Any ideas?

4417 Views 18 Replies 9 Participants Last post by diabetes86, Sep 15, 2010

Melanie

Discussion Starter · Sep 13, 2010

I cannot seem to get my blood sugar down to a normal level. I eat a proper diet- think The Mediterranean Diet or The South Beach Diet, with concentrations on fresh vegetables and grilled fish. I don't do dairy- just Almond Milk. My calorie intake is 850 to 1300 a day. I take a walk most days although that is less and less as my health seems to be tanking lately & it causes great pain, but I can sometimes ride a bike instead. My insulin intake is 26 units of Lantus once a day (I have tried night and morning) and 10 units of Humalog before each meal, in the middle of the afternoon and sometimes before bed (50 a day). I was put on Actos by one doctor (not an endo) but the first day my blood sugar dropped to 50 (US units) and then from then on it appeared to make it go higher, not lower, so that only lasted about 3 weeks. I was put on Metformin before that but it caused SERIOUS diarrhea and apparently did little for my blood sugar as it didn't change once I stopped taking it (after about 5 months of barely being able to leave the house). My blood sugars are generally 250 in the mornings, and drop to about 120 after my morning insulin and breakfast. By just before lunch they are usually back up to 160, they drop after some insulin and a low carb meal to the 120s. By 3 or 4 in the afternoon it is back to the 160-180 range, so I usually take insulin without food to get it back in line. I take more insulin with dinner & then by bedtime my blood sugar is back at 180 ish. If it is over 140, I take 10 units of H before going to bed & then I wake up with it back up to the 250s. I have tried checking my blood sugar every hour as I sleep & it just sort of creeps up. No huge jumps and no dips... Even with high blood sugars and low levels of food intake, I am still gaining weight like a mad-woman. 10 lbs last year and 12 so far this year just since January. I'm afraid if I take any more insulin I will look like a blimp by Christmas!!!

Any one else have this happen, & what did you do about it?

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Richard157

· #2 · Sep 13, 2010

I have a friend who is type 2 and he had good control for several years without insulin. Then he started having the problems you are having now, and he used injections of insulin. He was OK for a few years and then he had to use more and more insulin, with poor results. It was found that his pancreas was producing almost no insulin, like a type 1 diabetic. He started using an insulin pump. By programming the pump and learning exactly how to use it he set his basal rates to keep from having highs and lows. That resulted in his needing nuch less insulin. The lower insulin dosages and eating very low carb (about 80 carbs per day) caused him to lose almost all of the weight he had gained. He is now very healthy, with A1c's below 5.5 and has excellent control.

I am not saying a pump would do the same for you, I am just saying it was the solution for him. I also use a pump and it has also helped me lose some weight (34 pounds). I am only 8 pounds overweight now. Pumping insulin was the best thing for me, just like with my friend.

Your doctor might consider your using a pump as a last resort, if nothing else works.

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diabetes86

· #3 · Sep 13, 2010

Do you low carb eat (I dont know those diets)

a;so sounds like your Lantis is a little low, Lantus takes care of your fasting BG sounds like your fasting BG is high.

At 10 IU of log with meals how many carbs is that?

I take 10 IU of log for 18 carbs. 60 IU of Lantus for my fasting BG.

