Medical Forum / Diseases and Disorders / Diabetes / March 2008
Insulin Questions
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Tom - 27 Feb 2008 08:30 GMT I am male T2 diagnosed 10 years ago. My HbA1c usually runs around 7 - 7.5. I take Metformin (2g per day) & Glimepiride. I wish to go off the Glimepiride & use insulin & get my numbers lower. However, my doc doesn't think that insulin is neccessary.
But since it's available without a prescription. I was wondering if it may be a good idea to buy it on my own & use it. I have helped train a relative in using a Novopen3, so I know how to dial a dose & use it.
These are the different Novapen insulins available in my country (not in the USA) 1) MIXTARD 30 HM PENFILL (Biphasic) 2) MIXTARD 50 HM PENFILL (Biphasic) 3) INSULATARD HM PENFILL (NPH) 4) ACTRAPID HM PENFILL (Insulin Neutral)
Can someone explain me the differences between the different kinds of insulins?
Can I go on some slow acting basal type of insulin without any fast acting one? Is there a possibility of hypoglycemia with slow acting insulin if the doses are low?
Accucheck/Ultra strips are also outrageously expensive where I am - so taking multiple readings each day is also out of the question.
Alan S - 27 Feb 2008 09:13 GMT >I am male T2 diagnosed 10 years ago. My HbA1c usually >runs around 7 - 7.5. I take Metformin (2g per day) & Glimepiride. [quoted text clipped - 23 lines] >I am - so taking multiple readings each day is also out of the >question. Welcome.
I'm sorry, I can't help with answers on insulin. I'll leave that to those who use it; they'll be along shortly as the world turns and the Northern Hemisphere rubs the sleep from it's eyes.
However, if you don't mind I'll ask a couple of questions that may, at first glance, seem irrelevant.
If it's not too personal what did you eat for breakfast today? What was your fasting blood glucose level and what was it an hour after you ate? Or two hours after you ate? Can you answer those same questions for lunch, dinner and snacks?
While you think about that, here are a couple of links that may help you understand why I asked: http://www.alt-support-diabetes.org/NewlyDiagnosed.htm and http://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html
Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com Latest: ACCORD, Foxes and Grapes
Terryc - 27 Feb 2008 10:30 GMT > I am male T2 diagnosed 10 years ago. My HbA1c usually > runs around 7 - 7.5. I take Metformin (2g per day) & Glimepiride. > I wish to go off the Glimepiride & use insulin & get my numbers > lower. However, my doc doesn't think that insulin is neccessary. You do not want to go to insulin. It is a double edged sword.
Seriously look at diet modification and exercise first.
If the tablets are giving you problems, then change the brand.
> But since it's available without a prescription. I was wondering > if it may be a good idea to buy it on my own & use it. > I have helped train a relative in using a Novopen3, so I know > how to dial a dose & use it. How is your pain tolerance?
> Can I go on some slow acting basal type of insulin without any > fast acting one? Is there a possibility of hypoglycemia with slow > acting insulin if the doses are low? Insulin can kill you. OTOH, it might do nothing.
> Accucheck/Ultra strips are also outrageously expensive where > I am - so taking multiple readings each day is also out of the > question. But you can afford insulin?
If you can not afford the test strips, then stay away from insulin.
Tom - 27 Feb 2008 14:30 GMT > If the tablets are giving you problems, then change the brand. No problems. But, I just think insulin would be better for the longterm as compared to sulfonyureas.
>> But since it's available without a prescription. I was wondering >> if it may be a good idea to buy it on my own & use it. >> I have helped train a relative in using a Novopen3, so I know >> how to dial a dose & use it. > > How is your pain tolerance? Well, with the novopen the pain is far less than even a blood check.
>> Accucheck/Ultra strips are also outrageously expensive where >> I am - so taking multiple readings each day is also out of the [quoted text clipped - 3 lines] > > If you can not afford the test strips, then stay away from insulin. Converted into US currency, the Novopenfill of Mixtard 30 costs around 22$ for 15 ml of 100 IU/ml concentration. (5 x 3ml) The strips costs around 37$ for 50 strips.
Assuming I take 10 units of insulin per day, the insulin would cost me 4.5 $ per month. Assuming, I test 3 times a day, the strips would cost me 66$ a month.
So the insulin is far cheaper than the strips.
