Hi again Anna, Ive just had a scan back through the Victoza thread which I had not seen before as I don't have any knowledge of it, checked a bit on google ans it looks to me to be similar to Sitagliptin which I was offered when I came off insulin, thankfully I didnt need it as I managed to keep my bg in check just with the max dose of metformin and diet. But it looks like Victoza to be a pretty smart drug only asking your pancreas to work when bg is high. I would have had no problem with trying it had I needed to. I notice that you say you take it at 7pm is that correct as I am assuming you eat mostly through the day and I wonder how long the Victoza works for, just a thought It may be fine to take it at night, like I said I dont know much about it.
You say in one of your posts that you are happy with the weight loss that you have experienced with Victoza but that your bg is still high, and reading through your diet it seems that you are already cutting back on the carbs so not sure what to suggest especially as you also have several other problems requiring special dietary requirements.
The only thing I could pick up on was that you say you eat wholemeal breads and pasta, have you tested before and after eating these foods as generally wholemeal is no better than the white versions as far as carbs are concerned although they do contain more fibre which is, I imagine, why you eat it. Wholegrain breads are generally better in small quantities than white or wholemeal breads, and as far as pasta goes it is one of the few things that I cant eat at all as it really sends my bg levels soaring, so pasta for me is now a once or twice a year treat
but if you have tested it and your bg can tolerate it then thats fine.
You mention that you are concerned about weight gain if you should start in on insulin treatment and certain types of insulin I believe do seem to have a track record of weight gain. When I was on insulin I was taking Humulin S before meals and Humulin I, which I believe is an intermediate lasting basal insulin at night to keep me from going too low and I managed OK with it but I was very anal with matching my diet to it and trying to run high 4's and 5's all the time which my diabetes team where not at all happy with, I would say OK i'll run a bit higher and then carry on as I was, which I felt was OK as I was only very rarely dropping below 4 and my hypo awareness remained OK. I'm not suggesting that if you start a basal regime you should aim that low, in fact if I wasnt over 5 at bed time I would eat a packet of mini chedars or similar carby snack.
If I can help to put your mind at rest at all it would be to say that if in the future my condition worsened I would have no qualms at all about returning to insulin as once I got to know how much I needed to keep my bg down to low levels but out of hypos I found it OK, so much so that I was a little scared when they told me to come off it :lol: I guess we all have our comfort zones and dont much like change, but as long as you are on top of things the Basal insulin could be the tool you have been looking for.
As to your treatment by your diabetes nurse it sounds like bullying to me, perhaps she is trying to scare you into controlling your diabetes but it still sounds like bullying to me. I am lucky in that respect as I am quite assertive by nature, not aggressive, but confident when I talk to white coats or uniforms of any sort for that matter and whilst I don't always get my own way I usually get listened to, I also give respect and even if I know I am not going to agree with someone I will always listen to their point of view and then either question it if I feel I can or bite my lip and say nothing and then go my own way anyway if I disagree with them
Again I have been lucky in that my doctor who does not seem to know much about diabetes is always ready to listen and always happy to refer me to a specialist should the need arise, I know others aren't this fortunate and if you are in that category you have my sympathy. The hospital diabetes unit where I was treated too was excellent and had no problems with my reduced/low carb/ call it what you want diet, even referring me to a dietician who's only small concern was that I was not eating enough oily fish, but unfortunately I just don't like it :lol: She even stated that low carb was the way forward in diabetic care, so I really am one of the lucky few, and no you cant all move to my area as the PCT is in enough debt as it is thanks :lol:
So pretty much all I can suggest is dump the wholemeal breads and pasta if your other dietary requirements allow and express your concerns about weight gain with your diabetes nurse in as calm and controlled fashion as you can. If you start a basal regime and you start to have concerns phone up your D clinic and ask to see your specialist again so you can either adjust the medication or even try another type of insulin that may work better for you. Oh and test, test and test again to try to keep those numbers down
And lastly, try not to worry about things that have yet to happen, concentrate on the now and good luck
