24th February 2008
[QUOTE=cljcow2002;3454326]Hi everyone, I am a Type II Diabetic of 12 years - I currently am on Actometplus 30/1000 (Actos/glucophage) twice a day, NPH insulin 30 units at HS (for the past year) and am trying to tolerate 10 mg of Byetta twice a day. I run an A1c around 6.8. I usually run an AM blood sugar of 110 to 140, about 130 to 140 after meals.
So...whats my problem? In the past year I have gained over 20 pounds of pure abdominal fat - I have been on the Actometplus for around 1 year and have ankle edema at the end of the day. The Byetta while initially a great sucess at 5 mg (30 pound weight loss and was only on glucophage) now at 10mg makes me feel constantly nauseous. I feel like crap, I have tried to discuss putting me back on just glucophage 1000 twice a day but my endocrinologist wants my AM glucose to be 80-100. I have a feeling the Actometplus is not doing me any good and the NPH insulin is only causing weight gain - I feel like I am in a vicious cycle!
I am open to any suggestions as I have an appt with the endocrinologist on riday and want to clearly state my case that I do not feel well on this present therapy regimen. Thanks for any and all suggestions
Since you're already on insulin, my recommendation would be to go to a totally insulin-based regimen. NPH is an intermediate acting insulin; it's onset and length of action are not completely predictable, and it can cause a lot of lows. It's possible that treating the lows (if you've been experiencing a lot of them) could be causing the weight gain. Also, insulin usually causes weight gain if your blood sugars were running extremely high before starting insulin because, in that case, your body isn't able to utilize glucose and it starts burning fat for fuel. It is not, however, a healthy way to lose weight!
Considering the length of time you've had T2 and the amount of meds you're currently on, I suspect that in addition to being "insulin resistant", your pancreas has probably somewhat worn out. Many T2's will become insulin dependent eventually, if they have it long enough.
I would recommend going on a long-acting insulin such as lantus for your basal needs, along with a rapid-acting insulin such as humalog or novolog for meals. You would have to learn how to carb count, but it isn't all that difficult. With the lantus/humalog or novolog regimen, you would probably get rid of the edema and, with a bit of diet and exercise, you could easily lose the excess poundage.
Of course, your endo may have other ideas...see what he/she has to say.
Ruth
So...whats my problem? In the past year I have gained over 20 pounds of pure abdominal fat - I have been on the Actometplus for around 1 year and have ankle edema at the end of the day. The Byetta while initially a great sucess at 5 mg (30 pound weight loss and was only on glucophage) now at 10mg makes me feel constantly nauseous. I feel like crap, I have tried to discuss putting me back on just glucophage 1000 twice a day but my endocrinologist wants my AM glucose to be 80-100. I have a feeling the Actometplus is not doing me any good and the NPH insulin is only causing weight gain - I feel like I am in a vicious cycle!
I am open to any suggestions as I have an appt with the endocrinologist on riday and want to clearly state my case that I do not feel well on this present therapy regimen. Thanks for any and all suggestions
Since you're already on insulin, my recommendation would be to go to a totally insulin-based regimen. NPH is an intermediate acting insulin; it's onset and length of action are not completely predictable, and it can cause a lot of lows. It's possible that treating the lows (if you've been experiencing a lot of them) could be causing the weight gain. Also, insulin usually causes weight gain if your blood sugars were running extremely high before starting insulin because, in that case, your body isn't able to utilize glucose and it starts burning fat for fuel. It is not, however, a healthy way to lose weight!
Considering the length of time you've had T2 and the amount of meds you're currently on, I suspect that in addition to being "insulin resistant", your pancreas has probably somewhat worn out. Many T2's will become insulin dependent eventually, if they have it long enough.
I would recommend going on a long-acting insulin such as lantus for your basal needs, along with a rapid-acting insulin such as humalog or novolog for meals. You would have to learn how to carb count, but it isn't all that difficult. With the lantus/humalog or novolog regimen, you would probably get rid of the edema and, with a bit of diet and exercise, you could easily lose the excess poundage.
Of course, your endo may have other ideas...see what he/she has to say.
Ruth