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

Replies to This Discussion

Permalink Reply by MomsL8 on June 19, 2009 at 1:50pm

I have been on insulin and on oral meds, and am currently on Byetta, which thank the Lord, is working for me.

Insulin made me gain weight, yes, even Lantus and Levemir.

What your endo will probably do is run a c-peptide or a GAD immunity test and possibly an insulin resistance test to see how your pancreas is functioning now.

You can run the risk of burning out what little Beta cell insulin production you have now by going on Insulin too early. That is my case.

However, when I was on insulin, I found my life was a little freer in the sense that I could eat more of what I wanted, although I did do a low-carb diet then. Of course, it wasn't freer in the sense that I did have to test more frequently, and I did have to inject more frequently. Now, I really have to watch my diet more. Also, I had to watch how I exercised when I was on insulin.

There are pros and cons to every management plan, but if you can get away with your pancreas working, even at half speed, for as long as you can, I would say give it a chance.

But you are so good and right to want to be aggressive about managing your T2. So many of us don't get the benefits that our counterparts, T1's, have - that sense of early advocacy and ownership of our condition, so we tend (notice I am generalizing here) to not manage our disease as urgently.

It's good to be on top of things, and read, research, and talk to others.

Everyone's diabetes is different, but having a great attitude in wanting to lick it is always good!

Oh, and btw - my BSs were managed under insulin, but never as low as they have been now w/ Byetta and Metformin for 6 mos.

Good luck and Godspeed!

--Jill

▶ Reply to This

Permalink Reply by Cathy Jacobson on June 19, 2009 at 5:55pm

I have read all the comments and thank you all so very much for sharing your experiences with me. Please trust me when I say that I DON'T want to go on insulin, it has always been my contention that I would stay as far away from a needle as I could. However, in answer to some of your questions.

1. I have lost 50 lbs in two years.....and 29 of that twice, due to using Avandia.
2. I do faithfully follow every rule, regulation and suggestion that is given me by my diabetic team. I exercise five times a week, even though I am doing it on arthritic knees.....swimming and biking. for 60 and 30 minutes respectively.
3. I eat very healthy meals, not pre-prepared ones. My husband is a chef and has been very helpful in decoding the ingredients to things that I can eat and still have the flavor there. Bless his heart!
4. I do have a problem with chocolate, and limit myself to an ounce of sugar free when I can't bear to not have a piece.
5. I take my BS levels four times a day faithfully as my diabetic team have asked me to do.
6. I drink almost 68 ounces of water everyday, any more and my high blood pressure meds would be at risk.

So, I am not falling short very many places. I have been dealing with High bp; arthritis, diabetes, and some emotional things for a long time....I think I am doing well....except that my numbers are still in the 150's when I want them in the 120's or lower. But, shots, nope, I'm not excited about that, but I am excited about getting in control. We are doing some changing of things, and rearranging of meds...so maybe it's just a matter of tweaking the machine. Who knows, this disease is so very individual---it's amazing they don't have to come up with meds for each of us that are different.

▶ Reply to This

Permalink Reply by Anthony Holko on June 19, 2009 at 8:33pm

Dear cathy.

The needles are a triviality and the finger pricks are much more painful. BG in the 150's are not good. You will kill your pancreas dead. A little insulin now might be a good thing if you wait you will need a lot of insulin.

▶ Reply to This

Permalink Reply by Cathy Jacobson on June 20, 2009 at 7:42am

Not worried about the needles as a "pain" thing, just don't want to go there...but life is life,and I am the one who brought it up. Yet, in order to get the insulin my doc has to write the script AND monitor it with me. In my case, I totally believe in a team concept. I have an excellent team of medical and theraputic professionals who are working with me on health issues. If you read my previous posts, you'll note that this diabetic disease is not the ONLY thing I have going on....so 150's with the amount of pain I have with the arthritis is not abnormal.
It's just not the "perfect" I want. So we'll talk. Sometimes, Anthony, you have to look at the total picture to get the small bit in the corner. Thanks for your suggestion, I'll take it to the team, along with my request for consideration.

▶ Reply to This

Permalink Reply by Anthony Holko on June 21, 2009 at 9:33pm

Dear cathy.

I hear you. I also have to go with a suboptimal BG because thighter control would ballon my weight to 500 lb. Life is a choice among necessary evils. Try and get the best mix for you.

