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Discussion Starter · #1 ·
Hello,

I've had T2 diabetes for about 20 years. It's in the family, and also I've taken Zyprexa, Seroquel and Abilify which each one causes type 2 diabetes. I've been gaining way too much weight. The more insulin injections I take to control the levels, I gain more weight, and it becomes harder to control and it's a cycle I can't get out of. I'm at 320 lb up from 240 lb 10 years ago.

This is my treatment plan at this point:

Pioglitazone 30mg oral, once a day
Victoza injection, 1.8mg a day
Tresiba injection, 160 units a day
Novolog injection, 20 units per meal

I suffer from depression in bipolar disorder, and I haven't exercised like I should have. But when I do exercise now, I can barely go a block length without breathing so hard I have to quit. My gut is really big and I feel like there's no hope at this point. I don't over eat, and my carb intake is minimal, lots less than what my diabetes educator says to keep it at.

Is there really any hope out there for me??
 

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blugrass, I've responded to your intro post in our New Member Introduction forum, but I'll write here, too, that I think there is hope for you. It may be a longer road of little victories, but it can happen.

If you're already eating lower-carb, would you mind sharing with us what a typical day's menu looks like for you? Can we ask about your living situation (not huge detail, just whether you live alone or with others, if you have commitments outside your home, what your health care team looks like), etc.? That will help us offer some suggestions on changes you might want to make.

I hope some of our other "success stories" post their welcome and their thoughts here as well.
 

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Discussion Starter · #3 ·
Thanks Steve.
A typical day might be

8:00 am take injections and meds
9:00 am 1 egg mcmuffin and hash brown, unsweetened tea or diet coke
noon 1 banquet pot pie, 2 tangerines
4:00 pm 1 cafe steamer meal by Healthy Choice, 1 apple
9:00 pm 1 pot pie or cafe steamer meal

I've also been drinking a lot of Zero Sugar Gatorade throughout the day for electrolytes. Better than regular gatorade, but maybe still not the best. IDK.

Right now I'm living with my parents. Mom got dementia recently and I'm mentally disabled. Dad brings home groceries but it's mostly frozen foods like pizza, or cans of chef boyardee or chunky soups. I get food stamps so I could shop for myself but there isn't a lot of room to put my food. But I could work on that to try and improve what I eat. He's been buying pot pies and cafe steamers and stocking them in the freezer just for me. I know the pot pies need to go, but the cafe steamers aren't bad.
 

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Yes there is hope. Reaching out was the first step.

First questions that come to my mind is how many carbs are you eating, are you counting the carbs you eat, and is it less than 50 grams a day? Most diabetes educators allow way too many carbs. You posted right before I was about to, I think you need to count the carbs on the labels. You have lots of room for improvement right there alone.

Second question is, have you been tested for Type 1 antibodies or had a C-peptide test? Reason for asking is that if your pancreas has quit producing insulin other than the insulins you are taking. nothing else is doing anything beneficial for you. As much stuff as you are taking, sounds like they are not doing much. I think you'd still benefit from this but see how carb reduction does first.

Third question is, how are your insulin dosages determined? I think you would greatly benefit from changing dosing fixed amounts of bolus insulin to a method that that works off of your insulin/carb ratio and a correction factor. An endocrinologist or diabetes educator should be able to help you determine these numbers. Insulin carb ratio is the amount of bolus (Novolog) insulin to take per grams of carbs you eat in a meal. Correction factor would be how much does one unit of insulin drop your BG. They should also be able to balance out between meals BG with your basal (Tresiba) insulin dose.

I'm not a doctor, I'm not a Type 1, I don't take insulin, but I'd bet pushing on your medical team to look at a different approach would be a good thing to do. If they are happy where you are at, I would consider finding a new team.
 

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Thanks, blugrass. The additional info is quite helpful.

It sounds like life can get kind of chaotic for you. I'll echo mbuster's advice that it might be best to just start making more diabetic-friendly choices in what you eat and changing that as you progress.

As fast food breakfast sandwiches go, an Egg McMuffin is a decent choice; the hash brown not so much (but, writing as a former McD's hash brown addict, I understand the appeal). You might consider eating snack vegetables like celery or peppers or cucumbers (or non-sweet pickles) instead of some of the fruit.

