Insulin injection versus beta-cell stimulating drugs - Page 2

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Insulin injection versus beta-cell stimulating drugs - Page 2


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Old 05-02-2012, 16:05   #11
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Quote:
Originally Posted by policebox

I've heard conflicting opinions about the diagnosis of my DM, the doctor I trust in the most believes I am a late onset type I. Although I was able to manage my impaired fasting blood glucose for a few years through diet and exercise, last year it ultimately developed into DM.

She diagnosed me with DM T1 and we discussed my treatment options. She felt beginning basal insulin therapy would be the better option, but left the avenue of oral drug therapy open if I wanted to avoid insulin therapy, adding that she felt oral drug therapy would probably, at most, only postpone my need for insulin by a few years.

I opted to try oral drug therapy and did so for about a month. Although I had a modest improvement with my blood sugar, I was not seeing the results I wanted fast enough, especially since I did a lot of reading about DM during that month and was eager to prevent future complications of diabetes.

Although I never experienced any side effects, from what I read during my research convinced me that taking a sulfonylurea did not sound like a particularly good solution. Your sentiments agree with my doctor's opinion. Overtaxing an already struggling pancreas did not seem logical, especially since the only serious downside I saw to insulin therapy was taking an injection. But I rationalized it was silly to deny myself a superior treatment option, simply because of fear or the lesser convenience of taking a pill.

After you’ve injected yourself for first time and notice finger-stick tests are more painful than the average injection, it becomes no big deal. In fact, it's fun to whip out a needle and jab yourself in the stomach (okay that part isn't fun)... what I mean is when you do it in front of your squeamish friends and they react as if you are some sort of super human.
Now that's funny.

And the looks I get using insulin in one of the meth hotspots...priceless! Lol

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Old 05-02-2012, 16:24   #12
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I've heard conflicting opinions about the diagnosis of my DM, the doctor I trust in the most believes I am a late onset type I. Although I was able to manage my impaired fasting blood glucose for a few years through diet and exercise, last year it ultimately developed into DM.

She diagnosed me with DM T1 and we discussed my treatment options. She felt beginning basal insulin therapy would be the better option, but left the avenue of oral drug therapy open if I wanted to avoid insulin therapy, adding that she felt oral drug therapy would probably, at most, only postpone my need for insulin by a few years.

I opted to try oral drug therapy and did so for about a month. Although I had a modest improvement with my blood sugar, I was not seeing the results I wanted fast enough, especially since I did a lot of reading about DM during that month and was eager to prevent future complications of diabetes.

Although I never experienced any side effects, from what I read during my research convinced me that taking a sulfonylurea did not sound like a particularly good solution. Your sentiments agree with my doctor's opinion. Overtaxing an already struggling pancreas did not seem logical, especially since the only serious downside I saw to insulin therapy was taking an injection. But I rationalized it was silly to deny myself a superior treatment option, simply because of fear or the lesser convenience of taking a pill.

After you’ve injected yourself for first time and notice finger-stick tests are more painful than the average injection, it becomes no big deal. In fact, it's fun to whip out a needle and jab yourself in the stomach (okay that part isn't fun)... what I mean is when you do it in front of your squeamish friends and they react as if you are some sort of super human.
The only way to tell if you are LADA or slow onset Type 1 is to get a GAD Antibody Test and see if it comes back positive.If you are a Type 1, you have to use insulin, oral meds will do nothing. Type 2's are different. I don't think there is a fear of insulin or needles but for many it is a cost issue . My oral meds that I use, I get for free. Insulin would cost me several hundreds of dollars a month if not more. Plus with metformin I don't have to worry about lows. I can keep my bgs close to 100 most of the day without insulin. It sounds in your case that you definitely needed insulin and had no options, but many of us still have other options.

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Old 05-02-2012, 17:54   #13
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Over the past years I've gone the gambit with many different diabetic oral meds. At one point the docs had me on Actos and Amaryl. Both are sulfonlyrea's. When the media came out with the increased heart attacks and bladder cancer that was occurring with Actos and Avandia, I threw out the Actos and refused to take it. I was experiencing severe edema with it anyway, and that can definitely be a precursor to CHF. My Mom developed CHF and it was probably due to drugs for diabetes. No thank you!

I had taken Amaryl for many years. I never really obtained great results with it, and yes did experience several hypos (45 or lower) with it, but when I finally found the diabetologist that I am with now, she told me that she believed my pancreas wasn't dead; just drunk and needed a rest. That is the reason I went on insulin. I had tried insulin in the past (Lantus only) and the results were horrible weight gain and no better control with my bg's, so I ended up quitting that. Of course I did not know about LCHF WOE then, so perhaps if I did things would have been different. I was following the ADA diet and I ballooned up 50 lbs in a couple of months! Yikes!