▶ Reply to This

Permalink Reply by Cathy Jacobson on June 22, 2009 at 11:22am

I have a friend who gave me the following mantra when he moved away:" Make the healthiest choice possible for yourself, in all situations and at all times. It might not be the healthiest for anyone else, but you. It may not be the healthiest choice you'll make tomorrow or yesterday, but for today, make the healthiest choice possible." It works for all things, what's the healthiest choice I can make today, not the healthiest for you, but for me. It works.

▶ Reply to This

Permalink Reply by Samantha on June 20, 2009 at 8:54am

May I borrow your chef...

I work in a restaurant and am trying to get the chef to change some of his foods. We have what seems like a large percentage of people with allergies and/or diabetes that come to eat at our place and it is very difficult to find food we can eat. So far I have met with resistance from most of the management team (by the way, this includes my husband!) The catch phrase so far has been 'nobody will eat that crap'. Although, the few times I have gotten him to alter some recipes they were the hottest selling specials for the weekend. Maybe, just maybe, I'll win this battle with them....

▶ Reply to This

Permalink Reply by Cathy Jacobson on June 20, 2009 at 12:28pm

Samantha, I will sure get Bill to give up some of his best tips and recipes. The place where he worked before had the same attitude, until one of the cook staff was diagnosed with ulcers and diabetes....whoa, look out change happened quickly. It's a matter of offering it, and then asking the customers how they liked it. We did constant asking, polls, surveys last summer, and by a big surprise, theirs not mine, the lesser calorie foods, lesser sugared foods, lesser fat foods, etc were more popular. We now work for a franchise and there is little of our control over the food, but thankfully many of the things that they serve are already low end foods.
When the public starts demanding ( in a nice way) for healthier foods, restaurants will serve it. But I'll ask anyway, he loves to have his mind picked.

▶ Reply to This

Permalink Reply by Samantha on June 20, 2009 at 12:33pm

Thanks Cathy, I sent you a friend request.

▶ Reply to This

Permalink Reply by Kelly Rawlings on June 20, 2009 at 9:34am

Congrats on working so hard to control your diabetes. Sorry your numbers aren't where you'd like them to be, but it's impressive you're so on top of them and want to make necessary changes.

As most people with type 2 find out, your body changes (insulin resistance continues and insulin production by the body decreases) to the point where adding outside insulin is the best way to tame blood sugars. That's a biological fact and has nothing to do with willpower, etc.

If you are already controlling your total calorie intake and getting regular excercise, adding insulin won't necessarily cause weight gain. And, in any case, it's not the insulin that adds the weight, it's the insulin working on excess calories that can add weight. Many doctors don't stress enough that adding insulin is also a good time to re-look at a person's calorie and meal-plan targets.

Recent research indicates that the EARLIER and more aggressively blood sugars are managed, the better the long-term outcomes.

Another thing to discuss with your team are the other blood glucose-lowering drugs that are more weight-neutral than insulin: the DPP-4 inhibitor pills (sitagliptin/Januvia is FDA approved; saxagliptin/Onglyza, dutogliptin, and alogliptin are under review; vildagliptin/Galvus is approved in Europe) and the incretin mimetic injectables (exenatide/Byetta is approved for use with meals and ligraglutide, a one-a-day injection is under review).

I hope you are able to make some med therapy changes soon that you feel good about. There is some trial-and-error when any injectables are added.

PS: if you worry about shots, look seriously at pens. They're a little less obtrusive than vials and syringes, but may be more expensive depending on whether you have coverage or not. Best wishes, and let us know how it goes!

▶ Reply to This

Permalink Reply by JohnM on November 21, 2009 at 1:39pm

FYI, Onglyza has been approved by the FDA as of August 2009. LINK

▶ Reply to This

Permalink Reply by John on June 19, 2009 at 6:34pm

I have been on Levimir for about a year now 16units at night and Novolog for my short acting for meals. along with the metformin extended release 1500mg with dinner. I was originally put on oral meds for about 2 1/2 yrs and always had high glucose and seemed to be starving myself for fear of going high then I started insulin first a novolog mix 70/30 and it was a rollercoaster lots of lows, then went to the long acting and the short and it was the best thing that ever happened A1C came down and the best part was I could eat and plan my dose around what I was eating. I had no weight gain from the metformin and have been on it for 5 yrs.

▶ Reply to This

• First
• Previous
• Next
• Last