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-   -   At what point do doctors typically prescribe insulin? (http://www.healthboards.com/boards/diabetes/872634-what-point-do-doctors-typically-prescribe-insulin.html)

Uff-Da! 10-07-2011 03:15 PM

At what point do doctors typically prescribe insulin?
 
After deciding to give up soda September 1, I suddenly noticed symptoms of increased thirst and more frequent urination. I thought that rather strange, as I'd only been drinking one soda a day most days, occasionally two. But the symptoms persisted, so I called my doctor and asked her to call in an order for a fasting blood glucose test. My results came in the mail today, upon my request.

[SIZE="6"]289![/SIZE]

My late husband also had type 2 diabetes, and was on both an oral medication and insulin injections, so I'm somewhat familiar with what to expect, though he's been gone enough years that my memory is a bit faded and changes may have taken place in medications and diabetic care.

My appointment with my doctor isn't for another three weeks, so I'm very curious as what to expect. Does anyone have any idea at what blood glucose level insulin injections are typically prescribed? I'm sure hoping I can get by at least for a while with just diet and oral medication, but 289 sounds mighty high and I fear insulin injections may be in my future soon.

Carol
(age 70, BMI 21)

Cora1003 10-07-2011 03:27 PM

Re: At what point do doctors typically prescribe insulin?
 
There is no set number. Many folks are diagnosed much higher than you (600 or higher) and are often started on insulin to bring them down immediately. Afterwards, insulin is often used as a last resort when diet/exercise/meds are ineffectual and you don't get the results you want. In the meantime, try to avoid carbs as they turn to glucose and bring your numbers up.

Uff-Da! 10-08-2011 01:34 AM

Re: At what point do doctors typically prescribe insulin?
 
Thanks for the reply. That gives me some reassurance that the situation may not be as severe as I thought. After having my blood glucose test around 100 for years, having it shoot up so high in about a year and a half since my last test was a shock. My brother's test was only around 150 when he was diagnosed, I believe. But really - some people actually test at 600? I thought a person would be in a coma before that!

I already have a pretty good diet, but know I'm going to have to cut serving size on some of my carbs, especially those delightful pasta meals and homemade bread. This will, no doubt, give me some added incentive to get serious about getting some exercise, too. So often I've started but lost interest after a few days or weeks.

Cora1003 10-08-2011 06:58 AM

Re: At what point do doctors typically prescribe insulin?
 
You go girl. Many folks start out higher than you and have excellent success with diet/execise. I love pasta too, but limit my portions. There is an expression that goes "eat to your meter". So test 2 hours after you eat and see what the number is. This will tell you if you can eat that size portion, or that food at all.

Carl Tausig 10-10-2011 09:21 PM

Re: At what point do doctors typically prescribe insulin?
 
Hi!

I would suggest that you consider attempting to change your medical appointment to an earlier date. While it is not necessarily the case that you will even need insulin, a 286 (known) blood sugar, in an untreated individual, is a risk that you should not, I believe, be taking on. You could run into trouble.

Please consider calling your physician for a change of appointment.

Sincerely,

CT

Uff-Da! 10-11-2011 09:17 AM

Re: At what point do doctors typically prescribe insulin?
 
Thanks for the concern. When my doctor's office called to set the appointment, October 27 was the earliest I could get. I started decreasing carbs as soon as I got the blood test results, and I do feel a bit better. I haven't had that "yukky" feeling after eating that I occasionally got before. And I haven't had such extremes of post-prandial hypotension that I had before, either. (My systolic pressure used to fall as much as 50 points after eating.) That has to be related to glucose metabolism in some way. So, while I know my blood sugar is still far from normal, at least I think my dietary changes have brought it down a bit.

Uff-Da! 10-22-2011 04:51 PM

Re: At what point do doctors typically prescribe insulin?
 
Well, I'm far less optimistic today than I was on my previous post 11 days ago. I finally decided to go ahead and buy a glucose testing kit and supplies, even though it wasn't covered by Medicare since I haven't had the formal diagnosis yet. I got that yesterday and have been testing my blood sugar before and two hours after meals. The results are downright scary.

Last night my readings before and after dinner were 449 and 483 respectively. After a 12-hour fast, my BS was still 360 this morning. So I had a very low carb breakfast with a two-egg omelet with mushrooms, onion and sour cream, coffee (with non-fat milk and xylitol for sweetener). The result was negligible rise in BS, with a recording of 364 two hours later. By my before-lunch reading an additional two hours later, however, it had fallen to 289. That's an improvement, but 289 is still horrible! I thought I'd be able to get my BS lower than that by food choices alone, but it is not looking good.

From what I read, a diabetic does need carbs, so for lunch I chose low-glycemic carbs with about 3/4 cup bean salad over a green salad with a lot of asparagus added. The bean salad had been marinated in seasoned olive oil and wine vinegar, so I didn't need to add any additional dressing. Yet with that presumably healthy lunch, my BS two hours later was up to 378. I'll take my before dinner BS in another hour or so, but I'm not optimistic. (Edited to add: my before-dinner reading was 335, so it didn't come down much.)

I'm going to continue to take before and after meal readings until I am able to see the doctor next Thursday. Hopefully that additional information will give her more facts upon which to make recommendations. Those high readings, though, do make me more fearful that I'll be facing insulin injections.


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