I have been keeping a dirty little secret. I don't know why it feels like a dirty little secret, it's legal in 50 states and not immoral.
I've told everyone I haven't needed insulin since Kate was born. I was up to 30+ units a day of NPH. I haven't taken any NPH since her birthday. I also had an insulin pen of Humulin for the days that I just didn't control myself at lunchtime. Sometimes it was lunch out with the girls, or birthday cake at work, or just unfortunate run-ins with the evil vending machine. But it was important to control my sugars for the baby's sake, so I did what I needed to do.
Several times since the baby's been born I have let myself go hog-wild as it were, and used the pen to correct. I would be over 180 and feeling really crummy and take a few units to get back to status quo. It feels like a bad thing - something to feel shame about.
I had an endo appt on Friday and I did own up to my part-time usage of the Humulin, though only about 50% of it. I refrained from asking for a new pen or a prescription for one. The one I have was a sample and expires on November 1st.
It seems to me that if I have a pen, I will be less motivated to control my sugars with diet and exercise and my oral meds. The pen feels like I have an escape route. What amazes me is how illicit it feels.
I remember when my mother went from 2 shots a day to 3 and when my father went from 1 to 2. It was viewed as a negative. There was definitely no going back to the lesser number of shots and that was portrayed as a bad thing. Not just a bad thing, but a reflection on the patient's character.
I've seen ads lately from the pharmaceutical companies touting introducing insulin earlier in the treatment of Type 2 diabetes. I think they face an uphill battle convincing people that it isn't a negative or a point of no-return.
So for 2 more weeks, if I want to eat 4 donuts (yes, I have binged like that in the past) - I have an out and a way to feel better sooner and easier than talking a walk or a nap. Once the pen expires, I wonder if I will be more compliant, or just spend more time with uncomfortable highs.
It's funny (ok, maybe not funny, maybe odd) how the two types view things. If I had type 2 now, I wouldn't think anything of taking insulin. In fact, to me, insulin would make it easier to control type 2. The thought that having to take medication makes you a bad diabetic seems foreign to me, but I wasn't brought up with type 2, nor do I have much current experience with it. My only experience is with type 1 and insulin being a necessity.
A friend of mine has type 2 and when he told me he was going on Lantus because his oral meds weren't helping any more, I said "Oh, things will be much easier now." I don't think he'd thought of it that way.
What do you think would help with being compliant? I often wonder what I'd do if I were diagnosed with type 2 (possible, since my father recently developed it) and what I'd do to make sure I didn't go nuts. I tend to binge on occasion, too, and knowing that I couldn't do that any more would probably make me a bit nutty.
Kim
Reading this scares me a little. I think there's a danger if you just look at highs as being 'uncomfortable'. They also can be damaging.
I also sense a feeling that I've seen others talk about. It's that your diabetes isn't too bad as long as you're not using insulin. That having to start insulin somehow makes it worse. Don't get me wrong, insulin is challenging and a lot more difficult that using diet and exercise. But it's also liberating in that it allows you to eat differently and maintain tight control.
Please bear in mind that I have Type 1 diabetes. So I truly don't know what it's like to deal with Type 2. But I know how it feels to be scared of complications.
Bernard
http://bernardfarrell.com/blog/blogger.html
I totally agree that taking insulin does make controlling blood sugars much easier. I recommended it to a lot of moms with gestational when I had gestational. I was just exploring the feelings that I have of it being "bad" or a judgement of my character. No doubt that sense if detrimental to my overall health, as well as many other people with Type 2.
Oops, that last line should be no doubt that sense *is* detrimental of my overall health. Gremlins in the keyboard!