The frozen meals are kind of a challenge. I looked at some of the Café Steamers that are sold and some choices (like the Chicken Fajita) were not too bad in terms of carbohydrates but some (like the ones with potatoes or noodles) were pretty high up there for a diabetic. While I'm not a fan of wasting food, you might want to think about eating all the protein and whatever vegetables come in the bowl but not eating all of the potatoes/spaghetti/noodles. Of course, then it gets more difficult to figure out just how many carbs you ate for insulin dosing purposes, so you can decide if you want to get that complicated right away.

There are frozen meals that have fewer carbohydrates in them. Some of the Marie Callendar meals are not bad at all if you don't eat all the potatoes or noodles in them. Since your dad is willing to buy you different food than he buys himself and your mother, maybe he would buy different brands instead? Can you "shop" the store's Web site to see what they sell and what might be more healthful for you (as I reviewed the Café Steamers)? The more you can stick with meat (or poultry) and vegetables (without a batter coating for frying) the better you'll do.

Another option, since easy prep seems to be pretty important, might be to go a little non-traditional on food. Would you consider buying ingredients that require little or no prep and making meals out of those? Like maybe buying a bell pepper or two or a stalk of celery or a cucumber or a head of lettuce and a couple of blocks of cheese and a package of sliced deli meat and then just cutting up what you want to eat at mealtimes? It's not a lot of work to get the food ready and you'll be eating foods that are better for you than the frozen meals. But you've got to like eating like that and you're talking food with a shorter shelf life than what you can keep in the freezer. Maybe think about doing this for one meal a day instead of all of them; it might be easier to do this in steps than all at once.

And then there will be the movement part to address. I know it's tough now, but even just doing a little bit is helpful. Any chance you could look at on-line sites like craigslist or Facebook Marketplace and look for exercise equipment that someone is giving away? Bring it home and even if you do just five minutes on it one day and five the next and six the day after that, you are building up endurance and your metabolism. After a little while, it starts building on itself (kind of like interest on a bank account) and you'll be able to do more. Walking can do the same thing. The challenge is to get out there and do it (I live in Minnesota; right now it's 12 degrees and just being outside is a challenge 😀 ). Does your area offer fitness classes for adults in water exercise or even yoga or tai chi? They're all based on simple movement and, once it doesn’t hurt so much to just move, more is possible. What do you think?
 

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I can identify with your feelings. Like wow. Yeah I get what you are saying.

It is difficult for me to give advice to someone who already knows more than I do about all the levers to control Diabetes.

What I can say about emotions. My emotions lie to me. My rational brain is helpless when emotions tell me things, as they the rational side of my thinking is normally negative, and won't help out. My emotions are constantly argumentative as to why they are right. They can be negative. All I can think is emotions, shut up. I got other things in my life to do. Some might be fun, someday, some time.

Sometimes I have to remind myself about what I should be doing to control my Diabetes. A Tennis star said he would make checklists of what to think, in some situations. If things were not going well, he would go through his check lists.

For me, every day I get up and say, today, I will try to focus on eating smart, try to lose a bit of weight. Darn, I do the exact opposite. It is like if I have a good attitude, i have already lost the weight, enjoy. Leads to Pizza, French Fries, donuts, cookies, fried chicken, cheeseburger.
 

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I've read numerous articles about how when we state our intentions, the universe puts in front of us opportunities to re-state our intentions -- like the exact foods we're trying not to eat, etc. The victory comes in resisting those opportunities. The victory is not necessarily easy to achieve. But it helps me to remember that stating my intention brings those obstacles to the fore. They're a tiny bit easier to resist when I know they're coming.
 

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I’ll just add a few suggestions.

1. You need a good endocrinologist. Nothing against diabetes educators, but they are not endocrinologists. Some diabetes educators are not much more than nutritionists that may not understand this disease very well. I would not be here today without my endocrinologist to help me to understand this disease.

2. I agree with the suggestion for you to have a C-Peptide test to determine if your body is producing any insulin. You’re on a combination of meds for Type 1 and Type 2 diabetes. You really need to have an endocrinologist figure out if your Type 1 and then to tailor your meds. I’ve found that when my blood sugars get out of control if more about my meds being off than what I’m eating. If I take too much long acting insulin (i.e.: Tresiba) sometimes I won’t go low and rebound, I’ll just go and stay high. Everyone’s different, but your on a very high dose of Tresiba. It’s a proven formula, when you have poor control most endos/clinics will reduce your insulin using formulas based on your weight and then gradually increase it. You shouldn’t try this yourself though, you need to do this with the advice of and under the guidance of an endocrinologist.

