Jump to content

Photo

a1c=12 (ugh) (To Insulin or not to Insulin)

- - - - -

  • Please log in to reply
46 replies to this topic

#1
Jinx13

Jinx13

    Junior Member

  • Members
  • PipPipPip
  • 38 posts
My GP jumped all over me. He wanted me on insulin today. I argued that I went from 7.7 to 12 in the span of 6 months and that I thought it must be the change in meds (+Vytorin) or something related. I asked him to exhaust all medications before moving to insulin. He added 2mg of Amaryl and 30mg of Actos to my 850mg of metformin x 3 and asked me to come back in a week. If I wasn't under control by then, he wanted me on insulin.

I'm no rocket scientist, but I don't see how I'm going to be under control in a week on these meds. I think he's just playing me.

Further, I am really confused about the change in a1c. I've been DMII for 17 years and have maintained pretty well until this past few months. Does there come a time when the disease progresses to this on its own?

And should I watch for any side effects on these meds?

#2
4519

4519

    Member

  • Members
  • 286 posts
Why are you fighting insulin. I know, it is a different thing to deal with and does have its dangers(hypo's). But, it will take a load off your syetem right now. You can back off if things work out. Time is not on your side here. Do what is best for your system, not what's good for you daily convience. Insulin is as natural as you can get.

Can you progress real fast. Certainly it has happened. Usually in response to some trama or just plain old poor control. Look at insulin for what it is and what it does and you will see that it is not your enemy or something that will harm your body, if done correctly.
  • Scotty13 likes this

#3
Funnygrl

Funnygrl

    Senior Member

  • Seniors
  • 6,763 posts
An A1c of 12 is dangerous. You are killing off vital organs. You must feel like crap.

I would definitely agree with your GP that you should be on insulin immediately.

Insulin may be scary, but it actually has fewer side effects than oral meds. And you will feel better almost immediately on it. Plus, depending on what type of insulin you use, you may have a more flexible lifestyle.
  • janice21475 and Scotty13 like this

#4
gettingby

gettingby

    Senior Member

  • Seniors
  • 10,039 posts
Jinx,
After I was diagnosed as a type 1, my stupid family doctor put me on pills and I was miserable for a year. High bg's, tired all the time, the whole nine yards, including coma. I was very happy to be put on insulin.
I know my situation is different from yours but I think we all fear the unknown and new. For your health, please consider what your doctor wants.

:P 

~Cin~
Mom always says I'm special. Hmmm........wonder what she means by that?? LOL.
The best and most beautiful things in the world cannot be seen or touched, they must be felt with the heart.
~Helen Keller~


#5
Funnygrl

Funnygrl

    Senior Member

  • Seniors
  • 6,763 posts
May I ask why you don't want to go on insulin? If you tell us that may help us to be able to better talk you into going on it, I mean, help you make a better decision.

#6
Jinx13

Jinx13

    Junior Member

  • Members
  • PipPipPip
  • 38 posts

May I ask why you don't want to go on insulin? If you tell us that may help us to be able to better talk you into going on it, I mean, help you make a better decision.


The needles. The attention that must be paid to the process (I'm on the dead run all of the time). The "no turning back" aspect of it. The expense. How it will affect the progression of Meniere's disease. How it will affect my heart.

My GP is an impatient guy and expects you to trust him. The few questions I throw at him in an appt are met with dismissiveness. He even barked at me today for testing too often (4 times daily) -- "You are wasting strips and I have to discount that data! I need fasting and bedtime ONLY!"

He's a good guy. Has always taken care of me. I just think a step as major as this one (in my opinion) deserves a lot more discussion. I dunno. Maybe I'm just a PITA patient.

My pucker factor is way up there today. Sorry for griping.

Regards

#7
JediSkipdogg

JediSkipdogg

    Senior Member

  • Seniors
  • 8,782 posts
  • I am a:Type 1
At first I thought you were a PITA (no offense), but then your doctor's comment on the testing made me think otherwise.

