Need Advice---New Medication!!!

[betty714]

Quick briefing of me-

I have had type 2 diabetes for 9 years and it has been on and off in the control department. I made a stand this year to be in full control of this disease. I finally have medical coverage so doctor visits are more regular now. Also, became a vegetarian. My readings have been averaging 250ish which is too high, sometimes they have been 400.:eek:

Caught up to speed-

Today, I went to the doc's and we decided to try insulin. I have been taking 20mg glipizide and 2000mg metformin for 1 year and I am still getting high readings. I tried byatta for one month but did not like the nausea and then hungry in a hour feeling. I knew this day was coming to get on insulin so I am comfortable with the thought of injections.

Here is my drug list:

metformin 2000mg
glipizide 20mg
lantus 10 units (at night)
actos 30mg (one a day)

Has anybody used this combination that can give some advice? Any help/suggestions is greatly appreciated.

Thanks

[EasyType2]

Hey Betty,

I'm a T-2 - for some 19 years. I currently take glipizide 20 mg per day -- Metformin 1000 mg per day -- Avandia 8 mg per day -- Lantus 16 units per day.

Control is fair. Last A1c was 7.3. Awaiting results from most recent A1c -- and I sure hope it's better.

My Endo describes me as a "brittle diabetic" -- in that I have wide swings from high to low to high to low. I'm particularly susceptible to going hypo if I'm not very careful.

Respectfully disagree with your vegan regimen. It's hard to obtain adequate protein that way. Fish ( some specie ), white meat of chicken or turkey, and small portions of very lean beef would help with your protein needs.

You didn't mention exercise. That could help in maintaining better control if you're not now getting enough.

Best wishes!

[shockme]

hi betty! just so you know-metfromin and actos are available in a pill called "actoplus met". i'm on that and lantus. my bgs were much better after i started lantus! i started getting hypos,tho...sometimes for no apparent reason and sometimes due to an increase in activity. irecent started using my treadmill again and i have to be careful! take care,trish

[slipperyelm]

The response that suggests that you are having a hard time getting enough protein is not well informed, of course. The world is full of vegetarians who are well nourished.

But I would like to ask if you became vegetarian as part of a plan to control your diabetes, or was it separate. The reason I ask is that I ate vegetarian for years (with no protein inadequacey, incidentally) but the particular manner in which I did that had to be changed once I became T-2. I had a heavily carbohydrate diet, and far too calorie laden. Reducing both carbs and calories can help many T-2s.

If you have not already done so, consider whether there is the flexibility in your diet to reduce carbohydrates (and calories if weight loss is in order).

Your medicines, are okay if they work for you, right? Is 20 mg glipizide the top level that can be prescribed per day? I don't know, but it sounds like a lot to me. So because you are taking that much glipizide and also injecting lantus, I think you might want to keep in mind the option of multiple daily injections of insulin, matched to the amount of food (especially carbs!) you eat each meal or snack. You might be more satisfied with your control that way. If you inject insulin, I think you could most likely discontinue the glipizide. You might be able to discontinue the lantus, too, because if your pancreas is still making insulin, your pancreas might be able to provide for you basal insulin needs if you are no longer forcing it to make extra insulin to meet your meal-related needs. Sometimes people speak of injected insulin as giving your pancreas a rest. A "rested" pancreas can then provide for at least some insulin needs --like the basal level-- more reliably.

Anyway, that is just something to keep in mind. If your new meds/lantus don't work very well for you very quickly, I hope you will not hesitate to go to injected insulin (beyond the lantus).

[betty714]

Thanks everybody for the responses.=)

Well, I am on day 3 of lantus and my sugars this morning were 137!!! I can not even begin to tell you when the last time it has been that low. Trying to get over 250 was just not happening with the oral meds. ....I am doing the happy dance.....=)

Some answers to the questions-

Me going veggie is just a phase for now. I wanted to eat more veggies and fruits and really try to cut back on fatty meats and carbs. I don't have cravings for meat and actually am enjoying it. I am taking a protein supplement and I do slide in a fish meal once a week so I am not a strict vegetarian.

As for my medications-

My doc wants to keep my on the oral meds and they are maxed out for me. I have talked to him about going all the way on insulin but he seems to be taking the slow approach. I will ask him about the actoplus met.

And my personal favorite Exercise-

I have always had a problem with this topic, not enough and inconsistent. I am walking a least a mile every other day and now starting to up that. My problem is, I hate sweating but now realizing that I have to and this is the only way (exercise and healthy diet) to keep me in good health.

Thanks guys for the advice and I will keep you posted on my next blood test readings which will be in 3 weeks.

....still doing the happy dance....

[compugor]

wow, betty714 - its hard to mount a response to that! I thought I was a "seasoned" diabetic and could provide lots of insight on this forum but your situation is more "advanced" than mine. All I can suggest is that you not be shy towards insulin - its worked great for me! Couldn't really get the tight control I wanted via diet, exercise and medication (metformin ER 750 mg) so I recently went on insulin (15 units 1 x /day every evening) and it really makes a big difference. Of course diet overrides everything. If you have an eating disorder (like most of us do) then thats the problem. I believe I am finally getting my mindset in the right place and changing my attitude about eating - thats the key! Don't forget to drink lots of water and exercise! Also I have found taking supplements has helped me a lot - time-release B-complex, along with all the other good stuff (you can google it under "diabetes supplements"). I check my blood sugar at least 4x/day to stay on top of the cause & effect of it all. In a way, this dreaded condition is a positive in that it makes us stay so much more on top of our "game" than we normally would be. Live long and prosper!

[volleyball]

I guess you are really a low meat eater as opposed to a vegatarian. That good. If oyu are not a very active person and muscular, you don't need a lot of meat. And as long as you like beans.
My body would be hurting without meat but it is not nesssacry for all of us

[betty714]

thanks for the advice compugor....will look into supplements, I take a multi but probably need to add some others. I completely stopped drinking diet soda which was really hard for me but I am happy I did. Tea and water...lots of water.=)

I am on day 5 of shots and have been pretty happy with it but have noticed some highs toward dinner. Should I up the dose or give it some more time? The doc said if I need to, I can up my 10mg to 14mg. What do you guys think?

[xMenace]

Hey Betty,

I'm a T-2 - for some 19 years. I currently take glipizide 20 mg per day -- Metformin 1000 mg per day -- Avandia 8 mg per day -- Lantus 16 units per day.

Control is fair. Last A1c was 7.3. Awaiting results from most recent A1c -- and I sure hope it's better.

My Endo describes me as a "brittle diabetic" -- in that I have wide swings from high to low to high to low. I'm particularly susceptible to going hypo if I'm not very careful.

Respectfully disagree with your vegan regimen. It's hard to obtain adequate protein that way. Fish ( some specie ), white meat of chicken or turkey, and small portions of very lean beef would help with your protein needs.

You didn't mention exercise. That could help in maintaining better control if you're not now getting enough.

Best wishes!

Consider a pump Easy. It's the only way I found to control my swings.