breezeonby

· #4 · Sep 13, 2010

Melanie said:
I cannot seem to get my blood sugar down to a normal level. I eat a proper diet- think The Mediterranean Diet or The South Beach Diet, with concentrations on fresh vegetables and grilled fish. I don't do dairy- just Almond Milk. My calorie intake is 850 to 1300 a day. I take a walk most days although that is less and less as my health seems to be tanking lately & it causes great pain, but I can sometimes ride a bike instead. My insulin intake is 26 units of Lantus once a day (I have tried night and morning) and 10 units of Humalog before each meal, in the middle of the afternoon and sometimes before bed (50 a day). I was put on Actos by one doctor (not an endo) but the first day my blood sugar dropped to 50 (US units) and then from then on it appeared to make it go higher, not lower, so that only lasted about 3 weeks. I was put on Metformin before that but it caused SERIOUS diarrhea and apparently did little for my blood sugar as it didn't change once I stopped taking it (after about 5 months of barely being able to leave the house). My blood sugars are generally 250 in the mornings, and drop to about 120 after my morning insulin and breakfast. By just before lunch they are usually back up to 160, they drop after some insulin and a low carb meal to the 120s. By 3 or 4 in the afternoon it is back to the 160-180 range, so I usually take insulin without food to get it back in line. I take more insulin with dinner & then by bedtime my blood sugar is back at 180 ish. If it is over 140, I take 10 units of H before going to bed & then I wake up with it back up to the 250s. I have tried checking my blood sugar every hour as I sleep & it just sort of creeps up. No huge jumps and no dips... Even with high blood sugars and low levels of food intake, I am still gaining weight like a mad-woman. 10 lbs last year and 12 so far this year just since January. I'm afraid if I take any more insulin I will look like a blimp by Christmas!!!

Any one else have this happen, & what did you do about it?

Adding a sulfonylurea might reduce your readings some, it is worth a try. I hate to say this, but is sounds like you need more Lantus. Once you get your blood glucose under control then you can try and lose the weight. You need to consider what harm the high readings are causing your body versus what the 22 pound weight gain has done in a way to harm your body. I understand how you feel, I have gained weight from using insulin, but I can't touch a carb without using insulin. The next time that I get lab work done, I want my doctor to find out how much insulin my body is making, it can't be much. I wish you luck in finding something that helps you control your blood glucose.

onaughmae

· #5 · Sep 13, 2010

Melanie said:
I cannot seem to get my blood sugar down to a normal level. I eat a proper diet- think The Mediterranean Diet or The South Beach Diet, with concentrations on fresh vegetables and grilled fish. I don't do dairy- just Almond Milk. My calorie intake is 850 to 1300 a day. I take a walk most days although that is less and less as my health seems to be tanking lately & it causes great pain, but I can sometimes ride a bike instead. My insulin intake is 26 units of Lantus once a day (I have tried night and morning) and 10 units of Humalog before each meal, in the middle of the afternoon and sometimes before bed (50 a day). I was put on Actos by one doctor (not an endo) but the first day my blood sugar dropped to 50 (US units) and then from then on it appeared to make it go higher, not lower, so that only lasted about 3 weeks. I was put on Metformin before that but it caused SERIOUS diarrhea and apparently did little for my blood sugar as it didn't change once I stopped taking it (after about 5 months of barely being able to leave the house). My blood sugars are generally 250 in the mornings, and drop to about 120 after my morning insulin and breakfast. By just before lunch they are usually back up to 160, they drop after some insulin and a low carb meal to the 120s. By 3 or 4 in the afternoon it is back to the 160-180 range, so I usually take insulin without food to get it back in line. I take more insulin with dinner & then by bedtime my blood sugar is back at 180 ish. If it is over 140, I take 10 units of H before going to bed & then I wake up with it back up to the 250s. I have tried checking my blood sugar every hour as I sleep & it just sort of creeps up. No huge jumps and no dips... Even with high blood sugars and low levels of food intake, I am still gaining weight like a mad-woman. 10 lbs last year and 12 so far this year just since January. I'm afraid if I take any more insulin I will look like a blimp by Christmas!!!

Any one else have this happen, & what did you do about it?

Once I started pumping, my insulin requirement dropped about 40% and I am in the best control I have been in years. I am another T2 diabetic who's pancreas has stopped producing insulin. I was waking up with blood sugars in the high 200's and having blood sugars 240-400 even though I was eating almost no carbs. Going on insulin injections helped, but I was taking a scary amount of insulin per day and was still often in the 200's. My blood sugar is now within normal range most of the time.

Melanie

Discussion Starter · #6 · Sep 13, 2010

so maybe a pump?

