Oral Medications for Diabetes

[RobLL]

There may be some cases where the new 'wonder diabetes' oral drugs are helpful. But almost all of the new oral drugs have been found to have side affects which are more serious than the help they offer most patients. Avandia has just been found to be associated with osteoporosis. Two others may contribute to heart disease. Another affects the immune system, in a way which could be dangerous to those with certain cancers (of which, I have been treated for). Another (inhaled insulin) has been withdrawn because it didn't sell well enough (and didn't work all that well, anyway).

Most of them resulted only in small improvements in A1Cs, and not much help with BGs. This is not to say that maybe each provide benefits to certain users. But doctors, including U of WA Diabetic Clinic, have touted them for all sorts of benefits which simply never have materialized. I have told my doctor no oral drug which has not been out for 5 years in the general diabetes population, exception of course should it be the only drug and can do what I need. Might we want to have a general thread on oral drugs and report how they were really helpful, a little helpful, not at all, or with bad side affects?

http://www.phlaunt.com/diabetes/ I included this because she has a section on oral drugs

[dancinbr]

There may be some cases where the new 'wonder diabetes' oral drugs are helpful. But almost all of the new oral drugs have been found to have side affects which are more serious than the help they offer most patients. Avandia has just been found to be associated with osteoporosis. Two others may contribute to heart disease. Another affects the immune system, in a way which could be dangerous to those with certain cancers (of which, I have been treated for). Another (inhaled insulin) has been withdrawn because it didn't sell well enough (and didn't work all that well, anyway).

Most of them resulted only in small improvements in A1Cs, and not much help with BGs. This is not to say that maybe each provide benefits to certain users. But doctors, including U of WA Diabetic Clinic, have touted them for all sorts of benefits which simply never have materialized. I have told my doctor no oral drug which has not been out for 5 years in the general diabetes population, exception of course should it be the only drug and can do what I need. Might we want to have a general thread on oral drugs and report how they were really helpful, a little helpful, not at all, or with bad side affects?

http://www.phlaunt.com/diabetes/ I included this because she has a section on oral drugs

Jenny is always a great source of information.

I think you have a good idea.

Also, as we all have witnessed in the past, the same drug works for some and not for others.

The other important thing to remember is all the side effects of a drug are listed but many are rare. So, don't be scared off by the side effect listing. If you read all the pamphlets of some of the Rx's we take, you would never take anyone of them.

Now, the natural remedies folks would say yes to that! However, so many natural remedies are over sold too and we don't know what, if any, these "natural" remedies will have and there have been horror stories.

So long story short, sharing our experiences is a great idea.

Ralph

[eddiemcm]

My experience with prescription meds for diabetes:
1.Glyburide,a sulfonylurea,worked well keeping my
FBG and A1C low.I didn't like the fact that it left
excessive insulin flowing in my body that caused
several hypo episodes.I quit taking this one
2.1500 mg of Metformin ER is marginally effective.I am still taking this one
3.Avandia worked great but I was leery of the fluid buildup on my heart(I have a slightly enlarged heart)so I quit this one
4.Actos didn't work at all for me so I retired it
after a month
5.One 10 mg Glipizide ER pill each morning works fine.It is not supposed to cause a lot of
excessive insulin flowing in the body.It only
stimulates the pancreas when glucose level is high.
That's my experience with diabetes meds
Eddie

[ShesGG]

Byetta isn't an oral med but it isn't insulin so I will list it here

Metformin - 1000 x 2, still on it but it doesn't do the job on it's own. no bad side effects anymore but I don't think it works well enough for me.
Amaryl - 2 mg, stopped it. It burns out beta cells.
Byetta - 10 mg.., stopped it 2 weeks ago after another episode of nausea, vomiting and generally lying around in bed all day.

Januvia sounded promising but after reading the warnings, I don't know if I can risk it.

I am hoping for successful stem cell transplants within the next couple of years then we won't have to worry about all of this.

