I’ve been lately thinking, watching myself do stupid things and my body seeming to respond to food differently. There are changes I need to make and I may need to go on more insulin (I started Lantus when? February?).
I think a lot of people with type 2 have the attitude that it’s not as serious. Maybe because, as I’ve put it before, we can “get away” with looser treatment than type 1s without immediate consequences. I have certainly known how to manipulate my blood sugars. I know what I can eat or binge on without raising my sugar too much. Hell, when I was hospitalized my sugars were consistent enough that Larry was only ordering tests every other day. My nurses brought in treats on the off days so we could have treats without raising my tested sugars! I mean, it’s hard to take seriously sometimes.
The reality is that type 2 diabetes leads to complications just as type 1 does.
Type 2 diabetes produces or is a contributor to considerable morbidity in the form of metabolic complications, vision disorders, neuropathy, kidney disease, peripheral vascular disease, ulcerations and amputations, heart disease, stroke, digestive diseases, infection, oral complications, and depression. The associated mortality rate has been estimated at 5.5% annually. Moreover, the disease reduces life expectancy by 5–10 years.
http://clinical.diabetesjournals.org/cgi/content/full/21/1/14
We know this. We’re told this early on. And then, to a large degree, it seems to be ignored – at least in my experience. So now I’m finally seeing an endo and I get the test results back in a couple more weeks. I wonder what he’s going to say? I’m trying to keep better records and all that so he has more than my a1c to work with.
We’re already talking about the possibility of insulin, other than or in addition to the lantus? According to the ADA, most type 2s have lost enough insulin production 5-10 years after diagnosis that they need to be on insulin. I wonder what “most” means.
Needing insulin does not mean that you have failed to manage you (sic) diabetes well. Because type 2 diabetes is a progressive disease, eventually your pancreas is just not able to keep up with your body’s need for insulin—no matter what you’ve done to manage your diabetes. When other medicines no longer keep your blood glucose on target, insulin is often the next logical step for treating diabetes.
http://clinical.diabetesjournals.org/cgi/content/extract/25/1/39
I’m not sure how I feel about it. I think it would give me better control but wouldn’t reduce the problem. Does the possibility that my body may not be producing as much insulin now mean that weight loss (or bariatric surgery) in not going to help the insulin resistance? Will I abuse the insulin by using it to cover binges? Is it better to binge and keep my sugars down than to binge and be “punished” by being high? Just some thoughts.
Zazzy, I watched my mom die from diabetes. She didn’t have any one big thing – no heart attacks or strokes, no amputations – she just slowly wore out. It took years of being nearly useless (and feeling like a burden) before she finally faded away. Just couldn’t do anything productive anymore – no reading, no sewing, no piano – none of the things she had done so well and enjoyed so much. She had trouble even trying to watch tv. Her heart was weak, her kidneys were at low function, her eyes were going, and she had neuropathy in her hands and her legs. She was physically weak. Now I’m watching Ed go through the same thing. My mom was as well-controlled as it was possible to be at her time (they had only urine testing when she was diagnosed – took years to find out she didn’t spill sugar into her urine until she was above 300). Ed has never been tightly controlled. When I was caring for him here at home I checked his sugar before every meal and at bedtime. If it was over 150 he had to have insulin to cover the high plus one unit for every 10 carbs during the meal. This does give tighter control, but at what cost? I’m not convinced that it makes a great lot of difference to work so hard that you lose all enjoyment in living just so you can live an extra day or two in the end. After spending the day in the ER with Ed I’m nearly convinced that we should all take up sky diving at the end and leave this life while it’s still fun.
By: adamswife on August 30, 2007
at 7:00 pm
Another hard day at the ER? *hugs* I wish there were something helpful to say. I think I understand, at least some, and know that we’re looking at a similar future with mom. I don’t understand this whole getting old and falling apart thing. Sometimes I wonder when life is going to be fun? You know, you’re an adult so you can do what you want (right?) and you’re working and struggling and then suddenly old.
I want to have more fun and enjoy life in whatever way makes me happy, but I know I need to be healthier to do so. Will insulin help that? I don’t know, maybe. I’m actually still remarkably healthy other than the weight. Yes, my knee and arthritis issues are a problem but they’d be better without the weight. I want to stay healthy and be able to go and do what I want again.
My grandma, btw, only lived 1 1/2 years after diagnosis with diabetes. But then, she never understood exchanges. She would point at the starch list and insist she could have one of each. We are much luckier now with meters and medication choices. I was reading recently how they now think most amputations will be unnecessary with modern treatments. Part of me wants to fly free and really live! Part of me is still stuck in this ol’ swamp, not really moving at all.
By: Zazzy on August 30, 2007
at 10:25 pm
I think insulin will help some, reducing the bad part of highs some, but they will still be bad since all that excess carbs will be stored away in the fat cells, as to what to do about it I really don’t know, I don’t think there is a pill that can solve it, all one really can do is try to eat less carbs (less not none) and to try to spend more energy (exercise, thinking, etc) and keep oneself active and most importantly finding something fun that does that, not something that bores ones brains out, since being bored is probably more lethal than anything else I know, at least it is said to damage the brain.
I know mom is trying now to reduce her need for insulin by increasing the other meds that regulate blood sugars, and we also eat certain things that make our bodies more active inside and reduce some sugar cravings, but then I am one of those herb and alternate medicine people so I won’t bore anyone with details unless that is what people want.
By: TheDarkWraith on August 31, 2007
at 1:57 am
Eating better and moving more are definitely part of the needed changes.
An interesting thought is that high blood sugars tend to make us hungry. I’m told that’s because we’re not actually getting the energy from the food the way we need. So blood sugar under better control may (ought to?) have the side effect of less hunger.
By: Zazzy on August 31, 2007
at 11:50 am
Interesting thought. Insulin causes hunger leading to more eating which leads to higher blood sugars which also cause hunger? No wonder diabetics have such a hard time!
By: adamswife on August 31, 2007
at 4:21 pm