I’m going to start bolus insulin with a NovoLog FlexPen. For the past year I’ve been struggling with only diet and oral meds for post prandial control, I still have my own basal insulin function. While I’m curious if I can really stop the spikes, feel better, gain back some lost weight etc…I’m also feeling kind of down for some reason. Anyone else have mixed feelings when transitioning to insulin?
It sobers me whenever I step over a health threshold, like starting insulin, It's one more in a long series of concessions we make with this world.
What usually cheers me up is thinking about what people like me did just 100 years ago in 1914. I wouldn't be around to write this. Everything's relative.
My sister just had a knee replaced. One hundred years ago, people just became less mobile and suffered with the pain.
Your feelings are understandable and natural. It's healthy to feel them.
Insulin is a potent and powerful hormone. Using it well is a challenge that you are up to. Insulin was designed to gain weight. Having a natural basal wave to ride should make your bolus dosing easier.
Don't think of starting insulin as a concession, think of it as an opportunity to start to take better control of your own health. We live in a time when there are really amazing tools available to us, including insulin pens you can tuck in your pocket or purse and genetically-engineered insulins with really helpful properties. You should absolutely give yourself space for those mixed feelings (I had a similar reaction to starting a pump recently), but how you frame this down the road is ultimately also up to you. My two cents, anyway.
hi Lilli, can you tell me how you discovered you had D and how it has progressed til now? i am 49 try to control bg through diet and exercise only, but my numbers are slowly starting to get worse too. over thanksgiving i was low carb except for a very small amount of stuffing and sweet potatoe, which i then exercised after. later, after seeing that pumpkin pie stare me in the face, i had a small slice and thought 'just forget about bg for today'. later when i went to visit my father and was talking to him about D, he said why don't you test right now? 1.5 hours after that pie i was 200. then i did exercise bike and walking to finally bring it down.
“…sobers me up” is a great way of putting it Terry. I’ve been wanting to try rapid acting insulin (actually tried regular on my own but found it was too slow to work and had too long of a tail which I predicted and I had a nasty hypo). I’m hypo unaware from years of roller coaster BG and reactive hypos so I’ll be getting a Dexcom (even if I have to self fund it) to help guide me as I figure out what works. Maybe starting insulin represents the reality that this really isn’t going to go away, which when you’re slow onset you still think might happen. Thanks for the pep talk, only you guys here understand the technical and emotional aspects of this health problem:)
You’re so right niccolo, it is an opportunity, not only to take control of my health now but my future health as I’m already having signs of neuropathy in my feet. I credit this website and the people here for teaching me so much about the whole taking control of your own health attitude when it comes to controlling my BG!
I had a random BG of 198 several hours after lunch two and a half years ago. I had lost a lot of weight which may have been related to a hyperthyroid “attack” and I’ve haven’t been able to gain it back even though my thyroid levels have been normal for 2 years now. After the 198 I got a meter and began studying my own trends, found I went over 200 then had reactive hypoglycemia. At first that was my only diagnosis, despite the high BG. I had frequent urination when I was high, spilled ketones when over 220, I’ve had itchy, prickley feet for about 5 yrs, I’m prone to infections now which I never was before…so I had symptoms and several blood serum BG levels over 200 but doctors were not inclined to say diabetes yet because I’m auto antibody negative and my A1c is okay (average BG is not my problem, my BG can go from 80 to 250 to 55 in a few hours without insulin on board and moderate carbs). So I’ve been living in the diabetes gray zone for a couple of years now. My current doctor believes me, trusts me, knows I’ve educated myself, and is willing to work with me to find a solution and improve my health. But I’ve seen my share of docs who were not willing to treat a non-typical T1D or T2D so it has been a long, difficult road. It’s possible even rapid acting insulin will have too long of a tail for me, my hope is stopping the spikes will shut down my own 2nd phase that is causing the reactive hypos. If not, it’s back to the drawing board, maybe trying another oral. I will also try afrezza when it comes out as it’s ultra fast mechanism of action seems best suited for what is going on with my BG, right now anyway. I feel for you v, slow onset and not fitting into a diabetes box is very frustrating. Doctors are most inclined to treat A1c’s or fasting BG numbers and not individual people.
Lilly! I am you, one year ahead.
Don't feel bad... you're liberated. You WILL be able to control your BG much much much much much much much better (I think I left a "much" out there... :-)).
I was so excited by how well I could control my BG with bolus insulin I ran the T2 gauntlet to getting a CGM and a pump (Omnipod) so I could control it even better.
Also, in consultation with your endo/doc consider dropping all other D meds except for metformin. Met + bolus insulin can keep you in the 80s fasting, post-prandial under 140.
And like I said, you'll feel liberated rather than more burdened. Eat well, healthy, and wise, but eat what you want, when you want, and treat accordingly. Go out for a special dinner with family or friends and just, well, have a good time! No worries!
