Starting insulin after 2 years

Well after 2 years, we decided it's time to go to the next step. I have been taking Januvia and Metformin max amounts but my AIC has been between. .71-.74 and my FBS have been 7.9-8.5.(Canadian Measures) Plus higher during the day. I'm not to thrilled but at the same time, I am getting tired of trying hard and getting nowhere. I've lost almost 25 lbs, keep my carbs at no more than 40/meal or less, plus I walk almost 2km/day. My numbers still are not coming down enough. So I will be starting a once daily dose of Lantus. I'm really hoping this works.
Tonight is a good example. I didn't take my dinner pills until about an hour after I ate and my sugars are 16.2 an hour after taking the metformin.
Just looking for support and encouragement. Hubby still kind of acts like he denies my condition. He doesn't even want to come with me to the dietitian appt where I will lean how to take the insulin etc... Something I think is very important for him to be in attendance.
Thanks for you replies.

Good luck with your basal insulin start. Insulin, once it's calibrated for your body, is very effective at controlling your blood sugar. Learn all you can about it. While your doctor and dietitian can be a source of info for you, gaining and using the skill yourself is a better idea. Insulin dosing is a changing game; learning how to make adjustments yourself is a valuable and desirable skill. It's worth the effort.

One of the sources of info you could review is the package insert that comes with the insulin itself. While it is a bit technical, mixed in with the medical-speak are some plain English descriptions. Three key parameters are the onset, peak, and duration of the insulin. The longer acting basal insulins, while ideally they're thought about as "flat," they do have a moderate peak.

If the duration is not 24 hours, and I don't think any are, then you may be best served by taking a split does morning and night. You may start out with just once per day but keeping track of your blood glucose levels will inform your next step. I highly recommend you keep good records in the beginning, especially, as these will help with treatment changes.

Don't be afraid to test your blood sugar more than you may perhaps be used to. This is something that you can talk to your medical professionals about.

Sorry your hubby doesn't show an interest in this new treatment for you. You, however, are the most important person in this equation. Learn all you can, take notes, and observe your blood sugar readings.

I know it helps to have a second person listen to the same info. I live alone and I can manage my diabetes myself. You can't make someone want to do something they don't want to do. Perhaps he will change his mind when he's confronted with some medical crisis.

Good luck!

Hi Nancy - I am in a similar position after 8 years of oral meds. Started with metformin many years ago then eventually on Actos for a few years. Did not like the reported side effects of congestive heart failure and bladder cancer so I had the Doc switch me to Januvia. After a month I developed GI symptoms and spent my life close to the washroom for a month. Told the Doc I had enough of Januvia and it was time to get greater control. My A1C has hovered around 70, often 68 or 69. Everything I read told me that current thinking is leaning to insulin and metformin as the way to go. So I started on Lantus about 3 weeks ago and have been increasing the dose every 3rd day. Up to 28 U now. Although my morning readings are still 7+ I do feel better and seem to have more energy. I was really dragging my butt and going up stairs was a chore. Now I handle the stairs much better and feel more energized than I have been in quite some time. Hang in there and as previously stated, learn all you can, don’t rely on Dr’s to solve it for you. Take control and don’t let your husband drag you down. He may be in your shoes some day.

Thanks for your replies. It helps to have a community of people who have experienced what I am now going through. I have the Lantus solostar pens. Are there needles built in? I did get a script for syringes nor was I given any. So I assume the needles are part of the pen?

Nancy- no the needles are separate and you need to buy a box. They come in different lengths but I use the 4 mm BD Nano. You change the needle each time you use the pen. Since I am also a Canadian I can tell you that a box of 100 needles cost about $35. If you use Lantus once a day that box will last three months. Some drug plans cover needles but many do not. I had to pay for mine in Ontario. But at $35 a box that will be just over $10 a month. I take it that you have not gone for your session yet with the educator /dietician. They should show you how to use the needles and Solostar. When I went they had a little pin cushion for me to practice on. All just a learning experience. The needles are very fine gauge and really do not hurt much at all. I would wait until you go for your session and see what they recommend for you.

Thank you. perhaps they will have samples for me. I am in Ontario too. Are they available without prescription? Like are they behind the counter. I work with a private pharmacy that tends to be a bit higher on prices but their customer care is A+++ I don't mind paying a wee higher. for syringes though is I don't need a script I will source out the cheapest.

I don’t think you need a prescription. Mind you I bought the needles at the same pharmacy where I got the Solostar pens so it was pretty evident what they were for. I bought mine at Costco but Shoppers Drug, Rexall or Pharmaplus will all have them as will small private pharmacies. I would say shop around for the best price. Since you also have access to the web you could go to the Solostar web site and there is info about using the pens there. Info at

I was in much the same position as you a little over four years ago. I was taking three different drugs and despite rotating through different combinations it just wasn't keeping my blood sugar controlled. Only in my case the doctors were "insulin resistant," refusing to let me start insulin. Eventually I made the decision myself.

