Insulin questions

[cherokee_psh]

At my last endocrinologist appointment, the doctor suggested I look into considering insulin. My kidney readings were at the maximum of normal. I am currently taking Januvia and had taken metformin in the past (with unpleasant side affects). I have read a bit and now realize that he suggested this route because Januvia and Metformin are cleared through the kidneys. If the kidneys are not functioning well, there is a build up and bad things can happen. The A1C has never been higher then 6.3 and the maximum reading I have had is 219.

I am asking for any suggestions, experiences, or educational information (book, sites, etc.). My Dad was insulin dependent there were multiple amputations and death all within a short period of time. Honestly, I am seeking guidance on coming to terms more with the term "t2 insulin dependent". It just sounds like there was a failure, that I missed an turn somewhere.

[Moonglo]

If it makes you feel any better, there are plenty of t2's here who voluntarily switch to insulin- even to the point of initiating the discussion with their doctors, for one reason or another. Those that have done so seem to feel like it's one of the best decisions they've ever made, from what I have seen. It definitely does not make you a failure. Any diabetic who is not controlling their bg well, with or without insulin, will have complications. In my mind, the insulin does not make you a failure. Why be ashamed of using a sound tool that's available to you?

[imac]

It is the question if your kidneys are not one hundred percent, you have no choice but to go to insulin, as most oral meds end up in your kidneys.

[jenb]

Please please please do not feel that using insulin is an indicator that you have failed, or think that because you use insulin you are destined for complications. Insulin is a wonderful tool. Your body just isn't making / using a natural hormone, so you have the opportunity to replace that function. Try to think of it as a gift.

It's scary at first, and confusing. But once you have the basics under your belt, you will feel good and you will lead a normal life. It will just be your new normal.

Let me suggest that you go out and get one (or both) of these books: "Think Like a Pancreas" by Gary Scheiner, or "Using Insulin" by John Walsh. They will lead you through those first daunting steps. My copies of them are absolutely dogeared!

Don't feel alone....you have lots of companionship and sympathetic ears here!

Jen

[jtausch]

I think when people try to stay on oral meds the complications have set in either by not controlling the disease or the side affects from the meds. More drs are starting people of on insulin from the start, I was on meds fpor 6 mths then went to insulin, my sugars are better controlled on insulin. My last a1c was 5.9

[xMenace]

Insulin is a matching game. It sounds simple according to books and DE's and doctors, but in reality it it can be very difficult and mind boggling to figure out.

Much depends on your pancreas' output. Much also depends on your circadian rythms. You may get by with a low to moderate long term basal insulin. One or two shots a day and you'll do very well. You may not do well. They may prescribe then a mixed insulin, a combo of basal and faster acting. Again you may do well and you may not. The next step is typically MDI or multiple daily injections. Same. The final step is usually a pump. A pump can nearly always be tuned to your needs. I personally recommend a pump if you can swing it.

I've left out a whole bunch of ifs, ands, and buts. It's important to understand and belive that just about any problem with insulin can be figured out with the right testing. You need to know a bunch about various causes and effects and also how to test for them. Problem solving testing and compliance testing are two different animals. Everybody teaches compliance testing, but very few [patients or doctors or DEs] really understand problem solving testing. That's where other diabetics can really help. Knowledge is power! A couple of good books to educate yourself are "Think Like A Pancreas" by Scheiner and "Using Insulin" by Walsh. Both aren't necessary.

[cynthiazinn]

I was misdiagnosed as a type two and was on about 7 different orals. The side effects were unbearable. The day I threw all those pill bottles out and started injecting insulin was the best day of my life. I feel so much better. I think society has placed a stigma on insulin when in reality there is nothing more pure than a natural hormone that your body makes anyway!

[princesslinda]

Hi Susan, good to see you back! I think when your dad (and my mom) had diabetes, there wasn't a good way to monitor blood sugars, so they were often dealing with extremely high #'s long before doctors realized it and a lot of damage was done BEFORE they ever got to the point of being started on insulin, and by that time, it really was too late for insulin to help that much.

Today, both doctors and ourselves can keep up with our blood sugars easily, so at the first sign of problems, we can take the necessary action to prevent the complications our parents had.

Insulin is just another tool in our tool box to help us manage our diabetes. YOU ARE NOT YOUR FATHER. The better control insulin will give you will go a long way in avoidance of the complications we fear.

[cherokee_psh]

Thanks all for you support and helpful comments. I'll order the books Jen suggested from amazon tonight. I have 6 month to read up and come to a decision or acceptance before my next appointment. I am hopeful that the next test in April will be better. If not, logically, I know decision isn't the right word.