Just be sure and take the time to really learn your own parameters -- IC, ICF, ISF, etc. You'll need to check more with your meter if you don't get a CGM.
Welcome to the family!
It's possible even rapid acting insulin will have too long of a tail for me
Possible, but I'm pretty confident that you'll learn the best bolus timing to "get ahead" of the carbs just right. Took me a lot of experience to really dial it in, but these days I do a pretty good job of standing in for my pancreas :-)
Biggest issue I have is not taking enough insulin when there's an unusual situation (like Thanksgiving).
Thanks Dave, much much much…appreciated and needed support! It would be great to strike the spikes and not have to restrict my diet so much. I’m already gluten free 18 yrs so adding low carb has been a royal pain. I’ve always eaten pretty well and have no plans to go carb crazy, just want to enjoy a normal meal and get back to my normal weight so I can wear my wedding band again (it was sliding off my skinny finger), I’m just so tired of all the hot young guys hitting on me;-)
Hi Lilli. I got Celiac and Type-1 at the same time, 21 years ago. I figured out the necessity for going gluten-free right away, but it took months for my doctor to realize that I needed insulin. The day I started insulin--finally!--my life was saved and so was my sanity. Despite all the difficulties involved, I love my insulin!
Restaurants are still difficult for me in avoiding gluten, but we eat very well with our home-cooked meals. Lactose-intolerance became a problem after my operation on a gut blockage a few months back, this intolerance is probably mostly due to the Celiac. I've found that a good probiotic, containing the strain Rhamnosus, plus Lactaid pills have allowed me to keep eating dairy. None of this is cheap, but as I said, I now eat well and maintain a good weight. Good luck, and don't be afraid of insulin!
Mixed feeling for sure. My experience my be a little different since I am T2, I experienced several emotions when starting insulin
First was fear. Insulin was an unknown to me and something my doctor had threatened for years. It was with the help of the many friends here at TuD that I overcame this fear.
Next came a feeling of defeat. I felt I had failed at controlling my disease. I know now that this was wrong. There is no failure in diabetes because diabetes continues to march forward no matter what we do. Failure is when we fail to react to the progression.
The most important emotion was excitement. I was excited because I finally had a tool to continue the fight. I finally had a tool to make a difference. I was excited to get my BG under control at last.
Crossing this threshold is sobering but at the same time it is a chance to move forward. Diabetes does continue its march but we do not have to stand still and let it run over us.
It’s better than it was in the old days eating out though. I used to ask about gluten and the restaurants had no idea what I was talking about. I’m also lactose intolerant like you Trudy. I can eat a little with lactaid but too much dairy and I regret it, I can’t help but envy folks who can eat whatever they want, and now there’s the carb issue too. Ugh. Yes, I’m hopeful but a little nervous about bolusing, fingers crossed, carbs counted, I:C ratios to figure out…
Glad to know I’m not alone Gary. I kept wanting to try bolus insulin and now that I can I’m a little weirded out by it which surprised me. Sounds like the feelings are pretty universal whatever type you are. Because I’m very thin and have the 4th most common gene for T1D (and Celiac) and my heritage is Finnish with adult onset of T1D in those relatives, my doc thinks it’s slow onset T1D but I could be thin T2D as I’m still testing negative for autoantibodies. What ever type we are, a good treatment plan is key and support like we have here is also so important. I think I will feel the excitement part after I see how it works!
My then endo gave me really easy ratio and correction to work with; maybe she knew how bad I am at math. Anyway, 1:10 for insulin:carb ratio; 100 for correction. I need a little more insulin since then, esp. in the morning when I'm more insulin resistant, but I still use those numbers as a starting point. I think with a little experimenting you'll soon figure out good numbers for yourself. The Calorie King book and/or website are helpful for figuring out carbs. Useful books are "Think Like a Pancreas" by Gary Scheiner, and "Using Insulin" by John Walsh. Again, best of luck.
i never get hypos that i know of, anyway. what was he straw that finally broke the camel's back and led you to bolus? was it an increasing number of plus 140 readings that wouldn't come down with metformin and diet? how many carbs do you eat per meal? i hate to count carbs, and i only sporadically do it. usually i just eat low carb til i am satisfied, but that is leaving me with higher numbers starting with this September. so i am slowly getting used to the idea of going against my disorganized nature and counting. anyway, again, what tipped you and your doc to go the bolus route?
Many many readings over 200 with 50-90 grams carbs. Have to eat under 30 grams to stay under 140. Symptoms such as neuropathy, polyuria, frequent infections, spilling ketones, and low BMI. Still have good fasting BG though!
It will be interesting to see what degree of insulin resistance you have, if any. Let us know what your IC works out to be.