Hi Kim,
I'm a reporter doing a story on type 2 diabetes a nd I loved reading your blog. Would you be interested/available for an interview. I can tell you more if you contact me at mandyji1@msn.com
Thanks,
Kim
I think that it is wonderful that you have good control. I have type 2 for, I guess, about 10 years. I was so opposed to insulin that I went for a long time without it when I probably really needed it. I was so afraid that it would ruin my lifestyle. When I moved from oral medication alone to oral medication and insulin (early this year), my A1c moved from 12.5 to 7.5 in 6 months. I was thrilled and I am looking forward to a lower number when I get back to the doctor next month. Insulin is not as bad as I thought it would be. It is true, I have not completely given up sweets, but I can now fit them in and I actually worry less.
Also, doctor's tell me that diabetes is a progressive disease, so it makes sense that what may have worked before will not work forever. In other words, diet and exercise will move to the need for oral medications and from there you will need insulin as the disease progresses in your body, so there is no reason to feel like a failure as you progress. It is not anything that you are doing wrong. It is the progression of the diabetes itself. You may want to tell your family this, so that they do not feel like failures.
I also thought that I saw something in the comments about a type one person thinking that they can get type 2 now that their father has it. Type one diabetes is when the pancreas is not generating insulin at all. Type two is when your pancreas works, but not as well as it is supposed to. A type 2 person can become type 1 as their disease progresses to the point where their pancreas is no longer producing insulin, but a type 1 cannot also get type 2 or progress to type 2, since their pancreas is not producing insulin at all.
Suzan
Kim
I just wanted to add that wouldn't it be better to have the insulin pen if you had a bad day of control, rather than to have nothing to correct your blood sugar?
Suzan
Suzan,
Your comment about type 1 & type 2 simply isn't factual. A person with type 1 (where the immune system attacks the beta cells of the pancreas) can indeed get type 2 (where the body loses sensitivity to insulin), however the reverse is not true. A type 2 can eventually become dependent on insulin but that is not 'type 1', the mechanism is QUITE different; type 1 is an autoimmune disease, type 2 is a metabolic disease.
Kim,
There is no need to feel guilty for taking insulin, you should be proud of yourself for doing everything you can to keep your blood glucose in the normal range. Period. Full stop.
You still need to control your blood glucose for the baby's sake, that baby depends on you to be a happy and healthy parent. Insulin is not a free ticket, though, and binging will harm your health. The idea is to use medication to achieve control of the disease, not to counteract over-indulgence.
Suzan, yes, it's better to have the insulin pen, but best if I were not to lose control.
Onimity - I loved your last sentence - "The idea is to use medication to achieve control of the disease, not to counteract over-indulgence." - that's exactly where I'd like to go. Thanks also for clarifying type1/type2 so succinctly.
Kim I think you are very brave to talk about how you feel. I am a type 2 who just started with my diagnosis about tow months ago. I was given Glipizide and then had Byetta added, two shots a day. I can't maintain control without both of them, but am not letting anyone down by using them. As a matter of fact I started with all the really bad complications and am now working very hard to get a horrible A1c down and hold on to some part of a functioning pair of kidneys. I don't know what your highs are like, but for me there is a lot of sweating and rapid heart beat and a rise in my blood pressure. I don't want to keep those things and hope you feel your best when your sugars are lower too. You are worth far more than the donuts or the vending machine and if you need the insulin to manage it doesn't make you weaker it just makes you like all the rest of us. I had dinner out at a restaurant with some friends tonight and shot up right there at the table. No one said a word or treated me differently afterward. I didn't get up and leave the table to do it because I think people should all get used to us being around. together we can all make it through. Please give the insulin some more thought so you can manage the control. Please don't let the disease make you feel ashamed of using what you need. That isn't weakness on your part. That is you being stronger than the disease.
This is very scary, believe me. As a type 2 diabetic you can control it better with oral medications and the right lifestyle changes. Since you're not able to control it in this way, you may use insulin and this is not to be ashamed. But, if you use insulin, you should take it under doctor's prescription, because it has side effects. One of them is weight gain that you should control better.
http://www.all-about-beating-diabetes.com/insulin-side-effects.html