Tuesday, February 10, 2009 Shirley Chandler asks

Q: When should my doctor add insulin to help contol my blood sugar?

The doctor has recently place me on Janumet to help control my blood sugar. I am now taking 50mg/1000mg twice a day plus 4mg Amaryl twice a day and 30 mg Actos once a day. I am experiencing side effects which my doctor says is caused from the Metformin. I have been taking the Metforming for about 12 years and it seems to have no effect on controlling my blood sugar any more. I tried Byetta for about 3 months and was unable to continue that because of the severe nausea. Wouldn't it be better for the doctor to place me on insulin now, and if not, why not?

Thank you,

Shirley Chandler

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Answers (7)

Cherise Nicole

2/10/09 10:17pm

Shirley-

Hello! I agree with Frank. Insulin is great and in some cases should be the first method of treatment. You are taking a lot of oral meds. I took oral meds for a while. In January of last year I was placed on insulin. Insulin can make you gain weight but it can also help you with tighter control once you get all the carb counting and insulin to carb ratio. I also have to add, being on insulin takes a lot of discipline and patients. You may have to make a few changes until you get the correct dosage down. You should talk to your physician and let them know you would like more information on insulin treatment. You should also make sure it's a covered benefit through your insurance company.

Cherise

Community Moderator

frankenduf

2/10/09 5:22pm

This question is a little odd in that the 'insulin as treatment of last resort' paradigm exists because presumably nobody wants to take insulin- that is, if a patient is ok with starting on insulin, it likely should be started relatively early in diabetes treatment, as it is more potent with less side effects than the drugs- however, the main drawback of insulin treatment is weight gain- so, if you've lost weight and your sugar is high, it's a no-brainer to start on insulin- however, if you've been gaining weight, you may want to hold off on insulin until you've tried diet and exercise to actively lose weight- other reasons not to take insulin are kidney problems (which presumably you don't have because of the metformin), hypoglycemic unawareness, and insulin sensitivity

Susan

2/12/09 6:37pm

The doctor has me on januvia and glupizide. Should I be on something different because they are not controling my blood sugars very well.

Dick

2/12/09 10:26pm

I'll bet that there are MILLIONs of Type 2s who are languishing on oral meds . . . should have been started on insulin YEARs ago. I got off the orals before all my Beta cells were burned out = makes it a lot easier to control BGs when you do start on insulin.

IMHO if you have been messing around with different combinations of oral meds and your A1c is >7.5, it's time to start insulin. You may be the one who has to insist on it . . . after all, it is your life. Insulin injections (ouchless) or a pump is the ultimate way to control BGs.

Insulin is GOOD . . . it is absolutely critical for non-diabetics as well. If our own Beta cells aren't making enough, we can help out . . . makes sense to me.

Sharon

2/13/09 1:28am

Shirley this is just my opinion, but when I was diagnosed 9 years ago, they put me on pills, metformin, gilpizide, I took mysel off that one, it was horrible. Got a good endo who just immediately put me on insulin, it's the best thing since white bread, no dire warnings about the effects of all the oral medications, much better control and much less danger than from oral medications, I heartily endorse insulin, it is up to you, but you can ask your doctor to put you on it, Too many class action suits against too many of the oral drugs, do some reaserch online, you will be appalled!

Sharon

pickett2008

2/13/09 11:51am

yes if none of the pills are helping then yes insuin is the next step iam type1 diabetic and iam on insuin i tryed pills and they didnt help

Judi Hughes

2/18/09 11:36pm

I'm a type 2, had gestational diabetes 9 years ago and I had a difficult time controlling - was on two types of insulin 4 times a day! Fortunately, I delivered a healthy 7# boy! My PMD took me off the insulin right after delivery, and wasn't at all concerned about my irratic blood sugars, and refused to allow A1c's. After my husband died and I had to move to a medically underserved area, I have been on Metformin, Actos, ActosPlusMet with very poor results. New health care provider - A WONDERFUL PA, who IMMEDIATELY asked if I would consider insulin, to which I said, "Can we start today?" Now am on Levemir - I FEEL GREAT, AND LOST 12 POUNDS IN THE PAST MONTH!!! We are still working on the right dose, but boy oh boy, I WISH I HAD STARTED INSULIN SOONER!!!!

INSIST ON INSULIN NOW!!!

Q: When should my doctor add insulin to help contol my blood sugar?

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