[eddiemcm]

"Amaryl - 2 mg, stopped it. It burns out beta cells.'
Have never seen one study that proves sulfonylurea meds burn out beta cells.
Some of them do however cause episodes of
hypoglecemia unless the carb intake and dosage
is perfectly balanced(same situation with insulin).Incidently Januvia causes the pancreas
to produce excess insulin like the sulfonylurea
meds except Januvia is only supposed to do this
during a carb challenge(same claim for glipizide).
Eddie

[ShesGG]

"Amaryl - 2 mg, stopped it. It burns out beta cells.'
Have never seen one study that proves sulfonylurea meds burn out beta cells.
Some of them do however cause episodes of
hypoglecemia unless the carb intake and dosage
is perfectly balanced(same situation with insulin).Incidently Januvia causes the pancreas
to produce excess insulin like the sulfonylurea
meds except Januvia is only supposed to do this
during a carb challenge(same claim for glipizide).
Eddie

They stimulate the pancreas for insulin release. You want medication that will save beta cells and not prod and push your pancreas for however long you can while research is being done on drugs that will actually work or perhaps stem cell transplants that will cure this lousy disease.

Amaryl and Byetta never even worked that well on my numbers after the initial few weeks. All hat, no cattle as they say...

I'm not trying Januvia either until they show solid evidence that your skin isn't going to pull away from your body... Ick.

Sorry, it just seems that we should be further ahead in diabetic research. It's a killer disease. I really don't want medication that will cause more complications than will help people.

[Charran]

I looked back at the time when I was taking Metformin. At the time, I really thought it was working for me to reduce my BG, but now that I look at the HBA1C results, I was at 6.4. My doctor took me off of it at that point and I went with just diet and exercise and was down to 5.8 last time I had it done, so I guess in retrospect, it didn't help all that much. I didn't have any side effects from it that I know of. I had started off on 5 pills a day, then slowly decreased over time to 1 a day. Now I'm on nothing and doing OK I think.

[ShesGG]

I looked back at the time when I was taking Metformin. At the time, I really thought it was working for me to reduce my BG, but now that I look at the HBA1C results, I was at 6.4. My doctor took me off of it at that point and I went with just diet and exercise and was down to 5.8 last time I had it done, so I guess in retrospect, it didn't help all that much. I didn't have any side effects from it that I know of. I had started off on 5 pills a day, then slowly decreased over time to 1 a day. Now I'm on nothing and doing OK I think.

Congratulations. That is what I am hoping for but I think I am going to need some insulin overnight and into the morning. I'm trying to get the numbers down but it hovers right around 140 from 3 am to about 11 am.

My a1cs are in the mid 6% and I am trying different approaches for overnight but nothing is really helping.

[Charran]

You just have to keep trying different things I guess. I get a bad morning reading some days and have tried different things too. I haven't found anything that works consistently though.

[ShesGG]

You just have to keep trying different things I guess. I get a bad morning reading some days and have tried different things too. I haven't found anything that works consistently though.

Last night I ate some protein before bed and it was in the low 130s this morning but I agree that nothing works consistently.

I am reading now that your blood sugar should always be below 120 for good heart health.

I've been working out but maybe I have to work out harder, I don't know.

This sucks... :p

[Charran]

Yeah, I hear you and it DOES suck big time. It's all such an experiment sometimes. For awhile one thing will work and then another. It's hard, but what choice do we have but to keep working at it?

[eddiemcm]

"They stimulate the pancreas for insulin release. You want medication that will save beta cells and not prod and push your pancreas for however long you can while research is being done on drugs that will actually work or perhaps stem cell transplants that will cure this lousy disease."
Repeat my original statement.No study shows
sulfys or any other med that causes pancreas
to put out more insulin kills beta cells.Sounds like more unproven Bernstein wisdom.
Eddie

[ShesGG]

"They stimulate the pancreas for insulin release. You want medication that will save beta cells and not prod and push your pancreas for however long you can while research is being done on drugs that will actually work or perhaps stem cell transplants that will cure this lousy disease."
Repeat my original statement.No study shows
sulfys or any other med that causes pancreas
to put out more insulin kills beta cells.Sounds like more unproven Bernstein wisdom.
Eddie

When I was first diagnosed, I was sent over to the hospital to join about 20 others to get educated on diabetes. They told everyone about the carb choices, how many of the choices you got for each meal, etc..

That was the most misinformation I have received to date concerning my diabetes. Right now, I feel that Bernstein is helping, it is the first time I have thought that since being diagnosed. The Byetta was the last straw for me. I have never been so sick on anything in my life. I had to take time off of work and I am not one to do that.

