Hello everyone! I am a type II diabetic, and have been since 1990. I am one of those Type II's that does not fit the mold of mainstream media. I was diagnosed while in the Marine Corps and coincidentally also in the best shape of my life. I have never been overweight, and never had bad eating habits, however the family history has Type II's in every generation. Spending any time indoors makes me completely mental - I am into just about anything and everything as long as I am outside. From hiking, hunting, fishing, four wheeling, jet skiing, boating, etc etc.
Up until 9 days ago I was on oral medications only. Over the past 12 months my AIC went from a 6.1 up to a 14.2! This did not happen overnight, but because I was always so controlled on the oral medications I made the mistake of not checking my BG regularly. Long story short, my pancreas stopped functioning and I went on Insulin. I am taking Humalog and Lantis for a TDD of between 45 - 50 units per day.
My fasting numbers are now in the 80's and my after meal numbers are usually between 90 and 110. I attribute that success 100% to this forum. When I was advised that I would be starting Insulin I spent several days reading and reading until my eyes bled - who knew there was so much to learn? Myself and my endo are still dialing in the insulin, but I think that I am doing pretty well for using it less than 2 weeks - so I thought I would drop in here and give you all a huge Thank You! This forum has a huge wealth of information, and from REAL diabetics - that is very difficult to find.
I will be continuing to read and post as things come up, but I really want you all to know that this site really does help people, and I can attest to that! Thanks Again for such a great place!
Wow. I am overwhelmed with deja vú reading this thread. Often I feel as though I am preaching to the choir. This time, I'm listening to the choir. Practically everything here I have said somewhere, sometime, to somebody. Feels like old home week.
Like all of you who commented here, I get very plugged in by the all-too-prevalent mindset that says insulin use is a last resort, or an admission of failure. How absurd! It ought to be just the opposite. If you can't achieve control by other means, and you have this incredibly powerful therapy available, it's insane not to take advantage of it. That's how I see it, anyway.
If you had a broken leg, would you put off getting a cast a long as possible? Would you consider it a last resort, or view the need for it as failure? Of course not! You'd want it RIGHT NOW, the sooner to begin healing.
For the record: I have been T2 for almost 20 years. For most of that time I controlled it casually and somewhat haphazardly with exercise, oral meds, and a (semi) reasonable diet. About a year ago I realized that my A1c was creeping upward no matter what I did so I began an intensive course of self study. One of the first conclusions I reached was that insulin was a big part of the answer. Fortunately, I have a really terrific PCP who didn't need much convincing.
For whatever it's worth, I agree with jims about the etiology of T2. A century ago the average American consumed around 4 pounds of sugar a year. Today (according to the USDA), it's more than 150 pounds per person per year, and that's not counting the 50-plus pounds that are concealed in packaged process foods. So, we eat 30 or 40 times the sugar our great-grandparents did, and diabetes is spreading at epidemic rates. Could there be a connection? Nahhh . . . .
We evolved eating protein and vegetables. We didn't even eat grains in any significant quantity until agriculture was invented, and that's only been about 10,000 years. We simply aren't engineered to process large amounts of carbohydrate. Evolution just doesn't work that quickly.
Okay. I'll shut up now.
Wow, your post really made me think about things, David. You are right, 100% right, and who would know better than a diabetic? 12 years ago, I said I wouldn't give myself a shot, and it was only until I could see that it was a pen, and the help of an excellent diabetic educator that I said, please please can I have my insulin. I wonder how much better I would be doing now if I would have said yes right away, or at least been more open to it? Somehow, it appears that if we are on insulin, we are on our way down hill. Your analogy was great, I am going to use it when I try to explain to others about my insulin, Thanks,
Yes, exactly. I wish I had done this years ago. I hear you, loud and clear.
Amazing. I ended up at a point where I was 13.3 A1C and caught my liver misbehaving badly. My BG would not drop sub 184.
I started insulin - humalog 75/25 about 7 years ago.
Afer changing how I took metformin to arrest the liver monkey shines and work my diet ( modified mediterranean style diet - 1200 calories a day
as well as 2 miles walking a day).
Today, my pancreas after 26 years stopped its rip van winkle act and went back to working and I ended up yanking the starlix, actos and the 75/25 humalog. I now use humalog lispro - 2 units for every meal and I stopped my lantus which is very effective correcting the basil insulin.
My Doctor said I had a non standard T2 case that did not match any of his playbook and recommended practice.
Things are slowly changing and folks are beginning to realize the human digestive ssystem is complex and the Liver, and other hormones need checking and possible boosting and control and that always foocusing on the pancreas and insulin to the exclusion of the other factors for T2 is neither wise nor effective.