I am not really too overweight...- yet- at 5'7" im still in the 150 lb range but it appears that all this insulin is doing is making me gain weight, not bring my sugar down into the normal range. I actually went for 3 and a half months of eating no more than a dozen carbs per day- yep- per day. I was extremely hard to live with according to those forced to deal with me, yet my blood sugar remained in the 200s and I was creeping up on weight- although not as fast as I am now that I am trying to eat more vegetables. I've never been one to just "sorta" try something- more of an all or nothing person- so I am willing to experiment on myself

. I will start by upping my Lantus. It just makes me nervous that I am gaining weight with high sugar and low carb intake, but in for a penny, in for a pound, right?

If anyone else thinks of something, please let me know. I have added ground flaxseed to my repetoire and eat 2T sprinkled on whatever I am eating at least twice a day. I can't say it has helped my sugar levels but I'm sure my hair and nails are improving

.

I'll ask my endo about the pump next time I see him. My GP is sure if I just see a dietician again, I will be fine... he thinks I only need to test my levels in the morning & questioned why I am taking H when I should just be on more oral meds???? My endo from Mayo diagnosed me as a Type 1, but my GP thinks he is wrong and that I am just eating too much- he also suggested I eat more pasta, saying "it's a really good food for a diabetic. You should eat some pasta every day"... really. I try not to bring up my diabetes when I see him!

Sorry for the tangent
-Melanie

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Shanny

· #7 · Sep 13, 2010

Good grief, Melanie . . . your GP must drive you crazy! Amazing the misinformation believed by some (and not just yours!) medical professionals!

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Adjitater

· #8 · Sep 13, 2010

What tests did the endo from mayo run to determine that you were type 1

Melanie

Discussion Starter · #9 · Sep 13, 2010

Adjitater said:
What tests did the endo from mayo run to determine that you were type 1

ummmm. I wish I could think of what he called it...
I know I had zero insulin in my system- I had been on 1000 mg metformin 2X/day and Amaryl 2X/day and training for a triathlon but was finding that even a brisk walk was spiking my sugar to the 500-600 range. Every time I tried to work out I would get dizzy & just about pass out. I guess lucky for me I was going through some female hormonal issues and was non-stop bleeding. The endo suspected that was helping replace my "syrup"- which is what he called my blood- with fresh red blood cells. Also, peculiarly, I have hemochromtosis so I never had low iron

. Anyway...
he also said something about ketones... I will have to dig up that paperwork and see what it said. I was in a bit of a stupor at the time- things were not making much sense, probably because my blood sugar had been so high for so long. I might now be able to decipher what he was talking about.

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Adjitater

· #10 · Sep 13, 2010

Sounds like he did a C-Peptide and with no insulin beig produced I would tend to agree with him that you might be type 1. The other test should have ben to check for GAD antibodies if it was positive then there is no dought. Are you carb counting for each meal and adjusting insulin accordingly.

breezeonby

· #11 · Sep 13, 2010

Melanie said:
I am not really too overweight...- yet- at 5'7" im still in the 150 lb range but it appears that all this insulin is doing is making me gain weight, not bring my sugar down into the normal range. I actually went for 3 and a half months of eating no more than a dozen carbs per day- yep- per day. I was extremely hard to live with according to those forced to deal with me, yet my blood sugar remained in the 200s and I was creeping up on weight- although not as fast as I am now that I am trying to eat more vegetables. I've never been one to just "sorta" try something- more of an all or nothing person- so I am willing to experiment on myself . I will start by upping my Lantus. It just makes me nervous that I am gaining weight with high sugar and low carb intake, but in for a penny, in for a pound, right?

If anyone else thinks of something, please let me know. I have added ground flaxseed to my repetoire and eat 2T sprinkled on whatever I am eating at least twice a day. I can't say it has helped my sugar levels but I'm sure my hair and nails are improving .