We do get misinformation from our doctors but I'm not so sure they can keep up with all of the bad side effects these drugs have after being researched forr so little time. The drug companies just want to get this stuff out there to make money off of hopeful diabetics as soon as possible. Because we hate this disease, we buy it, hoping it will work.

I question anything that works directly with the pancreas. My doctor said it works directly with the food. How simple minded is that?

[ShesGG]

Yeah, I hear you and it DOES suck big time. It's all such an experiment sometimes. For awhile one thing will work and then another. It's hard, but what choice do we have but to keep working at it?

We don't have any choice but to continue the fight and I do feel much better now that I am low carbing and getting some really good advice from people here. :)

To me, dealing with diabetes is a little like when I was having a baby. Halfway through labor, I wanted to stop, change my mind, but there was nothing else I could do but to move forward.

It's better when we have people just like you to talk to about it.

[dancinbr]

Congratulations. That is what I am hoping for but I think I am going to need some insulin overnight and into the morning. I'm trying to get the numbers down but it hovers right around 140 from 3 am to about 11 am.

My a1cs are in the mid 6% and I am trying different approaches for overnight but nothing is really helping.

Try a glass or two of red wine in the evening.

It has an effect of "paralyzing" the liver and thus slowing down the liver in its morning effort of injecting more glucose into your blood. The dawn effect.

I have done this and I have seen this work.

There was a whole thread on this somewhere. Need to go back and look. It may have been under the Dr. Bernstein forum....

Need to retrieve my password from the site. I will take a look and report back

[dancinbr]

I know that not everything Dr. Bernstein says is gospel. However, he is a first person example of how many approaches do help or not help a person; especially himself.

The other aspect that should also be seriously considered and there are no studies on this either from what I can gather is what is an acceptable A1C.

The ADA would have you believe anything below 7.0 is fine. Most doctors, including my own are happy with anything under 6.0 or as many call it the 5's club. Mine is 5.4 right now.

But normal people without diabetes have A1C's belowe 5.0 or in the 4's.

Like from 4.2 - 4.6 roughly equating to BG readings in the 80s on a continual basis.

The thought I am having is perhaps going on a basil insulin like some have done in this forum (MizKitty and others) and getting more consistent readings below 100 and a lot in the 80s and an A1C under 5.0. We are trying to approach being normal with some sort of treatment.

There are many people who have been diabetic and manage to stay in the 5's club and have enjoyed life without diabetic side effects as well. So I understand the good feelings about managing your diabetes into the 5.0 - 6.0 range. But, the ideal might be under 5.0 for an A1C.

So maybe basil insulin is a good idea for T2 diabetics. I can control my curve with the theory of small numbers as Dr. Bernstein says it. I do my best to get close to 6-12-12 but most of the time I am more like between 30-60 carbs total per day, but the small number theory of carbs definitely prevents BG spikes and I have seen them when I have misbehaved. This is NOT good behavior.

I have also found that misbehaving for awhile can unsettle your numbers for awhile and it takes time to get them back down into the low 100s or under again.

Enough.

Ralph

[ShesGG]

Try a glass or two of red wine in the evening.

It has an effect of "paralyzing" the liver and thus slowing down the liver in its morning effort of injecting more glucose into your blood. The dawn effect.

I have done this and I have seen this work.

There was a whole thread on this somewhere. Need to go back and look. It may have been under the Dr. Bernstein forum....

Need to retrieve my password from the site. I will take a look and report back

Now THAT is something I hadn't thought of. I used to eat about a quarter of a sour apple before bed and that seemed to help. Not sure why I stopped that, maybe I got complacent.

[RobLL]

I carelessly let myself be switched from extended release to regular Metformin, and upped the dosage to 2000 mg. My Acid Reflux is STILL bothering me two weeks later, and I am taking OTC Prilosec and PepticAC generic and Tums. I am seriously considering going off Metformin ER. It had been three years since it last bothered me. I am pretty comfortable using insulin now, and don't need very much.

