I have Type II diabetes. I had gestational diabetes with both of my children. I am 40 yrs old and was diagnosed in 2001. I currently take Januvia and Amaryl. My fasting sugar levels are between 150-200. My sugar level was recently up to 269 (highest its been). I am having difficulty regulating my blood sugars. The GI dr I am seeing wants me to see an Endocrinologist about possibly going on insulin but I am EXTREMELY scared of switching.
Is there anyone that can offer advice? I have heard good stories about people switching and being very happy and feeling better, it just scares me so much. ANY advice is greatly appreciated. My husband has suggested a support group but I am only finding dieticians.
If it's the idea of shots, well, taking an insulin needle is NOTHING. I use short 6mm needles which are 32 gauge and I don't even feel them.
If it's the worry about being low -- well, as long as you eat regular meals and adjust your rapid insulin accordingly you should be fine. If you go on an insulin like lantus, you won't have a peak so you won't have to make sure you eat a specific times like other background insulins.
Honestly, I think if you did go on insulin you'll end up wondering why you didn't do it sooner -- your sugars will be MUCH better controlled and you'll have a lot more freedom in your diet. You'll feel a whole lot better too! And as long as you don't overdo it with your calories/day you won't have to worry so much about weight gain in the long run (although you may initially have a slight weight gain).
Look, managing diabetes does require some work (shots, testing, etc.), but it is WELL worth it. Your numbers are high enough that you are risking very serious complications which could include blindness, kidney failure, congestive heart failure, neuropathy, gastroparesis...and on and on. That's what you should be afraid of, not insulin!
And as far as support groups? Most of the local groups are geared to T2 diabetics who are managing with diet and exercise and maybe oral medication, usually the very elderly. It's really difficult to find support groups for those of us on insulin.
But, you know what? You've got a support group right here! Catheryn, myself, Itotito, Wallace (and many others!)...there are many people here who will be happy to answer your questions and give you whatever kind of support you need as you make the switch. I've found myself that I get way more support over the internet than I've gotten locally. In fact, that's why I post so often...I really feel compelled to repay in a way the wonderful support so many have given me over the years.
I know insulin seems like a scary thing. I also know many T2s see insulin as a "last ditch" effort, or that your diabetes has gotten "bad" enough that you "need" insulin. None of these are true. Insulin is just another treatment option for diabetes (for T2s, and is obviously the only treatment for T1s). Seriously, I feel pretty confident when I say that 100% of people who go on insulin, learn carb counting, follow their diet/insulin guidelines, and check often will DRASTICALLY improve their A1c's. Insulin allows you to have more freedom in your diet choices while having tighter glucose control. There are quite a few different options for insulin therapy. Give it some real consideration!
(Thanks for the "shout out" Ruth!)
I just started taking insulin at the end of January and it is great. I was so frustrated before when my oral medications stopped working for me. You get used the shots, they don't hurt any more than the lancet you use to test your blood. I have so much more freedom in my food choices now and I feel so much better.
I do get frequent lows, but I am still learning how to adjust my diet. The only downside is I have gained about 10 lbs, but I just try to look at my weight gain as a tool to help me make healthier choices. Sure, I could eat a big bowl of ice cream now and take a few extra units of insulin, but instead I'll have a cup of frozen strawberries.
I would be more afraid of the damage that could be happening to your body by having high sugars then of the insulin shots that will get your readings back under control.
Thank you for all of your support! After test and more tests, I have found that all of my digestive problems are side effects from the diabetes. I don't know that I am afraid of injecting the insulin (I took Byetta for a time). I guess I am afraid of what society thinks. I know that is stupid but I hear people say frequently that people that have to go on insulin do not eat right. I have drastically cut back on my eating-nature valley bar (breakfast), Subway (lunch) and cherios (dinner) so I don't have the awful stomach pains. I have been reading on this site that people have felt so much better since they switched from oral medication to insulin. I am so tired I am dragging.
I know I am ranting but it is hard for my family to understand. I don't want to worry them so I try not to talk about my medical problems. I was going to make an appt with my internist but I have been told it would be better to go to an endocrinologist. I guess I don't want to go there because of the horror stories of people that have been "wittled" on. It makes me sad for those people and I don't want to consider myself sick. I hope this all makes sense, my head is swimming with thoughts. I can't type fast enough.
Thank you for taking the time to respond!!
"I guess I am afraid of what society thinks. I know that is stupid but I hear people say frequently that people that have to go on insulin do not eat right." Well, those people are idiots who don't have the slightest clue about Type 2 diabetes.
Sure, a lot of people with T2 are overweight; but then, many people are overweight and don't develop T2. And I know some very thin people who have T2. My best friend, who has be underweight most of her life and is now at a good weight (145#, 5'10") is pre-diabetic. There's a very strong history of T2 in her family, so it was probably inevitable that as she's aged, she's getting closer to developing T2. She watches her diet carefully and exercises religiously...in fact, she goes to the gym 3 days a week, works with a personal trainer once a week, and goes for long walks on the days she doesn't go to the gym...yet her blood sugar levels are gradually creeping up.
As for considering yourself "sick"...well, better to have a manageable disease like diabetes then something else over which you might not have any control, like, God forbid, cancer. Diabetes is definitely manageable, if inconvenient, and the better you manage it, the fewer complications you face. I myself have had D for 25 years, on insulin for 20 years, and so far I have no major complications. But I've worked very hard at managing it all these years.
