Another T2 from Austin Texas

[poppa]

Hello everyone!

My name is Jim Mitchell and I'm a 48 year old type 2 diabetic.

I was diagnosed in 1996, and my Dr. at that time put me on Glucophage (500mg x2).

After about 2 years I was able to get it under enough control using diet and ginseng that I was able to drop the Glucophage.

Over the next 8 years I became complacent and over confident. I felt normal, and convinced myself that IF my blood sugar started to rise again I would feel it and do something about it...

I was, of course, an idiot!

Fast forward to January 2006. I was suffering from what I thought was simple constipation with some associated back pain...

No such luck. When I went to the Dr. I found out that my BS was at 365. I was sent to the lab for blood work, and urinalisys. My HbA1c is 11.5

Back on the metformin....
Slowly increased the metformin to 850mg x3...
Bg still too high...
Added Januvia and increased to the max dosage...
Still too high...
Added Avandia at max dosage...

Got my HbA1c down to 5.7 but it slowly started creeping back up.

Additionally, ever since I started on the Avandia I've been gaining weight regardless of what I do or don't eat. Dr. says it's water retention.

Over the last year I've had to eliminate ALL root foods, breads, pastas, rice (ALL types), Beans (except green beans), and more from my diet...

Last month (April 2008) HbA1c was back up to 9.7 :( :mad:

AND I was still hitting BGs in the 270-325 range 2 hours after meals, and FBGs in the 270+ range (Dawn Syndrome since day 1)

Finally my Dr. and I decided that I wasn't responding to the oral meds at all anymore :(

In april she took me off the Januvia and the Avandia and put me on Lantus. And changed the metformin to 1000 mg x2

Of course my insurance don't cover the pens, so I got a vial of Lantus and a box of syringes :eek:

I currently weigh about 245 lbs and am 5ft 8inches tall...

She started me at 10 units at bedtime for 1 week and told me to increase after that by 1 unit every 3 days until I get my FBG down to 140 or less...

I'm currently at 14 units, and my FBGs are 266 - 243.

I'm using a freestyle flash and testing 6-7 or more times a day...

I really don't think the metformin is doing anything at all as I had the exact same lunch 4 days in a row ( 4 boiled eggs and 4 jalapino peppers ) and my post meal BGs ran from 194 to 301.

I'm a machine parts inspector, and I'm on my feet and walk a lot at work, but don't get much exercise otherwise...

Somehow, going to the needle feels like starting all over again :(

I guess I'm just sick and tired of being sick and tired....

I'm glad to have found you, Thanks for listening to me whine :cool: ;)

[xMenace]

Welcome.

The progressiveness catches too many type 2's off guard like that. Glad you are turning it around and have found this place. It could have been much worse.

The medical community is largely at fault for this you know. There are very few if any who are happy with the care they recieve.

[adiantum]

G'day Poppa, I'm sorry your having a hard time of it now but very pleased you found us here.
Please post often & dont give up. You will get much inspration from others
I cant make comment on the meds as I'm coping OK at the moment with just diet & exercise yet I know this cant last forever.
I feel maybe you might get better resuts if you try for more exercise. Your body is used to the daily routine you have at work & perhaps needs a boost. It's worth a try ... we cant give in

[jacobsam622]

Hello everyone!

My name is Jim Mitchell and I'm a 48 year old type 2 diabetic.

I was diagnosed in 1996, and my Dr. at that time put me on Glucophage (500mg x2).

After about 2 years I was able to get it under enough control using diet and ginseng that I was able to drop the Glucophage.

Over the next 8 years I became complacent and over confident. I felt normal, and convinced myself that IF my blood sugar started to rise again I would feel it and do something about it...

I was, of course, an idiot!

Fast forward to January 2006. I was suffering from what I thought was simple constipation with some associated back pain...

No such luck. When I went to the Dr. I found out that my BS was at 365. I was sent to the lab for blood work, and urinalisys. My HbA1c is 11.5

Back on the metformin....
Slowly increased the metformin to 850mg x3...
Bg still too high...
Added Januvia and increased to the max dosage...
Still too high...
Added Avandia at max dosage...

