Last week I had an appointment with an endocrinologist. My primary care doctor and I decided it was time for this because I have not been able to get my blood sugar down below 200 in the morning in quite a while. I had started taking a slow acting insulin before bed last summer. That worked for a couple of months, but then the morning finger prick numbers started going up again. The primary care doctor had me increase the amount of insulin injected over a period of about two months, from 10 units to 25 units, and it still wasn’t enough. That is when we talked about seeing the endocrinologist.
Dr. Vavrik was a pretty nice guy, to the point, and I liked him. I think that liking your doctor is important, because when you have a good relationship with him or her, you feel like you can ask questions of them easier.
I asked him why, after nearly 15 years of being a diagnosed diabetic, and keeping my blood sugar under control since diagnosis until last summer, I was having such a hard time now. He explained that most type 2 diabetic have a good ten years after their initial diagnosis, if they eat right and take their medications, before their pancreas gives out completely, and complicates things. Since I experienced good control for more than 14 years, he said, I was lucky that my control lasted that long. He also told me it was nothing that I did right or wrong, that caused my blood sugar to suddenly go whacky. That is just the nature of the disease. After answering my questions about why and how this happened, we got down to talking about what to do now.
So, here is my new plan. I am still to take metformin 500 mg two times a day. Even though my pancreas has stopped working to produce insulin, taking insulin injections can cause weight gain. The metformin helps prevent that weight gain, so Dr. V wants me to keep taking it. Next, I had gotten up to 32 units of Lantus, the slow acting insulin that I take at night. He wants me to continue to take that as well, to keep my blood sugar lowered while I sleep. He said the trick is to keep your blood sugar lowered all the time, so taking the Lantus is good.
Then, he prescribed for me to take Novalog, a fast acting insulin, before each meal, three times a day. I now have to check my blood sugar before each meal as well. Since this is a fast acting insulin, it has to be taken 0 to 10 minutes before a meal. So, if we go out to eat, I should not ever inject my insulin until my food is served. That is because, if I were to inject the insulin, then there was a problem with my order and my meal was delayed arriving at the table, my blood sugar could drop to a dangerous low. So, the process is like this: order my food. Check my blood sugar. If it is below 160, I take 10 units of Novalog. If my blood sugar is OVER 160, I take extra Novalog determined by a chart I was given. I keep that chart in my kit along with my other diabetes supplies. Once my food is on the table, prepare the injection, give myself the shot, then eat. Simple.
Now, I have a question for you, my dear readers. Whether or not you are diabetic, I hope that you would take this simple poll. I want to find out how you feel about diabetics giving themselves a shot in the restaurant, in a public place. If you have any objections or anything else to say, please do leave a comment. It is very important to me, as a diabetic, to understand how others feel about this topic.