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MJB

If you found out you don't tolerate Metformin.....

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dowling gram

I was put on Metforman when I was first diagnosed. That lasted for 3 days of he---ll. I went back to my doctor and he wrote me a prescription for Januvia and I've been on it for over 5 years. I've had absolutely no problem with it. It works by stimulating the Pancreas Beta cells to produce more insulin

 

I might have tried the slow release Metforman but it was not approved in Canada at the time. Most say there are fewer gastric problems with it.

 

My sister was on Invokana but had to get off of it because of recurring UI infections. With Invokana excess sugar is excreted with your urine. That excess sugar is what causes UI infections

 

There are other meds. Janumet is a combination of Januvia and Metforman and may be good too. There are others but those are the ones I know about. I suggest that if your doctor puts you on another diabetes med. you look it up and see how it works and possible side effects before you start on it

Edited by dowling gram

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MJB

I just got back from my doc. He prescribed Januvia but I just found out it will cost me $450/month.

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PJ Lin

You may try insulin injection...Don't laugh, I am serious.

In some studies, scientists have found early insulin injection may reverse diabetes symptoms.

An interesting article to read: https://www.biopleo.com/blogs/news/how-early-insulin-injection-could-halt-diabetes-progression

See the study: https://www.medscape.org/viewarticle/588165

and I quote: "The Lancet suggested that early intensive insulin therapy (insulin pump or multiple daily injections) for 3-5 weeks at the onset of type 2 DM led to clinical remission and arrested beta-cell function decline.[3] "

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MJB

I was diagnosed in 2006 so it appears that the early insulin injection ship has sailed.

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dowling gram
17 hours ago, PJ Lin said:

You may try insulin injection...Don't laugh, I am serious.

In some studies, scientists have found early insulin injection may reverse diabetes symptoms.

An interesting article to read: https://www.biopleo.com/blogs/news/how-early-insulin-injection-could-halt-diabetes-progression

See the study: https://www.medscape.org/viewarticle/588165

and I quote: "The Lancet suggested that early intensive insulin therapy (insulin pump or multiple daily injections) for 3-5 weeks at the onset of type 2 DM led to clinical remission and arrested beta-cell function decline.[3] "

Why don't you quit with this. Everyone here has been diabetic for a while or years so your suggestion even if it's true is of no use to us. Besides it is not recognized by the medical community and no one is giving this treatment so your info is useless. This is just a theory and a dangerous one at that

Edited by dowling gram

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meyery2k

@PJ Lin - While we appreciate ideas and reasoned debate, the intent of this forum is to help people that have been recently diagnosed with diabetes.  Generally the doctor tells you you are diabetic, pats you on the back, and sends you on the way with a prescription of Metformin.  I came here because I believed people that live with diabetes would give me the best advice on what I could do.

 

Frankly, recommending someone to try insulin injections with no knowledge of how to use insulin may kill them.  Insulin can be obtained without a prescription and ignorance of how it works can be fatal.

 

While I understand that the person you have replied to may have this knowledge, a person newly diagnosed that is scared, angry, and depressed might give this a go.

 

If I may suggest a more helpful approach, perhaps you could post upon the things you do to keep your condition in check.  That is what people come here for.  If you wish to discuss articles and other ideas, please post those in the articles forum where it is understood that the posts are theoretical.

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PJ Lin
43 minutes ago, meyery2k said:

@PJ Lin - While we appreciate ideas and reasoned debate, the intent of this forum is to help people that have been recently diagnosed with diabetes.  Generally the doctor tells you you are diabetic, pats you on the back, and sends you on the way with a prescription of Metformin.  I came here because I believed people that live with diabetes would give me the best advice on what I could do.

 

Frankly, recommending someone to try insulin injections with no knowledge of how to use insulin may kill them.  Insulin can be obtained without a prescription and ignorance of how it works can be fatal.

 

While I understand that the person you have replied to may have this knowledge, a person newly diagnosed that is scared, angry, and depressed might give this a go.

 

If I may suggest a more helpful approach, perhaps you could post upon the things you do to keep your condition in check.  That is what people come here for.  If you wish to discuss articles and other ideas, please post those in the articles forum where it is understood that the posts are theoretical.

got it. Thank you.

Just tried to help but did not see your points. Thank you.

