Aimless ...

Hello, my name is Carlos and I am 48 years old ... Two years ago I had an attack of pressure and hyperglycemia (together), until that moment I suffered diabetes symptoms but neither I, nor did the doctors knew how to realize.

The issue is that two years later, they still do not give "foot with a ball" I continue with 250 of average glycemia and I inject 80u of insulin 3 times a day and nothing ...

I inject and measure 30min, 45min 1 hour later and at least 10, 20 or even the glucose rises.

Not as or I take anything with sugar and even without eating anything all day, blood glucose does not lower 220 ...

I live in a very small city ... I do not have the opportunity to "get angry" and change diabetology because there are not many that specialize here in Posadas, Misiones.

In fact, when I was admitted, the nurses told me to be happy since I was attended by the best diabetology in all missions ...

Comment apart, at this point I don't know if they were making a joke in bad taste.hehehehe

Now they tell me that my kidneys are starting to fail and that I get worse day ... It is clear to me that the doctor was burned the books and beyond rising or lowering or changing the type of insulin does not occur to him a solutionTo my problem.

I would like, if possible, to advise me something ... that they tell me that I can do according to my limitations ... I don't know ... I'm lost and aimless

Thanks for reading me!

Do you know what kind of diabetes do you have?And what glycosilada?

According to doctor I have type 2 diabetes and I have my last study in my hand and if I am not mistaken, so I understand (which is little) says: Ha1c 10% (NGSP) and below HA1C 86 mmol/mol (IFCC).
Does that tell you something?:-)

Buff, I think that is very high and the insulin units a buried, how many basal and how many fast?

That has to be a beastly insulin resistance, no matter how much you injected you, it has no effect.
Do you have overweight?Where do you live exactly?
If you are type 2 there are other medications apart from insulin.Forxiga, Jardiance and others eliminate glucose through urine.Ozempic also say it's going very well.A friend of mine was like you, the insulin did not effect and with the Jardiance it is very good.
I don't know if your doctor has contemplated these medications.But what is proven is that in type 2 diabetes when there is great resistance, insulin does not work.

The 3 of 80u are basal .... the rapid use when it passes the 310 of glucose to lower it Io sooner ...
I live in Posadas, Misiones (Argentina) I move here about 8 years ago ... I would not know if it is a small city or a large town ... the truth is that Posadas is the capital of missions.
I overweight I have a lifetime ... and although now I take care of me much more, I can say that my previous life has been very messy and now my body is taking its toll

@Dellanave, I think the first thing you have to do is lose weight, vegetables, protein and exercise, remove carbos.
Insulin resistance is close to overweight.
Also oral medication, as @isabelbota tells you, to combat resistance.
But try to lose weight, body fat is what makes you so resistant to insulin.
It is not difficult if you change the food and you propose it.
The glycosilada has to be below 7, that is an average of 140 glucose at most.
Metformin can also go well, in addition to insulin, and. It is easy to get, eat it with your doctor.
Greetings!

Ok, therefore in your case it is basic to lose overweight to reduce that beastly resistance that you have to insulin.240 units a day is a barbarity, and on top of that does not take effect.For example I get 8 slowly ...
When the resistance is lost.You have to do it for your health
And then as we have commented, you need specific medication for type2.Metformin, as Regina tells you, helps a lot to lower resistance and weight and is a very basic and cheap medication that you must have there in Argentina.
Regarding the others that I told you, the active ingredients (in case the brands vary in the different countries) are semagglutida and picaglifozin (the latter is also used in Spain to lose weight)
Talk to your doctor already and eat, it is clear that insulin does not work for you.

Basic guidelines to comment with your doctor, consult everything with your doctor:

- 800cal hypocaloric diet, without carbohydrates and fat without:
This is a coffee or infusion breakfast with 2 slices of protein bread.
Food a 200g plate of vegetables and 125g of fish or 100g of meat
Dinner 100g of protein, best fish.

No fruits, pasta, rice, pastries, bread, etc.

This diet is usually made until 80% of the target weight is lowered, then the dinner makes food for 1 month or 2, adding some vegetable.
And when the objective weight is achieved, fruits are incorporated.But always controlled not to recover weight.

- Fast insulin in each meal when before eating you are above 160mg/dl of blood glucose according to the hydrates that are eaten.(This is basic even if you have DT2, at least until glycemia)

- Basal insulin according to weight and habits, (in my case I use 16uds and I am DT1, 240ud is very much)
- Daily exercise of at least 1 hour, combining aerobic strongly (the muscles burn glucose)

Important: a diabetic does not metabolize carbohydrates, that is, everything that comes out of the earth.Sugar is the best known, but we have fructose, sucrose, polyalcohols, flours, rice, potatoes, vegetables, vegetables .... All this needs insulin;Also fat and proteins, but to a lesser extent.