As for the oral meds - throw those in the ashcan. I wish I had been put on the liquid insulin far earlier. The oral crap forces one to eat to prevent lows while the liquid insulin is totally flexible and can be easily sized for the carb loading of a meal. Properly done with sufficient exercise, one does not gain weight.
You are doing great a TDD of 45 to 50 is great not that much insulin resistance. And your blood sugars are fantastic.
Some docs, including endos are reluctant to put people on insulin because they don't have total control over anything. So make sure your endo knows that this is something that YOU want to do and WANT to get your "D" under control. Your numbers sound high, and if you are doing what you should maybe a sliding scale insulin before meals would do you good. Ask him/her about it and see what they say?
You can get all three of these books from Amazon:
Richard K. Bernstein, Dr. Bernstein's Diabetes Solution, 4th. ed. (New York: Little, Brown and Company, 2011)
Gary Scheiner, Think Like A Pancreas, (Boston: Da Capo Press, 2011)
John Walsh et. al., Using Insulin, (San Diego: Torrey Pines Press, 2003)
Notwithstanding the advice you may (or may not) receive from your health care team, it will be YOU who makes the day-to-day decisions involving management and control. You should read all three of these books if you're going to use insulin. They will give you the essential knowledge base you need in order to manage this very powerful tool effectively. (Actually, every diabetic should read the first one, insulin or no insulin, but that's a different discussion.)
Finally, tuD, these forums and the chat room are an immensely helpful knowledge bank to draw on when it comes to actual real-world experience of those who have been here before you.
I worked very hard to try to get good control as a T2. I had all these books and followed Bernstein since 2006, but I couldn't achieve what I considered my target. But my doctors were basically happy if I was at 7-8%. I kept pushing my GP for insulin as the medications, diet and exercise were not enough, but no go. My GP absolutely refused to be the one to initiate insulin. So I was referred to an endo after more than a year of asking for insulin. And my endo turned out to be just as bad, constantly changing medications, the latest greatest drug, some costing me $200/month. But still refusing my request for insulin. In the end, I just threw up my hands and started insulin on my own. I did it smartly, I own all the books David S. mentioned, plus more. It has been two years, I dropped my A1c like 1% and have never had a serious hypo. Even more surprising, I have not gained any weight since starting insulin.
After starting, I made an appointment with a new endo and just presented myself at her door already having started insulin. She has no problem with it. In the end, I think that no doctor wanted to be "liable" for the decision to initiate insulin. Frankly, this is "my" diabetes and it is my decision, I just acted on it.
Brian -- so much good information there. Thanks for posting your experience.
Being satisfied with 7 or 8 percent A1c's is absurd, as you recognized. I don't think there can be any question that the fear of liability is a major factor in the reluctance of some doctors to prescribe insulin.
Everyone's experience is their own. My GP was very willing to cooperate, in part I think because it was evident to him how much homework I had done. It wasn't all luck, though -- I ended up with this doctor because I went shopping. I interviewed doctors, told them what I wanted to do, and gauged the reactions. I picked the one who seemed least doctrinaire and most willing to work with me, and as it turned out, I chose well. He deals with me like a partner, not a boss.
The moral of all of that is, if your doctor isn't willing to do what's needed to normalize your blood sugar, you need a different doctor.
But the final, absolute bottom line is perfectly encapsulated in your last sentence. For each of us, it's our disease, our life, and our responsibility. You can get all the advice in the world, from doctors or anyone else, but achieving control -- the actual doing of it -- is up to you and NOBODY else.
In the end we have to take control of our own bodies. If we are very lucky we will find a doc/endo who will be willing to work with us, trust what we are feeling, not what the drug sellers are telling them is the "latest and greatest". Keep records of your numbers, your diet, your exercise, your emotions, etc and present that info to your providers. It IS our disease and we are responsible for taking care of us. I don't know about putting yourself on a med, how did you get your insulin without a script? But if that's what it took, you are lucky to not have done more harm....and to have such good results. I applaud you!
I think we owe it to ourselves to be "smart" patients, so I have always done a lot of reading and learning about diabetes. I bought and owned many books, including those listed by David S. above. When I started insulin, I was already very experienced counting carbs and knew everything I needed for intensive insulin management. I even asked Dr. Bernstein himself whether insulin was an appropriate step on one of his teleconferences. You are of course right, it can be foolish and dangerous to just start insulin, but I tried very hard to make sure I did it safely and smartly and I only did it as a last resort when it became clear that I was going to continue being denied it as an option.
And we are fortunate that human insulin remains an over the counter drug. In most of the US, you can walk right into Walmart and ask for Relion NPH and R without a prescription.
I am happy to have moved to insulin. No oral medication ever dropped my A1c more than a couple 0.1%. Finally, I have the control I want.