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Permalink Reply by Kaytea on February 19, 2012 at 8:14am

I was just thinking that if I could give the doctor something and he could see how much I ate how much Insulin I took and what happened to my sugar it may help. Im not a pro at this at all lol but it just seems to me that sometimes when I dont take a lot of Insulin (say 20) that I dont feel it does anything but I also wasnt checking my sugars to know, but I rarely had a low sugar when taking that much. I know this is not going to be a quick fix its going to take a while and a lot of effort but I just want to be able to feel better. I wake up sick a lot and I lost my job because I had to go to the hospital twice in a month.

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Permalink Reply by Type1Gal on February 19, 2012 at 8:23am

1) I think you need to see an Endo and discuss what type you are, sounds like, again, you're a type 2 and need oral meds. Were you told you were a type 1, did you test positive for the antibodies, low cpeptide? Type 2 and type 1 are two toally different diseases. Type 1 is an autoimmune disease and typically we are not insulin resistant, or not 120 units of basal worth.

2) An endo can run your meter or you can download it and bring in hardcopies or email to them.

3) Write down everything you eat, count carbs, write down your numbers.

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Permalink Reply by acidrock23 on February 19, 2012 at 8:27am

What did you go to the hospital for? Hypos? 2x in a month seems like "a lot"?

I think the key thing is to test a lot! Doctors require input and BG testing data, whether from a CGM or not, is critical to them being able to help you? What you are describing today is up and up and then down, apparently rather rapidly. This is, again, exactly what I did and, while I got "good" (sic) enough at it to do ok A1C-wise, smoother, more stable BG curves should be the goal? Another option that a lot of people suggest is to take less carbs, maybe eat lower carb food options for a couple of weeks? Without knowing the food in thing I'm not sure what your "ratio" is or what you are eating but, if 20U is for 60G of carbs (a standard dietitian's recommendation for a "meal"?), you could try 7U for 20G and see if that gets you a different result? I'd think it would be similar but it might make the curves less extreme and help you start feeling better?

Ah, now reading back through the thread that was posted while I was writing this, I have to agree maybe there's more to it and the checking on the diagnosis is a good idea. As is the writing down **everything**, however tedious that is. If the doc mis dx'ed you and there's a problem like that, a new doc may pick right up on that but I think there's some people here who've also had to argue with their doctors to get their problem fixed?

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Permalink Reply by Kaytea on February 19, 2012 at 8:54am

If the doctor does blood tests and it says I dont make Insulin doesnt that mean that I would have Type 1?

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Permalink Reply by acidrock23 on February 19, 2012 at 9:00am

I think so but I'm not 100% sure?

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Permalink Reply by Zoe on February 19, 2012 at 11:20am

The c-peptide test which tells you how much insulin you are making is important, but not definitive in diagnosis. The definitive test is for the antibodies that are indicative of type 1.

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Permalink Reply by Brian Wittman on February 19, 2012 at 8:57am

Hi Kaytea ~

I ahve read all the responses to your post. there are a few things in common here; things I both like and dislike.

What concerns me is that none of these posts have really addressed your question. They have done a pretty good job of chastising you for not taking care of yourself, telling you about your insulin doses and the like.

About getting a pump. There is a process to securing a pump. The first thing to do is get a diabetes management plan established with your endocrinologist. If you do not have an endo, get one, and if that endo is uncomfortable to you, see another one. Ask that endo to evaluate you and where you are with your diabetes control; through additional tests if necessary. Have some sessions with a CDE or take some classes to be sure you understand how to count carbs and understand how food intake affects your hourly blood sugars. Begin your day with a test and establish for yourself the occasions throughout the day when tests and insulin injections are necessary. Chart, chart, chart. Be sure you keep a log of your blood sugar reading, and for now, keep a food/drink intake log as well. Your endo and CDE will want to know this information. This will help you get into control and stay there. Your A1-c will come down. After all this has happened, that is the point where you and your endo can begin the discussion of getting a pump. Maybe the endo will want to add the CGM right away, maybe not. Fact of the matter is, you can't just get a pump and think your problems are over. The pump does make management much easier.