Metformin I am taking from the first day ... a pill at each meal .... the diet, well ... I'm in Argentina ... a kilo of meat costs 4 to 8 US $ D and the fish stillfurther,
My average salary is $ 240 so imagine ...
My diet is based on vegetables (namely in soup), chicken when you can and once a week noodles, something with potatoes or rice or flours (it would be as a "allowed") to not hate my life even more ....
The problem is that I measure 1.82mt high and weight 140 kilos
Over the years I have taken enough "belly" but as a young man I have done a lotEven in my best time it ever weighs less than 100 or 110 kilos, that is, these 140 kilos, although it is an important overweight, I do not think it is the main cause ...
My grandmother died at age 59 after suffering a lot (but much) with her diabetes and I am afraid to finish the same ... especially that now they tell me about the failure of my kidneys.
Two years ago I was "healthy" (Note between quotes) and three years ago a general checkeo that I made had given me perfect ... that is to say that in less than two years it fits.
I clarify that the Checkeos made them every year or two, due to what my grandmother had.

@Dellanave for what you say, a legume like lentil or chickpea is better than a rice or even a potato, both rice and potatoOn how to cook these foods in "resistant aldimon", on the other hand for a general rule, be overweight is an index of eating more calories than are consumed .... so it is minimal to have the habit of walking 1h a day ...You think that 140 is not so much ... but overweight and diabetes do not get anything but nothing right

I forgot, another tool you can use is intermittent fasting ... It helps a lot with the issue of insulin resistance, type 2 diabetes

@DELLANAVE: It is urgent that you go to an endocrine to help you lose weight and pay a medication that works for you.Do not miss any more time

ricki21 said:
@dellanave: it is urgent that you go to an endocrine to help you lose weight and pay you a medication that works you.Don't miss any more time

marine said:
@dellanave for what you say, a legume like the lentil or chickpea is better than a rice or even a potato, both the rice and the potato have a amount of starchthat causes glycemia peaks .. but you know it you can look info on how to cook these foods in "resistant aldimon", on the other hand by general rule, be overweight is an index of eating more calories than they consume .... soYou have to have a habit of walking 1h a day ... you think that 140 is not so much ... but overweight and diabetes do not get anything but nothing good

@DELLANAVE You have overweight, minimum 40kg and that is not little.I hope you can solve it .. greetings

@Dellanave Well, I am sorry to tell you that if you do not want to end like you ABU you will have to forget the potatoes and rice.
Not only are you with kidney problems, you can be blind by glaucoma or that ampute legs.Come on, you are the high risk but control glycemia.

You can make intermittent diet, eat only one meal every 16 hours, but light.That helps lose weight and insulin resistance.

I insist talk to your endocrine and teach you to eat for portions to use insulin in meals.Metformin is not serving you with these values.

And the weight is key, losing those 45kg would be very good for you, but doing sports to generate muscle.

If you had Covid, it may be DT1.Many people have debuted as a result of the Covid

Even if you get fast at meals it will not do anything with that resistance.The metformin does not leave it, if you think it does nothing leave it a few days and you will see the one that is looked.
Weight loss already and the oral medications that I have told you.Ask your doctor
@Ruthbia
In this life everything is possible, but that resistance and overweight and on all waist (he says he has no fat and arms fat) is a manual DT2.In those cases insulin is water, other things serve.

marine said:
I forgot, another tool you can use is intermittent fasting ... It helps a lot with the issue of insulin resistance, type 2 diabetes

Waters.I was "prediabetic" I made intermittent fasting for a few months and I became type 2 diabetic. The doctor scolded me, but it was late.

Isabelbota said:
that has to be a resistance to bestial insulin, no matter how much you do not take effect.
Do you have overweight?Where do you live exactly?
If you are type 2 there are other medications apart from insulin.Forxiga, Jardiance and others eliminate glucose through urine.Ozempic also say it's going very well.A friend of mine was like you, the insulin did not effect and with the Jardiance it is very good.
I don't know if your doctor has contemplated these medications.But what is proven is that in type 2 diabetes when there is great resistance, insulin does not work.

I agree with IsabelBota, you need recent and advanced medications such as Invokana, Jardianze DPP, Forxiga, etc.

These medications help a lot because apart from lowering glucose, they function as a cardioprotector and nephroprotector.

The bad thing is that they are expensive medications, but currently, there is nothing better (although each person is a world)

Without a doubt you have to go down about 30 or 40 kilos and this will help a lot.There is the diet and exercise but there are also weekly injections to lose weight but it seems that it is not very well tolerated, it causes digestive discomfort, patients are anxious, vomit, feel tired, etc.(besides being expensive)

Daily walking, 30 to 45 minutes, low carbohydrate or null food ... but I doubt that there is a strong change in 2 months ...

It could also be considered bariatric procedures either an intragastric ball, derivation or other.

Metformin cannot be left but perhaps need adjustment and also, perhaps it would be better for prolonged release.I had never heard that metformin be taken before meals ... at least the prolonged release is taken for example 10am and 10pm or 8am and 8pm ...

The endocrine could be very good, but if it is not updated with the new medications and trends to treat the DB2, perhaps if the patient should assess the possibility of looking for a 2nd opinion with another doctor.

matrix said:

marine said:
I forgot, another tool you can use is the intermittent fast ... It helps a lot with the theme of the resistanceto insulin, type 2 diabetes

Waters.I was "prediabetic" I made intermittent fasting a few months and became type 2 diabetic. The doctor scolded me, but it was late.

Fasting is totally opposite to type 2 diabetes, I recommend that you investigate the subject before saying that.