patients due to side effects (including weight gain (which is the last thing I need), increased edema and bone fracture risk and some have been diagnosed with bladder cancer) but perhaps the pro’s outweigh the cons? Maybe this could be the one that tips my favour?
Whilst I’d love to be able to afford medications like Jardiance it just isn’t financially feasible so it’s a process of elimination I guess? Your thoughts?
Fasting may not be the best way to treat yourself. Your body is looking for food, dumping extra sugar, causing blood sugar rise. The only time I fast is 8- 9 hours overnight. I am a type 2 of 27 years. Try having a lower carb meal like 2 eggs,1slice of toast,then take a short walk. See how you do. Exercise is a major role in this disease. Nancy50
I’m definitely going to need to change tactic so maybe a small breakfast like you suggest is the best way to go! I will try it for a week and see if it helps! Thank you!
