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Insulin or not?

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Posted 7/3/2011 8:00 PM (GMT 0)
Hi, i have joined the ranks of those with Diabetes (after a long road of mis diagnosis)..

Currently i am type 2, but I believe my medication (metformin x 4, januvia x 1) is not hlping to reduce the blood levels..

when do the doctors switch to insulin therapy?

My levels are very high..the lowest i can attain is between 170-200..and after eating it will jump to 250-300

Thanks
martin
Posted 7/3/2011 8:26 PM (GMT 0)
Martin, medication is only one of three parts of diabetes management. The other two are regular exercise and diet. Perhaps you can tell us a bit more about your diet, so we can be of more help.

Please don't be too anxious to switch to insulin. As with any drug, there are negatives as well as positives, and the if you can maintain without insulin it will probably be easier in the long run - less highs and lows, less chance of tissue damage.
Posted 7/3/2011 8:50 PM (GMT 0)
Thank you for replying

I am working to eliminate the carbs & reduce the sugar intake.. I could use more excercise
I see there are many resoureces on this site pertaining to diet/exercise
I certainly don't want to rush into an insulin treatment, and would prefer not to..its very expensive to say the least
Posted 7/4/2011 1:04 AM (GMT 0)
Welcome to the Forum, Martin.  Your blood sugar is too high and needs to be brought down.  If your body (pancreas) is not producing enough insulin by itself, then your doctor would prescribe insulin as part of your therapy.  If you are still producing insulin, then you most probably don't need it by injection but only your doctor can determine this.  As a type 2, there are several medications for helping to control your blood sugar depending on how your metabolism operates but no matter what meds you take for diabetes, diet and lifestyle, as Judy says, are the other two important ways to keep your blood sugar as normal as possible.

Please read the stickies at the top of the Diabetes Forum.  You will learn about how food/diet affects us.  Activity is also important.

By reducing your intake of potatoes or any food made with sugar or flour, you will help bring your blood sugar down yourself and possibly help your medication work more efficiently.  Activities like exercise, sports, walking, swimming, etc. help use the glucose in your system and this will also help control your blood sugar.

Are you seeing an endocrinologist?  

Posted 7/4/2011 12:26 PM (GMT 0)
Thanks for the reply

No i am not seeing an endicronologist at this time, will have to inquire with the doctor.
Being new to this disease, I suppose I have a lot to learn about managing it

Thanks for providing the info!
Posted 7/4/2011 12:58 PM (GMT 0)
I know (because I remember!) there is a lot to learn and understand about type 2 diabetes when you are first diagnosed.  I found there were always well-meaning people who told me what to do and eat.  However, I did a lot of online searching to learn more.  Basically, our blood sugar responds directly to what we eat:  it rises when we eat carbs.  Have a look at this website for more information:  http://www.phlaunt.com/diabetes/

If the meds you're on are not controlling the blood sugar even with an adjustment to your diet (which is very important), most doctors would refer you to an endocrinologist.

Good luck and ask all the questions you have.  We have some very kind and informed members here

Posted 7/4/2011 2:42 PM (GMT 0)
Hi Martinm,

I agree with everyone else has said especially the part of not being in a hurry to go on insulin. When I was first diagnosed I attended a diabetic course it was only one day but it taught me so much did dr tell you about one? You could always contact the diabetes association and ask them questions as well. Anyway sorry I drifted so after years of managing mine without meds my levels started getting too high so I was put on metformin and then after a few more years my dr added another pill and the 2 of them kept my levels controlled for many years. Now I am on insulin and I take 5 shots a day I still have to watch my diet and exercise. I hope you have great success getting your levels down and living a full. happy life with diabetes.
Posted 7/4/2011 7:12 PM (GMT 0)
I have been trying to avoid taking insulin and have been able to keep my levels bet 120-150. I eat a low carb diet. Try this bake some fish (not breaded) season to taste, steam some broccoli. Eat until full. Wait a couple of hours and test. Hopefully, you will see some lower numbers.
Posted 7/4/2011 7:12 PM (GMT 0)
I have been trying to avoid taking insulin and have been able to keep my levels bet 120-150. I eat a low carb diet. Try this bake some fish (not breaded) season to taste, steam some broccoli. Eat until full. Wait a couple of hours and test. Hopefully, you will see some lower numbers.
Posted 7/4/2011 9:02 PM (GMT 0)
My very best meal is half a grilled chicken breast with salad or a veggie. Leaving the bun off my burger helps, or if you just can't do that, use those sandwich rounds. Because I have to be a bit careful with salads and veggies, I often have only chicken or fish for lunch, with not sides.
Posted 7/4/2011 9:11 PM (GMT 0)
Martin, since you are new to all of this, and there is so much to learn I suggest at the very least you get in to see a nutritionist or take a nutrition class that is designed for diabetics and will help you learn how foods will effect your body. I also suggest you see a diabetes nurse educator or take a class for diabetics in order to learn "the rest of it". As mentioned there is a lot to learn, and one thing you will learn sooner or later is that there is not a one size fits all "treatment" when it comes to managing this disease.

