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Nurse visit today - Insulin time!

J

Joannef

Member
Messages
9
Type of diabetes
Treatment type
Tablets (oral)
I've had an appointment with the nurse at my local surgery today and she wants me to go on insulin. I've been on 2 x Metformin for the past two years but now can't get my sugar levels below double figures. They put me on 1 x 80mg Gliclazide just over a week ago but I still can't get into single figures. The nurse said today that she will speak to the doctor when he returns on Tuesday but she has told me I am "going down the Type 1 route" and the only option is insulin. I have asked if they can increase the gliclazide or can I take sitagliptin but she has said highly unlikely. Bit disappointed that they don't seem willing to let me even try. I only weigh 8 stone so they won't let me increase the metformin. The nurse has said they will start me off on basal ? once a day and see how that goes. I don't really know anything about this and wondered if anyone can offer advice. I will also need to keep taking the gliclazide & metformin. To be quite honest if I have to go onto insulin I think I would prefer to go completely onto insulin so that I could hopefully lead a bit more of a normal life. I have 3 cousins who are Type 1 and seem to be able to eat fairly normal meals in moderation. I would love just to have a bowl of porridge in a morning instead of eggs etc Does anybody have any opinions as to what would be the better option me ? Has anyone else been in the same situation ? Thank you
 
Seems like they are skipping a few rungs on the ladder, have they talked to you about Victoza or anything like that? After all else failed with me the put me on to a premixed insulin and now after I got used to that I am going down the same route as you seem to be going down, I'm no expert and don't know your case but there are other things to try I would have thought but the dsn knows more than me


Type 2 diagnosed 24/01/2013.
Novomix 30, Victoza, Simvistatin.
 
Have you been tested for type 1 (e.g. GAD antibodies, C-peptide). I would ask to be tested, your low body weight may suggest you are more of a type 1. I went for 2 years as a "type2", struggling with worsening control and increasing medication (metformin, glipizide, sitagliptin) which all eventually failed and mentally beating myself up for failing. I was tested for type 1 markers, and hey presto change in diagnosis and onto insulin. I am still on a learning curve but am feeling better than I have for years, physically, mentally and emotionally.
 
Been there as well flakey, dreadful experience.




Late onset T1, several auto immune issues.
Humalogmix25 twice a day, Methotrexate 25mg once per week, FolicAcid 5mg once per week, prednisolone 5mg daily, Allopurinol 300mg, Calcichew-D3 800iu, Levothyroxine 50mcg, Atenolol 50mg, Losarten 100mg, Aspirin 75mg, Nicorandil 20mg, Nitrolingual GTN spray, Metformin 2000mg, Allimemazine 10mg, Lanzoprazole 30mg, Atorvastatin 20mg, Co Codamol 8/500mg, Depo Medrone (Methylprednisolone) or double Prednisolone for 7 days in case of RA flare.
 
Hi. Yes, you are almost certainly a late onset T1 (been there done that!). I went thru Metformin plus Glic plus Sitagliptin. The latter two on full dose might delay the insulin for a year or so but insulin will be needed eventually. You are lucky you have been offered insulin; take it! I was refused for a year because I was assumed to be a T2 due to NHS ignorance. I was started on just Basal (24 hour insulin; well 18 hours actually) but my lovely DN added Bolus (fast acting for meals) a month or so later to give better control. You may find Basal is OK for a year or so but do ask for the full Basal/Bolus regime if you need better sugar control and food flexibility. BTW I asked the DN to stop the Glic when on insulin as it's pointless trying to stimulate non-existent islet cells when you are taking insulin anyway; she agreed but kept the Metformin going as it has some protective advantages.
 
Thank you all so much for your opinions. I think I know deep down insulin is really my only option and I am just trying to put off the inevitable. ....
 
I think after a few weeks your opinion will reverse from "inevitable" to liberating. I do hope so because it will mean everything is in a better balance. Best of luck.
 
To be quite honest if I have to go onto insulin I think I would prefer to go completely onto insulin so that I could hopefully lead a bit more of a normal life.
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Assuming for the moment that you have not been misdiagnosed, which is certainly possible since a lot of T2 do go on to require insulin, keep in mind that T1 (there is no insulin because the pancreas was destroyed by trauma or autoimmune attack, so we need to replace it) is a lot simpler than T2 (your insulin isn't working and your liver is making too much glucose but we don't really know why or how to fix it, so we have to resort to giving megadoses of insulin) so aiming to treat T2 with insulin only is IMHO a bad idea.
 
Flakey Bake said:
I think after a few weeks your opinion will reverse from "inevitable" to liberating. I do hope so because it will mean everything is in a better balance. Best of luck.
Click to expand...

Thanks Flakey Bake. I'm sure you are right. I will post as soon as I've spoken to the doctor. I think I have just got so used to feeling the way I do I'll be amazed to realise what it's like to feel well!
 
Hi everyone, I went back to the doctor's on Thursday and told them I'm not ready to go on insulin. The doctor said I'm basically trying to shake coins out of a piggy bank that I just don't have! He has agreed to increase my gliclazide for a few months and see how it goes. I woke up today with the best reading I have had for a long, long time 9.5! So the tablets are obviously doing something. Really pleased and I hope I can continue to lower it over the next few weeks. I realise that I am only buying myself a little bit of time and that insulin is inevitable but I want to avoid it for as long as possible. I did ask the doctor if I could actually be a type 1 and he just replied "this is the question - it's hard to tell". Think I will ask for the GAD test next time.
 
Hello Joanne

May as i ask if you have tried to reduce your blood sugar levels with dietary changes? have you heard of the low carb high fat diet? its basically reducing the carbohydrates in your diet, carbohydrates turn to sugar once eaten, so by eating carbs you are effectively eating sugar, if you reduce these foods (ie. bread, potatoes, rice and pasta) you will be reducing the sugar in your blood, i apologise if you have tried this, but if not, please consider it, its a very effective and healthy of gaining better control and far far safer than taking prescription drugs, i believe that many type 2 diabetics are already producing too much insulin, we are just unable to use it, so to pump more insulin seems counterintuitive, please feel free to ask questions about LCHF if your interested

best of luck



 
Hi Andy,
Thanks for your advice. All advice is grateful!! Yes I try to stick to a low carb diet. I do have very little carbs (although probably not as few as yourself). Sadly it doesn't seem to be what I am eating that causes my blood sugar to rise. I have done a Newcastle type diet for a few days this week and still have had readings of between 12 & 16 in a morning. I think my diabetes may be more stress related than anything - although I don't really have anything to stress about I do worry about everything!
 
maybe you could try going even lower? im sorry for being low carb evangelist. i cant help it

i hope you get yourself sorted soon x
 
I believe it will take at least a week and up to 8 weeks (depending on the amount of weight you have to lose) for BG to normalise on the Newcastle Diet. Maybe give it some more time?
 
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