3. You need to have an endo run an A1C on you (3 month average blood sugar). I may have missed it but I don’t think you’ve mentioned that you’ve had this done. That will help you and your endo to determine if you’re going low and rebounding (this would be a possibility if your A1C is lower than you would expect) or if you’re staying high all the time. I’m assuming you’re regularly testing your blood sugar but I don’t think you mentioned this.

4. Get a Continuous Glucose Monitor (CGM). You’ll need an endo to write an Rx for it and to explain why it’s necessary to your insurance company (I’m hoping you have insurance?). This was perhaps the the best investment of my life. There is no better tool to help you figure out what foods are well tolerated, which foods are not, and what the right dosages are of your insulins (make only one adjustment at a time). No amount of finger pricks will tell you what a CGM can at a glance. Finger prick blood glucose readings don’t tell you if your BS is rapidly increasing or decreasing. A CGM shows you what your BS is doing around the clock. This is different than an insulin pump, which I do not have, it’s just a small device that you place on your abdomen and it wirelessly sends your BS readings to your cell phone every 5 minutes. My A1C has improved greatly since I started using a CGM.

I wish you the best of luck. Your post shows you have the will power, desire, and intelligence to definitely improve your current situation. Incremental improvements are all that’s necessary to make a significant difference in your quality of life. You can do this.
 

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Yes, there is hope.
I have never ran across a doctor that understood low carb and how it effects your health. Not to say that there aren't' any, I just haven't seen them. My A1C was 8.3 when I was first diagnosed with type 2 diabetes. I found this forum which led me to doctors like Sarah Hallberg, and after about 2 months of low carb (about 50 grams a day) my A1C was down in the 6's and couple of months later down in 5's. My doctors look at me as an anomaly, but say "just keep doing what ever your doing". I haven't taken any medications at all. But the first thing you have to do is get real serious about your carbs. As others have noted, count everything you eat for awhile so you know your staying under your goal. After many months or several years, you will not have to count them as you will know what you can eat. I recommend staying away from the 5 deadly sins of diabetes. Eat none of the following
sugar
bread
potatoes
rice
pasta
If this is all you know about low carb it will help immensely. At least at the beginning be very serous about this. Don't say I'm going to cut back on these things, simply don't eat any of them at all. And when family and friends tell you that one piece of cake won't kill you, just walk away.
Once your A1C has been normal for a year or two, then you can think about an occasional cheat day. I've been low carb for 5 years and I might do a cheat day once or twice a year. If 50 carbs doesn't do it, try 40, if that doesn't do it try 30 .....try 20.....try...
 

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Thanks, blugrass. The additional info is quite helpful.

It sounds like life can get kind of chaotic for you. I'll echo mbuster's advice that it might be best to just start making more diabetic-friendly choices in what you eat and changing that as you progress.

As fast food breakfast sandwiches go, an Egg McMuffin is a decent choice; the hash brown not so much (but, writing as a former McD's hash brown addict, I understand the appeal). You might consider eating snack vegetables like celery or peppers or cucumbers (or non-sweet pickles) instead of some of the fruit.

The frozen meals are kind of a challenge. I looked at some of the Café Steamers that are sold and some choices (like the Chicken Fajita) were not too bad in terms of carbohydrates but some (like the ones with potatoes or noodles) were pretty high up there for a diabetic. While I'm not a fan of wasting food, you might want to think about eating all the protein and whatever vegetables come in the bowl but not eating all of the potatoes/spaghetti/noodles. Of course, then it gets more difficult to figure out just how many carbs you ate for insulin dosing purposes, so you can decide if you want to get that complicated right away.

There are frozen meals that have fewer carbohydrates in them. Some of the Marie Callendar meals are not bad at all if you don't eat all the potatoes or noodles in them. Since your dad is willing to buy you different food than he buys himself and your mother, maybe he would buy different brands instead? Can you "shop" the store's Web site to see what they sell and what might be more healthful for you (as I reviewed the Café Steamers)? The more you can stick with meat (or poultry) and vegetables (without a batter coating for frying) the better you'll do.

