[foxl]

Lori, I saw my Endo, she is strictly clinical in her management! She took me off Actos, and upped my metformin from 1700 mg to 2000 per day (big whoop, huh), and told me to eat -- get this 40 g of carb per meal. Nope, nope, not gonna!

But, she also added Ramipril for BP which I apparently needed according to the Retinologist (he saw vascular changes) she later referred me to ... so it was far from a fruitless appointment.

Anyhow she suggested adding Januvia would be next, but I told her I would be wanting to add insulin next, and she seemed open to letting me ... so I will continue to go back to her.

[Simon]

Well I started on basal then bolus a week later. That was 4 years ago. About a week ago I went to open my new box of basal to find it was the wrong cartridge and I couldn't use it. That's how I discovered I didn't need it anyway. Been off it a week now and all numbers are on target. Still need to bolus though.

[Subby]

Originally Posted by Simon

Well I started on basal then bolus a week later. That was 4 years ago. About a week ago I went to open my new box of basal to find it was the wrong cartridge and I couldn't use it. That's how I discovered I didn't need it anyway. Been off it a week now and all numbers are on target. Still need to bolus though.

Interesting Simon! What was your basal, and how many units, if you don't mind the question?

[Simon]

Was on Lantus. Averaging about 8 units a day but I had periods when I adjusted it by about 2 or 4 units each way depending on my morning readings. Mornings are about 6mmol/l now. I am a LADA though so I guess it's just down to very slow onset indeed. Having said that I had ketones in my urine at diagnosis so it's possible that I've actually recovered some pancreas function.

[houzaizi]

put on a basal and bolus immediately upon diagnosis.

[foxl]

Originally Posted by houzaizi

put on a basal and bolus immediately upon diagnosis.

At what A1c, and how much basal and bolus, please?

[Rekarb]

My endo was setting me up for basal before it all fell through. Now, as I look at my numbers, basal doesn't make much sense. I've been adjusting my carbs and boy I can really spike but given a few hours and I'm back down again. It seems my basal is doing most of the work.

The problem with my type of diabetes is the loss of an effective first phase insulin response leaving the basal to bring down the bgs. Overtime, the basal can't keep up and glucose toxicity takes out more and more beta functioning.

When we revisit the insulin issue, I'm going to ask my endo about a bolus to mitigate those spikes.

Just my two cents

Mike

[foxl]

Mike have you seen this on FPIR?

Diabetes - First-Phase Insulin

I did not realize it was important to suppressing gluconeogenesis!

[soso]

Originally Posted by Simon

Well I started on basal then bolus a week later. That was 4 years ago. About a week ago I went to open my new box of basal to find it was the wrong cartridge and I couldn't use it. That's how I discovered I didn't need it anyway. Been off it a week now and all numbers are on target. Still need to bolus though.

I was taking about 7u of basal per day until a few months ago.. then I had to start reducing..over time I got down to 3 u per day and stayed there.... a couple of times I thought why bother and stopped, but within a few days I started getting higher fastings so I resumed the 3 u.
Then on holiday I started getting low every afternoon so stopped it and it has now been 2 weeks . Just tthe last few days I have seen that climb again though, so I don't know... it seems such a small amount..worth noting as well that my recent a1c was 5.5 up from 5.2...

???

[Delphinus]

I started on a basal regimen at first. I couldn't get below 10 mmol/L doing just basal shots. I expected that anyway since my pancreas doesn't work at all.

I quickly learned I was gonna need more, and added rapid/regular insulin to cover carbs and make corrections.

Sorry, I am Type 1, but I wanted to jump in anyway.

The one thing we all do have in common, is our insanity.

Diabetes is cool!

[foxl]

Originally Posted by Delphinus

I started on a basal regimen at first. I couldn't get below 10 mmol/L doing just basal shots. I expected that anyway since my pancreas doesn't work at all.

I quickly learned I was gonna need more, and added rapid/regular insulin to cover carbs and make corrections.

Sorry, I am Type 1, but I wanted to jump in anyway.

The one thing we all do have in common, is our insanity.

