To inject, or not to inject. That is the question

DCaplinger · #1 (**permalink**) 01-15-2008, 10:16 AM

The more I read, the more I question it. Even now, as my daily blood sugars still range above 350 and often above 400, I question whether or not I should already be on insulin. I may be a bit premature, since I still have a pending initial visit with my Endo, however, I am really starting to feel the effects of high blood sugars.

Ever since I started coming down to the mid 100's, when my BGL's soar above 250, I can feel it. Right now, it's 350, and I feel absolutely drunk. The effects are getting worse. I am getting loopy. Two nights ago, my wife looked at me, and told me to test. It was only 325, but I was apparantly staring blankly at her, like I was stupified or drunk.

I am having problems concentrating. I am getting moody. Thankfully, I am able to catch some of the instances of when I'm getting cranky before I have a chance to get snappy. The big issue is, it's happening much more frequently. Also, I am so darn tired lately, even after a full night sleep. Morning, afternoon and evening time, I just want to nap.

I feel like I'm spiraling out of control, and the treatment just isn't moving fast enough. Of course, I'm sure this is typical during the initial treatment sequence, but I've got to have complete control of my facalties. I'm an armed Deputy Sheriff. I can't afford to have something go haywire while on duty, because of a lack of action in getting this under control.

Should I press my doc to start on insulin, until I can get under control and then try meds again... or just hold out, and let the medicine do it's job? I'm already up to 2000 mg of Metformin daily.

Regards,

princesslinda · #2 (**permalink**) 01-15-2008, 10:24 AM

Darian, I definitely think you should keep on your doc until he does something....your readings are far too high to maintain for very long without complications! OF COURSE you feel bad with numbers that high. You're pretty much at highest dose of metformin and if that's not controlling things, then you definitely need something else. Insulin may be just what you need. Just don't sit around with numbers like that much longer.

RLK · #3 (**permalink**) 01-15-2008, 10:32 AM

I think the Princesslinda said it all. I agree with her- push for more aggressive treatment, or find a doctor who's amenable to putting you on insulin.

DCaplinger · #4 (**permalink**) 01-15-2008, 10:46 AM

Well, I had my last doctor's appointment on the 7th (a week ago Monday), at which time I was referred to an Endo. I called the Endo's office a moment ago, and they have never heard of me. I called my PCP's office, and they apologized for having not sent anything to the Endo. I am sure I have changed 3 shades of red. My PCP will hear about this. I am scheduled to see my PCP on Monday. If I don't hear from my Endo by Friday, I'll be calling them back to set an emergency appointment. I've got to get a handle on this. I don't care if I have to be admitted over a weekend to get a jump start (of course, that shouldn't be necessary).

Thanks for the quick responses. Yes, I will be talking to the Endo about trying to get on Insulin, at least to give what beta cell's I have remaining a well earned rest.

Regards,

Jan B · #5 (**permalink**) 01-15-2008, 10:59 AM

Darian,

This just isn't right. I wish I could just give you a bit of insulin to make you feel better. Until this is taken care of, try not putting any more carbs in your body than absolutely necessary. You are making me love my insulin so much.

I wish you good luck.

Alice · #6 (**permalink**) 01-15-2008, 11:04 AM

It is really becoming aggravating hearing about all the doctors that aren't referring patients when they are supposed to do so...and after they tell you that they are going to take care of it...this just gets my goat...we have several members of this forum in the same boat.

And diabetics get blamed for not "taking care" of themselves. Good grief.

We really have to become our own best advocates and be vocal about these doctor appointments...good luck with your endo appointment. Luckily you don't have to wait the 1-2 months many of us experience.

JediSkipdogg · #7 (**permalink**) 01-15-2008, 11:17 AM

I truely think you need to talk to your doc about some other medications, if not at least insulin. Insulin will bring that 350 down like nothing (ok, in 4 hours, but you should feel better in at least one hour.) I'd try to get an appointment soon and talk about that with your doctor.

Most pill medicines take weeks to start working, but I'd think you'd need something more. Also, how did they diagnosis you as type 2 just out of curiosity?

princesslinda · #8 (**permalink**) 01-15-2008, 11:18 AM

Personally Darian, I wouldn't go through the rest of the week in the 300's waiting for the Monday appt. Call and ask to be an "emergency work-in." I work in a doctors' office, and we have these on a DAILY basis. You need/deserve to feel better sooner rather than later.