I think you should maybe look for a new doctor in your area, one that can better help to take the time to answer your questions and concerns. With an A1C that high you definitely do need insulin as it appears the medication just isn't working. It seems you might just need to start off with 1 shot a day of Lantus and see what that does to you. Then move forward from there if you need some other treatment, maybe even a pump would help you out. I know a few type 2s on a pump and it has done wonders for them.

But I would start with maybe looking for a new doc. Testing 4 times a day is actually not great, but not bad for a type 2. And him saying you are just wasting strips is bull.
  • janice21475 likes this

●Police Dispatcher
●Type 1 diabetic since 11 months old
●Pumper since December of 2002
~Animas IR 1000 (Dec. 2002 - Jan. 2005)
~Animas IR 1200 (Jan. 2005 - Jan. 2009)
~Cozmo 1800 (Jan. 2009 - ?)
●Dexcom Seven+ (Aug 1, 2009 - Oct 31, 2012)
●Dexcom G4 (Nov 1, 2012 - ???)

 

Diabetes is an Art, NOT a Science. You must master the control by skills and not by knowledge alone.


#8
Funnygrl

Funnygrl

    Senior Member

  • Seniors
  • 6,763 posts

The needles.


Those I can promise are not a big deal. They are tiny, and you can barely feel them if you can feel them at all. I think everyone here who is insulin dependant feels the same way.

The attention that must be paid to the process (I'm on the dead run all of the time).


Not bad again. I can inject in under 2 minutes. And half asleep now.

The "no turning back" aspect of it.


Not nessarily true, but so what if it is? If you are significantly overweight, lossing weight may help. But I will say this part of going on insulin bothered me the most when starting it, but I feel a lot better on it, so I just remind myself of that when I feel that way.

Also, if you kill off your kidnies or heart from constant high blood sugars, there is no way to go back from that either. But you can prevent it. And now is your chance to do that.

The expense.


It is no more expensive than oral meds. And insurance covers it.

How it will affect the progression of Meniere's disease. How it will affect my heart.


I can't comment on that except to say that improved glycemic control improves overall health.

Griping is more than welcome btw. I think you should see an endocrinologist.

Going on insulin is scary no doubt. But I bet if you tried it for a week and saw how much better you felt and how easy it is, you would be less bothered by it.
  • janice21475 and Scotty13 like this

#9
4519

4519

    Member

  • Members
  • 286 posts
You say, "...The "no turning back" aspect of it....." That is not true. Type Diabetics go on and off insulin as the situation requires.

You also said, "....How it will affect my heart...." You are taking it to protect your heart, eyes, etc. Insulin is produced by your body, why do you think it will harm your heart if you do it right?

The lack of insulin is what is harming your body now. Not taking it will only cause more harm.

As far as how he treats you, well, join the club. My doctor just stares at me when I ask some questions.
  • janice21475 likes this

#10
Jinx13

Jinx13

    Junior Member

  • Members
  • PipPipPip
  • 38 posts

why do you think it will harm your heart if you do it right?


It's the "doing it right" part that concerns me. I know me. I'm going to screw up now and then. Will hypos make a bad situation worse? It may be an unfounded fear (fears, really), but I am looking for answers even if the questions are pretty dumb.

Best Regards

#11
4519

4519

    Member

  • Members
  • 286 posts
I do see the fears you have. I don't think trying to talk you out of them works, and you do know you better than anyone else. I don't inject yet so I am only speaking from what others have said. Will you screw up once in a while, probably. Will hypos make a bad situation worse. I doubt it. You are in a pretty bad situation and hypos for a type 2 are a little different for a type 2. It is very easy for a type 1 to go hypo - calculate wrong or don't eat when you planned or it goes on and on. You will have to work a little harder to get your numbers down - remember you are insulin resistant and your body is already not using the insulin you do produce very well. It is a catch 22 kind of situation for a type 2 in your position. You system does not use the insulin you produce but you still need to inject because you do not produce enough insulin.

