I’m not sure I would trust a non-technical translator with medical terms, and I don’t think a text-heavy explanation would work for him. Also he doesn’t use a computer or a smart phone. No, I’ll be looking for a book with large print and lots of drawings.
I don’t think I’m panicking yet. But he already has one disability due to leaving a medical condition until it was too late to fix it (left arm/hand ulnar nerve shot, surgery only helped a little, no gripping strength). I’m afraid of any complacency. I wish there were a Type II diabetes version of “scared straight” that I could take him to.
Something I’m considering for both of us (I am pre-diabetic and need to lose weight) is something like a prepared food regimen on the order of Nutrisystem, assuming they have a program for glycemic control. I haven’t really checked into that option at all yet.
With a timely follow-up scheduled for this coming Wednesday, you’re on track for prompt good orderly directions from his practitioner. It’ll be up to your husband to engage in the necessary actions to improve things but it’s a plus that you’re there to help facilitate this. But he’s ultimately responsible for taking action. There should be lots of help and counsel available through your doctor’s office, including diabetic education, nutritional counselling, assistance in tracking and reporting blood sugars, etc. And it’s nice that this has come to everyone’s attention due to a routine lab check and not an MI, stroke, or other debilitating event. So take heart, and all the best!
I agree with the suggestion of a CGM. I am a brittle, mature onset diabetic (type 1.5). I really struggled for several years, my A1C started out at 15.8, partly because of being misdiagnosed at the onset. My numbers bounced around until I caved in and got a Dexcom 6 combined with Tandem insulin pump. What a life changer that has been!
I’m type II diabetic. I did most of the damage many years ago, when I was 248 lbs and drinking 3-4 Cokes a day plus lots of carb-rich food. After being diagnosed (at 7.1 A1C) I stopped drinking Coke, started exercising, and got down to 200 lbs, where I’ve been for 6-7 years now.
I still have trouble keeping my A1C down below 7. Last year, I was at 7.9. Doc prescribed Jardiance to go with the Metformin, and my A1C went down to 7.4. My doc told me we still had work to do, but that I was one of his ‘success stories’. He said he has lots of patients with A1C well over 10, who simply don’t do the things they need to do to get it under control.
My problem is carbs mostly. I also get sugar cravings I never used to have. I also can’t tolerate non-sugar sweeteners. They give me headaches. My solution is to occasionally pop in a Werther’s candy (2 grams sugar ) to get me through the worst cravings. I tried switching to black coffee, but I just can’t. So I put about 1/3 teaspoon of sugar in my coffee.
I was told by the dietition when I was first diagnosed that the key was to avoid eating more than 15-17 grams of carbs or sugar in a four hour period. So a little bit of sugar here and there was okay. Does this sound right? Or do I need to cut sugar out completely and never eat high carb stuff? I work on the carb problem mainly by cutting down portion sizes, or splitting a meal up (i.e. if we have pizza, instead of having two slices for dinner I’ll have one slice, and then keep the other one for a snack later on Same carbs, lower carb load at one time.)
There are some very good new diabetic drugs. I mentioned Jardiance, which is a pill. My doc said that if I can’t get my blood sugar down lower and have my diet under control, there are even better new drugs you can take by injection. For example, GLP-1 agonists.
I would not recommend a type 2 diabetic with an A1c of 8.0 who is on metformin only to get a CGM. CGMs are most useful when one does something immediate based on the glucose level, like taking a certain amount of insulin. CGM is most beneficial for those who are absolutely insulin dependent.
Yes, I can see how that makes sense. I would also add that another benefit of a CGM is the ability of the doctor to look at that charts created by it and make determinations on when numbers are climbing or dropping and adjust accordingly. I would assume that would benefit a T2 as well, but please correct me if that is an incorrect assumption :).
I would think that a continuous glucose monitor would be really good for learning what makes your blood sugar spike. Immediate feedback is helpful if you are trying to learn new habits.
My dad handles that with just regular blood testing. By doctor’s orders, he takes it fasting and then two hours afterwards. So he just noticed what he ate and which foods helped versus which ones hurt. For example, he figured out that pancakes were a huge problem, but cereal is okay every once in a while. (And this was even with sugar-free syrup).
