Yeah, but where’s the fun in that?!?
Just kidding… I know that you’re right. But this thread did bring up some interesting points and gave me something to think about.
Fun…fun…hmmm…There’s nothing in my Diabetes Management booklet about that!? I must be missing a page.
Perhaps I’ll make my own entry?
Call me a weirdo, but I think my blood glucose meter is fun. Maybe not so much when the readings are high, but overall I couldn’t wait to get the thing. It’s really cool.
I like the idea of pumps, too. We have a friend with one, and he showed me how it works. And from what I’ve seen of the omnipod, that’s even better. If/when I get to the point where I have to be taking a lot of insulin, I’m going straight to the pump. No syringes for me!
That said, I hate needles (I haven’t yet been able to do my Lantus myself even though it’s a pen. I lose my bravery at the last second. Luckily, my hubby is wonderful and he’s more than willing to do it for me) and I love electronic gadgets (I write software for a living.)
With your active lifestyle, the pod would probably be awesome for you! I can’t speak informatively about other pumps as the Omnipod is the first one I’ve used.
I actually didn’t mind giving myself shots, though I must admit that there was always this hesitation and moment of realization when I was like, “Wait, should I be stabbing myself?” But I muddled through.
Let your husband do it. Call it a bonding experience. ; )
I am supposedly a T2 who my Dr. says is completely Insulin dependent. According to him my pancreas has closed up shop. He sas it will never come back. He says it also doesn’t matter whether I’m T1 or T2 or T anything in between, what matters is how we treat it. He says what matters is I have Diabetes and it needs to be treated. Something I’ve noticed though is it seems from my own observations that T1’s take a lot less Insulin. I’ve notived that the T1’s take like 2 or3 or 4 units with a meal. That wouldn’t do anything for me. If I eat 60 carbs with no active insulin on board my pump will give me 13 or 14 units of Insulin. So in the course of a day, when my boluses and basals are all added up, I’ll get a hundred units of insulin in a 24 hour period. Most of the T1’s from what I can gather just get a fraction of that. I don’t know, I’m still learning. I know there seems to be this idea that Type 1’s are the real thing and T2’s are impostors. I wish we could stymy that idea, and just realize Diabetes is what it is-no matter the kind. We place entirely too much focus on wha Type everybody is.
By the way I took Lantus for about a year and gained about 20 pounds. My blood sugars were also not nearly as stable as they are on the pump. I’m not trading my pump for anything. I finally have control of my BG’s, my A1C has dropped dramatically, and generally feel better. Peace to all!
Bobby
Barbra,
You probably are NOT a Type 2. You probably have LADA.. This is important to understand because it has implications for your treatment. If you have LADA you should be on a basal./bolus insulin regimen, not pills and might consider a pump in a few years.
The traditional definition for Type 2 diabetes involves high insulin resistance and NO signs of autoimmunity, i.e. GAD or Islet antibodies. In fact quite a few insulin resistant Type 2s have autoimmune antibodies and some Type 1s develop insulin resistance as they get older. But that’s the definition.
Many of us turn out to have oddball forms of diabetes that doctors don’t diagnose well. It took me more than 7 years to get my diabetes diagnosed properly. I am not insulin resistant but also have no antibodies, and based on my history, it looks like I have a third kind of diabetes based on a gene flaw called MODY.
The most important thing is this, though. No matter what the cause of your diabetes, keep your blood sugars as close to true normal as possible and you will maintain normal health. Cutting back on carbs makes it a lot easier to do that, and finding the right insulin (they are different and perform differently in individuals) really helps greatly, too.
I do not have LADA - if you scroll up you’ll see my comments on that.
I had never thought of this before, but it would make sense that a T2 on insulin would require more than a T1, because T2’s are insulin resistant, meaning the cells have to be virtually flooded with insulin before some can get in. Which is what burns out our pancreas in the first place, and also causes the weight gains as all the extra insulin we produce as the body becomes resistant (even before diabetes arrives) lays down fat. So, assuming the body is still insulin resistant, much more insulin would be needed to get some into the cells of a T2.
I think you probably had a ,a href=“Glucagon - Wikipedia”>glucagon-stimulated c-peptide test. I had one of those too, recently. When I did some reserach about it, and according to one website I saw it was considered to be the definitive test to differentiate between T1 and T2, because some T2’s have antibodies and some T1’s don’t.
http://www.ncbi.nlm.nih.gov/pubmed/2355996
Basically, what they did was inject a hormone into you that causes your liver to dump it’s glucose store into your blood stream. Then they measured to see how much c-peptide your pancreas released in response to the glucose.
To quote this website,:
“During a C-peptide stimulation test, a blood sample is taken to measure C-peptide. Then a shot of a hormone to increase blood sugar (glucagon) is given into a vein in the arm. Another blood sample is taken. In people with type 1 diabetes, C-peptide levels will be low because the pancreas cannot make any insulin in response to the glucagon. In people with type 2 diabetes, C-peptide levels will be higher than the first blood test because the pancreas is making more insulin in response to the glucagon.”
