Sugar Diabetes and Insulin

[JanetRose]

When do doctors usually start people with diabetes on Insulin?

 

[golfgal]

When it can't be controlled by diet or exercise.

 

[tasha99]

When it can't be controlled by diet or exercise.

and medication

 

[Cheshire Figment]

If Type 1, immediately. If Type 2, they will try various pills first, probably for a few years, until it becomes necessary. From the time I was diagnosed until I had to start insulin was about eight years.

 

[claudia]

When do doctors usually start people with diabetes on Insulin?

if this is type 2 you're asking about it would be when it can no longer be controlled by oral medication....also if a person has been seriously ill that can affect the sugar levels so they may use insulin for a short period to get it back under control, then go back to the initial treatment that was working....

 

[Toad_Passenger]

When do doctors usually start people with diabetes on Insulin?

Well, I'm a Type I diabetic, and I wasn't allowed to leave the doctor's office after my diagnosis until I could administer myself an insulin shot. So, for me it was immediately.

 

[dakcp2001]

Well, I'm a Type I diabetic, and I wasn't allowed to leave the doctor's office after my diagnosis until I could administer myself an insulin shot. So, for me it was immediately.

Well, good for your doctor! On my home health rotation a patient could not figure out why the insulin wasnt helping her, she was injecting it into oranges- just like they showed her at th Dr office. Yep, these people are out in the world.

 

[DawnCt1]

Well, good for your doctor! On my home health rotation a patient could not figure out why the insulin wasnt helping her, she was injecting it into oranges- just like they showed her at th Dr office. Yep, these people are out in the world.

I have to say, that is not the first time I have heard that. On the other hand, it doesn't hurt!

 

[dizluvah]

As a type II - I recently was switched to insulin because I am pregnant - I will return to oral meds and diet for controlling blood sugar after delivery...

 

[arminnie]

My father had type 2 diabetes for about 20 years, but he never had to use insulin. He died in December at almost 89 from a stroke - but his sugar was still under control with medicine alone.

 

[cybrkitn]

Well, good for your doctor! On my home health rotation a patient could not figure out why the insulin wasnt helping her, she was injecting it into oranges- just like they showed her at th Dr office. Yep, these people are out in the world.

Ok, was she blonde by any chance? I am and have to admint that I have had a few "blonde" moments in my life .

Joking aside, I've only had GD and had to give myself insulin shots b/c I couldn't control it by watching what I was eating (I wasn't on any oral meds). Thankfully, I'm not diabetic now nor borderline.

DH has been diabetic since 1993 and was on oral meds only until last year. His doctor only put him on insulin (at night only) b/c he couldn't get his sugar levels under control. Mostly b/c he refused to watch what he was eating. Even after being put on insulin, he thought he could eat whatever he wanted . I tried telling him he couldn't do that. Needless to say, his insulin units went up to 55 before he finally took control of his diabetes and seeing an Endocrinologist (which IMO is what made the difference along with deciding to change).

About 2 months ago, DH took control of his diabetes and his insulin has been dropped to 45 units plus his oral meds. He's lost about 20 pounds so far and his numbers have been fantastic !

DFIL (who'se in his 80's) on the other hand and currently on oral meds, is about ready to be put on insulin by his doctor. He's not seeing an Endocrinologist and doesn't know how to measure his food, what he should and should not be eating nor eating at the right times. So, his numbers have been too high (I think he was in the 400's on one occassion ). He's been asking DH for help and tells him what he's had and at what times. I've even told him that he can't have breakfast at 7 am, lunch at 4 pm then dinner at 8 pm (which is what he did when he asked me about it). It's spread out too far and is not giving his body a chance to process the carbs for it to go down the next morning. His doctor is giving him a month to control it with diet before he his put on insulin. DH and I have both told him that he needs to see an Endocrinologist so that he can learn how to control his diabetes.

 

[pigletgirl]

I've heard that an internal medicine doctor can control a type II diabetic, until is becomes complicated. However if I were ever diagnosed with the disease I would want a specialist ASAP.

 

[SkyGirl]

I've heard that an internal medicine doctor can control a type II diabetic, until is becomes complicated. However if I were ever diagnosed with the disease I would want a specialist ASAP.

I would have thought the same thing and was shocked at how incredibly smart my own PCP is about Diabetes. I think more and more doctor's have to learn about the disease because more and more of their patients have it.

I inject 55 units of insulin every morning and 45 units every night. I also take pills to combat my Diabetes. Because my pancreas isn't working at all, I'll probably be on insulin injections for the rest of my life. But ... if it keeps me alive and active, I'm very thankful for it!

 

[Eeyores Butterfly]

A lot of PCPs have very outdated information about diabetes unfortunately. I highly recommend anybody who is diagnosed see an endocrinologist at least once. It amazes me how many people are given out of date and just plain wrong information about diabetes by PCPs.