Personally, I have an Animas Ping pump. I like the way the pump and meter communicate with each other. I like the colour screen for my old eyes. I like to be able to program in my own warning and alert tunes with the software, and the software is a wonderful tool for tracking where I am as far as control is concerned. There are a lot of fail-safes built into the pump and it never lets you do anything without being sure. I don't have a CGM, but am told that the Dexcom, that Animas uses is very good. I believe that the MiniMed is a similar pump. It had features that were nice, such as good software. I didn't like the fact that the pump had to be munipulated for each bolus, where the Animas Ping could be done from the meter, and I had a rotten encounter with the MiniMed sales representative. The Omnipod just wasn't for me.

Congratulations on your recent marriage and your desire to start a family. Making sure that diabetes is a very unique part of you, rather than having it define you, is the finest gift you can give them. Sometimes, it's good to be diabetic.

Be well.

Brian Wittman

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Permalink Reply by acidrock23 on February 19, 2012 at 9:02am

I agree that we did "drift" a bit, one thing I'd say about why I was blathering on about getting a plan is that if Katyea can come up with a plan on her own, or at least have the "concept" of what she wants to do in her head, she might enjoy a more productive visit with this new doctor?

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Permalink Reply by Don on February 19, 2012 at 9:25am

Just to throw this out there, it is possible to have both T1 and T2. Based on your high insulin doses, you sure seem to be Type 2. Either way, you will really benefit from your new-found motivation to get it under control. You may be truly surprised by how much better you feel. It is so worth it.

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Permalink Reply by Type1Gal on February 19, 2012 at 1:34pm

i believe this is incorrect. one either has the autoimmune disease - the Islet Beta cell destruction or they don't. there are type 2's who eventually become insulin dependent but they don't have the actual 'autoimuune disease', it still is a metabolic syndrome and often, weight loss, and lifestyle changes can help. a type 2 doesn't turn into a type 1 and a type 1 doesn't turn into a type 2. An initial misdiagnosis certainly can happen.

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Permalink Reply by Brian (bsc) on February 19, 2012 at 11:13am

I have not jumped into this conversation until now. A pump is a powerful tool. In the hands of someone who tests regularly, counts their carbs and takes their insulin on time, the pump alone can on average can drop you A1c by more than 0.5% and your insulin needs drop as well. But if you don't have good care habits already, a pump may not help you much at all. And most of all, diabetes is not something that you can just fix with some pill or some pump, it is something that you personally must take care of many times every waking minute of every day. I'm sorry, that is just the way it is.

And as I hear more and more of your story, I am really worried about you. You have not taken your diabetes seriously and you don't appear to have much in depth knowledge about you diabetes despite having been diabetic for 9 years. Your A1c is very high and most medical advice would be to immediately head to the emergency room when you start running 4-500 mg/dl.

I also feel like your medical team has let you down. I hear that you are on a fixed insulin regime. That you haven't gotten what I consider the very basic education. If your family doctor has been providing care, shame on him, you need to just drop him and find a good endochronologist. Start to take your condition very seriously. You need to take a series of diabetes courses to learn to count your carbs and to dose your insulin on a basal/bolus regime adjusting your insulin to the carbs in your meals. And then you need to correct your blood sugar as much as needed to eventually normalize your blood sugar. Perhaps find a diabetes center for these classes on your own. Get this education as soon as possible. Without these basic elements, a pump won't help. If you really want to take your condition seriously, be there for your husband and start a family, please take it upon yourself to learn how to do these things and make them an integral part of your life.

There are many people here who can help you, but you need to assemble the basic elements of your medical team yourself. And you should find a team that will help you get your blood sugar tightly controlled, not some team that puts you on a fixed regime and sits by while your blood sugars are at dangerous levels.

ps. Your current insulin regime is using very high levels of insulin in response to your out of control blood sugars. You are probably using 2-3 times the amount of insulin you actually need due to the high blood sugars.

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Permalink Reply by Type1Gal on February 19, 2012 at 1:45pm

i had extremely high blood sugars when i was diagnosed, probably walked around for a long time with very high blood sugars (didn't know what was wrong with me) until I went DKA, but that did not mean I was insulin resistant. I have always been very insulin sensitive, a factor in terms of diagnosing type 1 vs. type 2. I've never needed large (type 2 level) doses of insulin to bring my numbers down.

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