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dowling gram

Thank you Mike! You stated so nicely and eloquently a point I was trying to make in my bumbling way. I would hate any newbie to get hurt trying PJ Lin's theory. Put in the right forum they can understand it is a theory and a study and not a proven fact

Edited by dowling gram

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Hammer

MJB, I could not tolerate ANY of the oral diabetes medications...they all gave me severe diarrhea, and I tried all of the classes of them....metformin, metformin ER, Starlix, amaryl, glipizide, glymeride, prandin, you name it, and I tried it.  I decided to just stop taking them because I didn't need to have severe diarrhea all of the time.  Also, except for metformin, all of the other oral drugs cause your pancreas to produce more insulin, which will overwork your already taxed pancreas, and that will eventually wear out your pancreas.

 

I decided to go with using insulin, since it doesn't go through my stomach, and thereby, won't cause me to have diarrhea.  I also figured that what my body needed was insulin, since that's what my pancreas produces, but not in sufficient quantities to overcome my insulin resistance.  Using insulin would also help to preserve some of of pancreas's insulin production.  Of course, when you use insulin, you have to be careful about how to dose it, but it isn't that difficult to learn what your body's insulin to carb (I:C) ratio is.  Once you've determined what that ratio is, you can then use insulin to get really precise control of your glucose levels....and insulin is more immediate than oral medications.  If your on oral medications and you eat something that has more carbs in it than you would normally eat, your glucose levels can rise up higher than you want them to be, and it might take a day or more before those BG levels drop back down to where you want them to be.  With insulin, you count the carbs in the food you are about to eat, then take the appropriate amount of insulin for that many carbs.  If you calculated correctly, your glucose levels wouldn't rise that much, but if you miscalculated and they did rise too high, you just take a second, corrective shot of insulin, and your BG levels will drop back down in a few hours.  The key here, is to know how much insulin to take, because if you take too much, your glucose levels will drop too low, and that can be dangerous.

 

I take both a basal insulin (Lantus), and a bolus insulin (Novolog).  The basal insulin, Lantus, is used to lower my fasting glucose levels.  Your fasting glucose levels are your glucose levels when you haven't eaten for a number of hours, and they are your baseline or basal levels.  Lantus has no effect on your after meal glucose spikes, that's what the Novolog is for.  You inject Novolog before you eat, to help keep your after meal spikes from spiking too high.  Using both types of insulin helps me keep good control of my glucose levels, and they don't upset my stomach.

 

Keep in mind that there are other types of insulin, older types that aren't as fast acting as the newer types, but are a lot less expensive.  I have no experience with them, so I can't comment on them. The newer types, Lantus and Levemir are the two main basal insulins, and Novolog and Humalog are the two main types of fast acting insulin, although there are some newer insulins that are just as good as these insulins...Tresiba is one... and supposedly work just as well, but I've never tried them.

 

Oh. and if you are wondering about the pain that using a needle to inject insulin causes, well, there is very little to no pain when you inject.  The reason is that, unlike the needles they use at the hospital to draw your blood for blood tests, insulin needles are very thin...so thin that most of the time when I inject, I don't even feel it.(you'd think that you'd at least feel something touching your skin, but you don't).  Those needles at the hospital that they use to draw your blood, are a lot thicker, because you blood cells are large, and they need to use a thicker needle to prevent damaging the blood cells when they draw blood.  Those finger pricks that you do when you do a glucose test to check your glucose levels, hurt more than the insulin injections do.

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dowling gram
14 hours ago, Hammer said:

MJB, I could not tolerate ANY of the oral diabetes medications...they all gave me severe diarrhea, and I tried all of the classes of them....metformin, metformin ER, Starlix, amaryl, glipizide, glymeride, prandin, you name it, and I tried it.  I decided to just stop taking them because I didn't need to have severe diarrhea all of the time.  Also, except for metformin, all of the other oral drugs cause your pancreas to produce more insulin, which will overwork your already taxed pancreas, and that will eventually wear out your pancreas.

 

I decided to go with using insulin, since it doesn't go through my stomach, and thereby, won't cause me to have diarrhea.  I also figured that what my body needed was insulin, since that's what my pancreas produces, but not in sufficient quantities to overcome my insulin resistance.  Using insulin would also help to preserve some of of pancreas's insulin production.  Of course, when you use insulin, you have to be careful about how to dose it, but it isn't that difficult to learn what your body's insulin to carb (I:C) ratio is.  Once you've determined what that ratio is, you can then use insulin to get really precise control of your glucose levels....and insulin is more immediate than oral medications.  If your on oral medications and you eat something that has more carbs . in it than you would normally eat, your glucose levels can rise up higher than you want them to be, and it might take a day or more before those BG levels drop back down to where you want them to be.  With insulin, you count the carbs in the food you are about to eat, then take the appropriate amount of insulin for that many carbs.  If you calculated correctly, your glucose levels wouldn't rise that much, but if you miscalculated and they did rise too high, you just take a second, corrective shot of insulin, and your BG levels will drop back down in a few hours.  The key here, is to know how much insulin to take, because if you take too much, your glucose levels will drop too low, and that can be dangerous.

