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T2 need to go on insulin.

Discussion in 'Insulin' started by claudetteholmes, Jun 3, 2018.

  1. claudetteholmes

    claudetteholmes Type 2 · Well-Known Member

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    I have a meeting with my nurse on Tuesday. They will discuss my different insulin options. After reading all the info on insulin, I would like to hear from the forum. My experience in the last 10 years is that I had to self diagnose ( my doctor called me a type A diabetic, I eat by my meter and self manage as best I can) Thanks to the forum I have been low carb for 3 years. Here is some basic info.
    I am 48, t2 diabetic, in menopause, overweight. My sugars till beginning of this year was perfect. I started to pile on weight from last year even with exercise and low carb. Nurse told to just carry on as normal. I am now out of oral medication options. I was put on highest dose of gliclazide and were so ill last month with huge spikes from 18 to lowest 3.8
    Since coming off the gliclazide last week my sugars has stabilized. I had only one reading above 10. My sugars are all between 9 and 7.8. I feel the best I had in months no nausea, headaches, dizzy spells and my energy levels are up. I am much happier. What do I need to ask?
    Any feedback on your experiences going on insulin would be very welcome.
     
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  2. Crocodile

    Crocodile Type 2 · Well-Known Member

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    I'm not being flippant but start with the obvious ones first. If you are overweight as you say, lose it. I know it is easy to say but it makes a massive difference. May I ask why you piled on weight. Is it an underlying medical condition or just a case diet management.
     
  3. Jenny15

    Jenny15 Type 2 · Well-Known Member

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    I started insulin last week and today started to see signs that I'm finally lowering my BGs after a nightmare 2 year period that did permanent damage to my body. I can answer any question you like about it but I want to make two points.

    BGs between 7.8 and 9 are elevated but not severely elevated compared to a lot of people. What was your A1c like last time and for the previous couple of times? If you are able to achieve and maintain a fasting BG between 4 and 7 and an HbA1c under 48 within a few months, then you might not need insulin, but I'd need more info before I could say any more than that.

    I have found that even when posting in this, the insulin sub-forum, there are still people who come in to quiz me about mentioning insulin as a T2. There are strong feelings about the subject, even though many of the people are unlikely to ever face the kinds of decisions you and I are facing.

    If you want to discuss it just with people who use insulin, it may be best to do it by private message. It's a shame people have to do this but I'm just putting it out there for you.
     
  4. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    These numbers looks reasonably good to me though there is certainly room for improvement.

    What is a typical low carb day like for you? What other medication are you currently on?

    Being overweight would suggest that the problem is more likely to be insulin resistance rather than the lack of insulin. We really need to maintain high levels of insulin to keep our fats in perpetual storage.
     
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  5. claudetteholmes

    claudetteholmes Type 2 · Well-Known Member

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    Thank you so much. My family is full of diabetics. Type 1 and 2. Most of the type 2 s is on insulin pancreas is just not working.
    My last Ac1 result on the 30 April was 8.9
    2017 April was 5.2. 2016 was 6. Since they increased my gliclazide my sugars went nuts. I was feeling unwell but on 4 tablets were so sick. As to options it is great but I eat very low carb have done for a long time and have run out of oral drug options. Insulin is not the way I wanted to go but need to get my sugars down. Like my dad said the damage that was done in last 6 months is permanent. I have been to doctors so many times and finally they are listening but found the support medically sketchy my nurse is very supportive
     
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  6. Jenny15

    Jenny15 Type 2 · Well-Known Member

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    I can understand Glic making things go haywire. Since you have only just stopped it last week, you might want to wait a couple more weeks to see if things settle down to where they should have been before you started on it. Do you get your A1c tested more often that once a year? I think you should get it every 3 months at least until your BGs are under control. What damage in particular is your Dad referring to? What other diabetes drugs have you tried (or did not try because they were not going to be suitable for you)?

    If you decide you want to try insulin I certainly won't try to talk you out of it - you know more about your situation than I do. I'm just trying to understand as much as I can about your BGs and any other factors. Your low carbing is fantastic. Well done!
     