After reading on this forum people achieving good results with both basal and bolus insulin, I decided to go that route. So I currently am on basal and bolus insulin along with metformin only for my diabetes. I still have a difficult time getting very good results, but not due to the use of the insulin and LCHF WOE; I'm just going through that time in a woman's life when hormones are crazed and causing a great amount of havoc.

I personally would not go on anything other than what I am taking now. I've managed to keep the weight gain from the insulin below 15 pounds, and I'm hoping that will come off as well once my body calms down from all the hormones. My doc wanted me to try Victoza (discussion about this in another post on another thread), but I've decided to much risk with serious side effects to even try it. It is not on my insurance formulary, so why try something that "might" work and then not be able to afford using it? I'll just keep on with what I'm doing and hope it gets better soon. It is better than it was before starting insulin therapy and eating LCHF, but I want tight better control like others here. I know I'm better off for what I'm doing now, so I feel good and not sick like I did before.

Hope this gave you some insight.

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Old 05-02-2012, 18:08   #14
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Over the past years I've gone the gambit with many different diabetic oral meds. At one point the docs had me on Actos and Amaryl. Both are sulfonlyrea's. When the media came out with the increased heart attacks and bladder cancer that was occurring with Actos and Avandia, I threw out the Actos and refused to take it. I was experiencing severe edema with it anyway, and that can definitely be a precursor to CHF. My Mom developed CHF and it was probably due to drugs for diabetes. No thank you!

I had taken Amaryl for many years. I never really obtained great results with it, and yes did experience several hypos (45 or lower) with it, but when I finally found the diabetologist that I am with now, she told me that she believed my pancreas wasn't dead; just drunk and needed a rest. That is the reason I went on insulin. I had tried insulin in the past (Lantus only) and the results were horrible weight gain and no better control with my bg's, so I ended up quitting that. Of course I did not know about LCHF WOE then, so perhaps if I did things would have been different. I was following the ADA diet and I ballooned up 50 lbs in a couple of months! Yikes!

After reading on this forum people achieving good results with both basal and bolus insulin, I decided to go that route. So I currently am on basal and bolus insulin along with metformin only for my diabetes. I still have a difficult time getting very good results, but not due to the use of the insulin and LCHF WOE; I'm just going through that time in a woman's life when hormones are crazed and causing a great amount of havoc.

I personally would not go on anything other than what I am taking now. I've managed to keep the weight gain from the insulin below 15 pounds, and I'm hoping that will come off as well once my body calms down from all the hormones. My doc wanted me to try Victoza (discussion about this in another post on another thread), but I've decided to much risk with serious side effects to even try it. It is not on my insurance formulary, so why try something that "might" work and then not be able to afford using it? I'll just keep on with what I'm doing and hope it gets better soon. It is better than it was before starting insulin therapy and eating LCHF, but I want tight better control like others here. I know I'm better off for what I'm doing now, so I feel good and not sick like I did before.

Hope this gave you some insight.
I can relate to the weight gain. I've gained about 20-25 pounds after initiating Lantus therapy. I expressed my concern about this to my diabetes educator, but she said that I hadn't actually gained weight, I had just recovered weight I had lost during the period I was burning ketones prior to my diagnosis. The problem is, I hadn't lost any weight and now weigh more than I ever have in my life.

Although I'm concerned about it, none of my providers seem to want to address it, I would guess because I'm not severely obese. But it bothers me significantly enough to have a negative impact on my quality of life, so I think it's worth addressing.

As far as supplments to insulin, I am really interested in Symlin, which is indicated in both Type 1 and Type 2 diabetes. When I suggested it to my diabetes provider, she poopooed it, saying that in her experiences at the clinic it didn't work. She then suggested Januvia, which I was absolutely opposed to after having read about it and other DPP-4 inhibitors. I also mentioned my concerns about continuing on Lantus in light of its implications in cancer, most recently in December 2011 when a study was presented showing about a three time greater risk of cancer compared to those on metformin alone (which showed a lower cancer rate). Although I think the type of cancer it provoked was breast cancer and being male that's not generally a concern, but I think it's prudent to look at all the risks and benefits of something. Anyway, she said she hadn't heard of the studies linking Lantus to an increased rate of cancer. So, I can't say I have much faith in the input from my diabetes provider.

But I'd really like to try Symlin.