Got my HbA1c down to 5.7 but it slowly started creeping back up.

Additionally, ever since I started on the Avandia I've been gaining weight regardless of what I do or don't eat. Dr. says it's water retention.

Over the last year I've had to eliminate ALL root foods, breads, pastas, rice (ALL types), Beans (except green beans), and more from my diet...



You might be taking in to few carbs unfortunately while carbs are our down fall to few can be as well. If your liver decides you are not getting enough glucose she will start spitting it out into your system, that is why the dawn effect occurs.

What you should do is eat healthy and get lots of exercise.

Here are some tips to get you started.

Foods you can eat:

Meat = Beef well trimmed, chicken, fish broiled or baked, eggs, hotdogs without bun.

Nuts - most nuts are low in carbs, peanuts, walnuts, cashews, and almonds any that have total carbs of less then 10g.

spreads buy no sugar added jelly or try one of several reduced sugar brands , no sugar added Peanut butter – good for cholesterol

vegetables = almost anything but corn If you eat corn stick
with the small kernel corn on the cob. Eat lots of Green beans it raises good cholesterol.

Sugar free ice cream or no sugar added, sugar free jell-o

Chocolate that has a cocoa % >= 60% or low carb chocolate

Breads = whole grain or low carb whole grain.

Pasta = whole grain: Dreamfields, Wal-Mart has good brand

rice = brown rice, wild rice

sodas = diet only

Alcohol = Low carb beer, brands like Michelob ultra, Miller-Lite, there is at least two others. Red wine or wine that is at least 13% alcohol
I Like the four wise man myself: Jack Daniels, Jim Beam, Jose Cuervo, Johnny Walker


avoid high carb food any anything with a lot of refined sugar or white flour

Fruit = try different ones to see how they effect your BS. Remember a sugar is sugar no matter how big or how small. Avoid fruit high in fructose

if you have acid reflux avoid eating fruit at meal time.

General rule if it’s brown then its OK for diabetes

Never go to sleep with a low Blood glucose level when you wake up your bg will be really high. You have choice eat a small snack like hand full of peanuts or drink a glass of of red wine or a low carb beer. The trick is to convince your liver not to dump a load of glucose into your system. I recommend you read the sugar buster book .

[Hammer]

Hey there Poppa! I'm also on Lantus, and I had to increase it by two units every few days until I found what worked for me. Don't be discouraged by your numbers. The Metformin will help the Lantus work more efficiently, once you find the correct dosage of Lantus. It took me a while but it seems that 70 units of Lantus is what works for me. Yours might be a lot lower. When you reach the correct dosage, you'll see the numbers drop to where you want them.

Also, Metformin is good for your heart, so there are other benefits to taking it.

Hang in there and don't let the numbers get you down....you will see them improve soon, and when that happens, you'll feel a lot better about yourself.:)

[poppa]

.

Foods you can eat:

Breads = whole grain or low carb whole grain.

Pasta = whole grain: Dreamfields, Wal-Mart has good brand

rice = brown rice, wild rice


General rule if it’s brown then its OK for diabetes


A snack before bed is a good idea... But, ALL of the foods in the quote above spike mt BG by about 80 points for a single serving...:eek: :confused:

Now that I've started insulin I AM going to need to start adding some carbs back into my diet...


THANKS to everyone who has responded to my post!:D

[Achilles]

Hi Poppa, I'm too new to offer any advice but I wish you the best of luck. There are a lot of good people on this board and I have learned a lot from them and about this disease in a relatively short period of time.

This place is a good source of encouragement and a place to share some frustrations. It is okay because we are all going through this disease in some stage or another and you can just about always relate to someone else on here who is similar in the meds they are taking for control.

