It's looking like I'm finally getting good fasting control using Lantus. I haven't yet figured out the exact dosage, but it's gonna be around 12-14 units.
Talked to doc on phone today about post-prandial numbers, which still tend to go high depending on what I eat. I'd like to keep those numbers under 140 and still be able to eat a reasonable amount of healthy carbs. I know that there are diabetic diets out there that recommend 10-15 carbs per meal, but man oh man, that's not much. I would rather take a drug and be able to eat a whole-grain healthy sandwich without worry than be so incredibly low carb. Low-carb, I can do. but I'm just not happy on ULTRA low carb.
Problem is, which drug? My endo really likes Januvia, but I know a lot of people have good reasons to not like it (hi Jenny! :-)). That said, it seems like most of the evidence against Januvia has to do with people who have had cancer in the past and/or are the type of people who have prostates. I have neither a prostate nor previous cancer, so maybe it's not so bad for me.
Of course, Januvia hasn't been tested with insulin, and the Endo wants me to continue on Lantus along with it, so that's of some concern as well.
I discussed my concerns with him, and he pretty much told me that he'd be willing to put me on Januvia, a sulfonylurea, a pre-meal rapid-acting insulin, or Byetta. I think with all of those, with the exception of Byetta, he wants me to stay on the Lantus.
Part of me wants to go straight to the rapid-acting Insulin, because it seems like a safe bet. We know Insulin works, it's got a long history of medical research, and it'll let me eat pasta every once in a while if I want :-)
That said, if I can get nearly the same results with an oral agent, then sure, I'd rather not risk going hypo and not have to inject myself so much. Problem with orals is that each of them seem to have drawbacks. Januvia per the above, and sulfonylureas may decrease what little pancreatic insulin production I still have.
I'm not sure what the drawbacks to Byetta are, other than there were 6 deaths that may or may not be connected to it.
So.... can anyone give me some opinions?