Type 2 new to insulin

Hi all! I am a newbie to this board. I am on NPH and of course my doctor said 10 units morning and night. Well that got upped by me to 30 in the morning and 20 at night. I also put myself back on my glipizide and Janumet. I realized that an NPH will not cover my carbs at meals, but these 2 pills do with the insulin. I see an endo on Monday for the first time after 6 years of this disease and the beginning of kidney disease. So alot all of a sudden happened at the good age of 31. My last a1c was 12.6 done last month. I have never been this high. At any rate I am glad to be here and hope that any of you with insulin can let me know what to ask the endo.

Ask to be put on a basal/bolus regimen. (long acting insulin like Levemir or Lantus plus rapid acting for meals).

My recommendation to you - if you are willing, is to go on Multiple Daily Injections (MDI) in which you take a basal insulin such as Levemir or Lantus and a rapid acting for correction and meal boluses. It does require you to learn how to carb count though. It is much more physiological that NPH is. It also offers much more flexibility with timing of meals (you eat when you want to and not when the insulin says you have to) and the meal choices. There is peaking associated with the Nph and you have to “feed the insulin” or eat a certain amount of carbs at a preset time with NPH. I would def ask your endo about going on MDI if it is something you may be interested in.

You should ask for a c-peptide test (which tells how much insulin your body produces). With an A1c of 12.6, it sounds like you should at least test to make sure that you have type 2 diabetes and not type 1 diabetes or LADA. Many people are mis-diagnosed as type 2 diabetic.

Also, I agree with the others. Many people do not have good experiences with NPH. Try asking for Levemir or Lantus (slow acting insulins) plus Humalog, Novolog, or Apidra (fast acting insulins for meals).

Get him to give you a prescription for a modern slow acting insulin like lantus or levemir. They are vastly superior to NPH. Also ask him for a prescription for a fast acting insulin like apidra or novo. Get a book called using insulin by Walsh to set the proper dose of insulin yourself. Your doctor cannot do that unless he is 24/7 with you. Throw the glipizide away as far as you can. The janumet I do know. Get your A1c down to 6 and the kidneys will be fine. Best of luck.

Welcome. I started on insulin in December and am currently on NPH and R using an MDI regime. I was diagnosed as a T2 in 2005, just like you, but I actually don’t know what type I really am. The oral medications never helped me. The only thing that helped was diet and exercise. I’ve followed a low carb diet for almost the entire time, mostly a quite strict diet.



I do think insulin can really help. An A1c of 12.6 is just way too high, and I’m sorry your doctors have not been more aggressive. I guess I would discourage you from mixing glipizide and insulin on your own. You pancreas probably can’t do much to help you right now, and glipizide just pushes your pancreas to produce insulin essentially duplicating what the NPH is giving you. So I’d consult with your doctor on that medication. As others have noted, you will probably find multiple daily injections works out well. I bought the books “Using Insulin” by Walsh and “Think like a Pancreas” by Schiener, both available widely. They really help teach you about insulin regimes.



So I welcome you to the board and am really pleased that you found us. This can really be a turning point for you. I do hope that with your new doctor, a new approach and reaching out to us, that you can really turn things around, bring your blood sugar under control and enjoy a long happy healthy life.

Thank you to one and all! I will for sure ask my endo about all of this. Who knew! I don’t think my insurance covers anything but NPH and R if memory served, but I will ask. I’m glad to have all of you!

First of all welcome! You have come to the right place, the people on this forum are AWESOME and always there to answer questions and give advice. I was misdiagnosed as a type 2 a year ago and rediagnosed a few months ago as LADA and just started MDIs of insulin about a month ago. The best advice I can give you is to echo what the others have said and to ask for a newer insulin such as Lantus or Levemir (I personally would recommend Levemir over Lantus) and then a mealtime insulin such as Humalog or Novalog. Keep us updated!

Thanks!
I am glad to be here. I just want my BS to stop falling I really do not like the NPH at all. I just don;t think my insurance covers the newer insulin. I am with kaiser anyone else?

I don’t have Kaiser, stardust, though I’m thinking of switching to it this year for economic reasons. I would be seriously surprised if Kaiser did not use MDI insulins. My guess is that they push the NPH because it’s cheaper, but that if you request/push your doctor or endo, they will put you on MDI’s.

Okay guys I went the endo. She is keeping me on the glypizide and the NPH as well as metformin. She upped the glipizide to 10mg at morning. She is not putting me on a fast acting insulin because my fasting and after meal blood sugars with this regimen have been great. So 2 injections every day for now. She also upped my thyroid med. I think I am going to like her! She will be calling me in 3 weeks to check up on me… much better than a PCP!