American Diabetes Association Guide to Insulin and Type 2 Diabetes. Marie McCarren
was having nighttime lows. I switched my dosage times and am now taking two shots of NPH instead of one. This has really helped me! I take 6 units in the morning and 3–4 units in the evening, usually around supper.
What You Might Be Thinking: “I’m not confident I could handle the demands of insulin therapy.”
Try This: Make an appointment with a diabetes educator (see Prep Before You Go). You’ll leave feeling much more confident.
SUBJECT: LEARNING INSULIN IS EASY
FROM: D3
Yes, you have to learn to give an injection and to deal with the specifics of how the insulin you are given is used. But if you can do your BS readings, an injection is not that hard. Good luck and dry those tears.
FROM: MM4
You will have to learn to count carbs if you don’t do this already. If you haven’t been to a diabetes education class, now is the time to get signed up. The diabetes educators can teach you all of the things you need to know when you are on insulin. Hang in there. This isn’t the end of the world. The damage caused by uncontrolled diabetes is far worse than inconvenience of an injection.
What You Might Be Thinking: “Insulin therapy would mean I had failed, that I hadn’t done a good enough job taking care of my diabetes.”
Truth: As you get older, your pancreas makes less and less insulin. It’s not your fault; it’s the natural progression of the disease. You need to use insulin now.
SUBJECT: INSULIN IS NOT A SIGN OF FAILURE
FROM: MM4
OK, are you feeling defeated, that diabetes has won out, that taking insulin is the worst thing that could happen to you? Join the club. Most of us had the same feelings and yet, every day that I am on insulin, I count my lucky stars. And you are probably saying right now, “This person is nuts!” I felt so defeated when my doctor first suggested insulin.
I’d done so well for so long that this just seemed like the end. I tried one more oral med for four months and, with my A1C still going up, made the decision to accept the doctor’s recommendation.
FROM: D3
Too often I see patients and Drs staying with oral meds too long because many feel like going to insulin is akin to admitting to failure. It really should not matter how (which treatment option) a person chooses to get and maintain control of their BS, only that control is maintained. But sadly some Dr’s use insulin as a threat.
Do not forget this is a progressive disease. Sometimes you can do everything right—eat right, exercise, lose the weight, take your pills—and the pancreas still gets tired, insulin production drops, and no amount of stimulation works. That is when you have to move to insulin.
What You Might Be Thinking: “Once you start insulin, you can never quit.”
Truth: This is true for most people. A few people are able to stop using insulin. A person might be very insulin resistant because he or she is very overweight. If he loses a lot of weight, he might not need to use insulin. Some people have very high glucose levels when they are first diagnosed. They may need insulin at first. This will relieve the effects of high blood glucose. Then they may able to control their diabetes without using insulin for a time.
What You Might Be Thinking: “I’ll get fat.”
Truth: Studies show that when people keep taking metformin when they add insulin, they often don’t gain weight. Without metformin, average weight gain is 5–10 pounds. Don’t refuse insulin because of possible weight gain. Your high glucose levels are doing more harm than gaining a few pounds will.
SUBJECT: INSULIN DOES NOT EQUAL FAT
FROM: MM4
You might gain some weight, but it really comes down to what you eat. Generally, if you’re on insulin, you feel so much better that eating kind of becomes fun again. It’s not automatic that you gain weight on insulin—it’s up to you to continue to manage your diabetes with a good diet and continued exercise.
FROM: Hml
Insulin itself doesn’t make you gain weight; it just frees you up to eat a little more like you shouldn’t. It’s still all about spending more calories than you take in.
FROM: VV
I was on a steady losing streak with my weight until I went on insulin (Lantus and Humalog). Since then I have lost only a minimal amount. I feel so much better though and know this is simply because my body is better using the food that I eat. With regular exercise and good eating I do continue to lose weight, although VERY slowly. Probably about three pounds in the last three weeks. It can be frustrating, but I try to concentrate on how much better I feel and how much healthier I am.
FROM: g3
The weight gain is only when you get the dosage incorrect. You will get an urge to eat whenever you get either a low BG or can’t tell if you are full because you won’t get the BG spike that triggers fullness. If you eat bulky foods such as root vegetables, then you will get another trigger for fullness. Watch your diet and you won’t gain weight.
FROM: BK
Regarding the shorter-acting insulins, you do have to be careful not to “cheat” more because you can dial up a higher dose to cover the indiscretion. Having said that, on the few occasions when I did eat a bit more than I should, it’s been great to have the insulin to help. Good luck to you!
FROM: BA
Be extremely rigorous in portion control! Many of us have a really hard time estimating portion size by looking at it. Never mind the deck-of-cards and ping-pong ball comparisons. Weigh or measure the food. I was following my RD’s plan and not losing weight. She said, “You are eating all the right things—now tighten up portion control.” I bought a kitchen scale and began using it. Lo and behold, I also began losing weight. Try it for a few weeks and see if it makes a difference.
FROM: dec
I take 42 units of Lantus at night, with Humalog for sliding scale/carb covering, and 1,000 mg of metformin each night. I have been losing five pounds per month. I started at 20 minutes on the treadmill, and over time increased it quarter mile by quarter mile. Now that I’m steady on 30 minutes, the next thing will be to increase the incline so my body is doing more work.
As far as diet, I count carbs but not calories. I try to balance the carbs (the good ones, you know) with protein and with good fats. Everything in moderation. My approach is one of continual small changes/improvements, so I don’t feel deprived.
The exercise is what’s tipped the balance for me. I haven’t radically changed my eating habits since buying the treadmill, except for switching to 2% milk in my almost-daily Starbucks lattes.
Total weight loss is 65 pounds so far. Type 2 diabetes dx was the “rock bottom” for this little food addict, and I’ve been climbing back to redemption ever since.
FROM: fha
I’ve read that diabetics have energy-efficient metabolisms. This means we can survive on fewer calories, which is great in a famine, but not so great in a feast. So it doesn’t really matter what meds we’re on, an energy-efficient metabolism will cause us to gain weight if we eat more than we burn, and we burn slower than most. It helps me to think of it that way.