Guest guest Posted April 6, 2002 Report Share Posted April 6, 2002 Hi, (the other) Vicki...insulin may be a good choice for you...excellent control is definitely obtainable with insulin. (It does take some trial and error, however, to find your correct dose). As far as fear of needles...we all start out that way, I guess, but pretty fast it becomes just something you do. Considering the alternatives of diabetic complications due to prolonged high BGs (and you know what they are, smile) a little needle prick is well worth it. Pretty soon giving yourself insulin shots becomes second nature. Trust me. Vicki in Portland, Or. In a message dated 04/06/2002 10:31:17 AM US Mountain Standard Time, vmossman2@... writes: > Woudl insulin be a better choice for > me (much as I fear needles?) My primary goal is to have excellent control > with no more complications than I have currently! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2002 Report Share Posted April 6, 2002 << Pretty soon giving yourself insulin shots becomes second nature. >> I am getting so use to it I do it in a hurry now. I don't even think about it anymore cause if I do I don't want to do it. My daughter wants to learn how to give me a shot. YIKES they want to stick me with needles. Kathy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2002 Report Share Posted April 6, 2002 Vicki Mossman wrote: > OK - all this talk about sulfonylureas has got me concerned for sure! > > I'm confused and not sure what to do. Woudl insulin be a better > choice for me (much as I fear needles?) My primary goal is to have > excellent control with no more complications than I have currently! Hi Vicki, I was doing well in my control with Diet and Exercise until I had foot surgery in March 2001. I tend to do things rather aggressively and walked myself into the ground! My right foot actually had three individual surgical procedures at the same time. Anyway, my BGs went through the roof no matter what I did. I tried to wait things out to see if they would come back down, but they did not. I went to the Doc who started me off with Glucophage, then Glucophage XR, then added Actos. With all these oral meds max'd out, my BGs barely budged. I was expecting my Doc to suggest a sulfonylurea and was ready to argue with her. Instead, she suggested Insulin - Lantus at bedtime and Humalog before each meal. Since taking exogenous Insulin would preserve my own beta cells, I decided to try Insulin, even though I dreaded the needle. Well - long story short - I seldom even feel the shot (poking my finger hurts FAR more - even at the light settings), my BG's began to come down nicely. It has taken some tweaking, but the control is back and I am pleased. As I begin walking again this year (with more sense), I am hoping that the need for the Glucophage and Insulin will diminish or go away completely. If it does not go away completely though, I am still glad to have control again. To me, dosing on a per meal basis with a good Insulin like Humalog make s far more sense than trying to take a set amount of a sulfonylurea and then " feed " it all day/night long. Just my humble opinion! ) Rick Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2002 Report Share Posted April 6, 2002 Vicki Mossman wrote: > OK - all this talk about sulfonylureas has got me concerned for sure! > > I'm confused and not sure what to do. Woudl insulin be a better > choice for me (much as I fear needles?) My primary goal is to have > excellent control with no more complications than I have currently! Hi Vicki, I was doing well in my control with Diet and Exercise until I had foot surgery in March 2001. I tend to do things rather aggressively and walked myself into the ground! My right foot actually had three individual surgical procedures at the same time. Anyway, my BGs went through the roof no matter what I did. I tried to wait things out to see if they would come back down, but they did not. I went to the Doc who started me off with Glucophage, then Glucophage XR, then added Actos. With all these oral meds max'd out, my BGs barely budged. I was expecting my Doc to suggest a sulfonylurea and was ready to argue with her. Instead, she suggested Insulin - Lantus at bedtime and Humalog before each meal. Since taking exogenous Insulin would preserve my own beta cells, I decided to try Insulin, even though I dreaded the needle. Well - long story short - I seldom even feel the shot (poking my finger hurts FAR more - even at the light settings), my BG's began to come down nicely. It has taken some tweaking, but the control is back and I am pleased. As I begin walking again this year (with more sense), I am hoping that the need for the Glucophage and Insulin will diminish or go away completely. If it does not go away completely though, I am still glad to have control again. To me, dosing on a per meal basis with a good Insulin like Humalog make s far more sense than trying to take a set amount of a sulfonylurea and then " feed " it all day/night long. Just my humble opinion! ) Rick Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2002 Report Share Posted April 6, 2002 Vicki Mossman wrote: > OK - all this talk about sulfonylureas has got me concerned for sure! > > I'm confused and not sure what to do. Woudl insulin be a better > choice for me (much as I fear needles?) My primary goal is to have > excellent control with no more complications than I have currently! Hi Vicki, I was doing well in my control with Diet and Exercise