Ron it sounds as if your mother has been having a really tough time,
sorry about that.

There's no way that we on this ng can know enough about your mother's
health or medical needs to tell you if she needs insulin, other
medications, or not.  I would offer, though, that it sounds as if she
may need a new doctor, though, since you seem to have lost confidence in
the old one.

I sure hope they made that recommendation along with a very intensive bg
monitoring recommendation, with instructions for the appropriate dietary
adjustments based upon her monitored readings.

Susan

I was in the hospital and saw my self going into a hypo.

The nurse came in and was preparing to inject insulin.
I was fussng but she was going ahead.  Doctor's
orders.

At that time my Latin wife came in.  It was a real
event but I received some antihypo treatment and finally they
had to find me some food.

The point is that six years ago and there was very unqualified
people serving diabetics.

And  a strong Latin wife is not one to be messed with.

Anyway It got me home, which I wanted.  The doctor
ordered routine will get me very aggressive.

Most are better off if they  are the central person
in their diabetic care.

BUT hell it no fun to do that..  Gets in the way
of insults, politics, religion,  and trying to
be the expert.  

that she

She would have to be a type 2 diabetic for the hospital
doctors to say that. If the regular doctor raised it then
she is maybe showing higher numbers? How is her diet? She
may be able to get by on diet and oral meds. If her doctor
isn't an endocrinologist I would urge you to help her to get
to one rather than fool around with conflicting advice.
Insulin needs to have doses finetuned to suit the amount of
carbs a person is eating. A one dose doesn't fit all. A type
2 has insulin resistance, she really needs to be on an oral
anti insulin resistance med as well as insulin if needed.
But if it was me I would be seeing further advice from a
specialist.

Ron, as Susan said, we couldn't possibly suggest solutions
based on that information.

I'd strongly recommend two things. First, see if you can get
a doctor - any doctor - to refer her to an endocrinologist
as a matter of urgency. If you don't need referrals in your
system, then just make the appointment. Make sure that she
goes to the appointment armed with a full history of her
medical situation. If you don't know where to find an endo,
contact a local diabetes support group to see if you can get
recommendations. If she needs, and wants, your support go
with her.

Second, while she waits for the appointment, read this and
pass it on to her:
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

PS If her doctor is an idiot - it IS an issue. But first,
get her to one that isn't.

Cheers, Alan, T2, Australia.
d&e, metformin 2x500mg

Is your mom type 1 or 2?  A type 1 without insulin will die.  A type 2 may
or may not need insulin.  Did the Dr. do a C-Peptide test?  And why did the
Dr. screw around with her insulin dose?  Isn't this something the patient
does using a sliding scale?  I really don't know.  I've never used insulin.

Ron wrote in message
<1142726874.108093.115950@p10g2000cwp.googlegroups.com>...

". . . .The apparent cause was her doctor screwing around with her insulin
dosage. . ."

I control my own insulin dosage and have done so for years.    Your mother
doesn't seem able to do this so the hospital doctors suggested that she just
stop all together.   I would guess that they did this because many docs
regard the risk of hypos to be worst than the risk of high blood sugars in
older folks.

Maybe she can stop insulin,   maybe she can't.    Some comments  (guesses ?
?) in random order:

  1.  She is probably Type 2.   That means she should be doing something
about her Insulin Resistance as well.   You didn't mention anti-Insulin
Resistance meds. . .metformin and/or (Actos or Avandia).   They are now the
preferred "first meds" for T2 diabetics.   If she is not taking any,
perhaps starting one or two might give her enough control to allow her to go
off insulin.

 2.  Some docs give patients beta stimulators such as Glucotrol,
Glyburide,  Amaryl,  etc.    They force her beta cells to pour out whatever
insulin they can.     This can lead to trouble with hypos,  especially if
the patient is also taking the more controllable insulin injections.

Making a choice between beta stimulator therapy and insulin injections can
be tricky in older folks.    In younger folks,  the insulin injections have
more favorable effects.    In older folks,   the care and attention needed
for insulin therapy may be too daunting.

Note that I am 64,  choose my own insulin doses and inject several times a
day.    My friend Jim is in his late 70's and does the same.  "Daunting" and
"Older folks" are relative terms.

3.   As convenient as pills can be for Type 2 diabetes therapy,   there
often comes a time when enough beta cells are dead that none of the pills
will do the job by themselves.    If she has reached that level of cell
death,   insulin is the only therapy that will work and that's that.

However,   steady insulin therapy has been shown to permit Type 2 beta cells
to rest and regenerate.   Nine years of insulin therapy may have allowed
enough of your mother's beta cells to regenerate so that she can now get by
with pills,  exercise and diet control.

 4.  There are 10-classroom-hour insulin training courses at many
hospitals.   Doctors can't match a 10-classroom-hour training course in a
few 30-minute office visits.   If she hasn't had classroom insulin training,
maybe it's time she did.   Perhaps then  she could control her own dosages
and avoid these surprise hypoglycemic incidents.

If she takes a class,  she has a chance of getting to know a good
Nurse-Certified Diabetes Educator  (CDE).    A good CDE will beat a doc when
it comes to insulin management.   They do this all day,  every day and can
spend an hour on the phone with a patient.    The docs just can't squeeze
out the time to do this kind of stuff

 5.   The old-fashioned insulin,   "Insulin N"  (NPH) is notorious for
causing surprise hypoglycemic incidents.   I hope your mother is/was using
one of the more modern and more controllable basal metabolism insulins such
as Lantus or Levemir.    If not,   she needs some advice from a diabetes
expert.

6.   The older,  standard before-meal insulin, "Insulin R"  (Regular)  tends
to produce surprise hypoglycemic incidents because of its slow action.
Folks get lulled into taking too high a dose because the slow Insulin R
absorption allows sugars to spike.  Then the diabetic experiences hypos when
the food is totally digested but the slow Insulin R is still entering her
blood.   The more modern before-meal insulins such as Humalog and Novolog
are faster and thus can more closely match insulin absorption rate with food
digestion rate.

That's six questions for the two of you and her medical team to debate.
Come on back after the debates,   we can keep going.   We haven't even
started on DAFNE and the basal-bolus approach.

Note especially that Type 2 diabetes is strongly hereditary.   All this
stuff about anti-Insulin Resistance meds,  diet and exercise apply to you
and your siblings as well.    In fact,  right now you would be best served
if you took strong action to:

    1.  Lose fat lb,  especially abdominal fat
     2.  Gain muscle lb  (Ugh,  weight lifting)
    3.  Exercise every day,  the more vigorously the better
   4.  Cut your carb intake,   aim for the slowly-digesting carbs,  spread
your daily carb over several small meals.

That regime has been proven in formal medical clinical trials to delay the
onset of Type 2 diabetes in folks with diabetes genes.

Regards
 Old Al

Ron, I cant answer this question, but I would seek a second opinion from
a qualified endocrinologist.  Doctors in hospitals make lots of
mistakes.  My friend was in the hospital.  She had a seizure.  She has
been on phenobarbital for fifteen years.  They told her to stop as it
was ineffective.  She was checked by three other doctors who all
increased the amount of the pheno, not eliminated it.

Loretta

--
In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.

If she's a type 1, she'll die.

If she's a type 2, which is probably the case based on what you've
described it really shouldn't be that much of a problem if she is
going to manage her BG through diet, exercise and or oral medications.

For her sake, if you can, get her in to see an endocrinologist.  They
specialize in diabetes care.

Oops didn't realise this is another Sally troll post. She is
baiting you guys.