Tag Archives: insulin

The State of the Pancreas

I saw my endocrinologist last week. That wouldn’t be such big news, except for the fact that I hadn’t been to his office is almost 3 years. Between life changes, insurance switchings and everything that comes with it, I was always seeing my PCP because it worked well for me. But with the recent turn of events, my pancreas being so cranky and all, I decided it was time to go back to Dr. B and I’m so freaking glad I did.

I’ve always liked Dr. B. He’s personable, he cares about his patients’ mental well being above everything else, and he never gives me the talk about how things are so horrible, I better watch out. He may get frustrated—oh, so frustrated… but he never shows it. After all, it’s not his job to make me better… he’s just there to guide  and advise, but the biggest tasks are mine. So after almost 3 years, he was glad I went back, but not so glad that my diabetes is giving me a hard time.

The most important questions I had when I saw Dr. B were:

  • “Did my pancreas check out?”
    To which he replied that no, my pancreas is probably just overwhelmed and being stubborn.
  • “When do I start with rapid acting insulin?”
    To which he replied that it’s better to let the Lantus do its work and see if my pancreas responds.

So that’s what I’ve been doing, giving Lantus a chance. I’m up to 20 units a day, and my numbers—at least my fasting numbers—are getting better every day. I’m guessing I’ll find the “magic” number of units this week. However, my post-meal numbers are never under 200, and I hope they start behaving soon… (I’m low-carbing, dang it!). Based on my log, in two weeks Dr. B will decide if I need rapid acting insulin or add another medication to my metformin since Victoza didn’t quite agree with my stomach.

Whatever Dr. B says, this thing is no joke… it’s no joke when your blood sugar is 466 and you realize all hell got loose, and you want a quick fix. There is not a quick fix, not in the general sense (I don’t bolus). And it requires work, and tears, and a few swear words… and it never, ever ends.

I don’t know what I think I know

In the 15 years I have lived with type 2 diabetes, I have not had many meltdowns. I have suffered from diabetes burnout, denial, periods of anger, periods of negligence, and overwhelming moments courtesy of the endocrine rebellion I have been subjected to by my body. But I have not cried or thrown pity parties that often. Not the kind of pity parties where I bawl like a baby because I just don’t know what to do and no one understands me. Well, I had a fantastic meltdown last night when I was supposed to start my Lantus treatment. Why? Because I am afraid of hypoglycemia in the middle of the night and not knowing what to do.

Sure, I have dealt with a few lows here and there; my worst one being a 52 mg/dL that came with some disorientation and face numbness. Other than that, my lows are very rare and not that bad—most of them have been “false” lows when my body is trying to trick me. But a real bad low where I don’t know where I am or what to do? Nope, I don’t remember that, and I am terrified.

Now, we are talking about basal insulin, the one that has a long lasting action and a starting dose of 10 units. Insulin veterans must be laughing at me. But hey… I have never used the stuff before, and my body may get crazy, you never know. I have gotten mixed stories; people telling me they were OK, people telling me that they went really low, etc. I guess we are all different, but I think my fear comes mainly from the fact that I am supposed to do bed time Lantus, I am alone at night because my fiancé works 3rd shift, and I don’t think I can rely on my cats to help me that much.

After expressing my fear to a few people, one of them actually told me something that surprised me. She said I should learn everything I can about hypoglycemia and go from there. Now, wait a minute… I thought I already knew everything I can about hypoglycemia. Are you telling me I have to do the Hypoglycemia 101 course all over again? And if that is the case, does it also mean I have to relearn everything I think I know about diabetes? I guess I will have to go all Socrates… ipse se nihil scire id unum scia… I know that I know nothing. 

But I will be brave tonight, and I will take my Lantus. I am prepared with an alarm clock to test in the middle of the night, a bottle of glucose tabs, and juice boxes. What I need now is to keep on being the same brave human being I have always been and grab this insulin fear by the horns. I am sure my pancreas will thank me.

And then it got really cranky!

I had my regular diabetes check-up this week. The last 7+ months have been a constant battle, trying to figure out why my A1Cs have been so bad. I have been on Victoza for about a year now; it never stopped making me sick, and it obviously did not do the trick. Apparently my beta cells finally decided to take a leave of absence, and what once was a cranky pancreas, is now a full-on angry one. I wonder if I should change the name of the blog… again. J/K

My doctor decided it was time for me to try basal insulin if I was open to it. I told her I have never been afraid of insulin; in fact I think insulin therapy is a wonderful thing (you go, Dr. Banting!). Of course there was the feeling of failure… but no, I did not fail. I had a friend remind me that diabetes is a progressive disease, and this was bound to happen. I guess my pancreas gave me a good 15 years of overtime.

My butter compartment is now occupied by Lantus pens (which made me think of Lee Ann), and I will start this new phase of treatment this weekend. The doctor will decide about meal time insulin as we go. I have been pestering people with all kinds of questions (Thank you, Matt, for all your patience), and I have also been afraid because let’s face it, we are talking about insulin here. But I don’t have to be specific about that.  And all those questions, all those fears, made me realize I had to come back to the only group of people who completely understand what it is like to live with diabetes. Starting insulin for me is like having to relearn everything.

I realized that I was right… the DOC has kept me in check in one way or another, and I need the community from which I have learned so much. At some point I felt withdrawn and probably overwhelmed, so I left. But after seeing my doctor and having so many questions, I realized I needed the support. And I also need that daily reminder that when dealing with a chronic disease, it is better to turn to those who live with it as well. :-)

On Valentine’s Day

Lack of access to insulin is the most common cause of death for children with diabetes in many countries around the world. In fact, in some parts of the world, the estimated life expectancy of a child who has just developed diabetes could be less than a year.

This Valentine’s Day our community can help change that.

Through the Spare a Rose, Save a Child campaign, we raise awareness and donations for Life for a Child, an International Diabetes Federation program which provides life-saving diabetes supplies, medication, and education that children in developing countries need to stay alive.

Spare a Rose, Save a Child is simple: buy one less rose this Valentine’s Day and donate the value of that flower to children with diabetes. Your loved one at home still gets flowers and you both show some love to children around the world who need it.

One rose, one month of life. A dozen roses, a year of life for a child with diabetes.
We’re hopeful that you will embrace this cause this year.

Spread the word!