Did your endo do any other tests?
Oh, and the Metformin takes about 2-3 weeks to fully kick in, so don’t expect to see instant results from it.
I think it’s semantics. I began 5 years ago with a reading of 330. Got it down to 103 in 30 days just on 1000mg a day Metformin, and 45mg Actos. Now I take 26 units a day of Lantus, 2000mg Metformin, Actos, Amaryl. I am under control. A1C 6.9. I recently asked my doc about how far down I was going and when would I have to be totally dependant on insulin (i.e. type I). He said, “when you’re 70, maybe.” I’ve decided not to worry about it. The key is control. If it is eventually via insulin all day, so be it. Thank g-d for insulin I say. Type i, Type II, doesn’t matter. I have diabetes, period
Wimpy as this reply may sound, you kind of need to find your own comfort zone on what works. I am type 2, insulin dependant for three years now, Novalog and Lantus. If you try to follow advice for some type 2’s, it may or may not work as well for you. There is so much trial and error involved. Especially since I don’t fit in to most of the norms for type 2. When something works, do it again and remember what it was. If it doesn’t work, learn from it and move on.
Yes, that’s exactly the test I had. And I did have higher c-peptide levels in the 2nd and 3rd (5 and 10 minute) tests than I had on the pre-glucagon test. Not hugely high (1.0/1.7/1.5), but high enough for a Type 2 diagnosis.
The endo didn’t call for any other tests, but he did have the results from the previous tests my normal doc took, including at least 2 fasting blood glucose and several others. Normal doc said he could tell from the test results that I was producing insulin even before the c-peptide.
I’ve been on 2000mg/day Metformin since right before Thanksgiving, so it’s been long enough for it to kick in. I honestly can’t tell if it’s made a difference or not - I made diet & exercise changes at the same time, and it sure seems like any carb at all makes my BG skyrocket, metformin or no.
I have seen a difference in only 3 days on Lantus. I saw very low readings (for me, at least) even after we splurged and had pizza for dinner (thin crust, only two pieces, big salad, didn’t eat the ends of the crust). Plus, I did my own shot tonight, instead of wimping out and letting my husband do it for me. Woohoo! It’s just so great to see the numbers going in the right direction. 
So happy Lantus is helping! Great news.
Good for you giving your own injection. In case this helps with shots, I had to get syringes with half units. The plus was that these have finer needles.
BarbaraW,
I have heard from several people who were told they did not have LADA early on who were told later that they did. It can take a while for antibodies to appear, or you may end up with the rare kind of antibody to Tyrosine phosphatase not the ones that they commonly test for.
The difference in your C-peptide before and after meals is not diagnostic of anything. Please read about C-peptide tests here:
What Does That C-Peptide Test Mean?. Follow the link and read the original study. You’ll see that the same blood draw can vary by as much as your two draws did, even when tested at the same lab. It is a very crude test that only establishes whether you are secreting insulin or not, not how much! (That is what my endo told me, BTW, and it seems to be true based on the research.)
How large a dose of Lantus are you taking? That can be a clue to what kind of diabetes you have. If a very small dose is effective (3-6 units, say) you might consider MODY. Type 2s, even slim ones (and I know a couple, though they are only slim if they low carb) may use 30 units up to 100+ units a day. The 30 units is the very low end, dosewise for Type 2.
A Type 2 would have responded to Metformin with a significant drop in blood sugar within a week. I responded to Metformin by dropping 10 mg/dl after meals and not at all fasting. That was not considered a significant response and appears to be the result of curbing my liver’s normal production of glucose. When I go on a low carb diet while taking Metformin, I do not lose any weight during the first 3 days. When I am not on metformin, I lose about 3 lbs. This is liver glycogen depleting. Metformin stops my liver from storing glycogen, apparently. When I stopped taking metformin I just took one more unit of insulin per meal and that was that. Lately I’m back to my pre-metformin Insulin ratio with the same coverage.
If you are getting control, that is all that matters, but please be aware that doctors, even endos are way behind on the oddball forms of “Type 1.5” and long term it can have implications. Insurance often won’t pay for a pump for someone with a Type 2 diagnosis, for example. Mine won’t.
So keep an eye on things and if you see your blood sugars creeping up after meals, assume you do have LADA and insist that you get the kind of treatment a LADA would get. Also, if you don’t see a difference with Metformin, there is no reason to keep taking it. Over time it can be hard on your stomach lining.
