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Looking for someone to point me in the right direction!

T

Trulee

Well-Known Member
Messages
96
Type of diabetes
Type 2
I'm type II and have been for about 14 years - initially diet, then Met, then a mixture of various orals until changing the Byetta, Met and Glic approx 2 and a half years ago. I also had a heart attack 3 years ago so take various medications resulting from that too!!

Over the last year my control has started to slip again - initially on the Byetta I managed to lose almost 15% of my body weight (which I have kept off - weight now fluctuates up and down by 4lb a month at the most, but comes back to the 'centre' every time), but now my BG level are really 'uneven' through the day.

Breakfast is normally 'OK' though can have a tendency to start quite high, and after evening meals it can drop as low as 3.8 two hours after eating, but during the 'middle' of the day I can quite often end up with levels as high as 15 without eating or drinking anything I shouldn't :? - my last HBA1C was 8.8

I know when I go for my next clinic appt they are going to press for me to move to insulin - this really frightens me!! (I don't have a problem with needles, obviously with the Byetta I'm used to them anyway), My main fear is putting weight back on - I fought to lose the weight with the help of the Byetta, and for the sake of my heart condition I really do not want to start putting it back on again.

I know there are a couple of insulins that supposedly don't cause weight gain in Type II's but have no idea what they are, or if they work in any way differently from the others

Is there anyone out there who can point me in the right direction to find some research into this subject please?

What I really want to do is go to my clinic appt with the facts and costs of 'traditional' 'first line' 'cheap;' insulin, against the more expensive, and probably better for me ones

many thanks
Trulee
 
I wonder if Januvia {sitagliptin} might help you with the surges in the middle of the day? Its expensive I believe and usually has to be prescribed by a consultant but if t can stop the surges your HBA1C should come down. Worth a try or worth asking perhaps?
 
Thanks Unbeliever - will ask

I'm sorry I seem so 'woolly' about what I'm asking, I used to be very positive and research every possible combination of what I thought might help, but since the heart attack I don't have the same concentration span and find myself going round in great big circles getting nowhere most of the time
 
Best of luck Trulee. I don't think you are the only one going around in circles with it all.Sorry I don't know anything about the insulin question but my main object is o keep off it because I too fear it will make me put on weight which will lead to my taking more insulin which will make me put on more weigh etc.
The way my medication to date has been handled doesn't give me any confidence hat insulin would be handled better it is just anoher hing added to the mix..
Perhaps you should ask o see a consultant as here are various new drugs now but they seem to take a long time working their way into he system.
 
I'm apologise for putting this quite bluntly, but the only reason people on insulin tend to gain (excessive) weight is because they eat too much and CAN gain weight: Insulin allows muscle cells to utilise glucose for energy; when stores are full excess glucose is stored as fat. Your kidney starts filtering out glucose when levels get too high (>10ish) i.e. you are forced to throw food away.

Having said this, newer analogues (Levemir, possibly Lantus) are associated with a smaller weight gain. Many people here do complain about complications with Lantus, however.

Edit to add: You might also want to consider that all diabetic complications are due to damage to blood vessels due to high glucose levels (e.g. feet don't heal as quickly because of impaired circulation; this also increases the risk of heart attacks and stroke. Your doctor will have considered that if he suggests that you start insulin therapy.
 
Hi Trulee
I can understand your fear of the insulin and weight gain if you have fought so hard to lose the weight and you also have heart trouble to contend with, but if insulin will give you a better overall control then I would consider it . You know how to keep a check on your weight now, so hopefully you will be fine and make the adjustments to counteract any slight weight gain.

I have found that there was weight gain with my Basal insulin (Lantus) I do Ultra Marathon so to be honest the comment about diet and exercise being the only thing to make a difference when you are on Insulin was not rue at all for me, also I have spoken to others about this and they found the same.
When my Basal increased even with the same amount of miles a week and intensity of training sessions AND the same strict training diet my weight would increase if the basal did. I eat clean, same things day in day out when training, I would find the pounds would go on with a Lantus increase, interestingly the bolus increase made no difference at all. The weight would also go on as fat not muscle and I would see this happen as the Lantus went up so would the weight gain...not a lot ,but enough for me to see it and notice it with my times/performance.

I have read a fair amount of anecdotal evidence about this with Basal/Lantus . Now, Levemir is supposed to have a much more stable effect on weight gain, if that is a problem for you. It is even documented that people who have swapped form Lantus to Levemir without trying have lost weight.

It may be worth discussing this with your HCP and going for this Basal as it may be better for you, it is all trial and error at first but if Insulin gives you a much better level of control to improve your oveall health then seriously think about it as an option as there are a lot of options out there with different insulins.
I hope some of this helps and wish you all the very best :D
 
Hi Guys
Thank you all for the replies - but from them, it would seem I've been a bit confusing - I am not contemplating refusing to move to insulin as some of your replies would suggest - I know that in the long term that is probably the way to go.

What I don't want to do is go the 'wrong' way for me - I suppose I want the silver lining without any of the clouds beforehand, which is probably a bit unrealistic, but with everything else I take I really don't want to have to spend another year trying to find the 'right' insulin therapy for me.

thanks again
Trulee
 
Me again - see told you my concentration span is useless these days :oops:

Can anyone point me in the right direction to compare costs for Exanatide to Levemir?

thanks
Trulee
 
For the quickest reply Trulee you may find it better to start a new opic or ask again with the words Exanaide and Levemir in th etitle. Not everyone reads everything and those with the detailed knowledge may not have read your original post.

I did not think you were trying o avoid insulin but I think understood your reservaions. U feared puttting on the weight you had lost and didn't want to strt from scratch trying to find a suitable insulin regime because you have other issues to deal with.

I am in the same boat to an extent. I have maknaged to reduce my bg levels by exercise and reducing

carbs.If I begin insulin my weight will go up and my levels will rise Any significant change up or down
makes my macular oedema worse. My aim is to keep things low but stable.
I resist any but unavoidable changes for that reason. I know from experience what the result would be.

I read a study a few months ago which stated that insulin could not be said to be working if there was not an immediate gain in weight. In these cases HCPs were advised to increase doses immmediately.

Even if this was reversible I know it would damage my sight.
I don't wan o depress anyone but have to point out that in spite of the most stringent control and low levels some unfortunates do get complications.
If only it were as simple as energy in equalling energy out to avoid weight gain and keeping levels low to avoid complications.

Good luck Trulee. I hope you get the information for your "dossier " very soon . Perhaps diabetics will start employing researchers and lawyers soon before they visit the clinics!
 
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