IN the meantime I suggest you do a few things.

1. Keep a food diary. Write down what you eat, when you eat, how much you eat and do your best to figure out how many carbs you have consumed for each meal, day and don't forget snacks if you have them. This will required a lot of label reading, and you need to get in the habit of reading the nutrition labels on everything you eat, and also get a book that lists the carbs for foods so you can check the foods you may eat that do not have labels like fresh fruits and veggies.

2. Keep your carb intake consistent. Try to consume the same amount of carbs at each meal and also the same total amount each day. The American Diabetes Association is currently recommending 45-60 grams of carb per meal on a 3 meal diet. If you are the type who do not like to eat 3 "large" meals per day and would rather eat 4 or 5 times a day that is fine. Just divide 180 by however many meals per day you will be eating. For example if you eat 5 meals a day your carb count per meal would be 36. Even though 45-60 g per meal may seem high it is considerably lower than most people consume.

3. Be on the look out for "hidden" carbs. Some common items that many people overlook are dairy products like milk, butter/margarine, etc, breading on meats, etc. Also know that not all carbs are created equal. Basically the more processed a food item is the worse the carbs are. Maybe not in the carb count but in how they are going to effect your blood sugar. "Natural" carbs like those found in fresh fruit and also in veggies are the best kind. Whole grain pastas, rice, and breads are the 2nd, and things like white rice, white pasta, white or heavily processed wheat breads are the worst. Also don't forget about sugars that may be in certain vitamins and medicines.

4. Fiber. Make sure to get plenty of fiber in your diet every day. This will do a few things. It will help you feel better overall, help your body to absorb the nutrients it needs and get rid of those it don't and all the other good stuff that you see in those fiber commercials, but one thing you don't hear about is that fiber can help to reduce the negative effects of carbs on blood sugar. Some studies show it can be as high as 1 gram of fiber canceling out 1 gram of carbs, but more conservative studies say it is more than 1 fiber to 1/2 carb. Some doctors say that you should reduce you carb count by these ratios...for example...you figure you have 45g of carbs on your plate and you figure you have 5g of fiber that your "real" carb count is 40 for that meal. Personally I wouldn't go that far until more research is done, and instead keep your carb counting "normal" and consider the fiber as a helper instead of a reducer.

5. Fats have been found to really screw with a person's blood sugars in that they slow down the digestive process and keep the sugars "slowly" entering the blood stream for longer than they should and keeping your blood sugar raised for longer periods of time. So keep your diet on the low fat side especially when it comes to the really "bad" fats.
Posted 7/5/2011 3:26 AM (GMT 0)
Thanks everyone for all of your diet tips, thats probably the area i need to improve the most.
I've been keeping watch of the sugars, but neglecting the carbs I trhink. Next visit to the doctor i'll
ask him for some referrals to a nutritionist or further advice on diet needs

I appreciate the warm response,
and will give some of your meal tips a try!

martinm
Posted 7/6/2011 12:03 AM (GMT 0)
Your not the first or last person who did not know that carbs are sugar.

Like I said, or tried to in a long winded form, the 3 biggest things to do right now, other than to take your medicine, is to test as your doctor wants, keep a good log for both glucose levels as well as food, and maintain a consistent diet.

By doing this you will give you and your doctor(s) a solid base from which to adjust your total treatment plan.


One more thing you may want to consider adding to your logs, and that is general "health" notes. Make notes of days you are not feeling well. Anything from an upset stomach to a headache to...well everything that has you feeling less than 100% including if you are just feeling stressed out. Also include in your note if you took any medication for the problem, regardless if it is OTC or prescription.
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