> If you're getting prescription medication for your diabetes, is it not > possible to get your test strips on prescription? I can get prescriptions for everything, but I don't have insurance - so I have to pay for everything :-)
Andrew B. Chung, MD/PhD - 27 Feb 2008 11:15 GMT Aggressive lowering of HgbA1c with insulin especially without the supervision of a physician is not prudent according to the data from ACCORD.
It remains much smarter to lower HgbA1c by eating less, down to the perfect amount:
http://HeartMDPhD.com/BeSmart
Be hungry... be healthy... be hungrier... be blessed:
http://TheWellnessFoundation.com/BeSmart
Prayerfully in the infinite power and might of the Holy Spirit,
Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Swordbearer for the KING of kings and LORD of lords. http://HeartMDPhD.com/Sword
> I am male T2 diagnosed 10 years ago. My HbA1c usually > runs around 7 - 7.5. I take Metformin (2g per day) & Glimepiride. [quoted text clipped - 23 lines] > I am - so taking multiple readings each day is also out of the > question. Chris Malcolm - 27 Feb 2008 12:26 GMT > I am male T2 diagnosed 10 years ago. My HbA1c usually > runs around 7 - 7.5. I take Metformin (2g per day) & Glimepiride. > I wish to go off the Glimepiride & use insulin & get my numbers > lower. However, my doc doesn't think that insulin is neccessary.
> But since it's available without a prescription. I was wondering > if it may be a good idea to buy it on my own & use it. > I have helped train a relative in using a Novopen3, so I know > how to dial a dose & use it.
> These are the different Novapen insulins available in my country > (not in the USA) > 1) MIXTARD 30 HM PENFILL (Biphasic) > 2) MIXTARD 50 HM PENFILL (Biphasic) > 3) INSULATARD HM PENFILL (NPH) > 4) ACTRAPID HM PENFILL (Insulin Neutral)
> Can someone explain me the differences between the different kinds > of insulins?
> Can I go on some slow acting basal type of insulin without any > fast acting one? Is there a possibility of hypoglycemia with slow > acting insulin if the doses are low?
> Accucheck/Ultra strips are also outrageously expensive where > I am - so taking multiple readings each day is also out of the > question. If you're getting prescription medication for your diabetes, is it not possible to get your test strips on prescription?
I'm in the UK, where the general NHS test strip presecribing guidelines for T2s mean that very few of us can get enough strips to test more than once or twice a day, but it's still possible to test multiple times a day without buying more noce you've established some good stable daily regimes which only require very occasional revalidation, and allow you to save up test strips for strip-hungry experiments.
 Signature Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/]
Trinkwasser - 01 Mar 2008 20:22 GMT >I'm in the UK, where the general NHS test strip presecribing >guidelines for T2s mean that very few of us can get enough strips to [quoted text clipped - 3 lines] >revalidation, and allow you to save up test strips for strip-hungry >experiments. Yes I pretty much do that now, on the basis that I;d rather spend my money on good food than on strips which are only going to tell me what I already guessed.
I could NOT do this without having tested intensively at first though.
These days I always test when eating food of unknown provenance, and when I am ill or feel off colour, or when my exercise levels change markedly, then every so often I will run a whole day in detail.
I call it the Chris Malcolm Lite technique <G>
However, no way not never would I even attempt to try insulin without intensive and continous testing.
Too much to lose.
Màck©® - 27 Feb 2008 13:26 GMT >I am male T2 diagnosed 10 years ago. My HbA1c usually >runs around 7 - 7.5. I take Metformin (2g per day) & Glimepiride. [quoted text clipped - 3 lines] >But since it's available without a prescription. I was wondering >if it may be a good idea to buy it on my own & use it. no, follow your doctors advice. it's one thing to know how to dial a dose with a pen, any monkey could figure that out, it's another thing entirely to use Insulin safely without proper training. You could kill yourself.