The mistakes you make will be more in the short run while the high glucose numbers go on an on 24/7. Which one do you think will do you more harm?
  • janice21475 likes this

#12
JediSkipdogg

JediSkipdogg

    Senior Member

  • Seniors
  • 8,782 posts
  • I am a:Type 1

It's the "doing it right" part that concerns me. I know me. I'm going to screw up now and then. Will hypos make a bad situation worse? It may be an unfounded fear (fears, really), but I am looking for answers even if the questions are pretty dumb.

Best Regards


Hypos are bad. However, 1 hypo a week is better than 1 hyper a week. And just remember, to deal with a hypo all you have to do is drink so OJ, which never hurt the body. Also, in time, you may not even have a hypo is you get your amount of insulin correct. Not to mention many who use insulin in conjunction with oral meds never have hypos. So in the long run, you will be doing your body some good.
  • Scotty13 likes this

●Police Dispatcher
●Type 1 diabetic since 11 months old
●Pumper since December of 2002
~Animas IR 1000 (Dec. 2002 - Jan. 2005)
~Animas IR 1200 (Jan. 2005 - Jan. 2009)
~Cozmo 1800 (Jan. 2009 - ?)
●Dexcom Seven+ (Aug 1, 2009 - Oct 31, 2012)
●Dexcom G4 (Nov 1, 2012 - ???)

 

Diabetes is an Art, NOT a Science. You must master the control by skills and not by knowledge alone.


#13
4519

4519

    Member

  • Members
  • 286 posts
You did not mention "taking insulin means failure." You did not say that, but I think it is a common belief by us that don't have to inject insulin. You hear it over and over how we are controlling by medications aloned almost like it is a badge of success. The only failure here is not what you do but what you don't do. Not adjusting your diet, not exercising are failures to yourself. Taking insulin is just part of the program. Some don't ever have to take insulin, that does not make them any different than those that do.

I am retired and don't have to deal with this disease on the run all the time. That surely has to complicate ones life a lot. Just ask any type 1 that has been doing it for many years and you will see how they handle it. They won't give you a everthing is all roses - but they will tell you how they do it and have done it for a long time.
  • Scotty13 likes this

#14
Cinnabon

Cinnabon

    Senior Member

  • Seniors
  • 3,291 posts
jinx,
Have you compared the values of your regular home tests?
A 12 A1c is estimating you at readings of 320-345.
  • janice21475 likes this
T1- 27 yrs
MM-522

A1C steady @ 6.9 for 1.5 yrs. Endo decided to keep me there after a severe hypo causing car accident.
10-2010- 7.1:eek: Due to Ayestin, a medication for an Ovarian Cyst. Its gone but Very BAD side effects, such as constant HBS.

****
Posted Image
I see thru God's eyes!!!!

http://www.facebook....Leon/1068478571

#15
Jinx13

Jinx13

    Junior Member

  • Members
  • PipPipPip
  • 38 posts

jinx,
Have you compared the values of your regular home tests?
A 12 A1c is estimating you at readings of 320-345.


Yes. My home tests reflect that (avg 337 on my meter). I stepped up my diet (which I've used for many years) when the numbers went silly a few months ago. I figured it was a fluke or some other stress on my body. I see my GP every three months anyway, so I just waited until this appt to see what the a1c was going to be.

Regards

#16
4519

4519

    Member

  • Members
  • 286 posts
It could be something else wrong. What was your A1c 3 months ago? What kind of daily numbers were you getting. Infections will drive your blood glucose levels up.

