Giving Insulin A Shot
Debating the pros and cons of moving from metformin to insulin.
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
August 2008 — Insulin injections have kept my husband alive for the past twenty-two years. Type 1 diabetes does not allow for the common myths about insulin and diabetes, such as fear of needles, weight gain, and "really bad diabetes." There is no fear of needles because he learned early on that he cannot live without them. And while he did experience weight gain after switching insulin regimens in the late 1990's, the new regimen allowed for better control. Before anyone could tell him his diabetes must be really bad if he needs insulin, he already knew the highs and the lows of type 1 diabetes.
Because I am close enough to see how Greg manages his diabetes, I do not fear the possible need for insulin someday. How can I after seeing all he does to survive?
The question is, when will that time come? Has it come already? In April, my A1C was the highest it has ever been – even higher than at diagnosis. While it was still within acceptable range at 6.5%, it was hard to tell if I was on an upward trend or if I just had a few bad months between endocrinologist appointments. If I look at my meter averages now, I honestly believe that things haven't improved much, leaving me with a bad taste in my mouth – both literally and figuratively. True, I had bronchitis that left me unable to exercise for two weeks, but I tried to compensate for the lack of exercise by adhering to a strict low-carbohydrate diet during my recovery period.
Add to all of that how frustrated I am with the gastrointestinal side effects of metformin. Quite honestly, I'm sick of being sick. At home, at work, in public – the side effects find me everywhere. So I keep thinking there has to be a better way to control my type 2 diabetes.
Having done enough research, I know that I may not be the ideal candidate for insulin at this point in my type 2 diabetes life. I will be seeing my endocrinologist again next month and I will be discussing my options.
On the one hand, if my A1C level is surprisingly decreased, I will inquire about returning to a diet and exercise regimen without metformin. Ever since my bout with bronchitis, I've been more conscious about what I eat. Perhaps if I have enough willpower to avoid sweets and if I have enough motivation to exercise most days of the week, I can once again be successful at control with diet and exercise alone.
On the other hand, if my A1C level hasn't changed much (or even increased), I will inquire about new treatment options. Is it time to check my c-peptide levels to see how much insulin I'm producing on my own? If insulin production is still optimal, what can I do to stay in control without continuing to suffer with medication side effects?
One thing is clear – something has to change. If the answer includes insulin in the next few months or in the next few years, I will not fear it. To fear it seems to dishonor my husband on some level, and I cannot do that.
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dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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