 Signature Måck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org http://diabetes.niddk.nih.gov/dm/pubs/type1and2/ http://www.pandora.com enter "Jason & Demarco" http://www.ratbags.com/dechunging/
"To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt
(o ô) --ooO-(_)-Ooo--------------------
"I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins
DISCLAIMER If you find a posting or message from me offensive, inappropriate, or disruptive, please ignore it. If you don't know how to ignore a posting, complain to me and I will be only too happy to demonstrate... .
ted rosenberg - 27 Feb 2008 14:01 GMT > I am male T2 diagnosed 10 years ago. My HbA1c usually > runs around 7 - 7.5. I take Metformin (2g per day) & Glimepiride. [quoted text clipped - 6 lines] > how to dial a dose & use it. > Tom - this is an international group - You SEEM to be in Germany, but unless you tell us, we don't know
Novo will have a web site for your country which has the activity curves for each type of insulin. If you can't find it, Lilly has one also, and the Lilly equivalents are almost identical
> These are the different Novapen insulins available in my country > (not in the USA) > 1) MIXTARD 30 HM PENFILL (Biphasic) > 2) MIXTARD 50 HM PENFILL (Biphasic) > the difference here is the size of the pen I am guessing that "mixtard" is 70/30 premix
> 3) INSULATARD HM PENFILL (NPH) > NPH reaches max in 4 hours, then tapers off
> 4) ACTRAPID HM PENFILL (Insulin Neutral) > Either a fast acting analog, or "R" in either case reaches max in about 2 hours.
DO NOT TAKE INSULIN unless you test test test.
after a few years of experience you can possibly reduce the amount of tests
you can probably save a lot on the insulin by using syringe and vial, not pen. Do that and buy strips
Tom - 27 Feb 2008 14:45 GMT > Novo will have a web site for your country which has the activity curves > for each type of insulin. If you can't find it, Lilly has one also, and [quoted text clipped - 13 lines] > Either a fast acting analog, or "R" in either case reaches max in about 2 > hours. That means none of this is a pure basal insulin?
> DO NOT TAKE INSULIN unless you test test test. Is this neccessary even for low doses of only basal insulin.
> after a few years of experience you can possibly reduce the amount of > tests > > you can probably save a lot on the insulin by using syringe and vial, not > pen. Do that and buy strips I have put down the costs in another post - I doubt if I can save enough on insulin to cover strips.
Nicky - 27 Feb 2008 18:33 GMT >> DO NOT TAKE INSULIN unless you test test test. > >Is this neccessary even for low doses of only basal insulin. Of course it is. It's necessary even on d&e, if you want to do something about your numbers.
Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.6% BMI 25
Tom - 28 Feb 2008 03:31 GMT >>> DO NOT TAKE INSULIN unless you test test test. >> >>Is this neccessary even for low doses of only basal insulin. > > Of course it is. It's necessary even on d&e, if you want to do > something about your numbers. I guess you have comprehension problems. The question refers to testing to avoid hypos
Michelle C. - 27 Feb 2008 19:47 GMT > > Novo will have a web site for your country which has the activity curves > > for each type of insulin. If you can't find it, Lilly has one also, and [quoted text clipped - 30 lines] > > - Show quoted text - Tom,
You CAN NOT do insulin without a LOT of testing. 3 times a day won't do it.
I'm betting if you modify your diet and take up some exercise (providing that you do not have a health issue that prevents it), you can do a lot to improve your numbers. Take a look at this link: http://www.alt-support-diabetes.org/newlydiagnosed.htm Lifestyle changes are one of the cheapest things you can do--and ultimately will be healthier for you.
Best regards, Michelle C., T2 diet & exercise
Tom - 28 Feb 2008 03:32 GMT > Tom,
> You CAN NOT do insulin without a LOT of testing. 3 times a day won't > do it. I am not sure this is true. People were on insulin before home blood testing kits came into the picture.
ted rosenberg - 28 Feb 2008 03:46 GMT > >> Tom, [quoted text clipped - 9 lines] > > Not too bright are you?
GO., take Insulin without testing tell your family what your last arrangements are.. Be sure to have a plot picked out.
T1 diabetics often use very little Insulin, and T2's can use a lot It is not uncommon for a T1 to use as little as 1/2 unit, and a T2 to use as many as 600 units.
We have years of experience - you haven't a clue. If you don't test for peaks, you might as well not use insulin - you won't know how much to take, or if it is working If you don't test for lows, you might find yourself visiting [if you are lucky] the local ER, or [ if you are not] the local coroner or ME
It seems that the reason your doctor does not want you to use Insulin is because you are incapable of using it properly
Tom - 28 Feb 2008 06:04 GMT >>> Tom, >> [quoted text clipped - 10 lines] > tell your family what your last arrangements are.. Be sure to have a plot > picked out. I am not trying to reduce my sugar levels to 5.5 or whatever. I would be happy to keep at 6.0-6.5 with just metformin & insulin. So I want to take small doses of insulin - I would be happy to test 3 times a day for a month or so till I get the dosage right.
