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Just started insulin...
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camama3 posted:
Hi all, I am new here. Female, age 38, type 2 diabetic for two years now. I have been taking Metformin (1,000mg 2x/day) and Glipizide (10mg once a day). Last month my A1c was 9.3. Saw doctor on 2/22 and he prescribed Levemir. He wanted me to start with 20 units and increase 1 unit per day until I get a fasting blood sugar of 120. Well, that would have taken forever, so I increased by 5 units. Now I'm at 40 units, and my blood sugar readings aren't getting any better. 239, 246, 221... I haven't seen under 200 in MONTHS. Last night I had baked chicken and broccoli for dinner. Thought for sure I'd get a better reading this morning. Nope. For breakfast I had egg beaters and cottage cheese. Two hours later, 239. I'm not perfect in my eating, but I really do try to be careful not loading up on carbs and sugar. I don't know what to do from here. I called my doctor this morning to tell him things aren't getting better with the insulin...waiting on a call back. In the meantime, any advice from this forum would be appreciated. Thank you.
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auriga1 responded:
Hopefully, your doctor will have an answer for you. Everyone reacts differently to different insulins. Ask you doctor if you can try another insulin.

Are you using the insulin only? Do you still take any other oral meds?

I had a problem with the dosaging at first of both my insulins. I was taking Lantus as my basal and Humalog with meals. I had a strict insulin regimen where I had to record every BS reading throughout the day, recording before meal tests, post-prandial readings, a.m. fasting and before bed numbers. Hassle, but the doctor wanted to see what was going on so we could get to the right dosage. It took weeks to get it somewhat correct.

I was raising my Lantus every single day by four units until I reached 40U every morning. I have to take a rapid-acting insulin for any carbs I eat. I am extremely insulin-resistant along with (my doctor thinks) with a very under-achieving pancreas. My doctor believes my pancreas secretes little to no insulin.

Try and keep your carb consumption to a minimum on a daily basis. If you can, be physically active for an hour or more per day. Any exercise or strenuous physical activity helps your body utilize the glucose running around in your bloodstream. It happens with me.

My A1C was 13.2 and I have it down to 5.6. It took a lot of tweaking with the insulin dosaging and carb intake. I am extremely intolerant of carbs. The more physically active I became, the more my A1C came down. I still have to be careful how active I am so I don't go low.

I understand your frustration. Try not to stress too much because this also affects your blood sugar. Stay hydrated as much as you can preferably with water. This can help. Move and keep moving. It really does help.

Changing insulin may help. Hopefuly your doctor can help, too.
 
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glucerna replied to auriga1's response:
I'm glad you're working closely with your doctor and also paying attention to your food choices. Be as active as you can, and talk with your doctor about the amount of activity he recommends for you as another way to help bring down blood sugar levels. Physical activity also helps reduce insulin resistance which will help lower blood sugar levels. You're making a really good start. ~Lynn @Glucerna
 
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An_255895 responded:
I had the same issue as you with high sugars that wouldn't come down despite my best efforts. I was taking Metformin 1000 2 times per day, and 4 mg of Glimpizide once per day. I wasn't put on insulin, though. My doctor referred me to an endocrinologist that suggested Victoza. I hate sounding like a commercial, but it has made a big difference! My A1C has gone from 10.5 to 5.1 at the last check. I watch what I eat closely, but I also know the Victoza is what made this possible. Not sure if it would work for you too, but it might be worth discussing with your doctor.


Good luck!
 
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brunosbud responded:
I prefer to think of diabetes as an "autoimmune" disease (the body delivers an immune reaction against, itself, chronically destroying cells and tissues). This way, if I eliminate (or minimize) my exposure to sources that illicit inflammatory reactions within my body, I reduce my diabetes. The fact that diabetes is, in most cases, controllable and in some instances, reversible, supports such a model for this disease.
It's, now, widely accepted that healthier changes in lifestyle (diet & exercise) can help bring down blood sugar levels to normal levels. Here's a list of other potential risk factors that can affect inflammation levels (autoimmunity)...

1. Fructose (table sugar), wheat, oxidized cooking oils (ie. restaurants), corn oil, margarine
2. Sitting for hours
3. Vitamin & mineral deficiencies (D, C, magnesium, iron)
4. Haphazard use of antibiotics
5. Chronic stress
6. Lack of sleep or poor sleep quality (smoking, alcohol, sleep apnea)
7. Excessive Belly Fat
8. Overexposure to environmental/household chemicals and air pollution
9. Overuse of prescription medications, pain killers, supplements, vitamins
10. Presence of other inflammatory diseases (IBT, gum disease, PCOS, arthritis, gout, psoriasis, allergies)
11. Uncontrolled diabetes is a gigantic source of inflammation thus the disease feeds upon itself and accelerates the aging process

The model that I subscribe makes me ever vigilant for sources of inflammatory agents that will impede my body's ability to handle carbs (insulin sensitivity). Diet consumes just 10% of my daily concerns (I take no meds, btw).

The "Food is the Enemy" model consumes most of your attention, thus, when the muck-hits-the-fan, you're up a creek without a paddle. Also, since no two people share the same levels of insulin resistance & ongoing inflammation, it's extremely difficult to get any advice that's helpful to your particular situation.


Your concern is palpable and I hope you can find some level of comfort and control, soon. My only advice is to take considerable heed in your doctor's words when he urges you to eat as healthy as possible, exercise, everyday, get plenty of rest and lose weight (if needed). With Obamacare, he has no time to school patients as to why but each action is important for blood sugar stability...just know that they reduce inflammation, considerably, and make eating "din-din" less worrisome.

Lastly, when I read of sudden uptick of insulin demand, I think back to my father's life. Despite Parkinson's and T2D, he lived, well controlled, for close to 30 years. Late in life, though, he, too, experienced "out-of-the-blue" increasing demand for insulin. Since he was 87 when he past, his doc just listed "pneumonia" on the death certificate. Deep down, though, I know it was "inflammation" (cancer).
 
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cinthesooner responded:
camama3: From your post, it is clear to me that you have never visited a Registered Dietitian about your diabetes. First- you've only started the first step of new insulin therapy: adding a long-acting insulin is to help get your fasting glucose levels down. The meal you eat the evening before will have no bearing on that (hence, the definition of fasting). Actually, adding a small bedtime snack may help lower your AM glucose readings. Secondly- food is not the only thing that affects glucose levels. You do need to include carbs in your diet, although it will helpful to learn how many carbohydrates you need along with which foods do and do not contain them (the meals you list here have very little carbohydrate content and will have minimal impact on your readings-- your sugar is high because you have diabetes).
Ask your physician to refer you to your local diabetes educator/RD as soon as possible-- they will take the time to help you understand how it all works and provide you and your physician with recommendations to maximize your diabetes management. There is no need to struggle through on your own! This is what we do all day, every day. Good luck to you.


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