Thursday, February 27, 2014

It’s time to make progress…again


I’ve been moving down a path with my diabetes.  This path has had a few bumps and curves but the course was mostly straight.  The goal: see improved blood glucose, maintain a healthy weight and basically kick diabetes’ butt.  I’ve done fairly well in the 8+ years that I’ve been dealing with diabetes but now I find myself at a crossroads, of sorts.  It seems that my path has taken a sharp turn and I’ve lost my bearings.  

It’s been a rough winter, for a lot of reasons.  Last autumn I began to see my glucose numbers rise, especially in the morning. My sensitivity to carbs has increased, meaning that I can no longer eat most carbs without seeing big spikes.  I realized that over the course of a year I had gained 15 pounds (which has now crept up toward 20) all at a time when I’ve been exercising most days and eating less than I have in years.  Frustration abounds.  Depression makes itself known much too often.  I have felt defeated.

Today I had an appointment with my healthcare provider to discuss how things are going.  I was sad to sit there and list all my woes when I can remember my past appointments being more about “I’m doing just fine.”  My doctor came to the same conclusion I had: my diabetes is progressing and I need more help.

I’ve written before about my desire to use insulin.  I had actually hoped that she would give me a small dose of basal insulin to get things under control.  Nope. Not gonna happen.  You see, according to her, my diabetes isn’t at a point where insulin would be a good move.  Had I been in a better frame of mind, I might have argued with her, but she had a good point: I often have nearly normal glucose numbers (except in the morning).  My numbers are all over the place, but she said that she’s afraid that insulin would put me in danger of severe lows, not to mention it might cause me to gain even more weight.  I decided to be ok with letting that go for now.  

Next we talked about Victoza.  Her thinking was that it would help with my glucose and hopefully help me with the weight issue.  There’s just one problem: I have thyroid cancer which means I’m not a candidate for Victoza. 

The final answer ended up being an increase of my Metformin to 2000mg per day and adding Januvia.  I’m afraid that headaches and stomach distress are in my future, hopefully only for a short time.  I admit to being a bit bummed about adding yet another drug.  It helps that I read an article just today (thanks for posting that Bea) that says they are backing away from saying that Januvia is causing pancreatic cancer.  I am aware that there are possible serious side effects with this drug but I’m willing to give it a try.


It was a good appointment.  She listened to me.  She told me that I know more about diabetes than all her other patients combined and that I had even taught her a few things (and she’s a CDE! That's a good example of how we, as patients, need to speak up about what life with diabetes is like.).  She encouraged me to give myself a break now and then.  Those are words I needed to hear.

The word progression means “forward or onward movement”.  Sounds like a good thing until you pair it with diabetes.  My diabetes is progressing. Progress, on the other hand, is “a movement toward a goal.”  I can still work to make progress despite the progression of my diabetes.  It’s interesting to me that both words are derived from the same origin but can have such different effects on my life.  I have a choice to make.  I can wallow in the suckiness that is diabetes progression or I can choose to move forward; make progress toward better control.  I can do this.  I WILL do this.  The alternative just isn’t something I’m willing to accept.

4 comments:

  1. Kate, as much as I advocate for insulin, I will agree, when you are in a depressed mood is not the best time to start insulin. Get the thyroid problem resolved and then consider basal insulin if you continue with the dawn phenomenon problem.

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  2. Hi Kate! My diabetes has progressed as well, so I feel your frustration. I have a new doctor who is much more aggressive than the others I had. This doc feels like I should be able to achieve non-diabetic BG levels and put it in remission. My 1st attempt at his plan didn't go well. Very low carb but I wasn't eating enough fat and this too little calories and I was grumpy and miserable. We are trying paleo (low carb version) and Metformin again (ER this time). After a few weeks of the Met my fasting numbers are still in the 120-130 range :(, but I think overall the renewed effort is working as my A1C had crept up to 7.5 (and like you I'd gained some weight back). I'm down 11 lbs since the end of January and seeing 100-120 readings through out the day.

    Hang in there, and be your advocate. One of my docs said something very profound that more docs (IMO) should work with "you are the boss". Its your body, your life and you have to buy into whatever the medical decisions are.

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  3. Hi Kate,
    You posted this back in Feb by now I hope somethings have changed in a positive way. Yes your provider is right about the insulin, we certainly don't want to have hypoglycemia and your body will let you know why, it's just terrible. I wonder if you exercise and I mean lift weights or perform strengthen exercises. I have not read many of your posts but and I don't know if this is something you already do. I doing some research in this area and it appears that building muscles have a tremendous impact of insulin regulation int he body. It changes your metabolism and regulate your hormonal system in a dramatic way which comes to benefit glucose and insulin regulation. Just a suggestion...

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  4. I must say that your post is awesome ! you delivered a simple message very easily i too think that vegetables play an important role in diabetes treatment.

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