If you are a Type II, they will most likely try a combination of diet/exercise and other medications first. If you cannot control using those medications or diet/excercise, then they will start you on insulin. There is a growing movement toward earlier insulin for Type II diabetics. Some people will ask to go on insulin instead of the medications because the medications can have some negative side effects. It is up to you and your doctor.

 

[cybrkitn]

A lot of PCPs have very outdated information about diabetes unfortunately. I highly recommend anybody who is diagnosed see an endocrinologist at least once. It amazes me how many people are given out of date and just plain wrong information about diabetes by PCPs.

I totally agree. DH's regular doctor did absolutely nothing to help him understand his diabetes except to put him on oral meds . He asked about seeing an Endocrinologist and she told him that he didn't need to see one - WTH!

She went out on maternity leave the beginning of the year and the covering doctor immediately asked him who his Endocrinologist is. When he told her he didn't have one, she told him to find one. He did and what a turn-around! DH just found out last week that his regular doctor resigned and the covering one is taking her place. He's real happy about that.

I just don't understand why any doctor would tell their patient that they do not need to see an Endocrinologist or even suggest that the patient should see one. The regular doctors do not know enough about diabetes (or have out dated info) to help their patients.

 

[Toad_Passenger]

I totally agree. DH's regular doctor did absolutely nothing to help him understand his diabetes except to put him on oral meds . He asked about seeing an Endocrinologist and she told him that he didn't need to see one - WTH!

She went out on maternity leave the beginning of the year and the covering doctor immediately asked him who his Endocrinologist is. When he told her he didn't have one, she told him to find one. He did and what a turn-around! DH just found out last week that his regular doctor resigned and the covering one is taking her place. He's real happy about that.

I just don't understand why any doctor would tell their patient that they do not need to see an Endocrinologist or even suggest that the patient should see one. The regular doctors do not know enough about diabetes (or have out dated info) to help their patients.

I was very lucky that the moment I told my PCP my symptoms, he didn't even have me come in. He immediately sent me to an endo. I'm amazed when I speak to other diabetics (especially fellow Type I's) who don't see an endo on a regular 3 to 6 month basis.

 

[wdhinn89]

Well, good for your doctor! On my home health rotation a patient could not figure out why the insulin wasnt helping her, she was injecting it into oranges- just like they showed her at th Dr office. Yep, these people are out in the world.

I also heard about someone who would inject the insulin into the orange "just like the hospital showed them" and then would eat the orange to get the insulin. The hospital had to change their method of teaching people how to do shots. I was taught using a rolled up baby diaper.

A lot of PCPs have very outdated information about diabetes unfortunately. I highly recommend anybody who is diagnosed see an endocrinologist at least once. It amazes me how many people are given out of date and just plain wrong information about diabetes by PCPs.

I comlpletely agree!!!!

 

[DisneyBamaFan]

...I inject 55 units of insulin every morning and 45 units every night. I also take pills to combat my Diabetes. Because my pancreas isn't working at all, I'll probably be on insulin injections for the rest of my life. But ... if it keeps me alive and active, I'm very thankful for it!

Wow! That is a lot of insulin. My wife is a Type I diabetic and takes less that 30% of that on a daily basis. Have you looked into insulin pumps?

 

[SkyGirl]

Wow! That is a lot of insulin. My wife is a Type I diabetic and takes less that 30% of that on a daily basis. Have you looked into insulin pumps?

I was only diagnosed on March 25th. So far my doctor hasn't said that I need the pump. My endo first prescribed Lantus and Novalog, but my numbers stayed very high with it. The Novalin 70/30 along with 1000 mg. of Metformin twice a day seems to be bringing my numbers down although I still have sudden spikes.

 

[Toad_Passenger]

I was only diagnosed on March 25th. So far my doctor hasn't said that I need the pump. My endo first prescribed Lantus and Novalog, but my numbers stayed very high with it. The Novalin 70/30 along with 1000 mg. of Metformin twice a day seems to be bringing my numbers down although I still have sudden spikes.

These days the pump isn't really a "necessity" for anyone, more than it is a convenience for most. I control my Type I with Multiple-Daily Injections (MDI). I take Lantus in the evenings, and at each meal/snack I take Humalog based on a carbohydrate-to-insulin ratio. I don't mind sometimes taking 4-5 shots per day, since I've been on insulin since Day 1 of diagnosis.

As I've gotten older, though, I may start moving to the pump because I'm not out playing sports or other activities where the pump would have been a nuisance (although, again, the new pumps can be used in all circumstances). The MDI-plan that I'm on pretty much mimics what the pump would do anyway.

Please don't let anyone convince you that you NEED a pump. There is nothing the pump can do for you (beyond taking away the needles) that you can't do with injections.