Like you I had a chronically high fasting blood sugar and the insulin really helped. I also found that becoming smart about insulin really helped me understand everything. Eventually it will be important to become self-reliant. The books "Using Insulin" by Walsh and "Think Like a Pancreas" by Scheiner really helped.

I will just reinforce what others here have said. Like you, I got by without insulin for a long time but finally came to terms with the fact that I would never get the degree of control I wanted without it. So, like Brian, I chose to start it myself rather than waiting to be told. And it has been an absolute game changer. I could quote test numbers but that's really not the point; insulin is the most powerful weapon we have, by far. I wish I had chosen to start it years sooner. It is positively transforming.

As others have also said, you must become your own expert. Doctors and teachers can only do so much for you. They can give advice, but you are the one who has to put it into practice and discover by experience what does (or doesn't) work for you. Nobody knows your body like you do, and most importantly, no one else is there 24x7 to do it.

Here are the formal citations for the books Brian mentions, along with a couple of other good ones.

John Walsh et al., Using Insulin (San Diego: Torrey Pines Press, 2003)

Gary Scheiner, Think Like A Pancreas (Boston: Da Capo Press, 2011)

Richard K. Bernstein, Dr. Bernstein's Diabetes Solution, 4th. ed. (New York: Little, Brown and Company, 2011)

Jenny Ruhl, Blood Sugar 101: What They Don’t Tell You About Diabetes (Turners Falls: Technion Books, 2013)

ask your Dr but the lantus should be independent to what you eat. It is a slow, background basal insulin mainly for wake up and before tea readings. If your 2 hr post meal readings are still too high when on lantus, you may need a fast, with meal bolus insulin for what you eat. It may be the reason the dietitian is involved.

120g a day carb is Low carb..have you heard about LCHF ketogenic diets where the carb intake a day will be less than you are doing now. A lot of people find it helps with BG control and weight loss

it’s a long page and a few good video’s

For me, the more carbs we eat the more carbs we want. they don’t give up easy

the dietitian noticed the post meals when i went to see her the other night to learn how to take the insulin. she's calling me next week to follow up. we'll take it from there. I wanted to start insulin before anything else. 1st night was brutal but 2nd night went without a hitch and my sugars were 7.1 FBS. Lowest in over a year.

That's very good for day 2 and will only get better as the insulin is adjusted and stabilises BG. It's a good idea to only ride one horse at a time, or you will be all over the place. Time will tell if a fast insulin with meals is going to be of benefit.

Well it's been a week. I'm up to 14 units of insulin/day. I am at 7.0 but we want a 5.5-6. 7 is good but I thought I'd go 2 more units to see if we can get that magic number. So here's hoping tonight. The doctor said increase every 3 days until we reach target. Even though I am reaching 7's our goal is a wee less. The first night I had it pretty bad but since then, I hardly notice. I've hit 6.8 during the day even! My post meals some are still spiking to 10 but generally 8-9.5 is my post meal. My goal is 6-8 post meal. I'm encouraged by this though. Most of the post meals were after meals that were rich in carbs or things that I know will raise sugars.

I also want to mention that I have ulcerative colitis that has been in remission for 10 years and in order to keep it that way, I need high fibre, low fat. I am careful with restricting certain food. plus too much cabbages and green leafy stuff isn't great for me over a few days. So I have to alternate my veggies huge. Sometimes though it's a hit and miss. Like take cabbage for instance. I love it but it don't love me. Either way my diet has sure improved over the past 2 years, though it wasn't horrible to begin with.

Sorry I was a bit off in my goal numbers. Our target is 5.5-7. So 7 the other morning was right on the line. Since then I've dropped to 5.8, back to 7.3 then down to 6.4. I'm pretty happy with that. I'm feeling good. Post meals do sometimes do up to 10 but that is still okay. Iron is a bit under so I will be starting a bit of iron for a few months. So hopefully with that I can stop feeling sluggish midday. This is the best I've felt in years.
I know there will be ups and downs as that's the nature of the beast. However I am very happy with how things are proceeding! Thanks for everyone who offered advice and support. I sure appreciate. I'm so thankful I have this site to come to. Thanks sugar buddies!

Those numbers are looking good and you are only spiking under 3 after meals. I bet you are starting to feel human again too.

some of these links might be worth reading about your ulcerative colitis treatment with diet

Have you been tested for antibodies to determine whether your diabetes is actually a slow onset Type 1? Like T1, ulcerative colitis is autoimmune and many people have both conditions.

not to my knowledge but I get a good set of blood work twice a year from the gastroenterologist. It's pretty thorough.

Auto-antibody blood test are very specific and not often included in most standard blood tests. It would be worthwhile to discover in your diabetes is an autoimmune or type I diabetes.