Hi Sandollar
I am a newly diagnosed T2. Age almost 52, and male. I've been borderline for over a year. My fingers are sore now, lol. I am not on any medication. I think that I can back out of this with diet, weight loss and exercise. I'm optimistic at times.
I also have had a heart attack and a stroke. Gee the depression came down on me like a curtain! It comes with our ailments. It's part of the turf, I think. Don't be ashamed of your feelings. It is good that you are sharing them.
You can get help for the depression though. I take lexapro, 20mg/day and couldn't get by without it.
I found some information that may be helpful to you and others. This is NOT a doctor that is the author of this info, I don't believe. He is very knowledgable though, and people request his help. Good luck to you and see your doc if you think that depression meds may help you
---------------------------------------------------------- Sorry to hear about your husband’s distressing lack of control in his diabetes. My comments may sound a bit harsh. But these points need to be made. So please excuse me for "calling a spade a spade".
My first comment is that you need to be getting a lot more direction and support from your medical team. GPs have limited knowledge and abilities in this specialised field. He should be seeing an Endocrinologist, who will come up with a treatment plan. And will work with your husband to refine and improve it. The Endo will also refer him to other medical professionals, like a dietitian, opthalmologist etc, for important support.
Next, the bad eating/drinking habits must come to an end. Control will only improve if your husband is disciplined and responsible in what he eats and drinks. Discussions with the Endocrinologist and/or a Dietitian would provide the guidance and support he needs with this.
Once he has cleaned up his act, you will be able to form a view on whether the insulin regimen is suitable or not. The Endo will consider problems like waking with lows in the middles of the night and getting highs in the morning. And you will be advised on how to prevent this from happening. That could involve switching to a different insulin regimen.
I used Humulin N (or NPH insulin) for many years, so I know it well. I had similar problems with night time lows and morning highs. So I will describe my experience and how I dealt with it. Obviously, your husband must discuss his options with an Endo before making any changes.
Your body needs two types of insulin action. It needs a low but steady insulin action so that glucose can be turned into energy to satisfy basic requirements (like your heart beating, digestion, thinking etc). This is called the “basal rate” and is provided long-acting insulin like NPH and Lantus. And then your body needs spurts of much greater insulin action at mealtimes so that consumed carbohydrates can be processed and either turned into energy or stored. Humalog satisfies this requirement.
The problem with NPH is that, while it acts over a long period of time, its action peaks at about 5 hours after being injected. And when it peaks, blood sugar is lowered. So if it is injected before going to bed, your husband’s blood sugar will drop during the night. Either he will wake up and have to treat a hypo. Or the liver will come to the rescue and cause blood sugar to rise.
The effect can be prevented by eating something before going to bed. The trick is to figure what and how much to eat to achieve the desired result. Eating too much will cause highs and mean that he will have to get up in the middle of the night to empty his bladder. I find that a small apple works quite well.
Low blood sugars during the night can also cause a “rebound”. The liver sees a drop in the blood sugar as a warning that trouble might be on the way. So it releases glucagon, which in turn converts stored glycogen into glucose. This raises the blood sugar, averting a possible crisis. All this can happen while your husband is asleep. And it is why he wakes up with a very high blood sugar.
Once again, you can prevent this from happening by having a snack before going to bed. It doesn’t solve the problem entirely. I woke up with a blood sugar of 13.7 this morning. But it doesn’t happen often. And when it does happen, I normally know why.
Switching to Lantus may be useful too. As I mentioned, the problem with NPH is the peaking effect at 5 hours. Lantus does not have such a pronounced peak. So it doesn’t cause the nighttime drop in bg and the resulting rebound effect. Lantus has a much flatter action profile. So it is more suitable as a basal insulin.
I hope all this helps. You obviously need more information at this stage. And the challenge is not to get confused. Which is why the best starting point is to find a good endo.