Keezheekoni · #9 (**permalink**) 01-15-2008, 11:40 AM

I'd get in for an emergency appointment with your doc as well... There's no way I'd like to live in the 300s, much less the 200s, without some kind of intervention.

Insulin is a good thing!

DCaplinger · #10 (**permalink**) 01-15-2008, 11:41 AM

Quote:

Originally Posted by JediSkipdogg

Also, how did they diagnosis you as type 2 just out of curiosity?

It's funny you should ask that question. I asked my doc last Monday (the 7th) for sure what my diagnosis was. She said it had to be Type 2, because Type 1 is juvenile onset. If I had only known then what I know now, I would have immediately shut her down, demanded a referral to the Endo, and left the office..

There has been no C-Peptide done. There has only been an A1c and a cholesterol. There are a lot of unknowns still out there, because my PCP just simply doesn't know what to look for. The kind of things that someone who has Diabetes would know to look for, as would an Endo.

I will be trying the Endo back this afternoon to see about getting in to see him. I don't want to waste my time with my PCP any further, unless the Endo just can't do it within a week or so. If I can't get in quickly, I'll call my PCP back for a script for Insulin.

That brings me to the next question. I am an infant when it comes to insulin therapies. Do I need both basal and bolus, or just the basal while I'm on metformin? I have only about a 5 minute education on the subject, so any information that can be given me would be greatly appreciated. I need to be well armed with knowledge at this point.

I continue to thank God that you guys are here for me. I don't know what I would do without this resource.

Regards,

BlueSky · #11 (**permalink**) 01-15-2008, 12:32 PM

Quote:

Originally Posted by DCaplinger

... Do I need both basal and bolus, or just the basal ....

As you are having problems with blood sugar shooting up after meals, you need to inject the short acting stuff before you eat. If your blood sugar in the mornings and between meals is higher than you want it to be, you need the long-acting basal as well.

Your blood sugars have deteriorated so rapidly since your diagnosis a few months ago that it really looks like T1 or T1.5. If it were me, I would start with the bolus and add the basal if and when it is necessary.

Scratch · #12 (**permalink**) 01-15-2008, 01:15 PM

Get in with that endo as soon as possible. You might even try bugging your PCP though to see if he or she will order c-peptide and GAD antibodies tests and request that those results be sent to the endo.

I'd be willing to bet that it's likely if you do have type 1.5 type of bloodwork and it arrives at the endo before the appointment, you'll get a call to come in as soon as possible.

lewsterr · #13 (**permalink**) 01-15-2008, 01:31 PM

Darian, I agree with everyone here. Call the endo, and tell them how lousy you feel, and that this is an emergency. As Princesslinda stated, most if all physicians leave openings on their schedule for emergencies such as this. Don't wait! Unless you tell them that it's an emergency, they aren't going to consider it one. Your numbers are much too high, and every day that you sit around waiting, you are doing more damage. Call NOW and tell them you must have an appointment by tomorrow. You'll see how fast they get you in. Let us know how it goes.

morrisma · #14 (**permalink**) 01-15-2008, 01:39 PM

to what everyone has said.
In addition, you will feel WONDERFUL once those bgs get more normal and insulin is a magic elixer in that respect.
You will regret all the waiting - I did!
Good luck
Mike

verynicebecky · #15 (**permalink**) 01-15-2008, 03:21 PM

Quote:

Originally Posted by morrisma

to what everyone has said.
In addition, you will feel WONDERFUL once those bgs get more normal and insulin is a magic elixer in that respect.
You will regret all the waiting - I did!
Good luck
Mike

Seriously? I did inject during my last preg (14 yrs ago) and I did feel wonderful. I also watched my diet like a hawk and lost 60 lbs. I am seeing my dr. next week and I am sure that he will put me on insulin. In fact I am going to request it. I was diagnosed type 2 three years after I had the baby and I have been on oral meds since then with not so great control. The only time I had decent control was 8 yrs ago when I was walking for four hours a day. I just can't find the motivation to do that. Maybe getting on insulin will help with the motivation?