Talk to me about type II using insulin in addition to oral meds

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Permalink Reply by Mark on June 18, 2009 at 10:12pm

I think im going to do the same thing, i dont want any meds at all, i will keep with the BP meds but want insulin now to get this under the best and fastest control i can

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Permalink Reply by Mayla Gallego on June 19, 2009 at 12:18am

Cathy,

There are pros and cons of using insulin together with your oral medications. I think the first thing that you have to consider is how high is your blood sugar levels (consider both the random accu checks and your 3 month A1C). And, second do you honestly make an effort to lower your blood sugar levels and how long have you been trying....I think if you consider these factors, for sure you will know for yourself if you really need to incorporate insulin to your oral meds. Actually, you don't have to ask your doctor if you need insulin...the doctors will tell you if you need one. If your case is like mine, my sugar levels are quite high in the high 200s and mid 300s and I can honestly tell you that my efforts of lowering my bs are not that committed and it's been more than 5 years that I've been trying with ups and downs, then for sure incorporating insulin together with the oral meds is a good decision. If you're in the max. dosage of meds for diabetes and to prevent further damage to your organs, like kidney (kidney failure), then having insulin shots will help you to stabilize your bs level. Actually, insulin compared to other oral meds doesn't have side effects that damages organs (kidney, liver, pancreas) according to my doctor. However, be prepared of sticking a needle to yourself. The first time is the hardest since the thought and actually doing it (sticking a needle) is a mind boggling thing for me since I hate needles. It took me an hour and a half to do it. Also, after some time, you're running out of injection sites. Also, be prepared to gain weight. I think that's the bad part of insulin is that it makes me gain weight. Also, I find it very hard to go on a diet since there are times that my sugar is very low. The constant trips to the doctor to adjust the dosage of the insulin is another thing and being consistent is important. But, upon using the insulin, I can see the result immediately in my bs...it went down and much more stabilized. I suggest to you to really think it over and if you did all your best to diet and exercise and still your sugar level is high, I think you need to add insulin to your meds...and in the event that you are not so committed like me in lowering your sugar level, I suggest that insulin is a good way to go to lower your bs level. I hope these informations and or comments will help you.....but for the meantime, keep on smiling :-)

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Permalink Reply by Cathy Jacobson on June 20, 2009 at 8:46pm

Mayla, since I have been so adamant about not doing insulin, I doubt that my doc will bring it up until the need is definitely there. In fact, when I did ask her about it recently, she was sort of surprised by MY asking.

My last A1C was 8.4; which is very high for me, I typically run in the mid fives. However, I had had three cortisone injections for my knees during that time, found out that my father was dying, had had pneumonia over the winter, and my husband had lost his job. so there was a lot going on --- that had nothing to do with eating or exercising. Typically my daily BS run about 100 - 150 --- depending on the rest of my health issues. If I had my choice, it would be between 110 and 120...and that's why my questions about insulin for type II.

Am I doing the best job I can, I think my other posts answer that question very well. There is not much more that I can do, short of crawling inside my pancreas and squeezing out the insulin myself. I am very diligent, my grandmother died of diabetic complications, and I have no need, want or desire to be there or even close. I have close friends who have lost eye sight, toes, fingers and even a leg to this insideous disease, so I do much more than most of the people I know who have diabetes.

My meds are many but a few, metformin, I take 1000 mg twice daily, amaryl 10 mg twice a day. so I am not even at max as far as orals are concerned. All my tests come back that everything is working in the most efficient level the organs can. I wish my arthritis tests were as good.

The poke of a needle is not a big deal to me, for 20 years I gave myself daily injections for migraines and that was a breeze, I am allergic to bee stings so have used an epie pen often. Needles don't scare me, it's the idea that this is how far I have come, and I didn't even want to get close to this place. Thus my desire for thoughts from those who are there.

Thanks for your input....I appreciate your thoughts.

