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Type two tablets to insulin

S

sas401

Member
Messages
12
Type of diabetes
Treatment type
Tablets (oral)
Hi all, I am looking for some advice in relation to my husbands diabetes. He has been a type two for nearly 15 years and has been taking a cocktail of tablets since the start. He is currently on metformin (5 x 500mg a day), pioglitazone, and recently been changed to sitagliptin one a day. He also takes a variety of blood pressure medication. For many years he has been running at around the 7-9 blood sugar readings every day however for the past two years he cannot get his BG levels down. The doctors have changed him from one sort of medication to another with no avail, he is running from 16 - 25 BG every day since starting on the sitagliptin about 6 weeks ago.
He hasn't been looking forward to going on to injections but could see that it was necessary as he has a number of nerve complications that are already very evident (pain in hips, severe stomach pain, pain in calves). After the last visit to the docs 6 weeks ago the docs had told him injections would be the next step if the sitagliptin didn't work so when he could see it wasn't working, he got himself prepared to go this morning to the docs expecting to be put on injections there and then.
We were both amazed when the doc says that there was nothing they would do instantly and that it wasn't an emergency. They are reffering him to the hospital diabetic clinic which could take weeks if not longer. I am amazed that despite mentioning so many different complications that nothing was done to improve his BG readings in the immediate term. I am looking for some advice as to other diabetics experiences when moving from type two tablet dependant to insulin injectables. Is this the normal experience, are there any particular injectables that can be recommended or is it dependant on each individual person?
 
I am T2 and have been on insulin for almost a year. I was a bit apprehensive about injections as I was on max doses of Metformin and Gliclazide but BGs were still high and was hyperglycemic too. Do not be afraid of the hospital referral as your husband will be seen by a Consultant Diabetologist and Diabetes Specialist Nurse and will be in expert hands. He will get help on all manner of stuff regarding insulin and injections. I've felt a lot better being off oral meds and wish you and him all the best.
 
@sas401 This sounds very similar to the position that I am currently in....the earliest appointment they could give my partner was the end of January...about eight weeks since initial referral..
I have similar questions to the ones that you raise so will be interested to hear any responses and advice..
Wishing you both all the best.
 
I got a referral from my GP marked 'URGENT', took 4 weeks to get appointment.
 
Thanks all, its good to hear that we are not alone. We were just so surprised that even though the doc knew of the situation in advance that we are in the same position. Will see what happens.
Good to hear of your experiences eddie1968
 
No problems Sas, keep us updated if you feel free.
EDDIE
 
Hi. First, is your husband normal or overweight? If the latter then it may be there are too many carbs in the diet and this will help reduce blood sugar and weight. HCPs can be reluctant to precribe insulin as my GP said it was a 'last resort' when I was struggling with high blood suagr and a low-carb diet. Common sense prevailed a year later. Do insist on the move to insulin assuming the BS remains high. Sitagliptin is useful but not a substitute for Insulin when needed. Note that insulin is at it's best when you are not overweight as otherwise it will be adding to a body already overloaded with it, hence the importance of the low-carb diet.
 
Hi @EDDIE 1968 ,
I would be interested in hearing what you think are the reasons for going on Insulin as a type 2.( if you happy to share your story)
I am a type 2 and would hate the idea of injecting, so I have lost Lots of weight, Eat Low Carb. exercise at least 4 days a week at the Gym etc., all with the aim of keeping my readings as low as possible.
Last HbA1c was 5.4.
Do you think people with Type 2, progressively get worse over time, and will all end up injecting in Time ?
I dread the thought
 
Last edited by a moderator:
Recently changed to insulin my self.
what you do to speed things up is when you get your letter through for the community diabetes team there is a number for the specialist nurse on there to call if you need to speak to someone ASAP (if not ask drs where you have been refered to and get the phone number from the internet). Call it and tell them the urgency.
I waited 4 weeks for my letter to find my appointment 2 months later, when I went the consultant didn't turn up and they had to rebook for the following month. So I called the number on a Monday to explain my situation, the consultant agreed insulin needed, by the Wednesday I was in with the nurse for injection lessons and she sent drs request for urgent perscription, the Friday I started my insulin!
don't wait with those high numbers. They will only act on it if you make a fuss.
 


@leeemerick …thanks for that info..

Unfortunately my partner does not see any sense of urgency about dealing with his diabetes and when the referral came through for the end of January I think he was quite happy to wait until then ……on the other hand I am really worried about how far away this is and what damage is being caused in the meantime by high blood sugar levels. He is reluctant to test but when he has they have been in the mid to high teens with a high of 25.6….in my book this puts this down as urgent.

I have got an appointment to speak to the diabetic nurse on Monday…she did say that I could speak to her about my partner’s diabetes if I had any concerns and the appointment was the only way I could get past the practice receptionist…is tricky because I am not the patient. Will take the letter / referral date with me as I am concerned as to how far away the date is…perhaps she will be able to contact them and stress the urgency / request an earlier date sometime in early January rather than at the end.

Marking any referral urgent does seem to make a difference….my partner had to go for a chest xray last week (he is not well at the moment)…by the GP marking it ‘URGENT’ it meant that he could go the next day and sit and wait to be seen….if ‘ROUTINE’ it would have meant phoning for an appointment and being seen in about three to four weeks time…we went the next afternoon and he was seen within half an hour..

Am hoping that we can get through Christmas without any dramatic increases in blood sugar levels or any medical emergencies and that when he does get on to the insulin it will help to bring blood sugar levels down to a more acceptable level.
 
@Daibell my husband is a normal weight, he has actually lost half a stone since being on the sitagliptin. He does what excersise he can but it is limited due to his bad hips. His diet could be slightly better but us reasonably varied but we have never had any help where diet is concerned and it is only what i have picked up off the internet.

@leemerrick Good to hear your experiences too, will make sure that i ask for details today when i go back to surgery. I dont think it should take so long as it does.
 


Unfortunatly it does appear that as time has progressed it is got gradually worse. It might be different for someone whose diet has caused it in the first place however my husbands is hereditary and ig is following a similar pattern. Not sure if this is normal, suppose everyone is different
 
Hi. Thanks for the reply ref weight. It sounds like your partner may actually be a Late onset T1 LADA). The treatment processes are similar but insulin is normally essential once the tablets have run out of road. The low'ish weight implies the body isn't producing enough insulin to manage the carb intake. Your partner almost certainly needs to go onto insulin which provides excellent control once you have learned to balance it. It also enables you to eat more freely which for me has been a nice benefit as long as you still keep the carbs down sensibly to avoid weight gain
 
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