PDA

View Full Version : Just started insulin


Kathy from UK
05-06-2009, 05:18 PM
Hello,
I posted here (http://www.diabetesforums.com/forum/introductions-and-announcements/34487-greetings-and-a-question.html) when my husband Gary was first diagnosed and thought I'd update you on what happened - all feedback is welcomed.

Gary's diabetes was diagnosed when he was admitted as an emergency patient in December last year. We were surprised, especially as his levels were so high (around 18) - he has several health problems and is closely monitored, yet diabetes had never been suspected.

The nurse was confident it was type 2, brought on suddenly by the shock of the illnesses he'd had a few months previously. When I asked her about late onset type 1 (Gary is 59) as he has a list of autoimmune conditions she said she wasn't ruling it out.

I'd also like to clarify my first message, which was incorrect - Gary has a severe hearing loss and often misunderstands what's said to him. The nurse would have liked to have started him on Metformin at diagnosis but it was contraindicated by his Heart Failure. So she gave him gliclazide.

As time went by his levels began to increase so she increased the gliclazide. Again the levels increased and so the meds were increased again - and the levels rose again. Each time he's had an increase in meds it's been followed by an overall increase in his blood glucose levels.

She discussed Metformin with his medical team, who okayed its use. So he started this. It made no difference at all.

He has now started insulin injections - one a day of background insulin. His metformin has been doubled and the gliclazide discontinued. It's only been 5 days but already his levels are beginning to show a slight drop.

The nurse still believes he's type 2, that his pancreas is barely functioning and that he's very insulin resistant.

I believe his pancreas has been subjected to an autoimmune attack.

On some threads I've read people asking why should it matter? Well, it matters to me for two reasons.
Firstly, Gary is really struggling with his health at the moment and is very limited in what he can do. If we can get appropriate treatment for his diabetes sooner rather than later it should help.
Secondly, diagnosing it accurately can help to fill in the jigsaw puzzle of Gary's health problems - he's had autoimmune problems all his life, in the last 18 months it seems to have gone into some sort of overdrive.

As well as the meds, he has been trying to adjust his diet to avoid glucose spikes.
I'm really hoping we can get the levels down now.

David_S
05-17-2009, 09:35 PM
Did they test his c-peptide? My levels showed I was not making insulin.. they knew it was type 1.. the specialist did anyway.. the family Dr. gave me pills for type 2 which made no diff. for me. I was put on insulin at the endo's office and saw immediate results. You are probably right about this.. check his c-peptide results.

BlueSky
05-17-2009, 10:08 PM
It sounds like LADA to me. An antibody test would confirm that. Ask them to test for the GAD, ICA and insulin antibodies.

DCaplinger
05-18-2009, 09:00 PM
BlueSky knows his business. He needs antibody tests to ruleout LADA.

Regards,

D

Kathy from UK
05-21-2009, 02:51 AM
Thank you for your replies.

As far as I know he's not had any of the tests mentioned. He has another appointment fairly soon and I think I'll make a list of requests.

The background insulin is definitely bringing his levels down although they are still too high. We're increasing the insulin by 2 units every 5 days until his morning readings drop below 7.

If it is LADA will he (eventually) need fast-acting insulin before meals too?

Thanks again for your support. :)

DCaplinger
05-21-2009, 07:00 AM
More than likely, yes. However, he'll get into a routine soon enough. You just need to be there to support and remind him to take his insulin when he is supposed to. You know how forgetful we are. LOL.

Regards,

D

mazea
05-26-2009, 12:58 AM
If the type 2 medications aren't bringing him down, then he is most likely type 1.5 LADA. I would get a second opinion. A c peptide test can confirm LADA. Antibodies, like blue sky said can confirm this. Although, I'm LADA and don't have antibodies as they are not always present. Te me he sounds like LADA.
I find it strange how medical professionals try to push type 2 onto people like it is worse or something to have type 1.5. They are both illnesses and all the really matters is getting the blood sugar levels stable. A week is too long to push type 2 treatment onto someone who isn't responding. LADA can give you kidney damage when undiagnosed because it is slower than type 1.

Kathy from UK
06-04-2009, 01:46 PM
Thank you for your replies.

I've set Gary a daily reminder (ring tone) for his insulin and organise all his meds for him - he then administers the insulin / takes the meds at appropriate times. It seems to work! :)

Mazea, yes I agree....I think far too much time has been spent giving Gary inappropriate treatment. It's now 6 months since diagnosis and his levels are still running far too high. And we've both run out of patience.

Finally they have decided he needs fast acting insulin too - but he has to wait 3 weeks before his next appointment!

Um....we're not waiting that long. :mad: