Type 2 Doc suggested insulin

[Marley99]

Hi

I have high fasting blood glucose levels (first thing in the morning) about 15 and then throughout the day it seems to slowly come back down to the 7s. I have been told my HbA1c is "fine."

Doc wants to put me on insulin. It worries me because I understand once started there is no going back. The pancreas stops working completely.

I thought insulin is for type 1s. I have heard people speak of BGLs in there 20s which doesn't make mine sound so bad.

Is my fear of insulin rational?
Should I be more concerned about my BGLs.
Marley

 

[Indy51]

How long since you were diagnosed and what kinds of changes have you made to your diet and lifestyle? Have you been on any other medication/s?

It is definitely NOT true that once you go on insulin you can never come off it. I can think of a few members of this forum who have done exactly that. There are also many anecdotal stories out on the wider web about people coming off insulin after they've lost a lot of weight and normalised their BG using insulin and/or other drugs.

However, there are some issues (especially as regards driving) with using insulin, but in a medical sense it is not something to fear.

 

[PatsyB]

once you have your blood sugars under conmtroll you can start cut back on the insulin as I have done

 

[ally1]

Marly99 I, m having similar problems where fasting levels have risen in the morning and gradually go down in the morning. I,m on victoza and they dropped but have risen again. Am worried about going on insu'in but if it's going to help then it's worth it. Insulin is mainly for type 1,s but type 2,s have it as well

 

[Mep]

If your hbA1c is fine, I'm not sure why your doc is considering it? It could just be to get quick control during the day. I am type 2 and I've been on full time insulin therapy for over 6 years now. I was diagnosed in 1998 though. The only reason I was put on insulin is because they did the diagnostic tests on me again to find that my pancreas isn't producing the insulin I need. I do know though that some docs will use insulin to help you get quick control. But also some of us have to be on insulin, so we've gone past the option part (on insulin for life because we don't make the insulin we need, but not type 1). I've never heard of being put on insulin when you have your own insulin being for life.... because from what I've read there's been diabetics put on insulin for quick control and they come off insulin later on. You can do this if your pancreas is doing its job. The only time you can't is when your pancreas isn't doing its job which is the stage I'm at. Have a think about it. Personally if I had my time again I'd prefer insulin for quick control over oral meds any day. The reason I say that is because most oral meds stimulate your pancreas which in turn wears it out quicker in the long run. I wish you the best.

 

[BooJewels]

Doc wants to put me on insulin. It worries me because I understand once started there is no going back.

That is absolutely NOT true. I'm treated with insulin and have actually improved significantly whilst on it and have gradually reduced my dose - it just supplements what my body makes, it absolutely does not stop it doing so - in fact it takes the strain off it being forced to try and produce enough, probably protecting it long-term.

Although I'm surprised that the doc would put you on it if your HbA1c is 'fine' although with numbers between 7 and 15 that seems unlikely, unless you're going much lower at other times of day?

It may be that if you're only getting highs at one time of day, a single dose to target that time may be what he has in mind (a single long-acting basal dose at night for example). If you get that single high reading lower, it has a knock on effect on the rest of the day.

How is your diet - the single biggest factor to getting numbers lower is what you eat, followed by losing weight and adding exercise, maybe these need more attention?

Yes, your fear is irrational and yes, you should perhaps look at how you might improve your own BGLs first - can you put your hand on your heart and say that you're doing all that you can effort-wise?

 

[SRO]

Hi @Marley99

I had the exact same fear when I was (wrongly) diagnosed as Type 2. They mentioned insulin and I panicked!
Turns out I was Type 1 and needed it anyway - there wasn't a choice!
As soon as I started injecting, it no longer scares me.
I was petrified of hypos once on it - and after having my first one, it doesn't scare me as much. I know when to test and I'm getting there with what I can and can't eat.

If it is something that's going to give you better control - don't be scared about it.

 

[Kristin251]

I am type 1 as of 2 years ago and at DX BS was 550. I have since decreased bolus insulin from 12-15 to 1/2-1 unit and basal from 5 to 1 or none. All through diet. No real exercise, I just stay active. Of course as type 1 I will never get off it but lowering doses is wonderful.
As far as burning out the pancreas it is actually the opposite. It will give your pancreas a rest and allow it to catch up and keep up.
Of course diet is paramount to how well this will work

 

[Marley99]

Thank you for the many replies.

As per dietitian I start the day with 2 slices of toast and an egg. Salad (or veg) for lunch, and protein for tea. I generally don't snack or graze.

I'm losing weight slowly on a see-saw however I am not hugely overweight. I take medications for other health conditions, some of which are weight gainers.

I get a lot of incidental exercise as per physio and it is not possible to increase this.