From then I would be testing once a day & a HbA1c once a couple of months or so.
Please - I am broke. I can't afford to pay close to 40$ for 50 strips (that's the price here) & test 5 times a day, ending up spending 120$ a month.
> T1 diabetics often use very little Insulin, and T2's can use a lot > It is not uncommon for a T1 to use as little as 1/2 unit, and a T2 to use [quoted text clipped - 5 lines] > If you don't test for lows, you might find yourself visiting [if you are > lucky] the local ER, or [ if you are not] the local coroner or ME Out here, testing strips are very expensive. No one uses them other than people on insulin. Going to a lab & getting a test costs about 2-3 times of doing a test a home - that's how relatively expensive strips are here.
There are tons of people on insulin who test maybe once or maximum of 3 times a day. Even patients in hospitals are given insulin with maybe testing twice a day. People manage because they aren't given agressive insulin treatment - but just enough to keep their sugar levels from being excessively high.
> It seems that the reason your doctor does not want you to use Insulin is > because you are incapable of using it properly No. that's not the case - he says that HbA1c of 7 is good enough. As per him, insulin is only for people who aren't able to bring it down to 7 with meds/diet/exercise. Most docs here hold a similiar opinion. And I don't have insurance, so can't keep trying different doctors.
Ozgirl - 28 Feb 2008 06:23 GMT >>>> Tom, >>> [quoted text clipped - 23 lines] > (that's the price here) & test 5 times a day, ending up > spending 120$ a month. Ok, so what about diet? many here do diet and/or exercise alone, no meds. What do you normally eat?
Nicky - 28 Feb 2008 08:36 GMT >I am not trying to reduce my sugar levels to 5.5 or whatever. I would >be happy to keep at 6.0-6.5 with just metformin & insulin. [quoted text clipped - 8 lines] >(that's the price here) & test 5 times a day, ending up >spending 120$ a month. No, you don't get it. If you attacked your current high bgs, so that you could maintain normal bgs on your current meds or maybe drop the sulph, it would cost you maybe that $100 dollars ONCE. When you've worked out what you can safely eat, and a supporting exercise routine, you can drop back to minimal testing.
But if you go on insulin, you'll have to extensively test every day, or you'll end up dead in a ditch from a hypo or in hospital through wild swings.
Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.6% BMI 25
Andrew B. Chung, MD/PhD - 28 Feb 2008 09:02 GMT > >I am not trying to reduce my sugar levels to 5.5 or whatever. I would > >be happy to keep at 6.0-6.5 with just metformin & insulin. [quoted text clipped - 18 lines] > or you'll end up dead in a ditch from a hypo or in hospital through > wild swings. It remains smarter to eat less, down to the right amount to become euglycemic without the need for exogenous insulin:
http://HeartMDPhD.com/BeSmart
Be hungry... be healthy... be hungrier... be euglycemic... be blessed:
http://TheWellnessFoundation.com/BeHealthy
Prayerfully in the infinite power and might of the Holy Spirit,
Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com Swordbearer for the KING of kings and LORD of lords. http://HeartMDPhD.com/Sword
Alan S - 28 Feb 2008 09:18 GMT >Please - I am broke. >I can't afford to pay close to 40$ for 50 strips >(that's the price here) & test 5 times a day, ending up >spending 120$ a month. As you seem to be ignoring my posts I'll make one last try:
Testing on a Budget I'm very lucky to be in a country where diabetics in the past have successfully lobbied for specific support within the government health system to assist good diabetes control. I'm eternally grateful for the pioneers who created Australian medicare and the NDSS.
However, I'm daily reminded that others overseas are not so fortunate. Consequently, some have difficulty following the full "test, test, test" http://www.alt-support-diabetes.org/NewlyDiagnosed.htm regimen as Jennifer suggests because of strip cost.
For them, I suggest a "one strip a day" method. This works more slowly than following Jennifer's advice completely - but it can still work. When I say "one strip a day" I'm not counting the FBG or other tests the doctor wants - discuss with the doc if you can cut back there. In hard economic circumstances I can't see that doing FBG every second or even third day is going to be a problem for the doc - but check to be sure. Let's face it, the "average" type 2 out there is testing FBG maybe once per week, doing absolutely nothing with the result, and wondering why their A1c goes up every 3-6 months.
