I'm new to the tudiabetes family. I'm a T2 and have been managing with Byetta and diet and excercise. Lately my blood sugars have been up and down with extreme levels and I'm thinking of asking my Endo about a pump. I love to work out, hike, and camp with my son's Boy Scout troop. The hypos have made all of that very difficult and I hate being on a schedule. I lost 35 lbs last year and I have gained 5 of that back. My A1C went from 5.5 in July to 6.3 in November. With the highs and lows that I'm experiencing now I'm sure when I see the doctor today that it will surely not be good. Any advice on pumps and experiences with making the decision to move to insulin would be greatly helpful to me.

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Comment by PatientX on February 25, 2011 at 5:58am
Hello, welcome to tuD. I think a lot of times type 2 think that insulin may be the direction to go. It may be for some that are loosing the ability to produce insulin, but for others if insulin resistance is the issue an insulin pump or insulin is not going to be your next round for control. If you are having lows and highs it would seem that your body is still producing insulin. I have that issue where currently where I can go from 180 to 70 in no time. Adding insulin if that is the issue may control the high but you will be more likely to experience lows since your body may still be working up to a point. My current A1C has been between 6.5 and 7 and I am currently on metformin only. Since we are seeing lows you may still be producing insulin that is what my endo told me since I have a similar issue to you.

If this is the case for you adding insulin or a pump is not going to increase your insulin sensitivity. Have you logged what you are eating and see what the corrolation between the highs and lows and under what activities are you experiencing the highs and lows. You seem pretty active and that is the balance that I have to deal with. Numbers in the 60's hit me in the middle of workout. If I want to control the highs I have to watch what I eat. Usually meals with high carbs make me spike.

Good luck on your quest to find better control but to me it seems more test may have to be done for you to determine if you are still producing insulin but your resistance may be failing which would require oral meds. Cause if you add insulin does not mean that you will not take pills or other medicine to deal with the insulin resistance. Then if you are not a type 2 then insulin may be in your path. As we say in the software world you may not have enough information to determine a course of action. Try to get your doc to give you more info.
Comment by Donna on February 25, 2011 at 6:06am
Thanks so much. I was hoping someone would respond before my appointment this morning. My diet is very good but the highs at night are a problem. I only get really low when I work out and when I'm not able to get my meals on time. I see the doc in a couple of hours so your post has helped.
Comment by Hismouse on February 25, 2011 at 8:10pm
Hi Donna, not sure what you heard from your Dr. it would be great if you could tell us.You didn't say how high or how low you get.
At a time between insulin for me a Dr in AZ thought it would be a great change for me and try me on Byetta, Bad, Bad idea. I was type one, and it lasted 2 weeks, and another dr in the office said what in the ______ was he thinking, So ...but I am type 1..

Well I hope all went good for you, and some help to:) Debbie
Comment by Donna on February 26, 2011 at 7:11am
@Hismouse Thanks for your input. My doc said I'm doing very well and I'm not in need of a pump yet. I do need to manage some stress. She asked that I switch from Byetta to Victoza or do Byetta and Actos. I like Byetta as I have not had any problems with it but I don't want to be on Actos which I hear can cause weight gain. Victoza I plan to try but I'm a little nervous about the possibility that it could cause Tyroid Cancer. She reviewed my numbers and I have had a few highs in the 190's (but not many) and three lows at 60 but that was because I sometimes get to busy to eat. She said I'm lucky because I have options because I do watch what I eat and I work out often. She said I need to eat more carbs when working out. She said when and if I need a pump that will be no problem as she likes how they work out for her patients but I'm not in need as I have good control. I'm sitting here pondering if I will use the Victoza pen today. Morning reading was 99 today.
Comment by Richard P Cosgrove on February 27, 2011 at 8:43am
Hi Donna. I am T2 like you. I was Lantus and meds back in 2006 until 2008 then on Lantus and Byetta. I was referred to an Endo in 2008. As you can see I tried everything. Early in 2009 they took me off the Byetta because it wasn't performing and started Novalog injections along with Lantus at night. I had to learn to carb count. Sometime during the summer my PA and Endo suggested the pump. I went on the pump Nov 2009 and everything has turned around. Very few lows. My readings usually stay in the 115's during the day and drop a little before dinner but not to low. My A1c's stay in the 7's.

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