Insulin/Glucovance Question

[Tash]

After reading Dr. Atkins book , I talked to my endocronologist about the insulin test and explained him of what I read.
His response was that type 2 diabetic is always a 2 fold problem, first that your pancreas is not producing enough insulin and second your cells are resistant to it that is why he is treating it with Glucovance.
After reading lot of posts here now I am thinking :

Is it possible to be type 2 diabetic while your pancreas still produces enough insulin. I mean how does the doctor know without the test?

Second question is Do I have to quit Glucovance (as it has glucotrol in it) if I want to lose weight. I am on 2nd day induction and was wondering if there was anyone who did not have any problem with glucovance.

By the way I take 4 tablets/ day (2.5/500)

thanks, this site is the BEST

[wsgts]

What I was told is that there is enough insulin, actually too much insulin. Your body is ignoring the insulin you make or most of it, or it could be a combination of both, but more than likely, there is nothing wrong with your pancreas.

I guess it could be argued that because your blood sugar is not low enough, then the pancreas is not producing enough insulin, even if it is producing twice what is normal, so in a sense, it can always be true that the pancreas is making not enough. The question is how to handle it. So you are right, your doctor is guessing. But in reality, he/she would not treat it any differently if there was or was not enough insulin to do the job.

Most everyone currently agrees that the way to handle this is to try and treat the disease (insulin resistance) and not the symptom (high blood glucose).

There are many insulin "sensitizers" out there that work very well, and allow you to reduce you insulin level as well as your blood glucose level, which will in turn allow for weight los. I have personally been on Glucatrol, Glucaphage, Glucaphage XR, and Actos all at different times.

Glucaphage will help you to lose weight, no question, it has been proven in clinical trials. Actos is what I am currently on, and it has been a very easy medication to take with no noticeable side effects (you can see my eariler post on it).

Have you been a Type II long? Have you had a lot of trouble with blood glucose control?

Later,
wsgts

[Tash]

thanks for your quick response.
I have been type 2 diabetic for about 2 years now. My A1c used to be between 8.2 to 8.4 for the first year. Then in Sept of 2002
it was down to 7.6.
This test was alwasy done in the lab except for the most latest one. This last one was done in the doctor's office in about 15 minutes and that came to be very high 10.2. Granted I went on vaccation out of the country plus I have been eating some icecream from carvel, but whenever I used to test my blood sugar it wasn't used to be out of control that much. I would be getting
anywhere from 105-140 fasting and after 2-3 hrs of eating it would be 180. It was always high after eating because being where I am from our diet is mostly Bread and Rice which are no no to my condition.
But once I take the medication in the morning at 9 AM with breakfast (includes carb) I have to eat something by 3 PM otherwise my blood sugar would drop to the lower 50's and continue downward.
I am 30 lbs overweight and I really want to control my diabetes that is why I have decided to go atkins and hopefully continue low carbs throughout my life.
thanks for your help, it is greatly appreciated.

[4EVERTHIN)]

Dear Tash,
I too have type 2 diabetes and was on the same dose of glucovance as you-now I am only taking one pill a day -the lowest dose-thanks to this way of eating-but you must be very careful - test your blood sugar as often as you can-I had to tell my doctor that I was getting low blood sugar after just 3 weeks on this diet-and after he tested me and saw ALL my numbers were low he decreased my meds. Now that I have lost about 30 lbs. I only take one pill in the morning and I am still getting low readings around 60-70 before lunch so I am hoping to get off all meds soon. This diet really does work-if you give it all you've got -especially in the beginning-just remember watch out for low blood sugar- May God bless you in your effort to beat this nasty disease. Let me know if I can help :) :wave: :wave: :wave:

[wsgts]

You are definetely in a Catch 22 situation. To keep from going to low, you have to eat carbs, to keep from blood sugar getting too high, you can't eat carbs. I am really amazed you are able to keep 8.2 to 8.4.

Now, for a plan of action for you. Does your doctor know about the lower 50's measurement? What was his/her advice? I hope it wasn't "eat more sugar to keep BG up" (see the catch 22 here). The eat more sugar is not a solution, it's a beginning of a train wreck.

I am guessing your problem is the medications that produce more insulin. From what you are saying, you and I aren't that far away from one another as far as what the effects of carbs/sugar are on our bodies. Most of the time (except for the last time), I have been at 5.5 - 6.1 on my HbA1c, and that is usually the point the doctor's remove all meds from you.

So, I feel sure you can get there to perfect control, but you will have get rid of the insulin producer and make do with whatever insulin you can make (with the aid of sensitizers of course) your cells use.

One other thing, don't expect that when you get to your goal weight that you will be able to go back to eating bread and rice, it's not going to happen. You will need to keep some form of low-carbohydrate comsumption from now on, and it will be very possible that you will be off meds, and have perfect control.