Diabetes is cool!

Still, Jason, your reply is still relevant b/c it is about what MD's are deciding to do ... I enjoy our insanity and hope you are enjoying it too!

[conguitos]

Originally Posted by foxl

Lori, I saw my Endo, she is strictly clinical in her management! She took me off Actos, and upped my metformin from 1700 mg to 2000 per day (big whoop, huh), and told me to eat -- get this 40 g of carb per meal. Nope, nope, not gonna!

But, she also added Ramipril for BP which I apparently needed according to the Retinologist (he saw vascular changes) she later referred me to ... so it was far from a fruitless appointment.

Anyhow she suggested adding Januvia would be next, but I told her I would be wanting to add insulin next, and she seemed open to letting me ... so I will continue to go back to her.

Hi Linda,

the first docs put me on lantus 15 IU at 22:00 every day, then they prescribed me metformin and sulforienas, after 3 days I stopped all medication. The next endo wanted to give me rapid acting insulin, which I declined.

My first A1c was around 14, the second around 7 the third 5.6 and my last one 5.8. The first one was in January, the last one 4 weeks ago.

Last thursday we did the "sugar test", which I failed miserably, went up to 20 (around 400) in 2 hours, but 6 hours later I was again at 4,5. We'll see how much insulin there was in the blood, but I'll have to wait a month for the results.

What I've noticed until now is that when I stop eating for 1 day, the next 3 to 4 days my body will tolerate carbs quite well and if I go on a raw food + meat diet, I will be around 2.5 to 6, it looks like it doesn't matter how much I will eat. Sometimes I event had 3 to 4 before meal and a 3 to 4 pp, weird...

Just out of curosity, your C-Peptide results, what is the reference frame for the test you did? And your GAD-65? I hat at dx around 2500, the reference frame for my test was given as <9.

Thanks in advance.

[Rekarb]

Nope, I had not seen this. Thanks. I remember reading a paper on this but it was so loaded with jargon that I finally got lost. Now I understand better. They were essentially talking about the failure of the trigger mechanism that shut down the liver.

I've said before that a shot of whiskey does more for my blood sugar than any drug I've been prescribed. Basically, all this does is impair the liver's ability to put out glucose. What I was wondering was there a drug that really concentrated on that, especially when carbs have been taken in. Is that what Byetta is supposed to be about?

Mike

[Subby]

Originally Posted by Rekarb

I've said before that a shot of whiskey does more for my blood sugar than any drug I've been prescribed. Basically, all this does is impair the liver's ability to put out glucose. What I was wondering was there a drug that really concentrated on that, especially when carbs have been taken in. Is that what Byetta is supposed to be about?

Mike

Metformin. You can see what has been happening since I've been taking metformin for two weeks, here: Metformin findings of one T1

Interestingly my overall dose has still not reduced a great deal, so I think it's fair to say these effects are not the kind of ones associated with metformin helping with "visceral insulin resistance".

My theory about the main action of the metformin radically changing the gluconeogenesis processes (and probably similar or related liver functions), and hence leading to a marked change in my bg stability and needs on a daily biological cycle level, is largely supposition, in that I can't prove it nor has a doctor told me this is the process currently occurring for me. Please bear that in mind.

[tealas]

Originally Posted by Rekarb

I've said before that a shot of whiskey does more for my blood sugar than any drug I've been prescribed. Basically, all this does is impair the liver's ability to put out glucose. What I was wondering was there a drug that really concentrated on that, especially when carbs have been taken in. Is that what Byetta is supposed to be about?

Mike

Byetta has several key actions. It increases the levels of GLP-1 Glucagon-like peptide-1 - Wikipedia, the free encyclopedia. My understanding is that this essentially triggers more insulin release, but only when blood sugars start to rise over 120mg/dl (i.e. it will not cause hypo's), it suppresses glucagon release (from the pancreas, not sure about the liver) and it slows gastric emptying.

It can really work well for some Type 2's and MODY patients. For me it basically halted my digestive processes - so the side effects were not acceptable even though the blood sugar control was wonderful.