[CynthiaJ]

New to this forum and really enjoying reading the posts.
I haven't taken meds for 2 years until recently; was playing it a little too fast and loose, trying to do the holistic thing and spending a little too much time at that river in Egypt. However, I've seen the light and am ready to get things under control FOR GOOD. It's absolutely crucial that I get things under control fast and stay that because periodontal problems are going to cause me some tooth loss. I know that it isn't helping my blood sugar numbers either. But I can't get bone grafts and/or implants until I have a decent A1C (and I'm guessing mine is around 12 right now). And, of course, all the OTHER good reasons to be in good control!

I am seeing a new doc tomorrow; the one I saw on Wed didn't impress me. He refused to prescribe insulin, even though I asked and have used it before with great success. I'm taking the pills he prescribed because I needed to do SOMETHING. At any rate, I'm currently on 1000 of Metformin (he did give me permission to titrate-!!!) twice a day and 5 of Glucatrol XL. I started on 500 of the Metformin twice a day and just bumped it up to 1000 twice a day. I am also one of those diabetics that has a high fasting no matter what I do (and I've tried it all). My preference would be to be on levemir in the evening, possibly with a lower dose of metformin and novolog bolus. I'm lost almost 60 pounds over the last 3 years; I'd like to lost 20-30 more; hence, the levemir. I have a great program that does the insulin algorithm on my Palm TX. I really want off the Glucatrol. If I'm still making insulin, which I'm guessing I am (down to 181 a bit ago from 465 on Thursday), I suppose it makes sense to continue on the Metformin. But it is a lot easier to bolus before meals based on what I'm eating and what my blood sugar is. Currently, I'm doing moderate carb and watching the calories. My A1C goal is under 6. I won't be having any extractions until after the middle of May at the earliest; I'm also a singer and I have performance committments until then. While my friends are offering money to see an upper plate come flying out of my mouth on a high C (and I do hit those very nicely), it's an experience I'd rather avoid.

Anyway, would love to hear thoughts from folks on this. I plan on being a regular here. I'm an RN, so, yes, I should have known better, but a lot of us are "do as I say, not as I do". I have not had much luck in finding a good endocrinologist in these parts. I'm not interested in being treated like every other diabetic that walks into the office, because we are all different. And I see way too many patient in my job that have a bazillion side effects from all their meds. So, ANYWAY, thanks in advance for your thoughts!

[shutterbug]

Cynthia,

Welcome to the forum..

Originally Posted by CynthiaJ

....and I'm guessing mine is around 12 right now). And, of course, all the OTHER good reasons to be in good control!

...... I started on 500 of the Metformin twice a day and just bumped it up to 1000 twice a day. I am also one of those diabetics that has a high fasting no matter what I do (and I've tried it all). My preference would be to be on levemir in the evening, possibly with a lower dose of metformin and novolog bolus.

Reading the first 2 paragraphs, I wondered if you were a doc.

Then read that you are an RN. It would be nice to get advice from a RN.

Welcome again!

[pokie]

I am on metformin as well, 1000 mg x2 and glipizide 5 mg x2. I had the lantus added late last year, and novolog the beginning of this year. Only now do I have anything resembling control. When I see my doc in a couple of weeks we're going to discuss stopping the oral meds, I think.

[DonnyC]

I have added Novolin Nph insulin to my treatment along
with my oral meds. I really do like it.
My control is excellent. I take my regular meds
and adjust my insulin intake based on my readings
at certian times of the day. What more can I say
but the system works for me.

[BlueSky]

Originally Posted by CynthiaJ

.... I am also one of those diabetics that has a high fasting no matter what I do ...

In that case, some NPH before going to bed should do the trick. It has a pronounced peak at 6-10 hours. Bringing blood glucose down at night and in the morning has the biggest impact on the HBA1c. Apparently you can get NPH without prescription in the US ...