[eddiemcm]

Yeah,red wine will keep the liver from making glucose for awhile.It has to try to deal with the
alcohol/poison.I drink red wine also-sometimes
a bit of scotch.
Eddie

[ShesGG]

I carelessly let myself be switched from extended release to regular Metformin, and upped the dosage to 2000 mg. My Acid Reflux is STILL bothering me two weeks later, and I am taking OTC Prilosec and PepticAC generic and Tums. I am seriously considering going off Metformin ER. It had been three years since it last bothered me. I am pretty comfortable using insulin now, and don't need very much.

What kind of insulin do you take? I truly believe that if I can somehow get my DP and morning highs under control, I won't need much either.

[ShesGG]

Yeah,red wine will keep the liver from making glucose for awhile.It has to try to deal with the
alcohol/poison.I drink red wine also-sometimes
a bit of scotch.
Eddie

I don't think I've had alcohol in at least 3 years. I had a glass of wine at my niece's wedding about a year ago and it really affected me. I got up in the middle of the night and my legs were really wobbely. Maybe my sugar was really low, I don't think I was drunk, I was walking around at the wedding and dancing.

It was weird.

[eddiemcm]

"I don't think I've had alcohol in at least 3 years."
Probably a wise decision,ShesGG.I've always been a
bit skeptical of the benefits of red wine though I
don't claim to be certain one way or the other.
Cheers to all
Eddie

[ShesGG]

"I don't think I've had alcohol in at least 3 years."
Probably a wise decision,ShesGG.I've always been a
bit skeptical of the benefits of red wine though I
don't claim to be certain one way or the other.
Cheers to all
Eddie

Yeah, with my luck, I would end up with high blood sugars anyway and cirrhosis of the liver to boot. :lol:

[RobLL]

What kind of insulin do you take? I truly believe that if I can somehow get my DP and morning highs under control, I won't need much either.

I have taken Regular insulin, 3 injections a day, about 20 units a day. My doctor wanted me to use Lantus, and I started up at 5, and he has told me to go up gradually to 16. I actually am taking 17, and think it should be 20. Most of my readings are between 95-115, about 5 over my goal. After I am consistently at goal, I want to drop by increments of 5 until most of my readings are 80-100.

[dancinbr]

I have taken Regular insulin, 3 injections a day, about 20 units a day. My doctor wanted me to use Lantus, and I started up at 5, and he has told me to go up gradually to 16. I actually am taking 17, and think it should be 20. Most of my readings are between 95-115, about 5 over my goal. After I am consistently at goal, I want to drop by increments of 5 until most of my readings are 80-100.

Hi RobLL - I am assuming you are T2. You probably said it somewhere. I am thinking of asking my physician to write a prescription for Lantus as well.

That is the basil insulin, correct? I have done some reading need to do more on the topic. You do 3 injections per day rather than one at bedtime? I need to learn more about it. Going back to Dr. B's book and reading up on insulin injections and techniques. I do remember the idea of starting at a low dose and slowly, over time, working the dose up as you seem to be doing to get it to the 80-100 range.

Thanks.

Ralph

[dancinbr]

Yeah,red wine will keep the liver from making glucose for awhile.It has to try to deal with the
alcohol/poison.I drink red wine also-sometimes
a bit of scotch.
Eddie

I gather you never drink any alcohol, OK.

I do.

I am still here and my liver is fine !! :D

My tryglicerides are low and so on and so forth.

There are so many poisons in this world.

Ralph

[ShesGG]

I have taken Regular insulin, 3 injections a day, about 20 units a day. My doctor wanted me to use Lantus, and I started up at 5, and he has told me to go up gradually to 16. I actually am taking 17, and think it should be 20. Most of my readings are between 95-115, about 5 over my goal. After I am consistently at goal, I want to drop by increments of 5 until most of my readings are 80-100.

I am going to ask my Dr. for Lantus if I can't get my numbers down by other means before I see her in January.

I hate to ask personal questions but any side effects with Lantus? There are so many to choose from...

When I take the first dose at night, I will probably stay awake to make sure I don't go too low. :)

[RobLL]

Hi RobLL - I am assuming you are T2. You probably said it somewhere. I am thinking of asking my physician to write a prescription for Lantus as well.

