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|
Cheesy Apricot Stuffed Grilled Portobellos Peppy Pumpkin Pies Salad With Mustard Vinaigrette Cottage Cheese Parfaits Mexican Style BLT Wrap Chile Con Queso Taste of Italy Soup Zucchini Mint Salad Fishy Fettuccine Baked Fennel and Gorgonzola
Holidays are tricky, no? Between managing diabetes among massive amounts of junk food, managing stress to manage bloodsugar among (sometimes) massive amounts of family squabbling, shopping stress and the like, and trying to get enough sleep and exercise in the cold winter months - it's a lot to handle. So I've got a two tier plan to keep bloodsugars at bay this year. Tier one - diet and exercise. Typically, at this time of year I do what I call the nutrition and gym...