Oh, I am adding that I agree with what you said about trying to use as little insulin as possible. I asked to switch to basal/bolus for my insulin. I've gone from 60 units of Lantus per day to 24 units per day, with about 10 units of Humalog per day. I'm having fewer hypos now, which I don't know if I can attribute to changing my therapy or to me simply gaining experience with using insulin better.

You seem to have a very good philosophy as far as insulin use. Insulin is a good thing, but it shouldn't be abused. Knowing I can shoot up 40 units of Humalog and eat that entire 1/2 gallon of Blue Bell ice cream without spiking my blood sugar is an ignorant approach to have. But I like your minimalist attitude. Do everything you can with diet and exercise and then make up the difference with a little insulin.


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Old 05-02-2012, 18:19   #15
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You're having the same go-round with your medical team that many of us have . . . they think they know better than we, who are actually living with this disease. When you find what works, stick to your guns! Some of us use those docs/educators for nothing but writing our scripts, because their advice is useless. And for the record, when your blood sugar is controlled, burning ketones is the healthiest method for diabetics. I maintain a state of ketosis, and many others here do too.




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Old 05-02-2012, 18:26   #16
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You're having the same go-round with your medical team that many of us have . . . they think they know better than we, who are actually living with this disease. When you find what works, stick to your guns! Some of us use those docs/educators for nothing but writing our scripts, because their advice is useless. And for the record, when your blood sugar is controlled, burning ketones is the healthiest method for diabetics. I maintain a state of ketosis, and many others here do too.
I saw that when I was looking at your signature. It's not something I'm knowledgable about at all. As I mentioned in another thread, I researched trying to find what a good proportion of fat, carbs, and protein would work best for me. All I managed to see was a lot of conflicting information and snake-oil salesmen.

I also looked at the ADAs recommendations and did not feel those were satisfactory. I don't know what the general consensus of opinion about the ADAs "goals" and recommendations for people with diabetes is around here, so as a new boy I don't want to step on anyone's toes with my opinions. All I will say is that I did not find their goals to be high enough for my tastes.

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Old 05-02-2012, 18:33   #17
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I don't know what the general consensus of opinion about the ADAs "goals" and recommendations for people with diabetes is around here, so as a new boy I don't want to step on anyone's toes with my opinions. All I will say is that I did not find their goals to be high enough for my tastes.
Er - I think many to most of us agree with you! But, if you want any help stepping on toes, collectively we wouldn't mind stepping on the ADA's biggest one...

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Old 05-02-2012, 18:39   #18
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Yes, as moon says, there is significant agreement here that the ADA falls short in dietary guidelines, and that undue influence from corporate sponsors is the reason.




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Old 05-02-2012, 18:47   #19
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I've stated this before; I believe the ADA diet is a healthy diet, just not for a diabetic. For non-diabetics, I think it is quite balanced. However, we became diabetic not because we were gorging on sugary bad for you foods all the time. It was the starchy carbs that helped with that, plus family genes. I know my diabetes was heredity, as well as those carby foods I was enjoying. And of course the ADA doesn't really give you a "limited" carb intake...they promote like 105-140 carb servings per day! Again, for a non-diabetic whose pancreas can keep up with that load, great diet. But when you are having difficulty with being insulin resistant, insulin sufficient, and the rest, it just doesn't fly. Ask any diabetic here who has gone with the ADA diet and ended up gaining absurd amount of weight on it. Pair that with insulin use, and bam! Big time weight gain! Well, how does that help a diabetic with severe insulin resistance? It doesn't. It does the opposite. But let's face it, Big Pharma wouldn't be making loads of cash without it. Sad.

I can also offer to you that when I used Lantus, I was gaining weight like crazy. I use Levemir now and it seems the weight gain is much less and more manageable than it was on the Lantus. Perhaps you could ask to be switched?

And yes, I agree with you on the I could bolus and eat all that bad stuff I want, but that is defeating a healthy lifestyle. I wasn't eating all that stuff before this, so why would I want to now? Yes, I would love to enjoy an ice cream sundae once in a while, but right now I just can't because I don't have that tight of control to be able to afford "time off for good behavior".

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Old 05-02-2012, 18:51   #20
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.. [ketosis]...It's not something I'm knowledgable about at all. As I mentioned in another thread, I researched trying to find what a good proportion of fat, carbs, and protein would work best for me. All I managed to see was a lot of conflicting information and snake-oil salesmen.
You might like to read through this website on ketosis and a ketogenic diet. The author does a good job of explaining carbohydrate and fat metabolism and why high fat and low carb works so well.

Ketogenic Diet Resource

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