[CynthiaJ]

I'm off to the doctor this morning, armed with data and articles. The blood sugar is slowly coming down (under 200 yesterday), but not fast enough for me. And I'm being VERY good with the food intake. Hopefully, I'll get the insulin. I'm asking for levemir and novolog. It blows me away that a doctor would refuse insulin to a patient that knows how to use it that comes in with a blood sugar of 450. If I were in the hospital, they'd have me on insulin so fast it would make your head spin. And I really need long acting insulin to get my morning blood sugars down. I appreciate the suggestion about the NPH, but I'd like to try the levemir since it has less of the weight gain side effect of some others. Besides the potential side effects of the oral meds, I'm really concerned that I'm going to have a big drop in my BG when the nasty teeth come out and the periodontal stuff gets treated. I can regulate my blood sugar far better on insulin. So keep your collective fingers crossed for me!
Thanks again!

[Ronman]

BlueSky, I am a novice here and I have tried practically everything to get my morning fasting numbers down. I am now on Metformin and have been for about a month but I am still experiencing all the negative side effects that I did when I first started taking it. It does seem to be helping although I am really getting tired of feeling crappy all day. You mention NPH which you say is available over the counter. What exactly is NPH? Sorry if I seem to be highjacking this post.

[CynthiaJ]

NPH is an intermediate-insulin. It must be injected. It is designed to peak in action about 8 hours after you give it. While you can buy insulin without a prescription in the US, you must have a prescription for the syringes. I would recommend you see your doctor about it. In my opinion, for those of us with high fastings even under the strictest circumstances, insulin is the way to go.

[Lloyd]

Cynthia,

I am on metformin and a pump. I experimented with going without the metformin, my insulin usage doubled, so I went back on it after 3 weeks.

[CynthiaJ]

Thanks, Lloyd! I got my insulin, a Levemir Flex pen, Humalog pen and I'm staying on the metformin. I'm going to have to watch it pretty closely over the next several days; I took 1000 of metformin this morning, saw the doc, got my Humalog, had a quick PB&J (had to see my OWN patients), took 5 units and my blood sugar dropped to 131! I can't tell you how nice it was to see that number after seeing 465 less than a week ago! I'm going to start with 500 of metformin along with 5 of levemir tonight and titrate up slowly, using metformin twice a day and bolusing before meals with the humalog. I'm pretty excited! LOOOOOOVE my new doc!

[Scrabblechick]

I'm glad you love your doc and that he gave you something that's showing such immediate improvement!

I'm finally starting to see some real results, myself, and I'm tickled, too!

[lottadata]

Cynthia,

If you are responding that strongly to 5 units, you might want to talk to the doc about testing you for GAD and islet antibodies, because that's a very small dose for a Type 2.

A lot of us are told we are Type 2s when we aren't, because we have some middle age weight gain on us at the time of diagnosis, or because (as in my case) we gain weight as blood sugar control deteriorates and very high post-prandial blood sugars make us more insulin resistant.

If you end up able to control on 5 units of Levemir and 5 units of novolog, you probably AREN'T a type 2.

I control on 2 units of basal and 3 or 4 units of insulin and I turn out to have MODY.

[birdyland]

Good luck Cynthia. I'm not afraid of needles, I'm afraid of metformin!!! I'm kind of glad I did not take well to oral meds, as I am T2 and we are not encouraged to take insulin, especially at a young age (I'm 28). Good for you for pushing for what will work best for you.

Even now on insulin, my morning sugars are the hardest to control. I take more insulin at night than I do during the day.

Welcome, and good luck!

[CynthiaJ]

Well, that 5 u was a fluke, I think. Hard to say how much is stress-related and perio-related and how much is real, if you know what I mean. I'm consistently under 200, and pulled a 130 FBS this morning, but I don't think I was taking the Levemir correctly; think it needs to be every 12 hours. I also don't think wheat agrees with me. I'm just trying to be really careful this weekend; off to the stepson's wedding in Colorado tomorrow and the ex and I have never met until now. Let's just say she believes that I'm the Antichrist. Also having to have a lower partial completely redone with another dentist--long story, don't ask. And, big concert in Spokane next weekend, where I, who have lots of classical and showtune singing experience, will be doing my first solo jazz scat singing in a pretty tough Duke Ellington piece in a chorale concert (it's not all me). Just found out that almost 300 tickets have been sold and they just started advertising. No pressure. So, there's a smidge of stress there. But I'll keep plugging along. Eventually, I think I can talk my doc into some antibody testing, but I've only seen her once and I don't want to scare her.
Cynthia