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Time to acquiesce and give insulin injections a go?

Skippy1

Well-Known Member
Messages
73
Location
Derbyshire, UK
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
I was diagnosed in 2005 with an HbA1c of around 6/42% (average of 7 on my meter).
Using the NHS Eatwell plate/eat plenty of brown carbs, plenty of fruit, take metformin, gliclazide, injectables advice this rose to around 9/75%, 11 on my metre by the end of 2011.

Then in 2012 I found this forum, ate around 50 carbs/day, fasted some days and got the numbers back to single figures. It was going ok, then CKD, heart failure and cancer hit.
Since May I've not been below 20, often recording high 20s and Hi - same lc woe, maybe less food, more fasts.
For the past few weeks I've been increasing the glic from 1/day to 8/day with no effect.
C-peptide result was 2225 in 2017, over 5000 last week.

Endo Consultant / DSN have said they have nothing more to offer, it's up to me to let them know when I'm ready to start injecting insulin. Any last minute suggestions before I walk the walk?

Thanks, Suzanne
 
Skippy1 said:
Any last minute suggestions before I walk the walk?
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Hi Suzanne,
Insulin isn't necessarily a one way street! With numbers this high I would choose to get them down by whatever is needed to prevent damage. If circumstances change, medication may change too, and insulin is not the end of the world.
Wish you all the best!
 

Thanks, I know I may not have to be on it forever, but I've lost a lot of weight recently to be able to have a general anaesthetic for the cancer. Weight gain would mean further delays. Mobility is impaired too, so losing my licence would be an issue.
 
Sounds like you're juggling an awful lot of issues, "not fair!" is my gut reaction. (Which isn't helpful at all.)

Starting insulin isn't helpful with weight, although it's not a given you'll gain. Staying low carb will of course help with this.
Having BG's in the high teens and 20's will be an issue for your operation as well, as this impairs wound healing and makes you more susceptible to infection.
Have you lost enough weight to be eligible for the OP now?

Have you by any chance been put on steroids to help with the cancer? That would push your BG up.

You don't automatically lose your license when using insulin, most insulin users are allowed to drive, although you have to inform the DVLA.
 
I'm sorry you're having such a difficult time @Skippy1 . High bgs won't be doing your body any favours, so I agree that you should do whatever you have to to get them down. Remember, illness pushes your bgs up so the insulin doesn't have to be permanent.

I also agree with @Antje77 that if you're on steroids for the cancer your levels will go up while you are on them, they are known to cause bg issues. Going on insulin doesn't mean you lose your license, but I'd encourage you to be diligent about testing before you get behind the wheel and always carrying emergency hypo treatment with you (eg glucose, jelly babies).

Good luck.
 
Thanks @Antje77 and @EllieM.
No, I'm not on steroids. I keep asking if the cancer is pushing up the bg numbers and they say no.
I know I'm going to have to agree now but it feels I'm having to back down after battling their poor advice over the past 16 years.
 
Hi
I agree with all the advice so far and with levels like yours I would be feeling awful.
Your Cpep results are confusing me . If they are in the normal range there must be other things going on that are pushing up the blood glucose. It is incredible how the stress of being ill and being treated can create high blood glucose - good old liver just chugging it out so you can run away!
If you take insulin, it does not mean that you are giving in. You can still eat low carb and keep all those good food habits up but be taking a background dose. I think you risk damaging your kidneys further by running high.
I try to keep my own insulin low (don't make my own) but some days or weeks I need to take more. It is all about balancing the toxicity of the glucose levels versus the toxicity of having lots of insulin.
Perhaps you can just try it and see if it makes a difference?
 
I'd be interested to know what the medics think is causing your BG to run so high given your c-peptide is OK. If it isn't due to the cancer then what?

I agree with others. Right now I think you need to get your numbers down and insulin doesn't have to be forever. So long as you learn to manage the hypos you'll keep your driving licence. It won't cause you to put on weight unless you end up having to stuff yourself with sweets because you drop too low. Given you look to be producing your own insulin still they will hopefully start you on a low dose and track carefully.

And good luck with the surgery
 
Thanks, I really appreciate all the comments. I've been 30+ again since yesterday despite not eating for 36 hours.
@Circuspony - when I ask what's causing it I'm told insulin resistance and that T2 is a progressive disease.
@NicoleC1971 c-peptide range is up to 600, so at 5000 I produce massive amounts of insulin just can't use it.

The hospital rang this morning and offered me a cancellation slot for tomorrow to start injecting.
I accepted it. I'll go along and find out all of the details, but I will hold off starting until Monday as I'm spending the weekend in London, with tickets for the Festival of Remembrance.
 
Skippy1 said:
Since May I've not been below 20
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Hi Skippy, I've nothing much to add but just wanted to offer my sympathy, it's bad enough having 'just' the diabetes to contend with but when it's accompanied by other serious issues, it must feel impossible. All I would say though is that it's not good to have been over 20 since May and no matter what else is going on, it really does have to be tackled. Do you have the means to test for ketones? In my opinion, nothing is aided by very high blood glucose so getting it down in the interim period with insulin is a good thing, as others have said, further investigation is needed but you can't afford to sit there like that. Wishing you well.
 
Thank you
No ketones
I went for 'the lesson' today - pretty straight forward as I already test and inject. I'll be using Humalog 3. starting at 8 units 2/day and increasing by 2 units/day (until I'm back in single figures - could take some time!).
Thanks everyone for your comments and support.
 
Best of luck with the new regime. Let us hope you also feel better with normal numbers and that whatever is causing you to be insulin resistant eases.
A word of warning that going on (extra) insulin could make you hungrier which is a normal physiological response to lower bgs but if you can have low carb stuff on standby I believe this is better than covering the carbs with insulin just because you now can!
 
Just want to add like others said, it's not a one way street. I had a DKA in Jan and was moved onto basal and bolas insulin (24 & 6/6/7).

I've now lost a load of weight, am on a small amount of basal and no bolas and am in talks of coming back off of it.

So do what you need to to get those numbers down. You aren't guaranteed to be stuck on it and even if you are, better injections than consistently high BG.
 
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I've now been using insulin for a week.
My numbers are coming down, generally in the mid to high teens and I increase the dose each day.
My eating pattern has remained the same, so weight loss has continued slowly.
But ... each day, I inject at about 9am and about 1 hour later, my blood sugar has gone up by about 5 points eg 14-19, 16-22, even though I don't eat anything. It then falls back to the lower number during the morning. It's ok in the afternoon/evening when I inject in time for my main LC meal.
Any thoughts on why this would happen?
 
Antje77 said:
Foot on the floor effect? It's where your liver dumps glucose in your bloodstream to help get you going for the day.
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Thanks, @Antje77 , I wondered about that, but I've already been up for an hour or two before the rise and it didn't happen before I started taking the insulin.
 
Skippy1 said:
Thanks, @Antje77 , I wondered about that, but I've already been up for an hour or two before the rise and it didn't happen before I started taking the insulin.
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Your body may be trying to get the rise, as its used to it. It should get the idea and adapt soon. Our bodies often resist change for a while and keep doing what they have always done. You are doing great.
 
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