That is the basil insulin, correct? I have done some reading need to do more on the topic. You do 3 injections per day rather than one at bedtime? I need to learn more about it. Going back to Dr. B's book and reading up on insulin injections and techniques. I do remember the idea of starting at a low dose and slowly, over time, working the dose up as you seem to be doing to get it to the 80-100 range.

Thanks.

Ralph

Lantus is taken only once a day, it evidently has an unusually even release with no peaks at all, or so doc and the info sheet claim. With the exception of not so good FBG I was getting pretty good results with Regular insulin, which is what I took three times a day, and before each meal.

advantage Regular: cost at Walmart $23 a vial (1000 units) disclosure: I live in Chehalis WA, Walmart has been under water, the freeway to get to Walmart was 10 feet under water.

advantage Lantus: one injection a day, and with it I stay amazingly close with my BGs. Disclosure, this only works when I hew to my very low carb diet. Yesterday my wife and I toured the freeway flood sites, I had forgotten to eat breakfast, and ate Safeway deli stuff plus a cookie. This was probably moderate to low carb - BGs were 167 two hours later. It had been several weeks since I went that high.

I solved the 167 by taking 2 units of Regular, Lispro would have been better and faster.

[eddiemcm]

"I gather you never drink any alcohol, OK."
Ralph
I drink red wine almost every day.I will sometimes
have a few shots of scotch on a party night.
Like you,my blood parameters are good.
The following has really helped my glucose
readings:
1.10 mg of Glipizide ER taken early in morning
2.One or two Natrol carb intercept pills right before a carb challenge
I think I will try the 30 mg carb program for a month in January,2008 to see what it does for my numbers
Happy holiday season to all
Eddie

[ShesGG]

Lantus is taken only once a day, it evidently has an unusually even release with no peaks at all, or so doc and the info sheet claim. With the exception of not so good FBG I was getting pretty good results with Regular insulin, which is what I took three times a day, and before each meal.

advantage Regular: cost at Walmart $23 a vial (1000 units) disclosure: I live in Chehalis WA, Walmart has been under water, the freeway to get to Walmart was 10 feet under water.

advantage Lantus: one injection a day, and with it I stay amazingly close with my BGs. Disclosure, this only works when I hew to my very low carb diet. Yesterday my wife and I toured the freeway flood sites, I had forgotten to eat breakfast, and ate Safeway deli stuff plus a cookie. This was probably moderate to low carb - BGs were 167 two hours later. It had been several weeks since I went that high.

I solved the 167 by taking 2 units of Regular, Lispro would have been better and faster.

Do they have a fast acting Lantus? On the conference call, Dr. Bernstein was talking about a fast acting (I thought he said Lantus) to control just DP and the morning hours of high numbers. A half to one unit before bed and in the morning to start.

My BS is 84 right now and it stays pretty low throughout the afternoon and evening hours.

[RobLL]

Do they have a fast acting Lantus? On the conference call, Dr. Bernstein was talking about a fast acting (I thought he said Lantus) to control just DP and the morning hours of high numbers. A half to one unit before bed and in the morning to start.

My BS is 84 right now and it stays pretty low throughout the afternoon and evening hours.

NO, Lantus is meant to be all day acting

most rapid acting: Aspart, Lispro, Glulisine, US brand names Novolog, Humalog, Apidra
rapid acting: Regular, US Brand names: Humulin R, Novolin R
Intermediate acting: NPH, often called N, US Brands Humulin N, Novolin N
Long acting: Detemir, Glargine, US Brand Names, Levemir, Lantus

[dancinbr]

Do they have a fast acting Lantus? On the conference call, Dr. Bernstein was talking about a fast acting (I thought he said Lantus) to control just DP and the morning hours of high numbers. A half to one unit before bed and in the morning to start.

My BS is 84 right now and it stays pretty low throughout the afternoon and evening hours.

As I thought and followed up , Lantus is Basil and by definition is not fast acting.

Your are confusing the two types of insulin needs, one is the continuous slow release to mimic as best as possible the way a normal persons system works and keeps their BG steady at an 85-90 level.

The second insulin approach are the fast-acting variety that are trying to mimic the Phase I response a normal person has so that their BG levels never shoot up. It comes close but isn't as precise as the normal persons capability.