How have your sugars been these last couple of days?

Good luck,
wsgts

[Tash]

thanks for your quick response.
As you said that you were on the same dosage, was it hard for you to lose the weight at the beginning as this is what I have read on these posts.
I guess I'll find it out soon:)
thanks

[Tash]

Originally posted by wsgts


How have your sugars been these last couple of days?



Today I took 1 pill in the morning and one at dinner time (thats half of my usual dosage). And I just checked my blood sugar after 2 hrs of dinner and it is 105 (wow, i haven't seen that after dinners at all).
I will be calling my doctor tomorrow and talk to him.
thanks for all your suggestions

[MsTCB]

"Is it possible to be type 2 diabetic while your pancreas still produces enough insulin. I mean how does the doctor know without the test?"

To answer your question: Yes, it is possible to have type 2 diabetes while your pancreas still produces plenty pf insulin.
Mine does.

My doctor explained that the "tell-tale" sign of diabetes is that the body has an EXTREME OVER-REACTION to CARBS. My blood test showed that just 30 min. after I ate, even a low-carb meal, my B.G. was 300. THAT is what happens to a diabetic. It's the SPIKE in B.G. that happens after we eat even a TINY amount of carbs.

It's only after years and years of untreated high blood sugar that the pancreas will eventually "burn out" and stop producing enough insulin.

Hope this helps.

[Tash]

Originally posted by MsTCB
"To answer your question: Yes, it is possible to have type 2 diabetes while your pancreas still produces plenty pf insulin.
Mine does.

.

thanks for your reply. I guess that you must not be on any medication that makes the pancreas produce more insulin. Did your doctor suggest by himself for you to have an insulin test to determine this or ?

I do not know why so many doctors do not tend to think this way and always assume that pancreas is not producing insulin without any tests. I am just amazed at this. Perhaps there is a good medical argument to support their thinking, I hope there is, otherwise it just does not make any sense.
I am going to talk to my endocronologist once more if it doesn't help I'll just go back to my internist and hopefully he will approach it another way.
thanks

[MsTCB]

Yes, my doctor checks my insulin level every time he tests for my blood sugar(Halc).

Since 1995 I have gone through 4 different endocrinologists and I wasn't adequately treated by any of them.
Last year, in August, I FINALLY found a family practice doctor who has done a much better job of helping me.

I don't take anything to make my pancreas produce more insulin. I take Glucophage XR 2,500 mg a day.
Also, I just started a new medicine this week called Precose that I take right before each meal.
My doctor explained that it binds to the stomach lining and pulls the sugar out of my food and "holds" it there and then slowly releases the sugar out into the bloodstream. That way the pancreas isn't bombarded with the big blood sugar SPIKE. The pancreas doesn't get overburdened and can handle the blood sugar.

I agree; it's not right that they assume that you can't produce enough insulin without testing for that fact.

Also, my doctor is strongly against giving a Type 2 diabetic any insulin while you body still produces it. He said that studies show that in the long run, the extra insulin will cause more damage to organs than if the high blood sugar had been left untreated.

[wsgts]

The doctor I am seeing now is a General Practioner. He has been very helpful, and has even told me he doesn't usually treat anyone my age or my activity level with Type II (mostly old people).

So, it was kinda funny, when I went in because I couldn't get my BG down the first time, he asked me what amount of Glucaphage I was on last time.

I said 500 mg, and he then said "Ok, I think we should try 1000mg for a while....", he stopped and was waiting for my approval to the suggestion :) . I said that would be fine, just get them for me in 500mg xr tablets so I could take one when the day came.

After a couple of lows (68 on 500 and 57 on 1000) he gave me Actos 30mg samples (no cost to me) to see if those helped.

I am going to 15mg on Monday (notice I didn't say ask him about it), as my largest BG of the day is now 123 (in the morning) for the last three days.

Later,
wsgts

[Sherrielee]

I have been reading up on these drugs...as I will most likely be on one of them next week. I found this rather disturbing article on Actos:

http://defective-drugs.owenpatterson.com/actos.html

[wsgts]

I will have my doctor do a liver enzymes with my next hba1c. Would have to get Actos up because of it being unsafe.

Later,
wsgts

[c6h6o3]

Originally posted by MsTCB

Also, my doctor is strongly against giving a Type 2 diabetic any insulin while you body still produces it. He said that studies show that in the long run, the extra insulin will cause more damage to organs than if the high blood sugar had been left untreated.

Dr. Bernstein might disagree with that. Have you shown your endo the book? Dr. B. often prescribes insulin for Type II diabetics in order to take some of the load off of the poor pancreas and slow the progression of beta cell burnout.

And I'm sure he would say that absolutely nothing ravages the organs over the long term as much as chronically high blood sugars. Certainly not insulin.

It sounds like you haven't read the book. It's indispensible that you do so if you haven't.