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Diabetes Treatment As there is currently no cure for the chronic, Diabetes mellitus – the emphasis must be on treatment and management to avoid complications. Please use this section to discuss how you carefully control and manage your Diabetes. Please let us know what is and isn’t working for you. Feel free to discuss all areas of treatment and management of Diabetes including diet, exercise, weight loss, insulin usage, oral drugs and more.


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Old 06-09-2015, 04:47   #1
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Well, it was a good 2 year run on diet, then 13 years on diet and Metformin. But there are no carbs left to cut. A breakfast with 5 grams of carbs (salsa on my scrambled eggs) spikes my blood sugar over 30 points.

My doc agreed that flogging my pancreas into making more insulin was pointless. So she recommended Victoza. My insurance company refused to cover it, and gave me the choice of 3 other GLP-1 agonists. Two of them were tier 3, and the bydureon was tier 2, like the Victoza is alleged to be on their formulary. So I went with the bydureon. Does anybody have any experience with this once a week injection?

If I have understood the little information I have got correctly, I will now have the potential for hypoglycemic episodes. What are the best ways to avoid this?

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Old 06-09-2015, 06:15   #2
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My understanding has been that Victoza still tries to get your pancreas to produce more insulin - am I wrong? I also wonder why you can't just use ordinary insulin, since you have to inject now anyhow. If I get to where diet/metformin no longer work, I'm going straight to basal/bolus insulin.




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Old 06-09-2015, 09:30   #3
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According to your signature block, you have not been placed on the maximum Metformin dose yet. If a dose increase doesn't work ... then I'd definitely ask for insulin, as Shanny recommends.

I've used insulin, alone, from Day One. Given the current state of the art, I would not use anything but insulin or Metformin (as an adjunct to LCHF, of course).

Insulin and Metformin are the oldest diabetic meds, but they are also the safest -- and they're still the most effective. This is because they assist natural processes, while new meds push an ailing pancreas to work harder, until it gives out completely.

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Old 06-09-2015, 10:02   #4
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Like Shanny and Shalynne I have serious reservations about these drugs. Have you read this GLP-Agonists: Byetta, Lyxumia, Victoza, Saxenda, Bydureon, Trulicity and Tanzeum from Blood Sugar 101. ?

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Old 06-09-2015, 13:10   #5
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Why not just go for insulin??? This way YOU can control the amount of insulin you take and you shouldn't have any hypos. Drug-induced insulin is unpredictable.

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Old 06-09-2015, 18:47   #6
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I really considered going straight to insulin, and I am still considering it. My issue there is getting a small enough insulin dose and/or consuming enough carbs on a steady basis to prevent hypos. My blood sugar is spiking, but it is rarely hitting 200, and IIRC from my reading about insulin one unit will drop my blood sugar by roughly 45 points, and that is sometimes too much and sometimes too little, plus I don't have a nicely predictable response to any given quantity of carbs. Example, one Eggo waffle with peanut butter, roughly 24 grams of carbs, spikes my blood sugar exactly the same as the scrambled eggs (which is really 8 grams of carbs, counting the eggs). In a very real sense I would rather be on insulin, for the known safety of it.

I am on 2000 mg of Metformin daily, and the max is, I believe, 2250 mg. No easy way to get that extra 250mg, and I already have to be careful to eat with my Metformin or about an hour later I barf.

My Bydureon arrived today. I am going to give it a try and see if it does anything good for my blood sugar. It may, or it may not.

No, Victoza and the other GLP-1 agonists do not cause the pancreas to secrete more insulin. They lower insulin resistance, and decrease appetite. The side effects on the thyroid and pancreas terrify me. But so do diabetic complications.

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Metformin 1000mg bid
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Losartan 50 mg qd
Loratadine 10 mg qd
Pulmicort 180 mcg bid
Fluticasone 50 mcg qd
Ventolin 2 puffs prn
Tramodol 50 mg prn

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Cinnamon, 1000 mg bid
Turmeric, 2000 mg qd
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Old 06-09-2015, 19:41   #7
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If, by "the scrambled eggs" you mean Eggo scrambled eggs, what happens to your blood sugar when you eat "real" scrambled eggs?

If I misunderstood, please ignore this post.

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Old 06-09-2015, 20:07   #8
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I'm on insulin; it's my only diabetic med.

Like most, I take basal (long-lasting) insulin primarily, and I also keep bolus (rapid) insulin on hand just in case.

I have never been in the position of having to eat enough carb for my insulin doses. This is because I avoid eating so much carb that I need to take a bolus. (I must always take basal.)

The proper dose of insulin varies among diabetics. We each respond differently, and there's no way to tell how a person will respond to any given number of units.

Typically, when starting insulin, the doctor will prescribe a very low dose at first -- low enough that it may seem insulin "just doesn't work." Over time, the basal dose may be increased gradually, until it reaches the most effective level for you.

You may also be given a "sliding scale" to determine your bolus doses. It's the easiest method to teach -- but it is not the best method. Carb-counting is the best method for control.

A Certified Diabetes Educator (CDE) should be able to help you figure out your dosage levels. You may want to ask your doctor for a referral. (We can help, too!)

Insulin is an unusual med, because it is safest and most effective when we learn to determine our own doses.

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Female, 58, 5'7", 150 lbs.
A1C 13.5 -> 6.7 ->5.4 (1/31/14)
MEDS:
Humulin-N (basal) - Humalog (rapid bolus)
MAGIC POTIONS:
Biotin --10,000mcg (for hair health)
B-complex
One-A-Day Women's 50+ Advantage
KyoDophilus (pro-biotic)
LIFE SUPPORT:
Black Coffee - Unsweetened Iced Tea
Low-Carb, High-Fat Convert
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Old 06-09-2015, 20:27   #9
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I want to reiterate. The one unit of insulin drops a person by 45 points.
That is a guideline and a conservative guideline at that. Every person is different. Doctor's usually start at that mark, and they are so scared a person is going to run low they don't prescribe enough insulin at first. You should be able to inject (one unit rapid) during a period of which you don't eat and your blood sugar is above your target number. Then wait 4 hours and see how many points it drops you. Your doctor would probably not rush into rapid acting right off from the start (bolus insulin with meals). Many times basal is all you need. And a starting dose there is a formula based on your weight. Mine was 15 units then a unit or 2 is taken away or added every 3 days til you fasting is at your target.

I wouldn't worry about dropping low, all you do is eat to correct it.

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Old 06-09-2015, 20:46   #10
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Quote:
Originally Posted by RCG View Post
If, by "the scrambled eggs" you mean Eggo scrambled eggs, what happens to your blood sugar when you eat "real" scrambled eggs?

If I misunderstood, please ignore this post.
I mean real scrambled eggs, ingredients eggs, and a buttered pan. I like to put 5 carb grams of salsa on them after cooking.

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Metformin 1000mg bid
Ranitidine 150 mg qd
Losartan 50 mg qd
Loratadine 10 mg qd
Pulmicort 180 mcg bid
Fluticasone 50 mcg qd
Ventolin 2 puffs prn
Tramodol 50 mg prn

A1C 6.6

Cinnamon, 1000 mg bid
Turmeric, 2000 mg qd
Vitamin D3 5000 mg qd
Fish oil 3000mg qd
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