  7. claudetteholmes

    claudetteholmes Type 2 · Well-Known Member

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    I have been on Metformin for 6 years and then eventually became housebound because of tummy upsets. I have now permanent problems with very sensitive tummy and IBS. I tried the wee out sugar medication ( cant remember name) ended up in hospital with kidneys inflammation. Then gliclazide and sitagliptin low dose for 3 years till menopause started 20 months ago. I exercise I eat well I fast weight just slowly increased. Going to drs was your sugars is fine weight will get better as you go out of menopause. It didnt became ill . On high dose gliclazide my average sugar in last month was 12.8?
     
  8. claudetteholmes

    claudetteholmes Type 2 · Well-Known Member

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    Also I have asked in past for more tests but was told I am so well controlled ( ocd self management) that the cant justify cost of bloodtests. As to damage my feet have lost some feeling my feet/ hands are always cold. My nails are blue. My eyes are worse. Blurry vision if sugars are higher than 9. Repeat gum infection. My poor dentist is up in arms and said my oral health is down. Repeat infections.
     
  9. Jenny15

    Jenny15 Type 2 · Well-Known Member

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    The more I read about people's experiences with Glic the less I like the sound of it. I think you won't really know where things stand with your BGs until the effect of Gliz has gone. IDK how long that takes but I'm guessing more than one week.

    Are there any meds you are still taking?
     
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  10. claudetteholmes

    claudetteholmes Type 2 · Well-Known Member

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    Just sitagliptin. I was told by dr that gliclazide is fast acting and unlike metformin that is systemic it doesnt build up in system. Gliclazide takes maximum 8 hours to leave system. My last dose was last Tuesday. When doctor looked at all my graphs and concluded that my pancreas is not producing enough insulin . So need to see nurse to get options
     
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  11. Jenny15

    Jenny15 Type 2 · Well-Known Member

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    You are now entitled to 3 monthly A1c tests at least temporarily, because your BG is no longer well controlled. I can explain the ins and outs of it later (getting late at night here in NZ) but basically it's wrong of them to deny you these tests. If you had been having them then you could have intervened sooner.

    You could ask your dentist to write to your GP with his or her concerns.

    It may be that you only need a small insulin dose to just give you a push as you get back to where you need to be. And you might find that you can go off it after a few months.

    I'm concerned about all the other symptoms you now have and whether you have a GP who takes your concerns seriously enough to give you the help you need. These other issues need to be looked into, with referrals to specialists where needed, and trialing meds like gabapentin (just one example) for nerve pain. Some meds can treat the problem, others give symptom control, which in itself can greatly improve your quality of life.

    Let's assume for a moment that you go on insulin and your BGs come down to the right level and your A1c (hypothetically) is in the 40s. Would all of your other symptoms be gone? No.

    You would be preventing further harm, but that's all. I suggest writing down a list of your symptoms and taking them to your GP to discuss ways to get the assessments/reviews you need. If your current GP has proven useless, I hope you can try a different one.
     
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  12. claudetteholmes

    claudetteholmes Type 2 · Well-Known Member

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    Thank you I will. Rest well and we speak later xxx
     
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  13. Jenny15

    Jenny15 Type 2 · Well-Known Member

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    I don't know anything about Sitagliptin so am unable to comment on whether it is like Glic and may be doing more harm than good.

    If your doctor believes you have insufficient natural insulin then yes you definitely need to inject insulin. Most T2s are not in this situation, so I didn't mention it. There are blood tests they can do to measure insulin levels in a situation like yours.

    If the above is true then there probably aren't any questions you need to ask the nurse on Tuesday that you haven't already thought of. Once it is agreed that you are going to start insulin, the rest is very straightforward.

    Write down this list of things you need prescribed or otherwise to obtain somehow:

    Script: (Nurse should know all this but check she didn't forget anything)
    -Insulin (usually 2 pens to start with, there are various types of insulin)
    -Disposable needles for pens. 4mm is best.
    -BG meter and plenty of test strips

    (even if you have your own meter, because their free one may be different. Most meter kits come with a lancet pen and plenty of spare lancets but make sure you have enough. You should not inject insulin or drive a car within 24 hours of taking it unless you have the means to test your BG, which means a working meter and plenty of unexpired test strips. If you run out of lancets you can use something else but it hurts a lot.)

