[email hidden] (tioga 0630) wrote in message news:<[email hidden]>...
Quoted message said:Hi. My mother is 74, diagnosed with Type 2 for about twenty years. Within the past three months,
the Avandamet and Metformin seem to have lost their punch, and she recently was told she had to
take Insulin (12 units twice a day).
12 units twice a day says nothing. It leads to guessing games and incorrect advice. One person made
a guess at 70/30. The other choice would be Lantus, a favorite of many docs for Type 2 patients.
But, is she still taking the oral meds along with the insulin? And, is her pancreas still producing
some insulin, although not as much as it previously did?
If it is not producing any insulin, then her treatment will be closer to that of a Type 1 diabetic,
and she may very well be taking 70/30, although 12 units twice per day without any oral meds sounds
like a small amount to me. However, you said she is getting low ! With the 70/30 insulin, one is
stuck with those percentages. Maybe she needs different amounts for only one of those two. You get
those different amounts by drawing each insulin out of a separate vial into one syringe. There are a
few extra steps, but it is not difficult to learn, and it will reduce the low BG at night. That is,
if she is taking 70/30.
I do not think she needs a so-called modern insulin regimen, which would mean multiple shots
each day, and probably the use of Humalog, a fast-acting insulin. She doesn't have a problem
with high blood sugars. Apparently, she is doing okay on two shots per day, and the problems are
with being low.
Having a snack at night is not a resolution until one finds a new doctor. It is a normal part of
being an insulin dependent diabetic. Anyone taking insulin, who does not have an evening snack, is
asking to get low at night.
Quoted message said:She has been experiencing two troubling symptoms--low readings at night (61 to 43) and has felt
hunger pangs within two hours after eating (and food has never been an obsession with her).
See above comments about a snack at night. Hunger is usually from a low BG. First, check the BG when
she feels hungry, even if it is after a meal. If low, eat more at the meal, or reduce one of the
insulin amounts if taking two, or the Lantus if taking that. If taking 70/30, it will not work to
reduce that because she will be reducing two insulins, when she only needs to reduce one. When she
is low, she should have a snack or some form of carbs.
Quoted message said:
The doctor in her medical group on call when she had a low recently said she should lessen the
insulin. However, her regular doctor said she should "up" it.
Fire the regular doctor ! First, make sure she understood what he meant. If he did mean to increase
the amount, ask why, in no uncertain terms. Make him explain his reasoning to you, before you fire
him. One does NOT avoid a low BG by taking more insulin. Reducing the insulin will raise the BG.
Increasing the insulin will lower the BG.
Quoted message said:I'm not asking for medical advice on this group;
Yes, you are.
Quoted message said:but I would like to hear if other people switching from oral
"regimens" to injected insulin have experienced these reactions.
There can be many variations with either a Type 1 or Type 2. Switching from oral meds is not the
main issue. The main issue is learning to deal with the insulin. Does this mean she is completely
off of oral meds? Is her pancreas producing any insulin at all?
Quoted message said:
Also, just an admittedly morbid question, but what should diabetics worry about more--very high
day readings, or very low night readings?
Yes ! Both are not good. It is six or a half dozen as to which will be more problematic. Having a
slightly high BG is not a solution to a low BG. Good control is the solution. Possibly a more
routine diet, with less change in the amount of the carbs at each meal from day to day, and more
frequent monitoring of the BG for a few weeks while the insulin amounts are being regulated. This is
not going to be a set thing without changes.
Quoted message said:I ask this because the reason she began the injections in the first place is because her day
readings began to stay consistently high (on the orals).
Makes sense, although there are other oral meds, such as Starlix or Prandin, which stimulate the
pancreas to produce more insulin. These may not be indicated for some older people with other health
considerations.
Quoted message said:Thank you very much for reading this, and if anyone could point me to a link where laypeople can
learn more about the reactions of the two different regimens--i.e., injected versus oral--I'd be
very grateful to learn about them here.
I am not familiar with info sites about switching from oral meds to insulin. Each is generally used
independently of the other, and for those who switch to insulin, any site with insulin info will be
helpful. You can start by typing in the name of the insulin on Google.com to do a search for the
manufacturer's site. They will also have other links.
I am surprised that Julie Bove said, "If she is eating too many carbs, then all the meds in the
world won't help her." This is true if there is a problem with a high BG, but with a low BG, carbs
are exactly what an insulin dependent diabetic needs. How else would you get the BG up? It is not
good to leave it between 43-61.
Quoted message said:Quoted message said:Julie Bove Skipping meals can cause BG to go too high.
Quite the contrary. Skipping meals causes the BG to go too low.
Quoted message said:Quoted message said:Julie Bove High readings will kill you slowly and painfully. Low readings usually won't kill, but
they can kill a person who is using insulin.
If the reading is low enough, it can kill anybody. It usually won't get that low, and even if a
person went into shock from a low BG, they generally come out of it as the body starts to digest fat
into glucose. However, it is better not to get that low. Just take some fruit juice, or other source
of carbs to raise the BG when it is low.