I am not an expert on this, but this is the basics

[ShesGG]

As I thought and followed up , Lantus is Basil and by definition is not fast acting.

Your are confusing the two types of insulin needs, one is the continuous slow release to mimic as best as possible the way a normal persons system works and keeps their BG steady at an 85-90 level.

The second insulin approach are the fast-acting variety that are trying to mimic the Phase I response a normal person has so that their BG levels never shoot up. It comes close but isn't as precise as the normal persons capability.

I am not an expert on this, but this is the basics

Oh I'm definately confused about insulin.. :lol:

I believe Rob said in one post that his numbers are (were) pretty good with the Lantus but he still had Dawn Phenomenon and that is my problem now with Metformin only.

My numbers are higher at night and throughout the morning. I see my Dr. on Jan. 3 but I want to think about what I would like to do about that before my appt.

I want an insulin that will take care of my DP. morning higher bs, will not make me gain weight or get spikey readings. I really just want near normal readings and to feel well without having some other side effect ruin my day.

Hopefully, I can find something like that.

[RobLL]

Shesgg - I would very much recommend that you get and read Dr Berstein's book. Some follow it implicitly, most of us follow it, but with a little slack. It is, as I have said before, encyclopedic in its coverage of ALL aspects of diabetes. You really can't understand and control your diabetes, make intelligent decisions, cope with the widespread ignorance of the diabetes establishment without having this information.

[ShesGG]

Shesgg - I would very much recommend that you get and read Dr Berstein's book. Some follow it implicitly, most of us follow it, but with a little slack. It is, as I have said before, encyclopedic in its coverage of ALL aspects of diabetes. You really can't understand and control your diabetes, make intelligent decisions, cope with the widespread ignorance of the diabetes establishment without having this information.

It's finding the time to sit down and read his book.. The holidays are manic this year.

I did get on his conference call and read his website. I would be one to follow with a little slack although, I have been sticking to the very low carb food plan for about two weeks now.

I've also started taking the orgainic vinegar 3 times a day (once before bed) and it seems to help a little with nightime numbers. I've lost 7 lbs. I lose a pound and then stay the same for about 2 days and then lose another one. It's kind of fun getting on the scale now.

I will get to his book, you did tell me that before and I really am not trying to blow the advice off. It's just hard right now.

[dancinbr]

It's finding the time to sit down and read his book.. The holidays are manic this year.

I did get on his conference call and read his website. I would be one to follow with a little slack although, I have been sticking to the very low carb food plan for about two weeks now.

I've also started taking the orgainic vinegar 3 times a day (once before bed) and it seems to help a little with nightime numbers. I've lost 7 lbs. I lose a pound and then stay the same for about 2 days and then lose another one. It's kind of fun getting on the scale now.

I will get to his book, you did tell me that before and I really am not trying to blow the advice off. It's just hard right now.

Hello,

Reading Dr. B' Diabetes Solution is probably the most important time you will ever spend on yourself.

Many of us have DP. Some with Dr. B's strict discipline, LC and exercise a couple of times a day learn how to steady their numbers 24/7 as he teaches us to do so.

Make the time. Take a chapter a day, but keep at it. Having read his book you now have a reference as opposed to being confused and not understanding.

Do yourself a favor, give your self a Christmas gift or a Hanukah gift of live to yourself. That is how important this is to YOU.

Be well.

Ralph

[glennette]

To me, dealing with diabetes is a little like when I was having a baby. Halfway through labor, I wanted to stop, change my mind, but there was nothing else I could do but to move forward.

It's better when we have people just like you to talk to about it.

Well said! I remember the feeling even from 35 yrs. ago.

:agree: I really would like to see a poll or folders for the different medication, too.

I'm thinking of trying one since the lowest I've been able to get my A!C down to is 6.1 and I think I've tried every supplement possible. So it would be great to see what & how much the different ones work for different people.

[dancinbr]

Well said! I remember the feeling even from 35 yrs. ago.

:agree: I really would like to see a poll or folders for the different medication, too.

I'm thinking of trying one since the lowest I've been able to get my A!C down to is 6.1 and I think I've tried every supplement possible. So it would be great to see what & how much the different ones work for different people.

Hello Glennette - Did you achieve 6.1 with diet and exercise only?

