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Is control easier with insulin?

ClareBearJ said:
Is insulin really only used as a last resort in type 2?

Ive had trouble with control since diagnosis, only with being on the high side really. I had my testing strips taken off my prescription months ago as I dont qualify for them being a type 2. So nowadays I test very rarely with the remaining strips I have left. I knew something was wrong just now so tested for a result of 29.9 mmol.

I currently take Janumet twice a day along with 2 gliclazide twice a day. Just wondering if the tablet options are running out, or if they have more up their sleeves? Sometimes I think itd be easier being on insulin as in this situation I could quickly bring it down.
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My highest reading after diagnosis was around 419 mg/dl ~ 23 mmol/L. We are all different, but for me, no medication, no insulin, no exercise...just carbs reduction. So that is something to consider...should carbs reduction be the last resort?

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HSSS said:
Well a non diabetic is very unlikely to go further hypo and unconscious or dazed and confused and infact being in the 3’s isn’t unusual for metabolically healthy people as their liver glucose and insulin work effectively in tandem unlike ours.

That said I’m sure lots of people do in fact drive in a state they shouldn’t (eg just plain old tired or whilst sick) but being under 4 for a diabetic on strong glucose lowering meds is a known, quantifiable and recognised risk whereas other risks are less measurable. I guess the nearest comparison would be alcohol as that is also be measurable and that risk is legislated against.
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Nice answer, thank you.
Whilst I was taking insulin I had a few low readings (actually almost every day) However I did not 'feel' any different.
It must be quite hard for people who have little or no awareness or obvious symptoms that they are going that low.
It was only because of my constant testing throughout the day that I was aware.

Getting back to the title of the thread. For me it was far easier whilst I was on insulin to keep my BG numbers low without a doubt. However I was never going to feel 'I' was in control. Which is why I was so determined to reduce my Carbohydrate intake and see how I could reduce the insulin dose. Eventually I was told to stop taking insulin by my diabetic specialist, who was amazed at how my numbers had reduced in such a short space of time.
 
poemagraphic said:
True. I wonder how many non diabetics drive around all day under 4. Can a non diabetic go hypo?
I know very little about this deadly issue we tussle with daily.
I do know that I feel more alive, more healthy, more energetic, more mentally alert in last few weeks than I have done in over twenty years! All thanks to this website, its contributors, and my new found LCHF lifestyle. Long may it continue.

Being put on Insulin three months ago was in hindsight the best thing that could have happened to me.
What a huge wake up call that was. I was 100% determined to come off it after my first night of sticking that tiny needle in my tummy. It felt like 'Seppuku' Not a good feeling for a black belt like myself.

Po
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If I had to be 5 to drive, I'd only be able to drive for the total of a couple of hours a day, after a decent meal, with some carbs (albeit modest quantities).

No meds, ever. Aics under 30.
 
DCUKMod said:
If I had to be 5 to drive, I'd only be able to drive for the total of a couple of hours a day, after a decent meal, with some carbs (albeit modest quantities).

No meds, ever. Aics under 30.
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Do you feel at times sorry for those who have such a struggle to keep their numbers low, or those who just are unable to get in to single figures for whatever reason?

Whilst on a visit to the DN last month for my first insulin awareness day a lady asked me why I was even there. I had just handed my log to the nurse who said she was pleased with my current numbers. The nurse then went to this lady and said "I am unhappy that you keep having readings over 17" Well I don't suppose she was too pleased either. Hence her retort to me when the nurse said my numbers were good (I was averaging 6.2).

My A1c used to be over 100.
 
poemagraphic said:
Do you feel at times sorry for those who have such a struggle to keep their numbers low, or those who just are unable to get in to single figures for whatever reason?

Whilst on a visit to the DN last month for my first insulin awareness day a lady asked me why I was even there. I had just handed my log to the nurse who said she was pleased with my current numbers. The nurse then went to this lady and said "I am unhappy that you keep having readings over 17" Well I don't suppose she was too pleased either. Hence her retort to me when the nurse said my numbers were good (I was averaging 6.2).

My A1c used to be over 100.
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Well, I started at 73, so hardly borderline or the like.

For those who struggle and struggle, and are doing their best, I feel for them, and often wish there was more I/we could do to improve their lot, but provided I am doing my best for me, and helping those I can, I have to be content.

Don't get carried away thinking because I, or anyone else for that matter who now has great numbers has just found it all a walk in the park. All it means is we have each walked our own version of the hard yards.
 