The Dexcom G7, which has advantages over the G6, will soon be available in the U.S.
I am going to disagree with this. We have many Type 2 patients who use CGMs. The lack of finger poking itself is a benefit. Trends can be identified, trigger foods (which are not the same for everyone) can be identified, and the data can serve as motivation toward attaining good diabetes control, which could potentially obviate the need for insulin therapy. The CGM will also alarm for abnormal readings.
The big trick is getting insurance approval for T2.
Which is why I was poking my finger 8 times a day for a while. But still, its not something I had to do for a prolonged period of time as I am now down to 3 pokes (or less) per day and have reduced my fast acting insulin shots from 3 large dosages to one single medium level shot before breakfast. YMMV on what constitutes a large shot, but thats not the question being asked here.
I can see @Qadgop_the_Mercotan 's point of not wanting to go staight to a continuous montering system straight off the bat. If the patient can’t work through the steps with standard pricks to the fingers then maybe the next step would be a monitoring device. But it seems like an expensive first line of action.
Exactly. I think type 2 patients on insulin can be potential excellent candidates for CGM. And I’ve argued successfully in the past to get those patients on CGM. But if a patient is only on metformin and is not having significant high or low BS symptoms nor evidence of poor DM control and who has access to a fingerstick reading if/when symptomatic is not going to get great benefit, in my experience.
And we still don’t know enough about the OP’s husband’s situation to state that he needs a CGM at this point. I’d want to know a lot more first, before I considered CGM in that case, much less tried to convince an insurer to cover it.
IMO/IME it really helps to have the discipline to write down accurately 100% of what you put in your mouth. Every meal, every snack, every furtive grab of 3 M&Ms. For meals it’s how many ounces or cups of what and the number of total carb units. Pretty quickly you’ll learn the parameters of your usual meals and yhis isn’t as onerous as it sounds. Easier for home-cooked or packaged than for restaurants though.
The power of truly seeing what you’re truly eating, and the near-realtime validation of what works and what doesn’t from a finger stick two hours later is monster-valuable.
This is a problem a motivated informed person can drive through successfully once they can see the signposts along their personal road.
Or they can elect to close their eyes, fold their arms, and let Fate take them off the road to wherever it will. Lots of miserable disability down that path into the wilderness.
I chose Door #1 as have many others here. I hope the OP’s husband has the wisdom and fortitude to do the same. Or at go as far in that direction as he can.
Thank you for letting me know that! I will definitely look into that when it’s available. I hope they fix the issue of it staying attached, that’s really my only problem with it. I do realize that just may be my individual issue.
Just for grins, how much do these things cost if not covered by insurance?
If you haven’t tried stevia extract (usually combined with a small amount of dextrose) I recommend it. It is a natural product made from the stevia plant which naturally contains glycosides, a compound that is something like 1000 times sweeter than sugar so a normal amount effectively does not have calories and does not raise blood sugar. Here’s an article about stevia and diabetes. Stevia and diabetes: Safety, benefits, risks, and side effects
@Roderick_Femm I tried Stevia, and all the rest. I even had my wife swap it into my coffee at a random time as a blind taste test to see if I was imagining the effects. Nope. Artificial sweetners just make me feel sick. I have no idea why. I do suffer from chronic headaches and take medication for it, so maybe I’m just one of the unlucky ones. All I can really drink that I can tolerate is water with a bit of lemon or lime in it.
Sorry to hear that. If you’ve tried it then there is nothing more to say, except to reiterate (for the benefit of other readers) that it is not an artificial sweetener, it is a naturally sweet sugar replacement
The Dexcom G6 consists of three components: The receiver, the transmitter, and the sensor. If you have a smartphone you do not need the receiver.
Transmitters, which last 3 months, will run about $180-$200-ish.
Sensors, which need to be changed every 10 days, cost about $100 each (maybe a little less).
There are discounts and coupons available that may help.
The G7 will be widely available soon. I don’t know the cost, but sensor and transmitter is just one piece. Also, insurance coverage will take some time to be widespread. Maybe the G6 prices will come down when the G7 is out.