I currently do not take medication for diabetes. I do not 'go low.' I get unlivable side affects from oral medication. I understand they balance the highs and lows so when there are no lows to balance I wind up permanently higher than normal with all the effects of highs.

Going on to insulin is still scary and I'm hoping doc will come up with an alternative.
Marley

 

[Indy51]

As per dietitian I start the day with 2 slices of toast and an egg.

The two slices of toast alone would send my blood glucose into the stratosphere. Unfortunately it sounds like you're stuck with a "conventional wisdom" dietitian instead of one who knows the effect that carbohydrates have on blood glucose levels

 

[BooJewels]

I'm not quite sure how to advise you @Marley99 as you seem to give some contradictory or incomplete information. You say that your HbA1c is fine, but with numbers running between the 7s and 15, that would give rise to an HbA1c of around 70, which isn't really 'fine' but also not high enough to indicate the necessity for insulin treatment.

You're not on meds for it, but that number would suggest that it's necessary. You say you get unlivable side effects on oral meds - is that why it's not possible to treat your diabetes with meds? Does that mean that insulin is therefore the only treatment option? Have you tried meds for your diabetes - there are many types of treatment that work in different ways, so several options to consider.

And failing other options, as you've already been told above, insulin is not to be feared. I resisted for a long time after my medics suggested it was necessary - as I had tried everything else and nothing worked for me - I was low carbing, on the max dose of 3 meds and exercising daily. At the time I started it I was at an HbA1c of over 100, so I had to seriously do something.

But it was the best decision I've made, I improved and felt better within a couple of weeks, even though we brought my BG down very slowly - and I'm now on about half the dose I was a year ago. Administering it takes about 20 seconds per dose and at the moment, I do two injections a day. The injecting simply isn't scary at all, much less painful than finger pricking as the needles are tiny.

 

[Mep]

You mention living with other health conditions and I know how hard that can be. I'm also on various meds that cause weight gain. I'm already mumbling to my doctor about having gained 7 kgs in the past 6 months when I was taken off and put back on one of my medications. It's like my body has gone crazy with it. I'm now having problems with swelling and joint pain from medications. Movement in general seems to trigger a lot of symptoms on me so exercise is hard. My diet is restricted too because of another condition. I'm not sure if you have any diet restrictions or not? A lot of people here like to follow the low carb/high fat (LCHF) diet. If you haven't tried that at all, you might want to give it a go. I gave it a go years back myself and it didn't work out for me, although no harm giving it a try. The best way of course is to eat to your meter... keep a food diary and record what BGL results you get from what you eat... I found that helpful especially being newly diagnosed. You then get a good idea on what foods work best. I wish you the best.

 

[kesun]

Hi

I have high fasting blood glucose levels (first thing in the morning) about 15 and then throughout the day it seems to slowly come back down to the 7s. I have been told my HbA1c is "fine." Doc wants to put me on insulin.

Hi Marley,

Are you sure your diagnosis is T2? Your BG pattern sounds more consistent with MODY. Combine this with the fact your doctor wants to put you on insulin before trying metformin and I'd go back and ask for clarification of your diagnosis.

Insulin is fine, as others have said, though I could never bear to inject it into my stomach because of my personal ick factor. I'm one of those who've come off insulin, thanks to a combination of a re-diagnosis and the Bernstein diet.

Best of luck,
Kate

 

[Marley99]

I'm sorry if I am not clear. I am only repeating what I have been told. And yes I am confused. I have tried metformin and others. Only to find I am sicker and worse off. I have been told that I am type 2. What is mody

 

[Mep]

I'm sorry if I am not clear. I am only repeating what I have been told. And yes I am confused. I have tried metformin and others. Only to find I am sicker and worse off. I have been told that I am type 2. What is mody

MODY (Mature Onset of Diabetes in the Young) is a rare type of diabetes and it's different from type 1 and type 2. If you have MODY then you should have someone else in your family with it as well as it is a genetic mutation of some sort from memory.

It sounds like you've been type 2 for a while then? It could just be that you are no longer producing sufficient insulin. I explained that earlier that I am in that boat. I'm not sure if you've had a c-peptide test done recently? If things aren't working on diet and oral meds that is when it's a good idea to get those diagnostic tests redone which includes the GAD test to check for antibodies (in case you have type 1.5 aka: LADA).

If you're not producing sufficient insulin yourself, then yes you don't have much of a choice about being on insulin. If you do have your own insulin, then I'm sure your doc can discuss the full treatment options available. You get to choose to see if it will help or not.

I wish you the best.

 

[Marley99]

Thanks
I will ask about a c peptide and GAD. I am 50 so too old for MODY but diabetes does run in the family. I will find out if I am a 1.5 something else I am unfamiliar with.
Marley