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Discussion Starter · #1 ·
I have been diabetic since 2002/2003 and always been on oral diabetic medications and even at one time had my diabetes under control with weight control. My HA1C recently has not been responding to oral medications and my husband and I are wanting to have a baby so my PCP has decided I should start using Lantus. I have been on Lantus since mid-July along with Metformin. I am really fusterated because it seems like the more units of Lantus I use the
higher my FBS has been.
I have been really watching my diet and carb intake to bring down my weight as well as my BS but I am not getting great results. And to top it off, we want to have children and we are at a point where we want to start trying. I talked with my OB/GYN about it and he suggested I use a short-acting insulin and use it three time a day but my PCP wanted to start me on Lantus and frankly I am not seeing any results and I am so mad. Does anyone have any thoughts on this. I would really appreciate some feed back. This really sucks because I feel like I have taken like 10 steps backwards instead of forward (or to bring us closer to getting pregnant). Thank you for your time.
 

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Hears the thing there both right. if you want to control your BG you need both types of insulin.

you need insulin because your BG is too high.
carbs raise BG

you need to see a endocrinologist or diabetes educator to find out how to adj your insulin.

this is how I did it.

if your like me even eating very low carb <50 day I still need insulin.

its easiest to adjust your basil insulin first when that is working then adjust your bolus insulin (fast)

you want your fasting BG (fasting is not necessarily your AM BG do to DP) to be about 100, adjust your basil insulin by 10% on every 3rd day until you get good results. then you can work on the bolus insulin.
 

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Discussion Starter · #3 ·
One question.....what is DP? And right I am just using Metformin 1000mg BID along with Lantus (15 units). Like I said previous, I just mid-July. I am not on short acting insulin as of yet. My OB (who used to specialize in high risk pregnancy) did suggest short acting insluin as well as an oral diabetic meds and also said I should use the insulin three times a day but my PCP decided against his reccommendations for right now. I did meet w/ a dietrician and diabetic educater who both thought I could get my HA1C down w/in the suggested range for pregnancy with insulin and possibly glyburide but once again my PCP shot that one down as well. I am upset because it seems like my BS (fasting or 2 hrs post prandial) are horrible-anywhere from 180 on up and when I was on oral meds I was around 130 so to me I feel like I am regressing not progressing.
 

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DP is dawn phenomenon... your blood glucose may rise in the morning due to the hormones your body produces when waking up.

What kind of diet are you eating? How low-carb?

Can you find a new PCP or go to an endocrinologist...because if you are getting better results with oral meds then maybe that needs to be considered, especially if you are wanting to get pregnant. Insulin may be better for long term, but you want to make sure your numbers are under control before conceiving in order to give your baby the best start (I'm sure you know that already!).

I just had my third baby three months ago and controlled my numbers with glyburide and diet. I've been insulin resistant since my teens and only got pregnant the first time because of Atkins. Low-carb certainly increases your fertility - my MIL actually got her period back after having gone through menopause five years previously.

Not sure if that helps any! I have no experience with insulin as I've not had to use it yet, and hopefully never will.
 

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Discussion Starter · #5 ·
Thanks for the info. I did call and speak with a diabetic educater and she said maybe the Lantus is not enough for my body--I might need to add some glyburide along with Lantus and/or Metformin. Another reason why I see the elevated BS is because when I first start the Lantus---I went right from oral meds to insulin and the oral meds were still built up in my body but now those levels are gone and I am no longer getting the help from those. As for finding a new PCP, she is a new PCP because my previous PCP cut back on his office hours therefore cutting back his patient load---and I was one of the "luckey" ones who was left go from his practice. I do like my new PCP, she is young and seems like she will be in the area for some time. I just don't think she has a lot experience with a young type II diabetic trying to have a baby. I really want my numbers where they need to be before we concieve because I want my future child to have the best possible start to life. I do have a f/u appointment with her coming up in the next week and believe this will be discussed. I am willing to use any medication to get my numbers within range and to be able to concieve and it they are within range, then I feel better as well. Lately I have not been feeling well and I know it has to do with my numbers. If you have any other suggestions, please by all means,
 

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Discussion Starter · #6 ·
feel free to give to me. (sorry, my fingers hit enter). I am open to trying anything. I am not getting any younger and I would like to be young when I have my children.
 

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I have been really watching my diet and carb intake to bring down my weight as well as my BS but I am not getting great results.
Some people believe that watching their carb intake means eating whole grain bread and lots of fruit instead of pies and cakes. Some of the forum members and I are type 2 and are not taking any meds, but have taken our bg down where it should be with diet and exercise alone. When it comes to food, the main thing that raises bg is carbs, so I lowered my bg by cutting out all pasta, potatoes, rice, bread, fruit and starchy veggies like corn, beans and peas and other things. Here is a link to a recent post I made when someone asked what they should be eating. I think it will help you out.
 

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I agree with Gizmo... what are you eating? What do your meals consist of, how many carbs, what kind of carbs, etc?

I stick to whole foods. If I have a carb, it's fruit or baked / mashed potato or corn on the cob. I am one of the "lucky" ones I guess though, and maybe "caught" myself before totally destroying my pancreas. I can eat a peach and not spike. I can eat a medium baked potato or 1/2 cup mashed potatoes and not spike. I can even eat 1/2 bar of dark chocolate without a spike. Not everyone can, you have to test test test and see what works for you. If you get a high number after you eat something, then it's best not to eat that item again, or try a smaller portion of it first. Someone had mentioned french fries spiked them so they couldn't eat potatoes... but they were eating frozen fries which are highly processed and have all kinds of things added to them... if frozen processed fries spike you, try having some homemade potato wedges...if those spike you, try making sweet potato fries or zucchini fries instead.

Every one is different, diabetes affects us each in a different way. Your meter is your best friend!
 

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Discussion Starter · #9 ·
Thanks again everyone for the wonderful help. I did have a f/u appointment with my PCP and we discussed the amount of Lantus I was using. I am now up to 30 units but again it still seems like the higher I go with the units the higher my bs is. But then again, we have had two birthdays in our family in the last week and one of them was mine, and I know the food I did eat was a contributing factor. I know I will get there, I am just impatient because we are so ready to start trying to concieve. I good news is, I have been able to fit in a great 30 to 40 minute walk every night but I do take one night off a week. I am feeling better each day and I do have more energy, I just need to let my bs come back down and keep it there.
 

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Docs often tell us to eat lots of whole grains and fruit. Unfortunately, many of us cannot touch them without spiking our glucose.

Add to that the fact that your doc likely (and most wisely) started you out on a low insulin dose, and yes, you will get higher glucose levels at first.

You may need to adjust your insulin dosages and schedules more than once in the first few weeks/months. That's normal.

As for diet, you may want to start out with low-carb, including natural fats such as olive or coconut oil, real mayo, real butter and cream. Foods labeled "low fat" tend to contain added sugar and carbs.

You'll also want to test your glucose fairly often, especially when trying "new foods." I like to test 1 hour after first bite, then 1 hour after that, taking a correction bolus (rapid insulin) dose if needed. It's called "eating to your meter" and it's the most powerful tool for figuring out what you can eat, what foods need more caution, and which foods are impossible. I try to keep between 70-120 at all times, with uhhh, mixed success.

Brest of luck on your future plans, and please keep us posted!
 
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