This other daily test strip is purely to let YOU know what's happening when you eat.
First, it will take a few extra BG tests for two or three days to discover when your peak timing is. Once you know that for each meal, you can focus on that timing. Some reckon you also need to test before meals to see what the rise was; in these circumstances I would see the pre-meal test as a waste of a strip. Just concentrate on the absolute peak level. Target one meal per week. Most of us have problems with breakfast, so I'd recommend starting there.
Test at the peak spike time, just for breakfast, until you have modified your breakfast to the point where the spikes are acceptable to you. I use Jennifer's guidelines:
FBG under 110 (6.1) One hour after meals under 140 (7.7) Two hours after meals under 120 (6.7)
which are similar to the AACE, but check with your doctor if in doubt. Concentrate on that meal for one week, by that time you should have something workable. I've given some alternative breakfast ideas here, http://loraldiabetes.blogspot.com/2006/10/breakfasts.html but think outside the square and find what works for you. There is no law that decrees cereal, juice, milk or toast before noon.
Then concentrate on Lunch for week two, Dinner for week three and so on. Then repeat over the next three weeks. Over time you will find a range of foods that are OK - and a range of foods that aren't - and slowly build a safe menu base.
Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com Latest: Motivation, Likes and Dislikes
bj - 28 Feb 2008 16:36 GMT > Out here, testing strips are very expensive. No one uses them > other than people on insulin. Where is "here"?
Màck©® - 28 Feb 2008 18:55 GMT >>>> Tom, >>> [quoted text clipped - 52 lines] >to 7 with meds/diet/exercise. Most docs here hold a similiar opinion. >And I don't have insurance, so can't keep trying different doctors. Reread what you wrote above. Under those conditions it would be dangerous even for a newly diagnosed type 1 to be under medical care in your community. It would be damned stupid and bordering suicidal for a type 2 to be on insulin receiving that level of non-quality care from the medical profession in your community.
Combine that with your obvious reluctance not test correctly while using insulin and you guarantee failure.
you're complaining about the cost of test strips. Most people are twice what you have available. And yes without insurance. Unless they live in a country where medical expenses are subsidized through their taxes.
If you start having hypos while on insulin do you understand that you will have to increase testing at the time of each hypo to once every 15 to 20 minutes until the BG returns to normal?
If you are not fully prepared to do what it takes then you should not go on insulin.
 Signature Måck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org http://diabetes.niddk.nih.gov/dm/pubs/type1and2/ http://www.pandora.com enter "Jason & Demarco" http://www.ratbags.com/dechunging/
"To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt
(o ô) --ooO-(_)-Ooo--------------------
"I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins
DISCLAIMER If you find a posting or message from me offensive, inappropriate, or disruptive, please ignore it. If you don't know how to ignore a posting, complain to me and I will be only too happy to demonstrate... .
Terryc - 29 Feb 2008 01:05 GMT > I am not trying to reduce my sugar levels to 5.5 or whatever. I would > be happy to keep at 6.0-6.5 with just metformin & insulin. > So I want to take small doses of insulin - I would be happy to > test 3 times a day for a month or so till I get the dosage right. How do you plan to burn off the fat that insulin produces? What do you think insulin does with all that sugar it takes from your blood stream?
Màck©® - 29 Feb 2008 01:57 GMT >> I am not trying to reduce my sugar levels to 5.5 or whatever. I would >> be happy to keep at 6.0-6.5 with just metformin & insulin. [quoted text clipped - 4 lines] >What do you think insulin does with all that sugar it takes from your >blood stream? slightly misunderstood. If your cells need the glucose the insulin allows them to burn it for energy/fuel - no weight gain. When there is more glucose than the cells need for fuel the insulin then helps the body to convert the excess to fat/stored fuel.
For a type 1, exercise and a proper diet with adequate insulin injections produces no weight gain.
For a type 2 dealing with insulin resistance, it is very easy to have excess glucose and excess insulin in the system, which adds to weight gain. Proper diet and exercise become even more important to keep the weight off.
 Signature Måck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org http://diabetes.niddk.nih.gov/dm/pubs/type1and2/ http://www.pandora.com enter "Jason & Demarco" http://www.ratbags.com/dechunging/
"To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt
(o ô) --ooO-(_)-Ooo--------------------
"I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins
DISCLAIMER If you find a posting or message from me offensive, inappropriate, or disruptive, please ignore it. If you don't know how to ignore a posting, complain to me and I will be only too happy to demonstrate... .