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Permalink Reply by Teena on June 19, 2009 at 1:54am

Hello Cathy. I think Mayla's answer hit it right on. It will highly depend on how high your daily blood sugar level is. When I was first diagnosed, my blood sugar was very high ( 200 and up). At first I was on insulin shots. With constant diet and exercise, Im averaging now from 90 to 150. My endo changed my medication to a combination of glimiperide 2 mg and metformine 500 mg. ALthough unlike insulin, oral meds does not work as fast. And I really have to be consistent on my diet and physical activities. One thing going for me though...I hate needles!

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Permalink Reply by Michael Gray on June 19, 2009 at 3:53am

Cathy,
I am a T2 diabetic diagnosed 12 years ago and tried all the oral meds that were available including Byetta and never got my BG under control until I went on Levemir, which is a basal or long acting insulin. What a blessing! After I finally got my dosage correct and then having hope once more, I started on a reasonable diet and my BG daily averages have been in the upper 90's. ( I test 6x daily). I also take 1000mg metformin 2x daily to help the levemir 'smooth' out throughout the day. It probably saved my life. So, yes, if you need it to help with the control then do it. Also check out Jenny Ruhl's article on Insulin on her blog "Blood Sugar 101". Jenny's a poster here on TU Diabetes forums and her blogs helped me get my act together and thrive.

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Permalink Reply by Samantha on June 19, 2009 at 5:24am

Cathy,
Insulin can make all the difference in the world, it has for me. I've never heard anyone say they started on a short acting insulin. I have only heard, as in my case, people starting on a basal type insulin. I would think bolusing opens you up to a whole new set of complications, especially if your pancreas is still producing insulin on it's own.

I was completely unable to get my sugars under control through diet and oral meds until the Levimir came along. I am now almost down to a normal fasting number in the morning and my food spikes are not as high as before, nor does that high last as long as it did before the Levimir.

I think you should keep it as simple as possible, A long lasting insulin, once a day(sometimes twice) works all day and you don't have to do the math for bolusing and inject X amount of time before meals.

The greatest thing I have learned from all the back and forths between types is the grass is not always greener on the other side. Bolusing insulin is a constantly changing type of thing and difficult to manage, if you're sick, hormonal, or even just stressed your body will utilize the insulin differently opening yourself up to extreme lows and sometimes highs that just wont go away.

Personally, I wouldn't use a short acting insulin until I have exhausted all other choices.

You don't really say why you are considering this, what meds are you on and how is your control now?

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Permalink Reply by Kathy on June 19, 2009 at 10:30am

Michael and Samantha,
My doctor is talking about putting me on Levimir next month along with my metformin. She tells me I won't gain weight on this and I'll be able to continue losing weight. Do you find this to be true?

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Permalink Reply by Cathy Jacobson on June 19, 2009 at 1:21pm

I'd like to know the answer to this question, also. So far, I haven't found a med yet for diabetes that doesn't have "may cause weight gain" as a side effect. If you hear of an answer, please let me know.

Cathy J

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Permalink Reply by Anthony Holko on June 19, 2009 at 2:03pm

Some people have lost a lot of weight with metformin. Insulin will cause weight gain. You can try combining it with metformin or avandia to combat that. Or a hell of a lot of exercise which is really good to help reduce insulin resistance.

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Permalink Reply by Scott on June 19, 2009 at 1:54pm

well... it's kind of a balancing act. If your insulin dosage is correct, your weight should remain relatively stable. If your dosage is too high, you will eat more to cover the lows. If your dosage is too low, your body will start converting the extra sugar in your blood stream to fat cells. yeehaw!! Love the D!!

/wink

Scott

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Permalink Reply by Anthony Holko on June 19, 2009 at 2:05pm

Dear Kathy.

Your doctor is an optimist. It will need a lot of exercise to combat the potential weight gain.

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Permalink Reply by Samantha on June 20, 2009 at 8:45am

Kathy,

I have been on Levimir for 2 or 3 months now and I have been gradually losing weight still. I have been very cautious about my food intake and still have room to cut down on calories, fat and carbs. I have not gotten into a routine exercise program yet, but I do work on my feet and run constantly while there, so I am sure this helps some.

The weight gain is something that might happen. It really depends on how much work you want to put into maintaining or losing from where you currently are at. And, I'm sure it has everything to do with how you are genetically programed for weight gain/loss.

Good Luck. Levimir has made my D so much easier to maintain.

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