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Does it ever hurt to start insulin early?

M

Medina27

Well-Known Member
Messages
85
Type of diabetes
Type 1
Treatment type
Insulin
Hi, newly diagnosed, probable type 1. Blood sugar was at 15 now down to 8 thanks to Metformin

Doc wants me on low dose insulin (8 units?) which I could start tomorrow morning if I wish

Is there any good reason to hold off on the insulin since the tablets are clearly working?
 
if you are type 1 I would personally start on insulin straight away, it will maximise the length of your honeymoon period
 
I would also start insulin sooner rather than later if it were me. It may well prolong your honeymoon period, stop any risk of dka if you came down with an infection and you could improve a little on the 8.
 
Might want to expect some bumps in the transition from Metformin to injections though, don't be worried if your bloods seem a bit haywire for a few days. I haven't been in the same position but i know when i've changed insulins in the past i've had some dodgy readings :)
 
If your Type 1 then I'm surprised you aren't already on insulin to be honest

I wasn't allowed home from the hospital until I showed them I could inject myself

If Type 1 then start insulin as soon as you possibly can BEFORE your levels get too difficult to manage on other medications and you begin to struggle
xx
 
Is this a GP recommending this course of action or a consultant at a hospital clinic ?
 
Medina27 said:
Hi, newly diagnosed, probable type 1. Blood sugar was at 15 now down to 8 thanks to Metformin

Doc wants me on low dose insulin (8 units?) which I could start tomorrow morning if I wish

Is there any good reason to hold off on the insulin since the tablets are clearly working?
Click to expand...

If you are type 1 then insulin then you have no choice on whether you "wish" to start insulin sooner rather than later you will have to start insulin full stop!!.....Who has diagnosed you and told you this....was it your GP??
 
You say PROBABLY type 1. Are you awaiting test results? If not on what basis and by whom?

whilst I am by no means arguing with the above advice if you are type 1 if you are in fact type 2 then insulin at the get go is unlikely to be the only or best option especially without exploring others alternatives.

Is metformin often used with (some) success in new type 1? I’m surprised it would help this much.
 
JMK1954 said:
Is this a GP recommending this course of action or a consultant at a hospital clinic ?
Click to expand...

porl69 said:
If you are type 1 then insulin then you have no choice on whether you "wish" to start insulin sooner rather than later you will have to start insulin full stop!!.....Who has diagnosed you and told you this....was it your GP??
Click to expand...

Consultant/Nurse at a Diabetes Clinic

HSSS said:
You say PROBABLY type 1. Are you awaiting test results? If not on what basis and by whom?

whilst I am by no means arguing with the above advice if you are type 1 if you are in fact type 2 then insulin at the get go is unlikely to be the only or best option especially without exploring others alternatives.

Is metformin often used with (some) success in new type 1? I’m surprised it would help this much.
Click to expand...

He expects it to stop helping and would "eat his hat" if I wasn't type 1

Still need to take antibodies test which he said isn't 100% conclusive anyway

Either way some usual things like no ketones, acanthosis nigricans normally seen in type 2? And not long ago I had symptoms of low blood sugar

Blood is at 10.5 this morning. Pumped my first insulin shot
 
Medina27 said:
Consultant/Nurse at a Diabetes Clinic



He expects it to stop helping and would "eat his hat" if I wasn't type 1

Still need to take antibodies test which he said isn't 100% conclusive anyway

Either way some usual things like no ketones, acanthosis nigricans normally seen in type 2? And not long ago I had symptoms of low blood sugar

Blood is at 10.5 this morning. Pumped my first insulin shot
Click to expand...

Gave you a 'winner' not because of likely being T1, or having those symptoms, but simply because you took your first shot.
Big step.
It will all become very standard in time, but wanted to recognise that it probably feels like a huge hurdle for you.
:)
 
Hi. It's usually better to start insulin early if you are suspected of being T1. I was refused it for too long and regret that. If tablets don't help control then insulin is needed. Check that the clinic is also doing a c-peptide test to check your insulin level. The GAD antibody test can sometime prove negative, as mine did, even when T1 is in the wings as more than antibodies can cause beta cell destruction. If GAD shows positive then you are T1.
 
