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gliptins and/or glitazones?

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pippaandben

Well-Known Member
Relationship to Diabetes
Type 2
I am Type 2 diagnosed May 2010. Medications have increased gradually since then and now I am on 2 1000mg Metformin and 4 diamicron (sulphonylurea) which is the max dose I think. Tomorrow I am going to see my Dr as over the summer my BG has crept up - some I know down to me not being quite so strict when on holiday!! Also it does seem that hot weather does cause an increase.

Testing am and bedtime and over the past week have been regularly in low20s in am and on one occasion 30.3 at bedtime when I had not had anything to eat since 7.30pm and bedtime reading was done after midnight. I am now getting scared. Occasionally feeling very thirsty - but not every day. Think I've lost quite a bit of weight over the summer probably about 7-10lbs. Apart from that I feel fine in myself and the only other symptom I can think of is being a bit sleepy during the evening - but then I am a (young) 67!

I know the next step before insulin is one of the above drugs. Any advice and /or questions to ask Dr if he gives me the choice of which way to go welcomed.
 
Hi, it sounds to me like you might be better just going straight to insulin with the levels you are reporting. Your weight loss is quite possibly due to the fact that you are no longer producing sufficient insulin to allow you to use the glucose in your blood, hece the high levels and your body having to seek energy fro other sources such as fat stores and other tissue. I would think that further increasing medications will only be a very temporary solution, if at all. I would make an appointment as a matter of urgency - let us know how things go! Once you can get those levels under control you will feel so much better! 🙂
 
I quite agree with Northerner. It sounds to me like you have lost a great deal of your own insulin production. If it were me I'd be asking for a referral to a Specialist, because it doesn't sound like you have straightforward T2 diabetes, but maybe have slow onset T1. Otherwise known as LADA or T1.5.
 
Thank you both. Dr has said I need to go straight onto insulin - not worth trying other tablets as by the time they have stabilised me I will have packed up producing even more insulin. So have been given a testing timetable 6-7 times a day plus ketone test daily. These I am to phone through to surgery daily. I see the diabetes nurse on 29th for half hour session to explain all. Bit of a shock when it does come to this but my levels were so high I was prepared. I had also fasted overnight so that a blood test could be taken straight away. Will I have any say in the manner of insulin injection? eg is there a preference over single or multi use pens. Also as I am going to the Red Sea in December does anyone have any experience of Egypt rules on sharps - Do I need a lettter from Dr for UK security? Ugh so many questions - my head is going round in circles - already had a sob session. Pitiful really
 
I understand it must be a bit of a shock, but really it does sound like the best approach to take. Insulin comes in either disposable pens or cartridges that are easily fitted into reusable pens. I prefer the latter as there is less waste and the pens are more robust, given that they are intended to last for years, not days 🙂 I would definitely ask for MDI (multiple daily injections), also known as basal/bolus, for your insulin regime as this will give you the greatest flexibility and control. Two injections a day of mixed insulin imposes restrictions on both your diet and eating times, but basal/bolus provides a long-acting 'background' insulin (basal) and a fast-acting insulin which you match to the carbs in your meals (bolus).

I would get a letter from your DSN (if you have one) or your doctor if not (although you may have to pay the doctor) stating your requirements to carry insulin and sharps - ask for an open letter not tied to a particular date so you can re-use it. You could take a BD Safeclip on holiday with you to store the needle tips safely:

http://www.bd.com/uk/diabetes/page.aspx?cat=14153&id=31358

They are a couple of pounds from the pharmacy or can be got on prescription.

Here is the Diabetes UK travel guide for Egypt which you may find useful:

https://www.diabetes.org.uk/Documents/Country guides/Egypt September 2010.pdf

Any questions, you know where we are! 🙂
 
Thanks for the links Northerner. Very useful. I am now up to 17 questions for the nurse. I have tried to absorb as much info I can. After phoning in 4 days of readings Dr phoned Friday pm -said he wanted my weekend readings Monday morning and I may have to go in earlier to see the nurse and start treatment. OMG it's really happening isn't it.
I am now getting really anxious - which won't help BG. Had another 30.3 reading Thursday after dinner and then yesterday HI on meter which means 33+. Down to 28 this morning - hoorah!!
I can understand the multiple injection theory - but does this mean that when I have mid meal snacks - usually fruit - the basal will sort that out or do I have to corrrect?
ProbablY a basic question the nurse will tell me - but I am so worried I will be doing my body even more harm than I have already. Luckily still feel ok in myself - and I am enjoying not having to wear glasses except for close reading.
Are there any threads for new insulin users? Just searching for the names throws up so many. Thank you
 
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