until I had foot surgery in March 2001. I tend to do things rather aggressively and walked myself into the ground! My right foot actually had three individual surgical procedures at the same time. Anyway, my BGs went through the roof no matter what I did. I tried to wait things out to see if they would come back down, but they did not. I went to the Doc who started me off with Glucophage, then Glucophage XR, then added Actos. With all these oral meds max'd out, my BGs barely budged. I was expecting my Doc to suggest a sulfonylurea and was ready to argue with her. Instead, she suggested Insulin - Lantus at bedtime and Humalog before each meal. Since taking exogenous Insulin would preserve my own beta cells, I decided to try Insulin, even though I dreaded the needle. Well - long story short - I seldom even feel the shot (poking my finger hurts FAR more - even at the light settings), my BG's began to come down nicely. It has taken some tweaking, but the control is back and I am pleased. As I begin walking again this year (with more sense), I am hoping that the need for the Glucophage and Insulin will diminish or go away completely. If it does not go away completely though, I am still glad to have control again. To me, dosing on a per meal basis with a good Insulin like Humalog make s far more sense than trying to take a set amount of a sulfonylurea and then " feed " it all day/night long. Just my humble opinion! ) Rick Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2002 Report Share Posted April 6, 2002 Vicki Mossman wrote: > How do you figure out which type of insulin to use and what dosage to > use? I'm beginning to think I should discuss the possibility with my > doctor at my next visit this month. Hi Vicki, As Phyllis W. mentioned, your Doctor would set an initial dosage schedule for you. Since the advent of Humalog, more and more doctors are prescribing it for the daytime mealtime Insulin needs, although there are still plenty of occasions when a different regimen is called for. Humalog is fast acting and does not last as long as other types of Insulin (thinking R & N here). In many people, that is exactly what they need. Others, especially those with diabetic digestion problems (help me folks - my mind is going blank on the condition), food is digested and absorbed more slowly and a longer acting Insulin is sometimes needed in those cases. He may also recommend a " basal " insulin such as Ultra Lente (UL) or Lantus. This insulin would cover the background insulin needs (if required). Dosages of either or both would be adjusted over a period of time. The docs are not anxious to give anyone a hypoglycemic event, so they'll make changes slowly over a period of time. Once you've been at it for a while, you'll eventually learn how insulin affects you as an individual and it will be easier for you to make minor tweaks as the need arises. > > Also, how does the cost of insulin and syringes compare with > Glucophage and/or Glyburide? > In my case, everything is $10.00 per prescription fill. I am able to make the insulin last longer than any oral meds, so for me it is cheaper. This is an insurance YMMV issue though. > > Thanks for everyone's comments! You're welcome. My input on this particular subject is only meant to say, don't be afraid of Insulin. Everyone's situation is different, but I truly believe that it's a great drug and when used properly, can boost your enjoyment of life. We can't get this diabetes " monkey " off our backs, but sometimes we can knock it unconscious for a while! Rick Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2002 Report Share Posted April 6, 2002 I guess Amaryl is one of these, even though it is fairly new. Is this correct? I wonder if my problems are linked to this. Phyllis N Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 6, 2002 Report Share Posted April 6, 2002 I guess Amaryl is one of these, even though it is fairly new. Is this correct? I wonder if my problems are linked to this. Phyllis N Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2002 Report Share Posted April 7, 2002 I prefer using Ultralente for background twice a day as it's virtually peakless. And I use fast-acting Humalog, dose matched to carbs eaten at that meal. This works really good for me. Vicki In a message dated 04/06/2002 4:56:55 PM US Mountain Standard Time, vmossman2@... writes: > > How do you figure out which type of insulin to use and what dosage to use? > I'm beginning to think I should discuss the possibility with my doctor at > my > next visit this month. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2002 Report Share Posted April 7, 2002 The word you're thinking of, Rick, is " gastroparesis, " , i.e. delayed stomach emptying. Hey, you're too young for senior moments! Vicki In a message dated 04/06/2002 7:44:48 PM US Mountain Standard Time, rick@... writes: > Others, especially those with diabetic digestion problems (help me > folks - my mind is going blank on the condition), food is digested and > absorbed more slowly and a longer acting Insulin is sometimes needed in > those cases. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2002 Report Share Posted April 7, 2002 The word you're thinking of, Rick, is " gastroparesis, " , i.e. delayed stomach emptying. Hey, you're too young for senior moments! Vicki In a message dated 04/06/2002 7:44:48 PM US Mountain Standard Time, rick@... writes: > Others, especially those with diabetic digestion problems (help me > folks - my mind is going blank on the condition), food is digested and > absorbed more slowly and a longer acting Insulin is sometimes needed in > those cases. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2002 Report Share Posted April 7, 2002 Vicki Mossman wrote: << I have been on 1000 mg Glucophage 2 x day, 5 mg Glyburide 2 x day for several years. (Actually it was 2.5 mg of Glyburide 2 x a day for several years, and it was increased to 5 mg twice a day about 6 months ago). After an A1c of 8 a few months ago, my doctor had me add Avandia 4 mg once a day. His intention was for me to take the Glucophage and Avandia and be able to stop the Glyburide. I also began eating low carb the end of January. My bg's came down nicely, and I began to lose some weight (I've lost 22 since the end of January). >> All that sounds good, Vicki. I can tell you about my sister, who was diagnosed type 2 about 45 years ago. She was on Glyburide or Diabeta or another sulfonylurea for many years. About a year ago, she was maxed out on three different diabetes meds, and her HbA1c's just kept climbing ... 9, 10, 11. The doctor told her it was time for insulin. She is terrified of needles! She began low-carbing, lost 40 pounds, went off the sulfonylurea, has cut her other meds by two-thirds, and feels much better. Her HbA1c's are around 7. After several years on sulfonylureas, you may never be able to achieve an HbA1c below 6.0, but I want you to know that with your present regimen of good diet and weight loss, your changes of maintaining good health are very good. Many type 2's find it easier to lose weight on the Glucophage and off sulfonylureas, which in many cases cause weight gain. << Woudl insulin be a better choice for me (much as I fear needles?) >> You could give it a try. Two-thirds of insulin users are type 2's. But what I've seen is that you need to exercise regularly and have your weight in normal range so as to minimize insulin resistance, so you don't have to use too much of it. I have heard of type 2's who use 100 units daily, several hundred ... even one good soul who was shooting a thousand units! << BTW, my physician is an internal medicine doctor; I like him very much, but not sure of his expertise in diabetes care. I'm on an HMO and require referral to see any other doctor. Also, the town I live in doesn't even have an endo! >> Aah, I sympathize ... We live in a small town too. My husband's doctor refuses to diagnose my husband as diabetic or prescribe the appropriate tests until his *fasting* readings reach the 120s. I'm about ready to feed Rob a glazed donut before the finger-stick, to get his doctor's attention! Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2002 Report Share Posted April 7, 2002 Art Mc asked about sulfonylureas. They were the only form of medicine available for type 2's until about five years ago. They work by forcing the pancreas beta cells to churn out even more insulin, to try to overcome our insulin resistance. Here, from http://www.rxlist.com, are some popular brands: Glucotrol, Diabeta, Glyburide, Micronase, Glynase Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2002 Report Share Posted April 7, 2002 Rick wrote: << Others, especially those with diabetic digestion problems (help me folks - my mind is going blank on the condition) >> Gastroparesis. I struggle with that word myself. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2002 Report Share Posted April 7, 2002 Rick wrote: << Others, especially those with diabetic digestion problems (help me folks - my mind is going blank on the condition) >> Gastroparesis. I struggle with that word myself. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 7, 2002 Report Share Posted April 7, 2002 Phyllis N. wrote: << I guess Amaryl is one of these, even though it is fairly new. Is this correct? I wonder if my problems are linked to this. >> Yes, Amaryl is one of those drugs, dear. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 Kathy wrote: << A while back there was someone that said about Glyburide type of drug will wear out your pancreas. My Aunt is on Glipizide and I think that is similar to glyburide and I had said something about it wearing out your pancreas and she is frightened now and what I was wondering is there any sites I can direct her to? >> Studies say that within six years of commencing use, 60 percent of type 2's on sulfonylureas will lose pancreas function. It goes about treating diabetes in the wrong way ... pummeling the pancreas to churn out even more insulin, when what is needed is an approach to improve insulin resistance, so that the pancreas beta cells don't have to work so hard. That is accomplished by lowering carbohydrate intake, weight lifting, weight loss, and regular exercise. Because of the long history of sulfonylurea use, this notion that type 2 diabetes is inevitably " progressive " has developed. Doctors feed their patients sulfonylureas; they see their patients' pancreases fail; they eventually move them on to injected insulin; complications develop. Never do the doctors recognize their own role in prescribing wrong medications! Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 This is very concerning to me. I took glucotrol for 8 years, then they switch me to Amaryl about 2 years ago. 1/2 of an Amaryl will bring my blood sugar down more than all other drugs combine. I used to take Avandia, glucophage and amaryl and my blood sugars were never good. Then I took 2000mg of glucophage a day and my levels were still not that good. Then I say not good, I am talking about 190 in the morning and 135 in the afternoon. I have never had the blood sugar levels that people on this list talk about, even on Atkins. They were always about the same as above. Now I am taking only 1/2 of an Amaryl, eating about 100 carbs a day and my blood sugar is 150 in the morning and 100 at night. It has never been better. I had a C-peptide test about 6 months ago and my insulin production was normal. Now I am just confused. Which is more important to take the Amaryl and have good blood sugars or protect my pancreas? The glucophage makes my legs hurt really bad, after good use of it for 8 years??????????????? So I have recently stopped it. I tried over 15 times stopping and starting it over the last two months to see if I could tolerate it. I would stop for 2 days - leg pain gone away. Then I would take only 500mg a day just to see, hoping my legs had gotten better, in 24 hours, my legs would ache so bad, I could barely walk. Also, when I take Actos, my heart races like it is coming out of my chest, so I stopped it after 2 days of use. I repeated this 4 times in 2 years hoping something else had effected my heart, with the same results. The Avandia - which I have only tried once for about 3 months, made my ankles swell up like watermelons, every night, so I stopped it. Now, I am just upset and feel that no one can help me get better. Does anyone know of any new medication or can anyone give me any advice on the Amaryl? Last A1C was 6.5 Thanks, Phyllis N <<Studies say that within six years of commencing use, 60 percent of type 2's on sulfonylureas will lose pancreas function. It goes about treating diabetes in the wrong way ... pummeling the pancreas to churn out even more insulin, when what is needed is an approach to improve insulin resistance, so that the pancreas beta cells don't have to work so hard. That is accomplished by lowering carbohydrate intake, weight lifting, weight loss, and regular exercise.>> _________________________________________________________________ Join the world’s largest e-mail service with MSN Hotmail. http://www.hotmail.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 Studies say that within six years of commencing use, 60 percent of type 2's on sulfonylureas will lose pancreas function. It goes about treating diabetes in the wrong way ... pummeling the pancreas to churn out even more >>>>>>>>>>>>>>>>>>>>>> I finally had my appt with the Endo last Thursday and brought the above up. She said it was BS. Told me that a twenty year study of 7000 people in the UK had disproved it. She was also dead against low carbing. No big surprises there and I don't have the test results back yet, but from looking at my readings book over the last couple of months she suggested I reduce the glyburide from 5 to 2.5 per day and keep the metformin at 2000 for now, but did leave room for cutting that as well. She was very pleased that I had lost twenty pounds since my last visit and DID agree that weight lifting is a good thing for Diabetics to do. I just hope that the HB1ACXXXX>>???? comes back good (last time it was a little below 10) so that I can wag that in her pretty face:-). Art Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 12, 2002 Report Share Posted May 12, 2002 Studies say that within six years of commencing use, 60 percent of type 2's on sulfonylureas will lose pancreas function. It goes about treating diabetes in the wrong way ... pummeling the pancreas to churn out even more >>>>>>>>>>>>>>>>>>>>>> I finally had my appt with the Endo last Thursday and brought the above up. She said it was BS. Told me that a twenty year study of 7000 people in the UK had disproved it. She was also dead against low carbing. No big surprises there and I don't have the test results back yet, but from looking at my readings book over the last couple of months she suggested I reduce the glyburide from 5 to 2.5 per day and keep the metformin at 2000 for now, but did leave room for cutting that as well. She was very pleased that I had lost twenty pounds since my last visit and DID agree that weight lifting is a good thing for Diabetics to do. I just hope that the HB1ACXXXX>>???? comes back good (last time it was a little below 10) so that I can wag that in her pretty face:-). Art Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 Art Mc wrote: << Told me that a twenty year study of 7000 people in the UK had disproved it. >> She is talking about the UKPDS. That study didn't study sulfonylurea use, but the risks of complications if diabetics didn't achieve tight control. Unfortunately for us, some people with initials after their names think they know it all. You can look up info about the UKPDS on the internet. Here's a good place to start: http://www.dtu.ox.ac.uk/index.html?maindoc=/ukpds/ Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 Art Mc wrote: << Told me that a twenty year study of 7000 people in the UK had disproved it. >> She is talking about the UKPDS. That study didn't study sulfonylurea use, but the risks of complications if diabetics didn't achieve tight control. Unfortunately for us, some people with initials after their names think they know it all. You can look up info about the UKPDS on the internet. Here's a good place to start: http://www.dtu.ox.ac.uk/index.html?maindoc=/ukpds/ Susie Quote Link to comment Share on other sites More sharing options...
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