    A sharps bin that you can hand in when full and get a new one. (I am using a homemade bin since I would have to pay for the service).

    Written info about using insulin, including dealing with hypos, sick days, and the laws about driving. (Very important)

    Jellybabies or some other suitable sugar source for treating hypos.

    Phone numbers for your nurse(s) and an after hours helpline if applicable.

    I always have my meter and my jellybabies with me when I leave the house. I am a bit OCD about the possibility of someone crashing into my car, and then I would need to prove I wasn't having a hypo).

    When the nurse shows you how to inject, you don't need to inject insulin there and then - she should have demonstration pens that only have saline in them.

    I recommend planning your first insulin shot for the evening meal just in case it makes you dizzy and lightheaded for 4 hours like it did me. This seems to be rare.
     
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  14. masonap

    masonap Type 2 · Well-Known Member

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    Hi, I’m male, 64 yrs old and I’ve been on insulin for a little over 2 years. I had previously been diabetic on tablets (metformin) for about 15 years. Over that time my control slowly got worse until I moved to Germany where it also got worse, my highest HbA1c was 9 and so they said it was time for insulin. At the same time I discovered low carb was probably the best the way forward. So on insulin and low carb I’ve lost 3 stone and although still overweight at 13.5 stone a lot of people who know me are staggered at my weight loss. I also exercise regularly, I walk just about every day and recently I’ve started jogging too (that’s very hard).
    So life on insulin. What’s it like? Some days it is a pain and a fiddle, making sure you take all of your kit out with you, being aware of the temperature so that you protect the insulin, and then testing and injecting before every meal, and one other test and injection before bed (4 injections a day). Results? FANTASTIC. My last test was 4.9 and the one before that was 5.0.
    I wouldn’t be too concerned if your team want to put you on insulin, for me it has been great. I don’t like the finger pricks (and never have) but in comparison the insulin injections are nearly always pain free (in my tummy). I don’t think there is a way to guarantee pain free injections but if I have to say how often mine are painful I would say out of 28 injections a week that 2 or 3 are slightly painful, and others occasionally ‘sting’ for a few seconds as I inject myself. In the end what’s a moment of discomfort if the end result is what I need?
    I’ve got some issues around long term bad control and for the last 2 years I’ve worked hard at looking after my body, keeping my diabetes under control, whilst not letting it take over my life.
    Oh and I should say that my diabetic specialist (things are a little different here in Germany) who I see and get tests from every 3 months, has reduced my insulin injections (number of units you dial in the pen) by half, and I now only take one metformin tablet a day in addition to the insulin injections and I feel great.
    Please don’t think that going onto insulin is a sign of failure, it isn’t, and you may just find, as I did, that it will be great for you.
    I wish you all the best.
     
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  15. Boo1979

    Boo1979 Other · Well-Known Member

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    For a bit of balance - I have been on Gliclazide for over 20 years with no problems and, largely as a result of combining it with diet, I am currently on the minimum dose od modified release Gliclazide (30mg) and returning hba1c results in the non diabetic range
     
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  16. Fenn

    Fenn Type 2 · Well-Known Member

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    Hi, I can’t offer any advice but empathise, I am in a very similar situation, I’m on met, alogliptin and jardinace, I’m trying very hard to improve my numbers by July, the dsn said we’ve no where else to go with meds, my hba1c was 13, been dB for over 5 years, I think the jardinace is working as I’ve had 9.9 today which is great, I do feel for you, insulin is scary, I will be getting a test done (can’t remember the name) privately to check I’m not insulin resistant before I accept the insulin.

    Best wishes, I hope it works out
     
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  17. Jenny15

    Jenny15 Type 2 · Well-Known Member

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    Thank you. I'm open to hearing about positive experiences with Glic. I just hadn't heard any so far and had read several people saying the tendency to hypo made their BGs swing around wildly. Thanks for sharing your experience.
     
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  18. claudetteholmes

    claudetteholmes Type 2 · Well-Known Member

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    Thank you so much for your post, I feel inspired
     
  19. pc01827

    pc01827 Type 2 · Member

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  20. pc01827

    pc01827 Type 2 · Member

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