 

I take both a basal insulin (Lantus), and a bolus insulin (Novolog).  The basal insulin, Lantus, is used to lower my fasting glucose levels.  Your fasting glucose levels are your glucose levels when you haven't eaten for a number of hours, and they are your baseline or basal levels.  Lantus has no effect on your after meal glucose spikes, that's what the Novolog is for.  You inject Novolog before you eat, to help keep your after meal spikes from spiking too high.  Using both types of insulin helps me keep good control of my glucose levels, and they don't upset my stomach.

 

Keep in mind that there are other types of insulin, older types that aren't as fast acting as the newer types, but are a lot less expensive.  I have no experience with them, so I can't comment on them. The newer types, Lantus and Levemir are the two main basal insulins, and Novolog and Humalog are the two main types of fast acting insulin, although there are some newer insulins that are just as good as these insulins...Tresiba is one... and supposedly work just as well, but I've never tried them.

 

Oh. and if you are wondering about the pain that using a needle to inject insulin causes, well, there is very little to no pain when you inject.  The reason is that, unlike the needles they use at the hospital to draw your blood for blood tests, insulin needles are very thin...so thin that most of the time when I inject, I don't even feel it.(you'd think that you'd at least feel something touching your skin, but you don't).  Those needles at the hospital that they use to draw your blood, are a lot thicker, because you blood cells are large, and they need to use a thicker needle to prevent damaging the blood cells when they draw blood.  Those finger pricks that you do when you do a glucose test to check your glucose levels, hurt more than the insulin injections do.

If that works for you or anyone else then fine but I'd rather take a pill a day than have to have injections through-out the day. If my pancreas wears out and my numbers go higher then I'll think about insulin. Right now I barely count carbs and barely test because I know what raises my BG. All I have to do is have an A1C every 6 months and pop a pill with my breakfast.

For reference-- I do test a few times a week and am always with-in my preferred range. My A1C has never been over 6 since 3 months after diagnosis over 5 years ago.

Edited by dowling gram

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Hammer

I agree with you Dowling, whatever works best for each person is what they should do.  I know that injecting insulin isn't what most of us want to do, and insulin isn't the answer for a lot of us.  It was just that MJB, like myself, can't tolerate oral diabetes meds due to the stomach distress, so the only solution for people like us is insulin.  One of my other concerns with oral meds, except for metformin, is that they will over work your pancreas which will eventually wear it out.  At that point, insulin would be necessary in order to control one's BG levels.  As my previous doctor pointed out, when you develop type 2 diabetes, you already have impaired pancreatic function, so your pancreas is already producing less than optimal insulin, so taking medications that continue to push your pancreas to produce even more insulin will wear it out even more.    Had that person started on insulin sooner, it would have preserved more of their pancreatic function, so that they wouldn't need to inject as much insulin.  Saving as much pancreatic function as you can, also gives you better control of your BG levels, because, if you eat something, and you under estimate the carbs in the food, which means that you'd inject too little insulin, your pancreas will help to make up the difference so that you don't spike too high.  If your pancreas is too worn out, it can't help you much if you inject too little insulin. 

 

But again, like you said, what works best for me, might not work best for someone else, since each of us have our own unique situations.☺️

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MJB

Thank you all. I'm now taking one  2.5mg glyburide and 2x1000 metformin a day. My fasting BG was 217 this morning. I deal with a stomach ache daily. I'm calling the doc today as this has to change. I think I'll ask for a referral to an endo. 

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Hammer

MJB, you said that your fasting BG this morning was 217....what did you eat the night before?  A fasting BG that high usually means one of two things....that you ate some high carb foods the night before, or that you might not be a Type 2 diabetic....maybe a 1.5?

 

I'm sorry to hear that you are having digestive issues with the oral meds.  I totally understand that, and when I tried the oral meds, I had severe digestive issues with them, and when you take into account that I had a 90 minute drive to get to work every night, and I left my house at 8:30 PM to get to work, I knew of every place on the way to work that had a rest room, because at some point, I had to use them all.  This was the reason why I switched to insulin....no more digestive issues.