So maybe it's time to stop worrying about what society, or even your family, thinks and start truly taking charge of your own life. You may still have a chance to reverse the digestive problems, but you've got to take action quickly.
Type one diabetics are on insulin as their only course of treatment -- I don't think anyone would say a T1 diabetic is not eating correctly, so I really wouldn't feel bad about those thinking you weren't eating properly. Anyone who knows anything about diabetes knows that's just the natural progression of the disease -- my dad's doctor told him that every T2 will eventually end up on insulin, usually within 10 years.
And think of how much better you'll feel and how much leeway you'll have with your diet!
Update-the nurse practitioner increased my meds. I now take Januvia once a day, Amaryl & Metformin 2x's a day. She said she didn't want to put me on insulin because it would make me gain weight. I had resigned myself to starting insulin-I thought about all the children & teens that have to given themselves shots and it suddenly took on a new meaning. I have been thinking maybe I wouldn't be so tired. I have an Endocrinologist appt 06/29 and I'm interested in what he will say. The NP says she can monitor my sugar. I also found out that one of the reasons why my bs has been out of control is I have a really bad kidney infection.
Question-Should I let the NP handle my bs or turn to an Endo for further care?
Update-I saw the PA for the Endocrinologist who put me on Lantus and Humalog. The Lantus was not working for me. I went back to the NP at the Internist and she has been the biggest help. She put me on a Humulog pen and asked me if I thought about going on an insulin pump. I waiting on the approval from the insurance to get my new pump. Believe it or not but I am getting excited about it. I finally thought about the kids that have to have shots and became a "big girl" and took my medicine.
I am still trying to figure out the shots. About a week ago I took 30 units (usually take 20 units 3x's a day) because my sugar was 315 but it was at 11pm. I thought it was too much but I knew my sugar was quite high. I stayed up and was knitting when I didn't feel well, thank god I stayed up, my sugar was 65 and dropping. I had to learn the hard way not to take too much.
I am looking for carb counting classes to take to help with the insulin pump. I want to say thanks for the support everyone has given.
Nice to see your update. I'm glad you finally went on insulin...once you work out the kinks, I'm sure you'll feel a lot better.
I am concerned, though, that no one is giving you the training you need to manage well on insulin. Why do you say the Lantus was not working? Lantus is a basal insulin...it is supposed to manage just your basic metabolic needs. Once you get the right dose of Lantus, it should keep your blood sugar regulated if you don't eat, without making you go too low. Then the humalog should be geared to your food...not a set amount 3 times a day but rather an insulin to carb ratio. This requires that you learn how to count carbs when you eat. Sounds complicated, but it's not really all that difficult, as most of us eat many of the same foods all the time so we get to know those by heart (i.e., 1 orange = 15g carbs, 1 apple = 15g carbs, my cereal (Cheerios) 1 cup = 20g carbs, etc.) Most people start off at 1 unit to every ten grams of carbs. So, when you eat, you count the carb grams and give yourself a unit for every 10 g of carbs...if your meal is, say, 55g of carbs, you'd give yourself 5.5 units. If you find that you're always high at two hours after meals, then you may need a higher ratio, such as 1 unit to 9 or even 8 grams of carbs. If you're always low, then you'd need a lower ratio, such as 1 unit to 11 or 12 grams of carbs.
Another ratio that you and your doctor need to figure out for yourself is a correction ratio. That is exactly how much one unit of insulin will lower your blood sugar. Mine is 30 points for one unit. So if my blood sugar was 315 before bedtime and I hadn't taken any humalog for at least 3 hours and my bedtime target bg was, say, 140, then I'd need to lower it by 175 which would mean I'd need 5.8 units (which on shots I would round to 6 units)...not 10!
All of this sounds really complicated, but it's truly not as bad as it sounds! Usually it takes only a week or two to get the insulin to carb and the correction ratios figured out , and then it rarely changes. And you'd have to learn how to count carbs anyway if you're planning to go on a pump...without that, a pump is just a waste of money.
So my suggestion to you would be to ask your endo for a referral to a registered dietician for education on counting carbs; I'd also continue to take some sort of basal insulin...either lantus or levemir. You absolutely cannot get good 24-hour coverage just by taking humalog, because it only last for about 3 hours (four at best). By taking too much at meals you risk going low, and without a basal insulin you're going to be running high overnight. Once you go on a pump you can use just humalog to regulate...but you'd still have a "basal" rate which serves the same purpose as the lantus or levemir, and then you give yourself "bolus" shots which are geared to your insulin/carb ratio.
Well, Ruth beat me to it. I was a pumper for 5 years (stopped using it because I am a T1 with a pancreas transplant) and it was the best thing ever. It does take some work, but once you get the hang of it, it is fantastic. As Ruth said, you will need to learn to carb count and figure out your insulin to carb ratio. You will be your own little science experiement. The pump is nice because you can give fractions of a unit quite easily. Also, you can set different basal rates which can help with the dawn phenomenon much better than plain old lantus.
I hope that needles are more advanced now than they used to be.
I am on med now for 30 days, and after the bloods my dr. will
see if I can continue. I think she plans to. But I am worried about
the constant high Accucheck extreme level of glucose in the urine
and also the lithium, the bubbles -- i do worry about NDI.
My dr. told me that glucose in the urine excludes the possibility
of NDI or nephrology. Cross my fingers.