Hang in there:hello:

[JoanW]

Welcome Poppa, and hang in there.....14 units of Lantus may be way too low an amount for you. Keep adding your units as your doctor suggested, until you get good morning numbers. Don't be surprised if it climbs and climbs....
I am a Type 2 also and overweight and my basal requirements are 100 units of Levemir a day, 60 in the evening, and 40 in the morning, so perhaps you will have to come way up on your dosage before you see any good results. Don't try and rush it though, it is much safer to take the increases slowly and steadily. Now I am able to get fasting levels between 98 and 120 nowadays. Good luck...and keep coming back to this forum, lots of nice people here to help you.

[slipperyelm]

I don't understand trying to fight meal time spikes by increasing your all day acting Lantus. Why not take a fast acting insulin at meal time?

I do not entirely agree with Jacobsam's food recommendations, by the way.

[poppa]

I don't understand trying to fight meal time spikes by increasing your all day acting Lantus. Why not take a fast acting insulin at meal time?

I do not entirely agree with Jacobsam's food recommendations, by the way.

I think you're mixing 2 different points of discussion here...

The Lantus increasing is to lower my fasting BG to 140 or less, per my Dr.'s instruction.... Ie:' to start establishing my basal insulin requirements, and has nothing to do with my meal time spikes...

My mealtime spikes seem (to me) to show that the metformin is pretty much not doing anything...

And Jacobsam's recomendations were (I believe) directed towards helping me with my Dawn Syndrome. Though, many of the foods he mentioned cause me to spike badly, and I simply can't tolerate.... Perhaps that will change once I start to take bolus injections....

:)

[slipperyelm]

Do you actually get your blood glucose down to an acceptable level before going to bed? If you go to bed with it high, then yes, it is likely you are going to wake up with it high, regardless of whether you have dawn phenomenon. If you get your BG down after meals, including at bedtime, you will have a greater chance of getting your fasting BG to an acceptable level. Metformin may be doing all it can for you at the dosage you take. If your levels are never down to normal, how about additional meds or bolused insulin?

Are you thinking that if you get your fasting BG down, then your post meal BGs will all be better? Because then you would not be stacking more glucose into a system already brimming with glucose? I think you should work on both fasting and post prandial.

I thought Jacobsam was talking about a general diet, because I don't think anyone would recommend those carby foods to help dampen dawn phenomenon.

[Hammer]

Slipperyelm....Lantus isn't used alone. You need to use it with something else, since Lantus only controls your basal levels. If you use Lantus, then you need something like Prandin, metformin, or Byetta for your spikes. You take the Lantus and then see what your fasting levels are. You adjust the Lantus based on those fasting levels.

You also have to adjust whatever you're taking for the after meal spikes in order to keep the spikes low. In my case, I take Byetta. Since Byetta only comes in 5mcg and 10 mcg pens, you need to see what works for you. I use the 10mcg pens, and it works very well. Lantus by itself won't control your spikes.

[Janlaton]

See if the Dr will sub for the Avandia it does cause weight gain! It is harder to lose while taking it but it is possible. I know I am losing about 2 lbs a month.

He may also be willing to give you furosemide or hctz to take 2 or 3 times a week. I take the smallest does of furosemide 2 nights a week and this keeps the fluid down for me.

GOod luck. Praying you will do well.:)

Oops HCTZ is really hydrochlorthiazide but if you say HCTZ the drs will know what you mean!

[poppa]

WOW! I'm suffering from a bit of information overload here...

Currently all I'm doing is following my Dr.'s orders.

I was instructed to take the 850 mg of metformin twice a day with meals, and pulled off all the other oral meds...

I was also instructed to take Lantus at bedtime, starting with 10 units for 1 week then increasing by 1 unit every 3 days until I got my FBG down to 140. She said that once I had my FBG at 140 she was going to send me to an Endo to set up a bolus plan for mealtimes...

I'm currently at 18 units of Lantus, and still seeing FBGs in the mid 200s. BUT, that's down from the low 300's...

I did an overnight Basal test when I was on 16 units and at bedtime my BG was 231, at 3:00 am it was 237, and at 7:00 am it was 244. Seems pretty flat to me...

I obviously still need more insulin to get my basal levels lower...