I don’t find it any easier to keep my bg reading under control with insulin. You normally only get free meters & test strips if you are on insulin if you are a type 2 who has normally high bg. Like you I normally have high bg reading & never had a hypo in the 13 years I was using gliclazide. I am using insulin for the last year & a half and I have slightly better control of my bg. As soon as I started with insulin I was given a meter and test strips, which I get on prescription. You should never have to pay for your own test strips & unless you are likely to get a hypo you have no real need to test. You dn should be testing you every 3 months until you get it under control. You need to take their advice. There are thing to try before insulin like Victoza,
Empalifiozin etc.
Even on insulin you will still be taking pills also.
I take
Amlodipine 10mg x1
Atorvastatin 20mg x1
Empalifiozin 10mg x1
Indapamide 2.5mg tablets x1
Lisinopril 20mg x1
Sukarno SR 1000mg x2
Basal insulin 24 units in the morning & 22 units at nigh.

Until recently I was also taking 2 gliclazide a day. When I was taken of them my control went out the window which is why my insulin has been increased and split. Better you control your eating & stay on just pills.
 
@Derbysocks - if you are on insulin then you need to test. Otherwise how will you know if your dose is right? You could be running dangerously low at night and sleep through it, and worryingly high during the day - and your three monthly HbA1c could come out as normal. Insulin is a dangerous drug that needs constant monitoring.

It’s like driving a car without a speedo and only knowing you have a problem when the speeding fine lands on your doormat.
 
ClareBearJ said:
Is insulin really only used as a last resort in type 2?

Ive had trouble with control since diagnosis, only with being on the high side really. I had my testing strips taken off my prescription months ago as I dont qualify for them being a type 2. So nowadays I test very rarely with the remaining strips I have left. I knew something was wrong just now so tested for a result of 29.9 mmol.

I currently take Janumet twice a day along with 2 gliclazide twice a day. Just wondering if the tablet options are running out, or if they have more up their sleeves? Sometimes I think itd be easier being on insulin as in this situation I could quickly bring it down.
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Yes!

For me anyway, its been very helpful, my control is very good or at least very good compared to very bad before the insulin, nothing was working for me so I am where I am and happy to be.

Is it bad for a T2 to take insulin? Maybe, is it bad for my bg to be silly high all the time? Definately! So I take it and hope for the best.

LCHF is terrific if you can get control that way, I would highly recommend it, worked for me for a lot of years, I did however have to eat extremely low carb and found that difficult long term, so now I eat low carb mostly

I do feel like a failure, especially reading this forum lol, but heyho, my bloods are very good, I am lucky I only need 20 units basal a day and novo to suit what I eat, generally between 6 -12 units, the control it gives me is incredible, its like choosing what number I want to be, hypos suck so I work quite hard to avoid them.

Whatever you end up doing, best of luck


EDit... i self fund freestyle libre, this has been a godsend, I never finger prick test any more, highly recommend if you can afford it, even if just for a little while, its an eye opener
 
Fenn said:
I do feel like a failure, especially reading this forum
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By your own admission low carb worked for some time. Without it you may have been on insulin many years earlier. No one can predict what course our individual diabetes make take in the future. We each do what we can right now and reassess as things change. Sure many of us prefer - when we can - to take no or fewer meds but that’s not always an option. As you rightly say being healthy is the goal, the method varies.

Low carb ran its course as the sole means of control so you took steps to regain control. Where’s the failure in that?
 
HSSS said:
By your own admission low carb worked for some time. Without it you may have been on insulin many years earlier. No one can predict what course our individual diabetes make take in the future. We each do what we can right now and reassess as things change. Sure many of us prefer - when we can - to take no or fewer meds but that’s not always an option. As you rightly say being healthy is the goal, the method varies.

Low carb ran its course as the sole means of control so you took steps to regain control. Where’s the failure in that?
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Thanks.

Insulin is demonised, im sure this is understandable, its all good, my children are going through exams at school, I repeatedly say “just do your best, no one can ask any more of you” well ive done my best, so if I am a failure I am at peace with it hehe.
 
Even on insulin control can be complicated. The old fashioned exercise and reduced eating can really compliment insulin treatment, for better control.
Insulin doesn't normalise my bgs without considerable hard work with my restricted mobility.
Although without insulin I'd be in hell for sure.
 
ClareBearJ said:
Is insulin really only used as a last resort in type 2?

Ive had trouble with control since diagnosis, only with being on the high side really. I had my testing strips taken off my prescription months ago as I dont qualify for them being a type 2. So nowadays I test very rarely with the remaining strips I have left. I knew something was wrong just now so tested for a result of 29.9 mmol.