#17
Cinnabon

Cinnabon

    Senior Member

  • Seniors
  • 3,291 posts
It seems liek the 12 A1C is probably accurate. Im sorry for all this that u are going thru, but DONT be afraid of insulin. You never know if once you are better with your levels, you might not even have to take all that much. Jinx, be more afraid of all the complication an 12 A1C can bring (a diabetic w/ comlications is reaching out to you w/ advise). We are here for you!:biggrin:
T1- 27 yrs
MM-522

A1C steady @ 6.9 for 1.5 yrs. Endo decided to keep me there after a severe hypo causing car accident.
10-2010- 7.1:eek: Due to Ayestin, a medication for an Ovarian Cyst. Its gone but Very BAD side effects, such as constant HBS.

****
Posted Image
I see thru God's eyes!!!!

http://www.facebook....Leon/1068478571

#18
Jinx13

Jinx13

    Junior Member

  • Members
  • PipPipPip
  • 38 posts

It could be something else wrong. What was your A1c 3 months ago? What kind of daily numbers were you getting. Infections will drive your blood glucose levels up.


Unfortunately, my GP's nurse forgot to draw an a1c at my last bloodwork appt. Before that, it was 7.7 (6 months ago). Prior to that 6.1 (9 months ago). I've been in and out of the hospital for a fussy heart the last 5 years and only once did my BG go over 200 while I was in there. It really hasn't been much of a problem for me until now.

#19
am1977

am1977

    Senior Member

  • Seniors
  • 4,534 posts
I have to say :dito: with the others here... by not taking control of this disease, you are ultimately hurting yourself. And no one wants to see you do that! You are putting yourself at risk for some nasty complications...some or which may not be reversible. :eek:

Believe me when I say, I understand your apprehension and fear. I, too, hated needles (well, I still do :rolleyes: ), but saying that, I know that some times things are not an option. I cannot make the decision not to take my insulin... I need to. That's what it comes down to- simple as that. There are no alternatives. Well, there are, but not pleasant ones... :frown:

In your situation, I think the same thing goes for you. I don't think you really have a choice- you need insulin at this point. It's apparant that what you are doing now isn't working if that's what you are averaging for your blood sugar level.

Like I said, I hate needles, but if you have the right technique, the right needle, etc... you can inject it quickly and easily :nurse:...which will take time to learn. But the more you do it, the less of a big deal it becomes. Plus, it WILL make you feel better. I'm not sure, but I think it's possible that your body has gotten used to being so high, but once you regulate your sugars and bring them back in range, you will see how different and how much better you feel in comparison. Trust me, you'll feel better.

The other factors you listed...well, I don't think they're good reasons to not use insulin. The fact is that something needs to change and I think insulin is the way to go (though I'm not a medical professional). Don't kick yourself later- once your health declines. Do what it takes now... and get healthy :top:

Take care of yourself :ciao:
I’ve faced myself
To cross out what I’ve become
Erase myself
And let go of what I’ve done

Put to rest
What you thought of me
Well I cleaned this slate
With the hands
Of uncertainty

So let mercy come
And wash away
What I’ve done

I’ve faced myself
To cross out what I’ve become
Erase myself
And let go of what I’ve done

Linkin Park~ "What I've Done" :thrasher:

#20
RickLV

RickLV

    Junior Member

  • Members
  • PipPipPip
  • 82 posts
Jinx,

May I ask what diet plan you have been using? I suspect that you have been trying to follow the ADA low-fat/hi-carb plan.

This is only a suggestion, but you might try holding your carbs to no more than 30g/day for a three day period and monitor your BG readings closely (as you are already on meds). Record Fasting, B4Meals and Meals+2Hrs.

If 30g/day scares you, you might try 50g/day then 30g/day.

I firmly believe the ADA numbers respecting A1c are too high and will "silently" continue damaging you and eventually require additional meds. You may be a case in point.

Keep in mind, I'm only making a suggestion.

Keeping my fingers crossed for you (not that that will help, but it's the thought).

PS - It just occurred to me; if your 7.7 A1c was a supprise to you, you must not be monitoring your BG daily. If you monitored, you would have had a heads up.




0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users