Terryc - 29 Feb 2008 05:31 GMT > slightly misunderstood. I was just making it very simple what he was doing. I think he is a believer that insulin is a magic pill, aka pop insulin and eat anything you want.
Uncle Enrico - 29 Feb 2008 17:30 GMT Tom,
As a new user of insulin, you would be better off going with one shot of a long-acting insulin like Lantus or Levemir than using either R or NPH, also known as (N).
The advantage of Lantus or Levemir is the avoidance of roller coaster highs and lows due to dosage errors with the other insulins. The body doesn't do well with roller coaster highs and lows. Painful neuropathies due to oxidative stress are the likely result of too much variability in blood sugar readings over time.
By the way, you'll need your doctor's approval to get Lantus or Levemir.
They're worth the extra money.
Terryc - 29 Feb 2008 01:02 GMT > Is this neccessary even for low doses of only basal insulin. Absolutely. Some people's levels are all over the place and the smell of insulin affects them. Some people have to test, calc and inject.
Other people have it lucky that they don't.
Seriously, play with your diet first. Read that Taubes NYT article under the WD40 thread and work on it as a guide.
The catch is, you will have to test before and after meals to work out if it works for you.
Alternatively, make a change (e.g no processed wheat products) between Ha1bc(?) tests and see if that shows a difference.
If you are going to self medicate, then you have to do a lot ot learning fast. Insulin is definitely not a golden fix. TANSTAAFL.
Tom - 29 Feb 2008 03:49 GMT > If you are going to self medicate, then you have to do a lot ot learning > fast. Where can I do this learning?
Terryc - 29 Feb 2008 05:51 GMT >>If you are going to self medicate, then you have to do a lot ot learning >>fast. > > Where can I do this learning? In another thread, someone asked about books if you want to buy something. Or, do you have a local lending library? Go see what they have. Try to get a good basic biological understanding as well.
You can also read this newsgroup. Just learn to ignore the humungous amount of chaff.
Internet searching might turn up stuff. Again watch the chaff.
The trouble is, everyone is different, so you have to learn a lot and work out what applies to you.
Basic endocrinoloy is important, but after that you can get confused with conflicting "studies" as different researchers push stuff that is good for their career. A lot of medical break throughs are not, they are just PR for research applications and they will not apply to you.
Some people swear that the medical teams advice is just the thing, because it worked for them. Others will tell you that they could shoot the medical team for all the good it did them.
Diet wise, that Taubes article at NYT(WD40 thread) is about the best summary article. If you can apply the principles to your diet, then you are off to a good start. Hopefully, it will explain the overall mechanisms. then you have to listen to your body and work out what it is telling you.
Read a bit, come back and ask questions. The catch is, you also have to know the back ground and attitude of the person who is giving you information.
guys@consolidated.net - 27 Feb 2008 16:25 GMT >I am male T2 diagnosed 10 years ago. My HbA1c usually >runs around 7 - 7.5. I take Metformin (2g per day) & Glimepiride. [quoted text clipped - 23 lines] >I am - so taking multiple readings each day is also out of the >question.
>Please find a good endo and work it out Too many different idea come here to be used in the real world.
In the good days, I was able to use MHD for good advice. Too many self appointed experts today.
You can add a lot if you do searches on established sites of professionals.
I was damn lucky that I did not get in trouble when I did my own work. I had no choice then.
Uncle Enrico - 27 Feb 2008 20:49 GMT There are a number of reasons doctors are reluctant to prescribe insulin for patients:
1. The patient is very overweight and insulin resistant, and the doctor fears that insulin in the hands of the patient with an eating problem will only lead to more weight gain, increasing dosages of insulin and a worsening of the metabolic condition.
2. The patient has not made a good faith effort to reduce carb intake, reduce portions and begin an exercise program.
3. The patient is not capable of self monitoring and self dosing.
If none of these apply to you, I'd speak to the doctor about why he/she doesn't want you on insulin given your A1c which indicates you need to improve your blood glucose control.
You're 10 years post diagnosis and your beta cells may be reaching their exhaustion point.
Has your A1c been worsening while diet and exercise patters have remained constant? That situation might indicate beta cell burnout.
I wouldn't recommend going into insulin without your doctor's approval and advice.
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