Another option, since easy prep seems to be pretty important, might be to go a little non-traditional on food. Would you consider buying ingredients that require little or no prep and making meals out of those? Like maybe buying a bell pepper or two or a stalk of celery or a cucumber or a head of lettuce and a couple of blocks of cheese and a package of sliced deli meat and then just cutting up what you want to eat at mealtimes? It's not a lot of work to get the food ready and you'll be eating foods that are better for you than the frozen meals. But you've got to like eating like that and you're talking food with a shorter shelf life than what you can keep in the freezer. Maybe think about doing this for one meal a day instead of all of them; it might be easier to do this in steps than all at once.

And then there will be the movement part to address. I know it's tough now, but even just doing a little bit is helpful. Any chance you could look at on-line sites like craigslist or Facebook Marketplace and look for exercise equipment that someone is giving away? Bring it home and even if you do just five minutes on it one day and five the next and six the day after that, you are building up endurance and your metabolism. After a little while, it starts building on itself (kind of like interest on a bank account) and you'll be able to do more. Walking can do the same thing. The challenge is to get out there and do it (I live in Minnesota; right now it's 12 degrees and just being outside is a challenge 😀 ). Does your area offer fitness classes for adults in water exercise or even yoga or tai chi? They're all based on simple movement and, once it doesn’t hurt so much to just move, more is possible. What do you think?
Hello,

I've had T2 diabetes for about 20 years. It's in the family, and also I've taken Zyprexa, Seroquel and Abilify which each one causes type 2 diabetes. I've been gaining way too much weight. The more insulin injections I take to control the levels, I gain more weight, and it becomes harder to control and it's a cycle I can't get out of. I'm at 320 lb up from 240 lb 10 years ago.

This is my treatment plan at this point:

Pioglitazone 30mg oral, once a day
Victoza injection, 1.8mg a day
Tresiba injection, 160 units a day
Novolog injection, 20 units per meal

I suffer from depression in bipolar disorder, and I haven't exercised like I should have. But when I do exercise now, I can barely go a block length without breathing so hard I have to quit. My gut is really big and I feel like there's no hope at this point. I don't over eat, and my carb intake is minimal, lots less than what my diabetes educator says to keep it at.

Is there really any hope out there for me??
Hello,

I've had T2 diabetes for about 20 years. It's in the family, and also I've taken Zyprexa, Seroquel and Abilify which each one causes type 2 diabetes. I've been gaining way too much weight. The more insulin injections I take to control the levels, I gain more weight, and it becomes harder to control and it's a cycle I can't get out of. I'm at 320 lb up from 240 lb 10 years ago.

This is my treatment plan at this point:

Pioglitazone 30mg oral, once a day
Victoza injection, 1.8mg a day
Tresiba injection, 160 units a day
Novolog injection, 20 units per meal

I suffer from depression in bipolar disorder, and I haven't exercised like I should have. But when I do exercise now, I can barely go a block length without breathing so hard I have to quit. My gut is really big and I feel like there's no hope at this point. I don't over eat, and my carb intake is minimal, lots less than what my diabetes educator says to keep it at.

Is there really any hope out there for me??
Hi Bluegrass, I can relate to your situation. I am not t1 or t2 but my brain damaged husband is T1. I am his only caregiver. I am personally acquainted with antidepressants and there effect. Our situation will not change for the good but our outlook on our situation can change. each day determine to do a bit of exercise but stop short of getting terribly winded. Ronnie and I walk about 1/8 mile down the road and back. Not much? We can manage that ( there is a hill) and on a good day we do that 3 times. We may stop and chat with our son across the road or a neighbor. That brightens our day. When sitting, get a pencil and write down a thing or two in your life that is good if it’s only that you woke up that morning.
you do eat a good bit oh carbs. Cutting back on carbs seems tough but you can eat less and help. As you stop eating a certain food and reducing your carb intake, you may need your meds adjusted. Inform your healthcare team that you are working to improve your lot and ask for their help. If they won’t help, try to find someone else for your healthcare team. We are in an area where a “good” endocrinologist Is rare. Have a better day!
 
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