Blood went from 10.5 up to 14.5 two hours after breakfast despite my first insulin injection of 8 units in the morning as well as metformin dose

Cause for concern?
 
Medina27 said:
Consultant/Nurse at a Diabetes Clinic



He expects it to stop helping and would "eat his hat" if I wasn't type 1

Still need to take antibodies test which he said isn't 100% conclusive anyway

Either way some usual things like no ketones, acanthosis nigricans normally seen in type 2? And not long ago I had symptoms of low blood sugar

Blood is at 10.5 this morning. Pumped my first insulin shot
Click to expand...

I understand ketones are not constantly present in type 1 either so no ketones just means no dka building up as far as I know

Low bloods are typically only seen when medicating with something that increases the amount of insulin in the body so I’m not sure how this helps diagnosis either

antibodies if positive are definite for type 1. If negative it could still be either type.

Please tell me they did a c peptide or insulin test?
 
eventhorizon said:
Which insulin are you using?
Click to expand...

It says insulin glargine on the pen

HSSS said:
I understand ketones are not constantly present in type 1 either so no ketones just means no dka building up as far as I know

Low bloods are typically only seen when medicating with something that increases the amount of insulin in the body so I’m not sure how this helps diagnosis either

antibodies if positive are definite for type 1. If negative it could still be either type.

Please tell me they did a c peptide or insulin test?
Click to expand...

I wasn't told much details. I think I remember seeing "c peptide" on the computer screen though

My next test is as follows - Anti-glutamic acid decarboxylase GAD Ab, Islet antigen-2 Ab (IA2)
 
Glargine is a long acting background, between meals, basal insulin. Usually taken once or twice a day. It will have little effect is controlling bloods sugars at meal times. If you are type 1 your doctor will most likely put you on a fast acting, short duration insulin which you'll use a meal times in combination with the glargine. This insulin regime is called 'multiple daily injections' or 'mdi'.
 
Insulin Glargine, also known as Lantus, takes around a couple of hours to 'get going'. During those hours you have eaten, causing your sugar level to rise before the insulin has become active. This may explain the rise in your test result this morning. Did you eat your normal breakfast ? What was it ?
 
I'd add to the above that you may still have some beta cells (producing insulin) and as well as taking insulin could look at a low carb diet as a way to extend their life span.
Richard Bernstein is a type 1 himself and a diabetes specialist who advocates low carb for many reasons and this one of them. There are plenty of type 1s who eat carbohydrate and choose to cover that with insulin jabs but I thought I'd let you know there are some choices.
You will need the background basal insulin because whatever you eat your body will still make glucose via your liver and the action of insulin's antagonist glucagon.
 
jamesfitz said:
if you are type 1 I would personally start on insulin straight away, it will maximise the length of your honeymoon period
Click to expand...
I'd start on insulin and not use Metformin. Be careful though and have some Graze bars, Lucozade or something with you at all times in case you get hypo with insulin, it takes time to get used to it and exercise or being unwell will affect your insulin doses. We've been there, just ask, it's a helluva learning curve but you'll get there
 
I think there are 3 important things for you to do:
1. Find out ASAP what type you are. T1 or T2 or one of the variations in between.
2. This diagnosis will determine your action with the insulin. In my experience as not T1 is that the insulin increased my sugar levels that required more insulin that increased my sugar that required more insulin that...etc., etc. I also put on over 20 lbs in about 5 months.
3. Depending on the true diagnosis, research and decide on the most appropriate diet for your condition and for you. This site and forum will be invaluable for this. My solution was/is a low carb diet and I no longer take insulin and I have lost 40+lbs.

Not sure if T1s would agree but if this is what you are then you may need to change your lifestyle, as well as diet, to deal with the practical requirements of your condition.
As some form of T2, along with the diet I do as much exercise as possible (walking and gym) and I have brought my condition 'under control', quoting my doctor and a diabetic nurse. In this state I now have more flexibility in when and what I eat.

Hope this helps at the start of a new road in your journey.
 
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