[SteveFromIowa]

At my last endocrinologist appointment, the doctor suggested I look into considering insulin.
I am asking for any suggestions, experiences, or educational information (book, sites, etc.). My Dad was insulin dependent there were multiple amputations and death all within a short period of time. Honestly, I am seeking guidance on coming to terms more with the term "t2 insulin dependent". It just sounds like there was a failure, that I missed an turn somewhere.

I started using insulin 12 years after initial T2 diagnosis.

Before insulin, the oral meds (first Actos, then Glipizide, then Metformin) seemed to be handling it so I pretty much ignored the fact that I had diabetes for the next 10 years. My diet was generally healthy, but I didn't resist the occasional brownie that showed up at the office coffee machine, or the milkshake on a hot afternoon after work.

My sugars started skyrocketing two years ago. I applied myself with diet attempts and exercise to get my sugars under control but NOTHING seemed to help. If I had known then what I know now, I would have added insulin to my regimen immediately. But insulin carried a huge stigma for me, plus the whole needle thing seemed too huge an obstacle for me.

I started insulin in May. I was over the needle thing after the first self-injection. My exact words were "That was easy!" DON'T let the needle thing get in your way. I was phobic about needles and now I don't even think about it. It was such a waste of my energy to spend so much time worrying about them.

As for the stigma, that has melted completely away. I don't care who knows. I LOVE using insulin. With it, the diet and exercise give me almost complete control. I test frequently and eat by my meter. I'm using less insulin now than when I started which is helping me lose weight.

If your disease progresses to the point that it can no longer be controlled with other efforts, DO NOT HESITATE! Add insulin to your tool kit. You may not need to stay on it. But if you do, you will probably find (like I did) that it is EASIER to control your disease with it.

[jbritt1]

Hello Susan, am a type2 diabetic also, been diagnois and dealing with it for 10 years. I presently am taking insulin called Humulog
Mix 75/25 along with Metformin HCL tabs and I found that these are good medicines in helping me to regulate my sugar. you know I woud suggest that you contact the ADA (American Diabetes Association) at !-800-342-2383 to speak to a representative for more information.
To your health, James Britt

[cherokee_psh]

"Think Like a Pancreas" by Gary Scheiner and "Using Insulin" by John Walsh arrived yesterday. I started with "Think Like a Pancreas". He has quite a since of humor! I only had about an hour so I only managed to get the first 3 chapters read last night. Linda hit my fear on the head....Logically I know I was caught sooner, mostly because his was found. His was diagnosis + insulin + 4 amputation surgeries = death a little less than 6 months.

I am beginning to accept that the most practical road is insulin if that pesky kidney still refuses to work. I still have a little over 5 months to come to acceptance if needed. I can, with a degree of certainty, tell them its the right one. Always some amount of discomfort there. Plus it has proven itself problematic in the past.

[Romi]

It is the question if your kidneys are not one hundred percent, you have no choice but to go to insulin, as most oral meds end up in your kidneys.

Just called quits to all the oral diabetes meds after diagnosed
with initial stages of a renal disease. I hope increased levels of
insulin will help.:confused:
age 44
diabetic since 2001 type-II
insulin mixtard 70/30---twice daily 38/34
Rovista 10mg daily
tritrace 5mg daily
asparin 75mg
h--5.8" W--88kg
Last A1c in July 2009 was 10:(

[It Ain't Over]

The fear of injections is a difficult one, except for those of us that have undergone them. It just becomes no big deal.
In most cases you would be trained by a medical professional, usually in a hospital setting, and they work with you to remove the anxiety and fears. Getting those blood sugars under control is such a relief the injections soon enough become very acceptable.

[ramon]

Wish I had started insulin years ago even though Im a type 2, I really believe my legs would not be red.

[Romi]

The fear of injections is a difficult one, except for those of us that have undergone them. It just becomes no big deal.
In most cases you would be trained by a medical professional, usually in a hospital setting, and they work with you to remove the anxiety and fears. Getting those blood sugars under control is such a relief the injections soon enough become very acceptable.

I have been on (a mixture of longterm+short term)insulin
known as Mixtard 70/30 since March 2009 with glucophage
850mg once daily. Doctor stopped gulcophage because of
renal disease and increased the dosage of Insulin to 72 units
per day. But my sugar levels are staying high since I stopped
taking oral medication, e.g. this morning fasting ---197?
My next appointment is two weeks away since the Doc is out
of the country, should I increase the Insulin intake?

[dbaratta]

I think when people try to stay on oral meds the complications have set in either by not controlling the disease or the side affects from the meds. More drs are starting people of on insulin from the start, I was on meds fpor 6 mths then went to insulin, my sugars are better controlled on insulin. My last a1c was 5.9

This is true. My doc told me everyone ends up on insulin eventually. I don't agree with him because there are plenty of stories out there where T2 end up on NO or little meds after losing weight and adjusting diet and exercise.....but, for some of us it is true.