It takes a while. Give yourself some time. It will get better! Breathe...
trauts:
fair enough. There is enough complexity there that some folks do show some sensitivity on coffee black. Apologies. For me it was always the creame, plastic cow that did the number.
You are right about dawn phen cranking on to 8/9am.
I have seen that as well. Thats why I have metformin at 10:00 pm and 12:00am and then again early in am at 5:45 am to get it back in there to arrest liver.
Taking insulin early may also help arrest that stinker as well.
Here again; sometimes I think I should become a pumper to help better arrest this nonsense.
Best wishes for good health and success fighting these gremilins!
Finally, you could simply go out-of-pocket at Walmart and buy yourself a vial of Regular insulin and just try it out. Some may be aghast at this suggestion. They probably have more respect of the medical profession than I do. If you do this, I would start conservative, keep good records, adjust and repeat.Not a bad suggestion, but I'd add to it that you only do this with another diabetic hanging out who knows about insulin -- either a T1, or an insulin-using T2.
Otherwise, this could be a bit risky, as you may not know/realize what's going on if it goes bad, particularly if you get nailed with a bad hypo.
Alcohol suppresses glycogenolysis in the liver.
Because of side-effects, it's a poor substitute for metformin
Heather - Fire your Dr. He sounds like an idiot. If you're in the US, you can buy Humulin R (Regular Human Insulin) from Walmart without a prescription for $25/Vial to combat your dawn phenomenon.
Looks like I spoke too soon. I was 122 when I woke up this morning. I've got about 15 minutes before I check my 1 hour pp reading. I'm not optimistic about it.
Honestly, I don't even WANT to go on insulin, given that it's a fat building hormone. I don't want to try sulfonureas, either. I was really hoping I'd found the trick. Ugh. So discouraging.
I feel your frustration, but don't be put off insulin. It is the most amazing "drug" when used properly. Injections are painless and the level of control you can achieve when you have it dialed-in correctly is phenomenal. Nothing else comes close. By way of example: I went to bed at 78, woke up at 91, worked out for 90 mins this morning and now two hours after breakfast am at 86. I'm T1 and achieve this with Levemir for basal and Humulog for bolus when on MDI. You're a T2 and it sounds like you can easily achieve similar results with nothing more than the occasional bolus to treat DP.
Also - there are so many powerful, synthetic pharmaceuticals out there to treat T2 with potentially serious side effects. I would be very wary of using them. Metfomin is the only one of the oral medications I trust because of its long and proven track record. Insulin is natural. It's the same as what your body produces. Granted, the analogs have some variations in absorption, but it is still fundamentally the same as what your body produces.
Lastly - fat does not come as the result of insulin. Too much or the wrong food does. All the insulin does (in both diabetics and non-diabetics) is metabolize the excess calories into fat that you cannot burn. If your caloric intake is healthy, then the insulin you produce or inject will convert the calories you ingest into energy you can use.
I hope this helps and good luck!
I didn't want sulfonureau's either but unfortunately as a MODY they work really well. Perhaps you might be a MODY? I was misdiagnosed as a type 2 and the metformin was not working on its own. I only take 1 to 2 mg per day of the sulfons and get good results. Prandin is also an option.
Agree w/Christopher.
Insulin is what the body's calling for.
The injections are painless with a dab of sting from Lantus.
I tried many of the pancreas stimulators and Byetta. I experienced awful lows on all of them. I've experienced some weight gain only through laziness and improper diet.
Hopefully,insulin and metformin will do the job for me. 72 this morning.
When I was on the pills 160 was the dawn reading,and it didn't bother my doc as my A1C was about 6.9%.
Only with the intervention of the diabetes educator did he finally prescribe Lantus.
I just need to knuckle down and avoid those refined carbs as they are The Plague to me.
I have the DP challenge. I was running the morning BGs of 150-180 (used to be 125-135).
Talked with my dr at the last checkup, he said A1C was same as last time, so not panic mode yet. He did ask me if I had tried the glimipiride that he had scripted the last visit, which I totally forgot about.
Becuz my parents were both insulin using T2s, it doesn't scare me, although like most of us given a choice, we'd probably prefer not to. I'd at least like to have it around.
Anyhow, back to the glimip. I had not realized it was a sulfonylurea until I was reading some info on it. My dr has always kept the sulfonylureas in reserve, saying that it tends to beat the beta cells to death. So I'm a bit scared of it. Keep in mind, I am on metformin and victoza already.
So fast forward, I'm experimenting with the glimip. I will say that a half 1mg tablet at bedtime, has dropped my morning BG back to the 124-135 range in two days of a half tablet usage. Yukky tasting tablet, btw...
My dr has told me to use that glimip. sparingly, so maybe careful usage would be less damaging.
I would advise strongly against self-experimentation like this -- especially with regular Humulin R.
The time to peak, and duration of action is just too long to be an effective management tool for a T2. Fast-acting, like Humalog, Novolog, or Apidra are really the only practical solutions. Unfortunately, these require a prescription.
Further, while insulin is a miracle treatment for any diabetic regardless of their disease etiology, it is also powerful, and can kill if used improperly. A person needs to learn carb counting, I:C ratios, correction factors, etc. in order to do it right, and then start conservatively, keep good records, and test test test to nail down their personal parameters for proper administration.
Now, all this sounds complicated and really burdensome, and those of us using insulin (especially with a pump) know this isn't that hard once you get the swing of things. However, there is a learning curve, and failing to traverse it can result in catastrophe.
Shopping for an endo is a good idea, IF you live in the area where there is an endo. In my area, NE South DAkota, there is not an endo within 250 miles of me. So without one, I'm messed up. We used to have one in town, but docs wouldn't send their patients to him since they would go to the endo and not the reg doc. Sad to say there is a lot of "my patient, keep your hands off" And in winter's like this, with temps in the -40's a trip 250 miles away isn't always a healthy choice either. Sometimes you just have to take what you can get or battle the medical establishment to get what you need
Are there possibilities of making phone appointments with endos?
excellent thoughts and comments. I use the humalog lispro (Apidra look alike) and I like the short 4 hour run time and fast response.
I hate the mixes -75/25 et all with its 12 hour run rate and the oral pills like glimperide et all that run 10 hours. It forces one to eat to prevent lows and dynamite trying to diet is almost impossible.
I agree with one exception. I find Humulin R extremely useful. For me, its slower action and longer duration handle high protein meals much better than rapid-acting (which I also use). A case of fitting the right tool to the right job.
But that's a minor quibble. Great advice overall -- spot on.
David(dns):
You raise an interesting point. This is also why lantus and other slow insulins factor in.
For me I watch every meal but I also after last meal of day (dinner) watch the 2 hour and 5.5 hour point late at night and if there was large extra glucose output at 11:00 pm I hit another shot of humalog lispro.
It in fact though comes back to role of basil and bolus and the right mix to achieve nirvana.
I had been on both but as not on pump, careful use of 4 hour humalog and controlling diet coupled with metformin allowed me to sneak thru. Is that perfect no; and sometimes I wonder if pumping might be a better shot!
Sounds like insulin may be helpful for you but if you have doctors that won't treat you responsibly, perhaps it is time to find a new doctor?
good point. The pill mentality is in my mind a disability.
Insulin approach allows one to diet strongly without risk of excessive lows.