Type 2 diagnosis about 8 years ago does it need to be rechecked

Type 2 diagnosis about 8 years ago does it need to be rechecked? Not sure if it was right to start with... this is my story...

I was diagnosed about 8 years ago. I was 25lbs heavier (I was up to 215 now I am 195 at a bad day. 5'6' big bone) I have done 2 half marathons and I am getting ready to start training on a full marathon. I checked with my general doctor to make sure I am good to do the full as well as ask if I need to be rechecked my last 3 a1c test have been under 7. I am currently taking humalog (short acting about 5units and a long acting at night about 20 units)He advised that I was good and not to worry about it. we tried to due the pill form (Glipzide, Actos, Glibird? and something else that I cant remeber). That I had asked to be back on the shots. Witch I do prefer. I dont like the side effects that I get on the other pills. Mostly the depression. no energy and the sickness that comes with it. I checked my sugars this morning yes it was up 235 that was after my 1.75 walk and meds.

I think for anyone (T1 or T2), insulin needs change over time. This can be due to increased insulin resistance, changing activity levels, changes in hormone levels, etc. I'm a T1 and my basal insulin needs definitely change every couple of years.

First question - are you seeing an endo? If not, that is the first thing you need to take care of.

Second question - what kinds of tests have you done to confirm your T2 diagnosis? You should have a c-peptide and antibody screen. A low c-peptide result and/or presence of antibodies would point to T1, not T2. Now considering that you're already on insulin, this would not change your treatment regimen, but it would be good to know for future reference.

I am not seeing one.. I have to request it thru the doctor who told me I don't need to worry about it... to stay on the same routine that the d is under control. not sure what test were done it has been a while since they were done. If I increase the insulin then the sugar is in the basement if I decrease it then my sugars register to high... and today is one of those days that the D is winning

I am afraid you have gotten the kind of lack of attention from doctors that people diagnosed with Type 2 are subject to. When I saw your subject line I was expecting someone who had been diagnosed pre-diabetes a few years ago, did regular blood sugar tests and was still under the line for a full diagnosis.

This is hardly the case for you. Congrats on your weight loss and your physical activity; I'm sure that all makes it easier to manage your D. However, you are on insulin and your numbers sound erratic. You need to work on developing a more stable insulin regimen. I assume when you say you are taking "about 5 units of humalog" that you are on a set dose or a sliding scale. Both are outdated types of dosing. In order to get more stable blood sugars you should learn to count carbs and experiment until you get your correct Insulin:Carb ratios to determine the correct amount of insulin for the food you are actually eating. You also will want to learn to correct highs. The more time you spend above 140, the more likely complications will develop. The more tightly controlled you can be the less chance you have of developing complications and the better your overall health will be. I'm sure as an athlete this is important for you.Just being "under 7" does not mean your D is in control. Tight control is getting lower down into the 6's and even the 5's. An A1C of 7.0 is an average blood sugar of 156 which is too high.

Clarifying your Type may not make a difference in your using insulin, but it will make a change in how you look at things. Your doses sound pretty low for a Type 2. I would get the antibody and c-peptide tests.

Your doctor appears way too casual and you might have to do some learning on your own to better manage your D. I highly recommend the book Using Insulin by John Walsh.

Zoe has some good advice. Please push to try and see an endo. Most GPs don't know the first thing about diabetes. I encountered a GP a few years ago who didn't really even know the difference between T1 and T2 and how insulin was administered. Thankfully, I'm well-versed in D-management, but it was still shocking. Thank goodness I wasn't looking for any advice!

Sometimes with things like this you really have to be the squeaky wheel. This may mean changing GPs or pushing your GP by providing him/her all your logs and data. A BG of 235 is NOT acceptable.

my bustedpancreas: I will look into it I am not happy with my gp so this makes a great reson to switch..

Judith: I try to stay with the healthy choices... I will admitt that I love my carbs.. I do try to go easy on them my current diet is getting better. at least it is not sodas every day.. maybe once a week trying to even break that habit. what I eat effects my running witch makes me a very unhappy camper.. sorry I didnt answer question... kinda of very bad on the sugar front.

I agree with Zoe:"Your doctor appears way too casual and you might have to do some learning on your own to better manage your D. I highly recommend the book Using Insulin by John Walsh.
See a new doctor sweetie preferably and endo, if you can get the referral.ReadUsing Insulin. YOU WILL need to begin to manage ON Your own, with a doctor who knows how to help you. Most type twos I am acquainted with, other than on the DOC (diabetic Online community) use sliding scale, as their doctors told them that it was the ONLY way to manage food intake and blood sugars. NOT!!!

Congrats on your weight loss and future marathon. There is a chapter in Using Insulin on Diabetes and Exercise. Good tips: Will tell you how to manage a carb load, or even if it is necessary to do so before running when your insulin dossges are set right. Cannot do that with a sliding scale or with set dosasges for each meal.. Read the book. It is cheap on http://amazon.com
and Wayna,you are worth it.

God Bless,

I agree your doctor is way to casual. He sounds very old school to me. I suspect that your glucose levels are all over the place. Sometime way high and sometimes low. This may average out to a decent A1C (if you call 7 decent, again old school)but it is definitely not preferred.

I would recommend the you see an endo or at least a good GP that is not living in the past.
Gary S

I have had a terrible time getting a proper diagnosis and treatment over my diabetic career. I am diagnosed as a T2. I tried the medication, metformin, Actos, Byetta, Victoza, etc. Alone and in combination. None of them had much of any measurable effect on my blood sugar control. For years I followed a strict very low carb diet (Bernstein) and trained hard. Eventually, I also moved to insulin (1.5 years ago). Insulin works. I have the best blood sugar control ever.

It is good to press for a proper diagnosis, but in the end what really matters is getting the proper treatment. And if you are really insulin resistant, then a low carb diet is going to be really important to achieving tight blood sugar control. I don't care how much you love your carbs, you already made huge sacrifices in other parts of your life for your health, you can do that with diet.

And proper adjustment of your insulin dosing will really help bring your blood sugar under control. Basal testing can establish proper levels to let you wake up with a normal blood sugar (I also go high in the morning, the Dawn Phenomenon). And you dose your mealtime insulin based on what you eat. You've gotten great advice, get the suggested reading and take ownership of things. Do that and you can greatly improve your blood sugar control and feel better.