I'll ask my endo about the pump next time I see him. My GP is sure if I just see a dietician again, I will be fine... he thinks I only need to test my levels in the morning & questioned why I am taking H when I should just be on more oral meds???? My endo from Mayo diagnosed me as a Type 1, but my GP thinks he is wrong and that I am just eating too much- he also suggested I eat more pasta, saying "it's a really good food for a diabetic. You should eat some pasta every day"... really. I try not to bring up my diabetes when I see him!

Sorry for the tangent
-Melanie

When you increase your Lantus, increase by 2 units every 2 or 3 days until your fasting blood glucose is 120. It may take awhile to get to 120 but you should get there. I am not sure you will be happy taking more insulin, not sure what else for you to do.

shortaphrodite

· #12 · Sep 14, 2010

Hi Melanie

By any chance did your doc test you for hypo thyroidism?? This will cause you to put weight on no matter what you do. Other sysmptoms are: you are sensitive to the cold, get a strange yellowy hue to ur skin, you may develop a lump in your throat called a goiter to name but a few!!

Next time you go, just mention it. A lot of diabetics have this problem.

Cheers

Lisa

Jen

· #13 · Sep 14, 2010

Hi Melanie. Like several others, I think you need to increase your basal insulin. Have you done any basal testing? Pick up either Think Like a Pancreas by Gary Scheiner or Using Insulin by John Walsh. These great resources will guide you through setting a proper Lantus dose. It may be more effective for you in two doses - one at night and one in the morning. I use Levemir and do 12u at midnight, 8u at 7:00 a.m. and 3u at 4:00 p.m. It took several weeks of testing, testing, testing to develop a regimen that works well.

Once you've optimized your Lantus you may find that you can reduce the amount of Humalog you're using.

Best,
Jen

Melanie

Discussion Starter · #14 · Sep 15, 2010

Adjitater said:
Sounds like he did a C-Peptide ..... Are you carb counting for each meal and adjusting insulin accordingly.

Yes, that was it, the C-Peptide... and I am counting carbs but it appears that I may not be adjusting accordingly

.

I have upped my Lantus to 30 units in the morning and 30 in the evening- 12 hours apart. I was a little nervous to inject 60 units at once... I know it is basically the same thing, but humor me here

...

So far, no change, with very high glucose in the morning and early evening/late afternoon (241 and 212 today)... we will see, tho. Also, I have made an appointment with my endo to discuss pump...

diabetes86

· #15 · Sep 15, 2010

STOP
If I read you first post right you are MORE than doubling your Lantus does in one fell swoop. Dont do that. Yes I am yelling, doubling your insulin dose could KILL you.

I may be over cautious but you need to be careful. Sneak up on it as Breezeonby said.

breezeonby

· #16 · Sep 15, 2010

I have to agree with diabetes86. Doubling your insulin dose might not be a good thing to do. It sounds like you are curious to see if increasing your Lantus will help. It most likely will, how much, remains to be seen. At the very most increase by 4 units every 2 days unless your doctor tells you something different. Please be careful!

Melanie

Discussion Starter · #17 · Sep 15, 2010

ooops- OK. I will back off a little

My numbers were still high yesterday but I did wake up with numbers in the mid 100s- about 100 pts down from the last many many years of mornings & I felt a little loopy most of the day even tho my glucose was in the 80 to 130 range... also about 100 pts down from most of my "regular" numbers...

now I have a headache and am feeling kinda yuck, so I suppose I will try not to kill myself with Lantus this week - thanks for the warning.

4 units at a time sounds about right

-Melanie

Melanie

Discussion Starter · #18 · Sep 15, 2010

Jen said:
Think Like a Pancreas by Gary Scheiner or Using Insulin by John Walsh.

Thanks Jen, I was just about to post a question asking for some resources on this exact thing! I will look them up right now...
-Melanie

diabetes86

· #19 · Sep 15, 2010

Glad your OK, I was worried.

You feel yucky cause your body is not used to such normal numbers. That is another reason to sneak up on the does by 4 IU at a time, it makes for a slower lowering and your body can get used to the new you.

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