Hi,
My name is Colleen Myers and I’m a drug rep that used to sell Glucophage so I knew alot about type 2. Then at the age of 43 I was diagnosed with type 1. After six years of hell with diabetes I am now in a heaven of sorts. I had pancreatic transplant surgery June 17, 2008 and I am cured. My fastings are always in the low 70’s and I don’t have to check blood sugars anymore although I do on occasion. I went to see the Foo Fighters a week after discharge from the hospital. Yes, I take anti-rejection drugs but I’ve had no side effects or infections. I have never felt this good although I’m sure I did before the diabetes.The difference between type 1 and type 2 on insulin? Every type 2 that lives long enough ends up on insulin but they are not type 1. After awhile with type 2 your pancreas deteriorates and no longer produces insulin. Thank God I’m off insulin. It caused clinical death, comas, etc. and I did very poorly on it. But most type 2’s that go on insulin do just fine. Take care. If you are under good medical care, insulin should not be a problem. Good luck and Happy New Year! PS: I could only take Lantus. I believe it is the best insulin available.
Sincerely,
Colleen Myers
Not that I don’t believe you, I do completely. But this is the strangest diabetes story I’ve ever heard.
Dear Colleen.
I am very glad for your success. I heard a second hand story of a Doctor that had a pancreatic cell transplant a method that was pioneered her in Alberta Canada and felt resurected after the procedure. He was unable to control his diabetes with external insulin and could no longer function. I am not sure that most type 2 do fine on insulin, you exist thats all. Pete’s wife was in her late 70 and was able to function with diet and sulfonylurea drugs only for many years and so did my friend Gerry’s father in law. My brother ended up with gangrened feet and probably would have done better on insulin.
Anthony,
Insulin would have helped, but more helpful would have been cutting back on carbohydrates. For the past 50 years doctors have put people with diabetes on HIGH carb low fat diets which raise blood sugar, under the mistaken idea that these reduced heart disease. They turn out not to, but they do raise blood sugar.
Type 2s get far more benefit from cutting down on carbohydrates than any other approach. Combining lowered carb intake with correctly dosed insulin (something most Type 2s ALSO don’t get) can give normal blood sugars for life and no diabetic complications.
For people with Type 2, lowering carbohydrates is far more important than for people with Type 1 because people with Type 2 are, by definition, insulin resistant. That means when they use insulin they need to use huge doses. These doses have other impacts on the body–such as depositing fat. By lowering carbohydrate intake, the person lowers how much insulin they need to take and that is always good.
Insulin that you dose to your meals is a lot healthier than insulin secreted in response to medications that pours out whether or not there is glucose coming in with food. That is a huge problem with drugs like Amaryl which make the person have to eat carbs to avoid going low.
The oral drugs with the exception of metformin all have bad side effects . Using the lowest dose possible of insulin probably is safest. If you want to be really paranoid, using R insulin rather than analogs is probably even wiser as these molecules are identical to those your body manufactures. The Analogs (lantus, levemir, humalog, novolog, apidra) are NOT.
Dear Jenny.
I have cut down on my carbs but have not seen a significant decrease in my daily insulin consumption yet. The blood sugars are better. If you need about 2000 calories per day how many carbs can you eat as fruit and veggies only ? And of course no bread, patatoes, rice or other like starchiness whatsoever. I intend to persist with a low carb diet. In my case I would have to also cut calories as I find that my liver spews out tons of glucose when I eat fat.
You are absolutely right in my case oral meds that inhance insulin were awful, way worst than insulin, gained as much weight on them or even more without any real benefit blood sugar wise.
Metformin makes me sick after 3 weeks at 3/day 500 mg each I become comatose. No diarreah or tummy upset just to tired to move.
No I am a Chem Eng and learn’t to love man made chemicals, like Dr. Strangelove the bomb. The reason for R would be to match the kinetics of the insulin to that of the food. Dr. Bernstein discusses this. In my case the liver may be spewing out sugar at 2, 3 or 4 hours after the meal and the fast insulin may not be doing much so late in the game.
Anthony,
Realize your question is directed to Jenny, but wanted to add my two cents about R. It may be that you have delayed stomach emptying. It may not be your liver dumping glucose, but that your food hits your bloodstream after rapid acting insulin is pretty much gone. This was my situation as evidenced by highs 3-4 hours after eating, sometimes even as long as 5 hours after. This condition makes it difficult to know when the post meal high will strike. It’s erratic. I started testing 1 hour, 2 hours, 3 hours & 4 hours after dinner to get a sense of what was going on. (In my case, it was the most pronounced after dinner. Probably due to this being my largest meal & the least active part of the day.) Used a ton of strips, but I did see a pattern emerging. While I was doing this careful monitoring, I stuck to the exact same amount of carbs & protein at every dinner & tried to eat at pretty much the same time every evening. I eat low carb. Never more than 15 carbs for lunch & dinner (less at breakfast).
In case this helps you (if you have delayed stomach emptying), here’s what helped me.
Lean meat, fish, chicken were easier for me to digest. Nothing fatty because it slows down digestion.
Veggies had to be cooked a bit. No raw veggies or super high fiber food.
One meal a day I drank protein shakes, or soup because these are so easy digest.