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MJB

Hammer, I was diagnosed T2 in 2006. I'll be 69 years old next month.

 

I eat LCHF and I controlled with diet and exercise alone for years. Something has changed. I'm off to see the doc in an hour.

 

Thanks for the reply, I'm thinking I may need to go to insulin. We'll see.

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MJB

So I'm doubling the glyburide and changing to MetforminXR. I get blood drawn in a couple of weeks and we'll discuss if the change in meds is working or not.

 

If not, then i'll probably get an endo referral.

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Perciival

Recently diagnosed (3 weeks ago tomorrow)  Went to ER due to blurry vision.  Wife thought blood sugar might be a problem so bought a glucose meter, tested and came back at 450.  Went to doc and put on 1000mg of metformin 2x a day.  Evening reading of 204.  Morning reading of 194.  Vision is back to normal.  Blood work came back and a1c was 11.8.  Two years ago it was 5.5%.  Suffer from chronic nerve pain and have been on Percocet, Lyrica and Tizanidine for 3 years.  In last 6 months have had epidural steroid injection to try and block pain in nerve roots.  1.  Why would blood sugar shoot up so much in 2 years with no real changes in lifestyle and 2.  Any help down this new path of life would be greatly appreciated. 

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adiantum

@Perciival , Welcome to the forum.

I'm sorry you have been put in this situation & believe you can blame those steroid injections for causing it.

Edited by adiantum

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dowling gram

Welcome Percival

You would get more response if you made a new post. People who have been here often won't come back to a post they have already seen and maybe replied to.

 

I don't know exactly why your blood glucose shot up but it could be the meds you'va taken or the steroid injection.

 

The best thing you can do is immediately go on a low carbohydrate high fat diet. Look at the Keto diet if you need help. This diet will do more to lower your blood sugar than any meds and it will help your nerve pain if it's Neuropathy pain caused by high blood glucose. Do not worry about the high fat as long as it's good fat and not transfat. When you cut carbs you need something for energy and the body switches to fat burning and it does not promote heart disease. You will have to learn to read labels and look up nutrition stats to find out how many carbs are in things.

 

If you don't have a glucometer get one. Walmart sells the Relion meter, lancets and strips. The pharmacist should be able to show you how to use it or look on utube. Test in the morning and before you eat to get a benchmark. Then at 2 hours after that first bite. Your blood glucose should be going down close to your benchmark. If it's not then go over what you ate to find the carb culprit and cut down or eliminate it from your diet. Aim for 100 carbs a day at first and you may want to lower it more after you get used to things.

 

It does take some work but the results are worth it. My blood glucose wasn't as high as yours but with diet and low does meds. mine lowered to normal in 3 months. I felt better and had more energy than I'd had in years.

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Kit

Hi Perciival, welcome to the group.

 

There are actually a few potential reasons where you might have seen such a jump in A1C over just a few years.

 

1)  Steroid induced diabetes.  This is a known phenomena, thought I am not sure how long and how much you need to be taking before this usually happens.

 

2)  Normal insulin resistance.  Insulin resistance can exist for years, even decades, before blood glucose levels start to rise.  I have known a few people where that jump happens over the course of a couple of years and this is also a possibility.

 

3)  Combination of the above two items

 

Statins are also known to induce diabetes in some individuals.  I'm not sure how quickly or how much is needed before this happens, but it is also a known phenomena.

 

As for how to deal with this, first some basics.

 

1)  Identify your goals.

Its difficult to work towards something if you don't know exactly what you are working towards.  According to the CDC, the chances of diabetic complications don't start happening til around an A1C of 6.0.  To reach this, the following general guidelines can help.

 

Fasting and before meals - under 100

1 hour after a meal - under 140

2 hours after a meal - under 120

 

2)  Eat to your meter.

Many of us here follow this general rule.  What it means is that you test yourself before a meal (to get an idea of base line) and again after a meal (two hours is a good general rule but there may be reasons why you might want to check earlier or later.  This will let you know how you are reacting to the foods you eat with your current treatment methods.

 

Do not trust what your doctor tells you, or what a nutritionist tells you, or even what we tell you here.  I was given the usual lists when I was first diagnosed.  I was also told I should not test more than once a day.  I tested more often anyway, even buying more strips out of pocket because they wouldn't give me anymore.  I discovered that most of the stuff they told me was safe took my numbers through the roof.  I'd be around 150, eat a meal, and end up over 200.