I currently take Janumet twice a day along with 2 gliclazide twice a day. Just wondering if the tablet options are running out, or if they have more up their sleeves? Sometimes I think itd be easier being on insulin as in this situation I could quickly bring it down.
Click to expand...

I am type 2 & managed to persuade my GP to prescribe insulin which does make control direct & so is far better than other medication but it also meant I could get test strips prescribed. You can of course buy test strips over the counter but the NHS should prescribe at least some for type 2 patients. It is only by testing can type 2 patients challenge assumptions made about us based on their Hba1c test.
 
Fenn said:
Thanks.

Insulin is demonised, im sure this is understandable, its all good, my children are going through exams at school, I repeatedly say “just do your best, no one can ask any more of you” well ive done my best, so if I am a failure I am at peace with it hehe.
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Fenn - I don't believe insulin is demonised, but I do firmly stand with trying other things before resorting to insulin, for T2s, as quite regularly it can lead to weight gain - especially where mixed insulins and/or fixed doses are prescribed. The need to eat a set level of carbs per meal, day in day out is just as wearing as constantly swerving carbs for some folks.

Insulin is also a very hard tether to the pharmacy and supplies, which can oftentimes be avoided, particularly by those near the beginning of their time with T2 diabetes.

Personally, I would like to avoid insulin forever, if I can, but if the time comes where my body or my circumstances change, rendering that a foolhardy stance, I will accept exogenous insulin.
 
Derbysocks said:
You dn should be testing you every 3 months until you get it under control. You need to take their advice.
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Mmmm... My DN told me on our first appointment never go to bed if your BG is under 8.
I have sat up eating a banana, I have sat up eating 1, then 2, then 3 jelly babies. I have sat up eating 3 Rich Tea biscuits waiting to get my levels above 8 before going to bed in case I die in my sleep of a hypo!

I wish I was kidding (as those who know me know I do)

I posted on the forum and decided that 'she' was flat out wrong.
I would take my insulin as instructed, be doing well at around 5-6 dropping below 5 even... then scoff till they got above 8. A couple of nights at the start of my injecting it was gone 3 am in the morning before I went to bed.
This is the guidance she is giving to all who she sees in her normal working day!!!

She also told me to consume around 60g of carbohydrate per meal.
Well that might work for some people I guess.
For me within a week of joining up here and spending hours reading others posts, and watching video links and reading countless articles of the benefits of a low carbohydrate diet.
I went to bed under 6 most nights and was eating less and less carbs and injecting less and less insulin to prevent me going hypo every day.

In the last three months I have stopped injecting insulin altogether and also now stopped taking Glicaside.

I now consume around 30g of carbs a day, and feel better than I have felt for over 20 years.
My DN would now just be taking my bloods for the first time after my first 3mts.

My levels would perhaps have increased and my insulin dose would have been increased also. Plus more Glic and who knows what else... Statins next (I was told I must take them, guess what I said, answers on a postage stamp to potheguywhoignoredthedn.


I was testing 10 times a day, every day, I still test often to see what effect different foods have and the time scale of those effects.

All I can say is I am glad I DID NOT follow the advice of my diabetic nurse.
Po
 
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HSSS said:
If you are taking insulin or glicazide this is always a risk.
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It is a very real risk.
I posted above a comment that may have seemed flippant regarding hypos...

However

I can not find one single death ever being recorded, attributed to a Type 2 on insulin dying in their sleep as a direct result of hypoglycemic reaction.
 
Maybe it’s “resorting” to insulin because it is a more heavy duty drug in regards to the effect it has on a person, the higher burden of self care required, the potential and severity of errors, in a type 2 the potential for simultaneously helping and hindering glucose management and insulin resistance, side effects such as weight gain. Long term complications are not necessarily lower despite improved glucose levels, possibly due to the continued existence of hyperinsulimea.

There are many other approaches including other medications and combinations out there too. Many of these medicines will share some of the drawbacks listed above. Now obviously these will not suit everyone for a wide variety of reasons from side effects to life choices.

Any choices, made knowledgeably, should totally be respected. Any made in ignorance deserve education.

For some genuine type 2 (I deliberately exclude other types along with those others misdiagnosed as type 2 when they arent) it is the best or only option having considered the alternatives. But there is no getting away from the fact it is widely seen as the ultimate and end of the line medication treatment for diabetes. In common language this is a position often termed “resorted” to. That is not the same as demonisation.
 
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