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Old 05-27-2008, 09:55 AM   #1
Join Date: Mar 2007
Location: Canada
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When the pills stop working....

Type 2 for two years now and have done OK at controlling BS (last A1C was 6-7)with diet and your average combo of pills (metformin, avandia, diamicron), but sometimes my readings are all over the place, even when I've been eating well. At what point is my doctor going to say insulin?
My fasting numbers have been creeping up (high 7's, sometimes 8) and I am concerned.

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Old 05-27-2008, 11:44 AM   #2
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Location: MA
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SamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB UserSamQKitty HB User
Re: When the pills stop working....

When you say your "last A1c was 6-7", what does that mean? 6.5? 6.8? 7.0? There's a huge difference between 6 and 7 on an A1c. 6.0 is the equivalent of an average blood sugar of 136, while 7.0 is the equivalent of an average blood sugar of 172.

Also, you say that sometimes your readings are "all over the place, even when I've been eating well." If most of your high readings are post-prandial, then it may be time for you to go on insulin, both a basal and a bolus...learn to count carbs and bolus the short-acting insulin based on what you're planning to eat. This would actually give you way more flexibility in what you eat (although you still need to be careful...weight gain is the last thing you want!)

If most of your high readings, however, are fasting, or before meals, or just occasional scattered weird readings, you might just need the addition of a basal insulin.

It's only my opinion, but I think the fact that your fasting numbers have been creeping up definitely indicates that the disease is progressing and it might be time to start considering insulin. I'd have a serious talk with your doctor about this. Going on insulin is truly a major pain in the neck at first, but it really does become routine after a while.

When I started on insulin, they didn't have really long-acting basals like lantus, or really short-acting rapids like novolog/humalog. They used NPH and R...and that was truly a horror story. You had to eat at the same time every day, take your NPH at the same time every day...and even then, the onset and length of action could be different each day. Now you get so much flexibility with the newer rapid-acting/basal regimen that it's really (IMHO) not nearly as difficult as it used to be.


Last edited by SamQKitty; 05-27-2008 at 11:45 AM.

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