 

This is why I always say that your meter is your best friend, even if it doesn't feel like it sometimes.  Its not going to lie.  Its not going to have any preconceived notions on what foods are "good" and which ones are not.  It just looks at the glucose floating around in that drop of blood you just fed it.  

 

3)  Diet

The dreaded word.  But what you put into your mouth is one of these largest factors in controlling high glucose levels.  There are three macronutrients.  fat, protein, and carbohydrates.

 

Carbohydrates have a very real and very direct affect on our numbers.  The more you eat, the higher you will usually go.  The body turns carbohydrates directly into sugar.

 

Proteins can have an affect on BG levels through a process known as gluconeogenesis.  This is where the liver can convert excess protein into glucose.  Honestly I've never been able to eat enough protein in one sitting in order to see much of a rise in my own numbers.

 

Fats - dietary fat has next to no affect on BG levels at all.  

 

Because of this, many of us here follow a lcfh (low carb high fat) or even a ketogenic diet.  If you look at our Dieting and Nutrition section, especially the recopies sub section, you will find tons of ideas and suggestions.  I happen to be one who follows a ketogenic diet.  I average around 30g total carbohydrates per day, about 60-80g of protein per day, and enough fat to give me the calories I need.

 

4)  Learn how to read nutrition labels and look up information for foods that don't have labels.  This is a vital ability for a diabetic.  You need to know what you are eating and whether or not it may fit into your diet.  Here in the US, carbohydrates are listen on nutritional labels as the total carbs.  It can then list Fiber, sugar, and sugar alcohols as sub items. 

 

For example: 1 cup (8az) of 2% milk contains

Total carbohydrates:  12g

    Dietary Fiber:  0g

    Sugar:  12g

 

This basically says that all of the carbs in that cup of milk come from lactose, or milk sugar.

 

5)  Sugar has hidden names!!!

Yep, there are a ton of different names for sugars.  I'll include some here

sucrose
dextrose
fructose
maltose
lactose
glucose
high-fructose corn syrup
brown rice syrup
maltodextrin
molasses
evaporated cane juice
cane juice
fruit-juice concentrate
corn sweetener
corn syrup
palm syrup
molasses

 

6)  Be careful of  sugar alcohols.  They are not all created equal.  Maltodextrin is well known to affect people almost as much as table sugar and is in a LOT of "sugar free" products.  Erythitol on the other had has a pretty good reputation on having very little affect.

 

And one last thing.  Steroids are notorious when it comes to raising blood glucose levels.  You may have trouble getting your numbers in line while you are taking them regardless of anything else you do.

 

I wish you luck.  Feel free to ask any questions you might have.  The only stupid question is the one left unasked.

 

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Kit

Oh, one very important addition.

 

It takes time for your numbers to come down under the best of circumstances.  As long as you are seeing your numbers go in a positive direction, you are doing well.

 

It took me three months to get from an A1C of 10.4 to 6.7.  Six months for an A1C of 5.2.  I forget how long it was before I was able to go for a month with my fasting readings under 100, but it took a long time.

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Perciival

Thank you all very much!!!  I obviously have a lot to learn!!!

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Kit
On 4/8/2019 at 3:48 PM, Kit said:

6)  Be careful of  sugar alcohols.  They are not all created equal.  Maltodextrin is well known to affect people almost as much as table sugar and is in a LOT of "sugar free" products.  

 

Ack, I have to correct myself.  Maltodextrin is a sugar.  Maltitol is the sugar alcohol which tends to affect people just as much as sugar itself.

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Hammer
21 hours ago, Perciival said:

Thank you all very much!!!  I obviously have a lot to learn!!!

Yes, there is a lot to learn, but don't get discouraged, we all went through the exact same thing that you are going through, and as we all found out, we learned a little at a time, so that we didn't get overwhelmed by all of the information.  Just keep asking questions here, and we will help you in any way that we can.  And like the others have said, steroids will play havoc with your glucose levels.  I consider myself to have excellent control of my glucose levels because I use insulin, but a few weeks ago, I sprained my neck and my doctor prescribed prednisone to help with it.  I took it for five days, and I had a hard time trying to get my glucose levels back down to normal.  I had to increase my insulin doses every day, just to try to stop my glucose levels from getting any higher, but the increased dose didn't work.  Once I stopped the prednisone, my glucose levels dropped back down in a day or two, and my insulin doses went back to what they were before I started on the prednisone.

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