Poor Diabetes Control
Question: I have type 2 and have with very poor diabetes control. I cannot take sulfonylureas or metformin and did not tolerate Byetta. I am currently taking insulin, 60 units of Humalog Mix 75/25 pen insulin before breakfast and dinner. I have very high fasting numbers, whether I eat over my allowed carbs or not. I have asked my physician if we could try another insulin - maybe another type or combination of types would work better for me. She has said, "All insulins are the same.” I find it hard to believe as a friend of mine is on 2 different insulins, also twice daily and she is finally well controlled. My question is do you think switching insulin would be beneficial? If not, what would you suggest? I am at my wit’s end.
Answer: Not all insulins are the same! You have a combo insulin (two types in the same delivery system). I compare that to driving an automatic car — yes, it may be easier to drive, but it gives you less control of the engine than if you drove a stick shift. If you are willing to add another injection, you could benefit from a “basal” insulin (that lasts for 16-24 hours, like Levemir or Lantus), along with mealtime coverage insulin (NovoLog, Humalog or Apidra). Your friend’s glucose patterns may only require two shots. If you take control of this new insulin structure, you may lose the convenience of only two shots, but gain better control as it is a better match to what your pancreas would do. The other important concept for readers to consider is continuous glucose monitoring (from companies like DexCom, Abbott and MiniMedtronic). This would give anyone with poor diabetes control several layers of sophisticated data that definitely helps minimize the time spent in the low and high range.
|PREVIOUS: Dealing with type 2 stigma||NEXT: A rare metformin side effect|
Pasta Coleslaw Low Calorie Cranberry Sauce Garlic Butter Chicken Super Quick Sunrise Slushy Braised Broccoli Rabe Turkey Scaloppine with Peppers Espresso-Crusted Steaks Tomatillo-Lime Salsa Roast Beef Tenderloin with Cranberry-Red Wine Sauce Caribbean Jerk Rub
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...