That is pretty good. Or did you use meds and still not get below 6.0?

I am pretty sure I would be around 6.0 with just diet and exercise.

However, the goal is definitely in the 5's and perfection is 4.2 - 4.6 as I recall from my Dr. B readings. A non-diabetic also has readings in the 80s 1 hour after eating anything. The max they would ever see shortly after eating is 120 and that would be a significant carbs.

Thanks.

Ralph

[MizKitty]

I've used Lantus since Sept. 06. I have it in pen form (Opticlik) with a cartridge, and just turn the dial to the number of units I want to inject. No syringes and vials. Very easy. I take 16 units at bedtime.

Lantus is 24 hour long acting, so there shouldn't be any issues with hypos like rapid acting insulin can cause. You need to start with a small amount, like 5 units, and test your morning FBG. Increase the bedtime dose by one or 2 units at a time every few days, until you're seeing the FBG number you're after.

My personal experience, doses higher than 17 units did not lower my BS any more than my current dose of 16 units. I don't know why, but I backed it up to 16 and stayed there. I have not seen any evidence that that much insulin causing weight gain or hindering my weight loss. But I eat consistently VLC, so there's not enough carbs floating around in my system for insulin to try to store as fat. :)

I take my metformin ER in the morning.

Last month, based on an A1c of 5.4, the doctor had me quit the insulin and continue with the metformin. Of course, I was excited with the idea of getting to stop insulin, so even though 5.4 is not quite as low as I'd like to be, I went ahead and quit to see what would happen. After all, I'm still losing weight, and thought maybe a small temporay BS increase would be acceptable and would continue to go down with the pounds.

But the BG readings went up significantly... 130's and 140's fasting, in the one-teens all day. (formerly 80's). I elected to go back on the Lantus.

Reading here a couple of members experience with going off metformin and nothing happened, and also on Jenny's site, she has mentioned that metformin seems to stop working after taking it a long time, I think in another 10 pounds or so I might try the other route of quitting the met and stick with the Lantus, and see how that goes.

BTW, I read that Metformin ER peaks at 7 hours. That might be useful to know in deciding what time to take it.

[glennette]

Hello Glennette - Did you achieve 6.1 with diet and exercise only?

That is pretty good. Or did you use meds and still not get below 6.0?

I am pretty sure I would be around 6.0 with just diet and exercise.

However, the goal is definitely in the 5's and perfection is 4.2 - 4.6 as I recall from my Dr. B readings. A non-diabetic also has readings in the 80s 1 hour after eating anything. The max they would ever see shortly after eating is 120 and that would be a significant carbs.

Thanks.

Ralph

Hi Ralph,

So far it's been diet alone. Started with an A1C of 10 eighteen months ago and got it down to 6.4 on the next one but the improvement has been so small since. :( Can't exercize yet b/c of arthritus in the hip and a bad ticker.

Still hoping to get the arthritus under control enough to start at least walking soon, seeing a PT. But what I've seen so far is that anytime I'm active my bg goes up not down. I've wondered if pehaps it's b/c of the pain that it causes me to be active?

I really need to get nearer to normal as I also have foot nerophathy and as I told my doc when she asked what my motivation is "I'm not losing anymore body parts before I die!" So I'll do what it takes to get nearer to normal. I just wanted to try diet first since I've been so sensitive to many drugs.

What have you found that helps you maintain good levels?

Thanks, Glennette

[dancinbr]

Hi Ralph,

So far it's been diet alone. Started with an A1C of 10 eighteen months ago and got it down to 6.4 on the next one but the improvement has been so small since. :( Can't exercize yet b/c of arthritus in the hip and a bad ticker.

Still hoping to get the arthritus under control enough to start at least walking soon, seeing a PT. But what I've seen so far is that anytime I'm active my bg goes up not down. I've wondered if pehaps it's b/c of the pain that it causes me to be active?

I really need to get nearer to normal as I also have foot nerophathy and as I told my doc when she asked what my motivation is "I'm not losing anymore body parts before I die!" So I'll do what it takes to get nearer to normal. I just wanted to try diet first since I've been so sensitive to many drugs.

What have you found that helps you maintain good levels?

Thanks, Glennette

When are you trying to exercise?

Your BG will go up if you haven't eaten.

