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Getting blood sugar under control using insulin
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nutrijoy posted:
I normally like Dr. Gabe Mirkin 's advice and newsletters. But in one of his most recent newsletter articles, he commits the same medical faux pas that seems to still predominate among most health care providers. To wit:
"If your HBA1C is still not under control, you need to take a bad drug that raises insulin levels. I usually start with Glipizide XL. If that doesn't control your HBA1C, I raise the dose, and if that still doesn't work, you will need to inject yourself with insulin."

Dr. Mirkin acknowledges that sulfonylureas are a "bad drug" but seems to feel that the use of insulin is a last resort. A small minority of physicians hold the opposite view and fully embrace the use of insulin as a first line medication for any patient who is unable to normalize blood sugars after recommended changes in diet, exercise, oral meds, and other lifestyle modifications have failed to yield desired results. If the patient continues to have blood sugar levels above safe ranges, they start the patient on insulin early on. In contrast, most practitioners and the vast majority of patients perceive the use of insulin not only as a very, very, very last resort but somehow as an indication of failure. This mindset needs to be changed and the sooner the better because of the horrific damage that it is doing to PWDs when elevated blood sugars persist over an extended period of time. Very often, by the time the use of insulin is finally started in these patients, the damage to their bodies is already so extensive that the use of insulin alone isn't going to make that much difference.

There are plenty of real life examples of members in this forum who were uncontrolled for too long a time frame, developed serious and advanced complications; and have since passed. Other members are still with us but suffer from a myriad of advanced complications including atherosclerosis and renal failure; all of which might have been prevented with much earlier insulin therapy/intervention. Of course, anyone that is so affected needs to urgently discuss this matter with their own respective physicians and become more proactive in their self-management of the disease. This article on Jenny Ruhl's BloodSugar101 site is a MUST read for all PWDs. If you are still struggling to get your blood glucose levels within safe ranges and/or already suffer from complications, discussing the use of insulin with your doctor and/or diabetes educator could very well help to maintain and prolong your healthy years. The too-often maligned Dr. Bernstein has always coveted the use of insulin early in the treatment cycle but has encountered stiff resistance to his views among many physician colleagues (note: clicking on the link will auto-download a PDF version of Bernstein's "My Life" story to your computer that you can read at your convenience). Nothing in this post, of course, should be misconstrued as medical advice any more than the articles that have been linked for you. Consulting with your own doctor is always the recommended course of action. This message is only intended to alert you to a harmful mindset that could endanger the ability to get your blood sugars under control -- sooner rather than later.
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