New to Insulin

[csmith2]

I just joined MedHelp, but I like what I've seen so far.  I just setup a Diabetes tracker.  I've got a question for you.  My doctor recently put me on Levemir FlexPen Insulin.  She told me to inject 20 units just before bed, increasing it by 2 units each night until my morning fasting level is 120 or below.  I'm already up to 45 units, but my fasting level this morning was still over 300.  How much is too much insulin?  The pen only goes up to 60 units in one shot.  It appears to me as if this insulin is having little to no effect on me.  

Any insight would be very appreciated.  Thanks.

[kwhop550]

its going to fluctuate for a while until everything kicks in my doc started me off at 60 units in the am and 30 units at night along with 500mg of metformin twice a day  good luck

[Zoelula]

Beating up on yourself won't serve any purpose. As WaveRider says, you know what to do. You did it before so you know it's possible. It sounds like you are at a turning point. It is a crisis but it also an opportunity. No, it is not too late, but you want to do everything you can to get your blood glucose down into target range. See an endo to get on the right insulin regimen. I can't believe your doctor told you to just keep upping your dose. My guess is you need to be on the standard basal (long-acting) and bolus (short acting before meals) regimen. Go back to the gym and plan your meals to reduce carb intake and help lower your post prandial numbers. You can do it!

[WaveRider]

OK, you have admitted your guilt. Now what? You know what to do to regain your health. Nothing I or anyone else says matters anymore, the ball is in your court to change your lifestyle.

[csmith2]

I know my BG is high, way too high.  I feel like it's all my fault, not the doctor's.  I was originally diagnosed with T2 diabetes about 7 or 8 years ago.  For about two years I was a very good patient.  I lost a lot of weight, joined a gym, watched what I ate, tested my BG 4 or 5 times a day, and generally did everything I was supposed to do.  I gained full control over my disease without any medication.  

But then I got tired of it all.  I began to resent the control this f*#$ing disease had over my every waking moment.  I just stopped trying after a while.  I tried to block it all out of my mind.  I started taking medicine.  I stopped going to the gym.  I gained my weight back.  I basically hid my head in the sand, which is where I've been for the last 4 or 5 years.  I just didn't care anymore.  If this disease wants me, then bring it on was my attitude.  I sometimes referred to it as slow suicide.

Having my doctor insist on putting me on insulin two weeks ago was sort of a wake up call I guess.  I'm 48 years old, not all that old, but not all that young either.  I could still have a good 20 or 30 years ahead of me at least.  I honestly didn't think I'd live to be as old as I am.  

So far, knock on wood, I've been lucky.  I have no serious diabetes related complications.  My eyesight is getting worse each year, but that's due more to age than diabetes.  I have little to no neuropathy or kidney problems.  But I know I'm playing Russian roulette here with my life.  

Maybe it's time I got serious again about my health?  Maybe it's not too late?

[csmith2]

I am still taking 1000mg of Metformin each morning, but she removed me from Januvia and Amaryl when she gave me the insulin.  She did not give me a maximum dose for the insulin.  Just one shot a day, just before bed.  Start with 20 units and increase gradually until my morning BG is below 120.  

I've already got a call into her nurse letting her know it doesn't seem to be helping much and that I'm already up to 45 units before bed.

I don't know if it matters, but I'm a big guy, weighing around 340lbs.  I assume that means it might take more insulin for me than for someone skinnier?

Thanks for your input.

[WaveRider]

"She told me to inject 20 units just before bed, increasing it by 2 units each night until my morning fasting blood level is 120 or below."
You know that age old adage "doctors practice medicine"? She is practicing on you instead of getting to the root cause of your high morning glucose [blood sugar]. I dislike doctors who will not take the time to diagnose a problem instead take the antiquated road of here take this pill and come back in two weeks.

To inject 45 units and still have dangerously high morning levels over 300 indicates something in your Endocrine System is misfiring - pituitary gland, thyroid, pancreas, adrenal glands, immune system. This is beyond the scope of family or internal medicine. You need to see an expert. Please ask for a referral to a doctor of endocrinology - an Endocrinologist knows how to diagnose then properly treat extreme high/low glucose levels.

Be sure to get copies of your medical records [by law its your given right]. Send them to the endocrinologist ahead of time so he/she is prepared for your arrival.

[Zoelula]

Did your doctor give you an upper limit to the basal dose? You also don't say if she still has you on oral meds, because it sounds like you have significant insulin resistance. I would talk to your doctor at this point, or better yet, ask for a referral to an endo. Your bg is dangerously high.