Different folks have different results with exercise. It is recommended that you exercise after eating. I will go for a walk mid-morning; a couple hours after breakfast and the walk does bring down the BG.

Dr. B talks a lot about exercise. Also, initially, it may go up on you if you are doing it the right times, but then long term it does bring BG down.

Best wishes.

[Lisa N]

Can't exercize yet b/c of arthritus in the hip and a bad ticker.

Glenette, swimming is a great exercise for those who have trouble with weight-bearing exercise such as yourself. Does your local Y offer a water aerobics class for older women? It might be something to consider that would help with your long-term goal of getting your A1C lower without adding medications. :idea:

[glennette]

When are you trying to exercise?

Your BG will go up if you haven't eaten.

Different folks have different results with exercise. It is recommended that you exercise after eating. I will go for a walk mid-morning; a couple hours after breakfast and the walk does bring down the BG.

Dr. B talks a lot about exercise. Also, initially, it may go up on you if you are doing it the right times, but then long term it does bring BG down.

Best wishes.

The problem is..that I can't acutally exercise yet. So far the Physical Therapist only has me doing 2 very small movement laying on my back. Which is hard to do at home as I have to get up and down from the floor (knees are bad too) In all truthfullness, I'm pretty much a physical wreck :lol:

I ment that when I'm a bit more active such as a shopping trip like yesterday and I'm still recuperating from that :lol: or doing some lite house keeping activitys I get the increase in bg but I never pay attention as to when I do or am able to do these thing. Just thankfull that I can still do them on occasion. Had a stroke 5 yrs ago and 4 yrs ago I was told to get on the heart transplant list. But all things concidered I'm doing pretty darn good.

I'm taking a break from the PT for the holiday season and he'll have a lot of repair work to do on me when I get back but he's good so I'm really hoping that soon he'll let me move up to the treadmill (fingers crossed).

Sorry this is so long, must be one of the new herbal teas that I got yesterday, making me so gabby.

Glennette

[glennette]

Glenette, swimming is a great exercise for those who have trouble with weight-bearing exercise such as yourself. Does your local Y offer a water aerobics class for older women? It might be something to consider that would help with your long-term goal of getting your A1C lower without adding medications. :idea:

Sorry, I didn't see this yesterday. Yes, that would be great Lisa.
I did water exercises many years ago at one in a nearby city. Really helped my arm mobility after a mastectomy.

I'll have to talk to my Doc about it next appt.
Thanks, Glennette

[RobLL]

Sorry, I didn't see this yesterday. Yes, that would be great Lisa.
I did water exercises many years ago at one in a nearby city. Really helped my arm mobility after a mastectomy.

I'll have to talk to my Doc about it next appt.
Thanks, Glennette

One caution on water exercise: be sure to wear some sort of protective shoe/slipper. Otherwise you can wear some skin away. Also do not try to keep up with experienced people in the class. Go at your pace, your body will tell you.

[Lisa N]

One caution on water exercise: be sure to wear some sort of protective shoe/slipper. Otherwise you can wear some skin away. Also do not try to keep up with experienced people in the class. Go at your pace, your body will tell you.

Good advice and wear those water shoes in the showers as well as the pool to protect yourself against athlete's foot fungus! :idea:
If the classes offered are anything like those in my area, there are 'beginner', 'intermediate' and 'advanced' classes that allow you to choose a class that best fits your level of ability.

[glennette]

Lisa & RobbLL,

Thanks for the great advise! Glennette

[kristen32]

I have to share my success with Januvia/Metformin. Some background info: I'm Type 2, normal weight, am on 100mg Januvia & 1000mg Metformin. I was diagnosed last year, but believe I've been diabetic for many years (family pre-disposition).

So I'd done Januvia & Met separately, but my doctor suggested trying both together & the results are amazing... with a low-carb diet, of course ;) I had a FBS of 96 this morning - not ideal, but waaay better than before. And my numbers stay in the 80s-90s all day, going up to around 115-120 max after meals. I'm just blown away, because I didn't achieve anything near this with the meds taken separately. And yeah, it might have something to do with the fact that I've REALLY gotten serious about the 6-12-12 plan. I do something like 6-12-12-12, but it makes such a difference!