Possible Problems with insulin/oral combination. Is there an alternative?

[nikki75]

I was diagnosed as Type 2 in 2003 but have recently been told that my c-peptide levels show I am not producing hardly any insulin at all. The doctor said my pancreas has "shut down" over time due to being stressed by having to produce high doses of insulin in the presence of high BG levels. What makes more sense to me is that my beta cells could have been damaged by high levels of glucose over time and this is what has caused the decrease in insulin production.

I was prescribed 2000 mg metformin each day/humalog 16 mg at breakfast, 16 at lunch and 20 with dinner plus lantus, (currently at 60 mg every night and increasing two units every three days). My A1C levels have been 13.5 for the past two years or more. I feel like my body is shutting down, which is why I am reaching out for help.

I noticed after I started taking my increased insulin levels along with metformin, I started experiencing severe upper abdominal bloating and weight gain, slow digestions, and difficulty with swallowing. Just recently, I have begun to feel like my heart is weakening. I am experiencing palpatations very often. I took myself off of the medication and those symptoms have stopped. But, my BG levels are still out of control (between 300 and 500 daily) which is what they were when I was taking the large doses of insulin. It was doing absolutely nothing for me.

I am currently taking natural glucose metabolizers that I got from an herbologist. I am going to see a naturopathic doctor tomorrow. Is anyone else experiencing problems with insulin or insulin/oral combinations? Does not 60 mg of lantus seem like a lot? Does anyone know about alternatives to insulin or orals?

[mortis505]

Without knowing more info about you. it would be hard to make any statements regarding the correct level of insulin usage.

For starters what are you eating? Can you ballpark the number of carbs you are eating per day? Do you exercise? What was your weight at diagnosis as opposed to now?

Many people experience abdominal issues when starting metformin. Go back and ask for Metformin ER(Extended Release).

[Subby]

One thing that can be said though: some people need far more insulin than that to keep their BGs steady. Some type 2s report usage of 200 or more units of insulin a day. Heck, some way more than that.

Even though a type 1, even when not overweight, I need close to 60 units basal. It seems to be an inherent resistance I have.

So while say 60 units basal is moving away from typical completely dependent non-resistant levels of requirements people tend to have (that's a mouthful) it does not seem outrageous in the scheme of possibilities that you might need this and more. There is a rule about insulin for (almost) everyone: there will be a dose that stabilises your BGs. It sounds like you just have not found it.

Between those BGs and a history of an A1c of 13, and pushing my insulin usage up to find better stability, I would chose finding the correct insulin dosage as effectively as I can, in a safe manner.

That's as may be. But the kinds of questions Mortis asks could be very salient as to what might be causing you to need more insulin than you might otherwise need. Obviously factors could be exacerbating your need for insulin. But, at the same time, basic resistance whether from weight or other, more unseen reasons, can really drive basic usage up.

[Subby]

Forgot to say: a change of insulin might be worthwhile too, have a chat to your doctor about it. Some have better luck with one type over another, as far as effectiveness, side effects etc. You have at least Levemir to consider as a possible alternative to Lantus.