I am 43 and have been diagnosed with type II diabetes last year. My Doctor had me on Metformin 500 and it worked for a bit. Now my sugar was above 300 and at times above 600. Currently I am on Metformin 1000 and insulin. I am up to 35 units on the insulin and nothing is working. My sugar stays around 320. I have been eating good and exercising and it stays the same. At this point I am just getting frustrated.
Well, 320 is definitely too high! So, in order for people to help here, can you give us a bit more information?
What kind of insulin are you taking 35 units of per day?
Are you using basal insulin (one or two injections a day) and then also counting carbs in meals and using bolus insulin to cover meals?
Have you had antibody and c-peptide testing to determine if you are Type 2 or Type 1? It is not uncommon for adults to be diagnosed with Type 1 now, even though some doctors still think that it is a childhood disease.
Ultimately, the goal of treatment should be to get your blood sugars down into a healthier range, and your doctor may be moving slowly with insulin adjustments, but 320 is pretty high…
Jay24
You should talk with your Dr about being tested for antibodies and C-peptide. Possibly you are a misdiagnosed Type 1 like many here, myself included. The high sugars might also be caused by stress, poor sleep habits, dehydration, etc. You should definitely call your Dr though. 600s are cause for concern, especially if they take time to come down.
I am type II. The insulin that I am using is Basaglar 100unit pen. When I went to urgent care when my sugar jumped to 600. the Dr. there told me to also take my Metformin with my insulin and wanted me to start novolog with each meal. My sugar went down the next day to 300s so I was hesitant to try novolog. However, I am now desperate and just started the novolog this morning. I have been trying to reach my Dr., but can not get a hold of her. May be time for a Diabetic clinic.
Some people who are really adult-onset Type 1s are misdiagnosed as Type 2s (due to assumptions because of age and/or weight), so unless you’ve had antibody testing done, it can be hard to know for sure.
Keep in mind, if you’ve been running in the 300s regularly, you may feel weird if you suddenly are in the 100s, even though that’s ideal. Your body just won’t be used to it, so it might feel like you’re having a low blood sugar at first. It should adjust pretty quickly though once you can get your blood sugars down more consistently.
Also, you probably want to check ketones, in addition to the other good advice here. 300-600 puts you in a potentially dangerous range for diabetic ketoacidosis (DKA) and might reflect seriously insufficient insulin. You can get ketone urine testing strips over the counter in a pharmacy. It’s a good way to help gauge whether you need urgent help now or not, since that’s the main risk someone might run in the short-term. If they test moderate or higher, I would go back to urgent care or the ER.
It was the urgent care DR. that prescribed Novolog not my family DR. That is why I was hesitant and was a bit scared to take it. I did start it today and will follow up with my family Dr. Thanks for info and I will monitor.
I actually feel fine. My Dr. does not seem worried. I am the one that has been monitoring and trying to get this under control. I suggested the bump up in metformin and the move to insulin.
3 hours after taking Novolog my sugar is down to 257 from 340. I am thinking that is a big jump. I don’t think I should use Novolog with my next two meals and monitor.
If metformin is helpful, 1000mg/day is still a moderate dose. Many/most probably increased to the maximum of ~2000mg/day. As far as your BG readings… are those fasting? random? maximums? Are you testing multiple times?
Metformin seems to have no effect. Those numbers are usually fasting. They seem to be similar after meals maybe a bit higher. Is it normal to be on Metforman and insulin? My family Dr. stopped it, but the urgent care Dr. said keep taking it for now.
Above 600 is very high. The type of high more associated with Type 1. To put that into perspective, I was diagnosed with diabetes (which turned out to be Type 1) at 437. I have never EVER been up to 500.
Don’t let the labels “Type 1” or “Type 2” stop you from saying to your doctor that you need more help. Like an endocrinologist. The moment my internist figured out something more complex was going on (my A1C skyrocketed), he sent me to an endo. I live in Seattle, so he sent me to Benaroya Diabetes Center. Benaroya is the bomb and they really set me on my path for how I deal with my Type 1. So much so that once I switched medical insurance, I was really the head of my care team and could recreate much of what Benaroya provided for me originally.
Seriously, if you haven’t, go see an endo.
Do persist in getting more help and don’t give up! One thing I noticed in your post was your phrase “up to” 35 units and that implied to me that maybe you were concerned that it sounds like a large dose. It’s possible that you are more insulin resistant than average. I was diagnosed in my late 40’s w/type 2 and started on metformin. A1Cs were 11-13%. Started sliding scale Lantus and Humalog about 30u per day. Then over 2 years creeped slowly up the scale to over 300u/day with A1C around 9%. I finally found an endo who would switch me to Humulin U500. Made a huge difference and finally got under 7% on 25-28u/day u500 (that’s 125-140 “normal” insulin). Am not saying this is your solution but simply that more insulin is not bad nor should you be discouraged if that is what will work for you. BG over 300 is serious as others have already said.
Kudos to you for using this site! There is a huge amount of insight and knowledge here in dealing with this complex, highly individual disease. The more you know the more you can be your own champion in dealing with the wide range of Med personnel you will encounter thru the years. Knowing what I know now I should have pitched my fit for U500 years sooner rather spending years thinking I’m never going to get to reasonable control. Don’t give up!
I agree with Obxdiva 35 units is not high at all I take way more than that a day. One thing you never said unless I missed it is what are you eating? How many carbs a day? Physical activity?Have you been to see a Dietitian to learn what and how to eat as a diabetic?
Based upon whose diet are you “eating good?” People have very different ideas of what that means for a diabetic. When I was first diagnosed diabetic with a FBG of 289 and an A1c of 11.5, my doctor gave me a suggested diet to follow. I tried it for two days - and my blood glucose went up to 548 two days in a row. I ended up going to the ER. The doctor’s diet had far more carbohydrates than I had been eating pre-diagnosis and certainly more than I could tolerate as a diabetic.
You’ll need to find what actually works for you, regardless of what any so-called expert advises. Your meter will tell you what works for you. That usually means you need to test before meals to get a baseline, then an hour or two after meals to see what the foods did to your BG. Then eliminate or reduce portion sizes of those that send you too high.