Re: Type 2s: Insulin Early is Easy, Insulin Late is Not

July 15, 2008

Bill,

If your A1C stays at 5.1 or 5.2, it will be difficult to convince your

doctor or endocrinologist that you need to switch to insulin. Your control

seems to be very good with the regimen that you are on. If you monitor your

blood sugar regularly and have bloodwork done to check your A1C, you will

know quickly when things change. At that point, it may be necessary to

switch to insulin and you have all the necessary information to make the

switch.

One other thing you may want to consider is that for some diabetics, the

switch to insulin from pills can be difficult. It may take some time to

find the correct regimen that will work for you and this transition period

can be difficult for some people. Finding the right insulin and dosage may

not take much time for you in your situation, but you should be aware, that

for some people, it can be difficult.

If I were in your situation, I would continue with my current medications

and only make the change when you start to lose good control of your blood

sugars. Ultimately, you will have to decide which approach works best for

you.

RE: Type 2s: Insulin Early is Easy, Insulin Late

is Not

The idea that " if it ain't broke, don't fix it " is good, but I know in the

back of my mind that some time down the road, which could be next year, five

years, or maybe next month, the pills could start to slip in their

effectiveness setting off forced change. Knowing this ahead of time, I would

rather be proactive and keep my good health rather than letting it slip and

then having to recover. That's why I'm seeking to better myself now rather

than later. If it's inevitable why wait until I'm backed up against a wall?

Bill Powers

July 15, 2008

When do you next see your doc bill?

RE: Type 2s: Insulin Early is Easy, Insulin Late

is Not

, my A 1 C has been pretty constant the last 6 years, 5.1. I think

once it was actually 5.2, but it's been 5.1 for the longest time.

Postprandial readings about 2-1/2 hours, I'm between 100-120 at the most. If

I take a reading earlier than 2-1/2 hours it can be almost 130. So for

whatever reason it is, I find that 2-1/2 hours works for me to see a

reasonable level.

I suspect that I will have an uphill fight to even get started on insulin

because generally my lab work is very good and I do have good control of my

sugars, but I'm not even going to say I'm close enough to being " normal "

either. I'd rather err on the side of caution even though I do have

generally good sugars because having a false sense of security is a very

dangerous thing and can lead to real problems. We all know that since the

docs are ruled by insurers, even people like SCAN, they're going to side on

the cheaper modalities, i.e., pills. This will be interesting to test how

well my doc is willing to go to bat for me when I present him with my

arguments for going on insulin as a preemptive measure rather than waiting

until it becomes necessary. I'll need all the luck I can get.

Bill Powers

July 15, 2008

Not that you shouldn't be proactive, of course you should, but serious

complications take many years to manifest themselves. I believe it was said

that you could just about do anything (i.e. not take care of yourself) for 20

years, but then look out! that was my case, almost to the year, and I know of

other diabetics who can say the same thing.

Dave

Victim of a crime? Know someone who was?

http://victimsheart.blogspot.com

RE: Type 2s: Insulin Early is Easy, Insulin Late is

Not

The idea that " if it ain't broke, don't fix it " is good, but I know in the

back of my mind that some time down the road, which could be next year, five

years, or maybe next month, the pills could start to slip in their

effectiveness setting off forced change. Knowing this ahead of time, I would

rather be proactive and keep my good health rather than letting it slip and

then having to recover. That's why I'm seeking to better myself now rather

than later. If it's inevitable why wait until I'm backed up against a wall?

Bill Powers

July 16, 2008

Hi Bill,

I have to agree with those who suspect that insulin wouldn't do you much

good. In fact, I'm a bit confused as to how you would even use it seeing as

your body is still dealing with glucose quite effectively ... If you are

already able to maintain normal levels after eating it would be nearly

impossible to come up with an insulin-to-carb ratio to cover food because

your body would be doing it for you, so any extra insulin you injected would

simply drive your sugar down even more. The same would be true of your

overnight blood sugars, especially if you are already having problems with

going low. You'd be playing a guessing game as to whether you could suppress

your body's own insulin release enough to prevent lows, in contrast to those

who do not have adequate blood sugar control without insulin in which case

the insulin is simply making up for that which their body is unable to

produce enough of or at all.

While it's certainly good to be prepared for the possible need for insulin

in the future, and certainly if dealing with consistent highs it is better

to start insulin earlier rather than latter, I'm not sure you'd be doing

yourself any good by putting yourself at risk of severe lows and using a

much less effective injected insulin rather than the rapid, fine-tuned

insulin that your body can produce.

Jen

July 16, 2008

It is my understanding that if you have a functioning pancreas, that even if you

introduce insulin through injection, that it will not drive a Type 2's blood

glucose lower than it should be. The pancreas just notes that insulin is there

where it should be, and doesn't necessarily crank out more unnecessarily,

therefore avoiding these lows. A Type 2 on injected insulin isn't subject to the

lows as much. A type 2 on insulin can put less stress on the pancreas, and

therefore keep the pancreas functioning longer, and more effectively.

In answer to:

>>>I'm not sure you'd be doing

yourself any good by putting yourself at risk of severe lows and using a

much less effective injected insulin rather than the rapid, fine-tuned

insulin that your body can produce.

July 16, 2008

,

Some good points in your post. You are probably right that it will be

difficult to even convince the doc for me to switch to insulin. As it is, I

could not convince him to refer me to an endo since the regimen we've worked

out is working as well as it is. My main concern is to stay one step ahead,

if I can, so that I don't wind up killing off all my beta cells and suffer

the attendant consequences. Sadly, it's going to come down to money, one way

or the other. While I don't want to rock the boat when it's sailing on

smooth water, I certainly want to have a firm grip on my own health

management, and if there's a chance of even better control that would be

nice. But yes, I have thought about the fact that the transition might not

necessarily go smoothly and I might wind up thinking " why didn't I just stay

on pills? " This is one of those really hard decisions, but at least I don't

have to hurry right away to make it since I'm in no dire situation right

now. I just don't want to lose ground on the progress I've made so far in

controlling my sugars to the extent that I have.

Bill Powers

July 16, 2008