My life changed this week. I was diagnosed with Type 2 diabetes. Fasting bs in the 400s
My doctor is wonderful....started on metformin, up to 1000 mg today.
My fasting was 256 this AM...and I am struggling to get it into normal range. BTW, I have had my days off during this. My questions are:
1. Should I return to work with high blood sugars? I noticed I had a headache, felt tired and grumpy the last several shifts I worked before I was diagnosed.
2. How does one manage this while working on a hectic Med/Surg Tele unit, working 7 PM to 7 AM 3 nights/week?
Thanks in advance for your advice. :bowingpur
Jan 26, '07
Quote from SCRN1
I was just diagnosed two weeks ago with Type 2. The doctor started me off with Glucophage 1000 mg BID and Diovan 80 mg daily. My BP is fine, but the Diovan is supposed to protect my kidneys. My blood glucose has not come down (mid 200s fasting - almost 500) and was changed to Actoplus Met five days ago. Still no change.
My doctor said they are finding that by the time someone presents symptoms and is diagnosed with Diabetes, they have actually had it for about 7 years. I'm not sure how long my blood glucose has been elevated but I did check out of curiosity within the year and it was normal. I told my doctor this and from what I understood, he explained it could have just been because of fluctuation and I had checked it when it was lower, but the process of changes had already begun taking place.
No matter what I have tried eating and that I've been taking my meds as directed, I still cannot get it within normal range. I am to see the diabetic educator at my doctor's office this Friday and am hoping she will help me with figuring out what I should eat. I've been searching the net to see what I need...how many carbs/meal or day and such, but it is so hard to find anything cut & dry. Does anybody have any suggestions I could use until I see the educator?
I also work 3 12-hr night shifts per week. I'm finding that the nights I work are my better days as far as my blood sugar goes. But I can't work 7 nights/week. Also, I find it harder to work with my blood sugar elevated. I don't feel as focused as I used to and I get blurry vision. The nurses I work with are aware of my new diagnosis and they've been so helpful in checking behind me meds I draw up in syringes and if I'm really blurry, they'll start IVs for me if I need them to.
Find an aggressive endo quick! Oral diabetes meds won't touch the BG levels you have. You need insulin, and the sooner the better. Your Hemoglobin A1C could have been 12% or higher. The goal for good control is 6.5% or lower. PO meds can achieve only about a 2 point drop in the A1C. It takes insulin to get the kind of results you need. Your vision will improve when your BG control improves, so don't go out & get new glasses.
In annual checkups, usually only fasting BG is checked. 126 mg/dl is considered diabetes. A Hemoglobin A1C can tell you how good or bad BG control has been over past 2 to 3 months. Many people will have a good fasting BG, but cannot handle a large amount of carbs at one time. So FBG might be under 100, but if A1C is 6% or higher, this means after-meal BG levels have been high enough to push the A1C into the diabetic range.
Lifestyle changes are important, but without insulin, high BG levels can't usually be controlled. You need a combination of long, slow acting insulin (Lantus, Levemir, or NPH, plus rapid acting mealtime insulin (Novolog, Humalog, or Apidra). This does not necessarily mean that you will need insulin in the long term. Many people are able to switch to PO after good BG control is achieved. Your weight loss was due to your body's use of fat for energy since you were unable to use the carbs in your food for energy. Insulin resistance prevented effective use of your own insulin.
I am an RN and a Certified Diabetes Educator, and I work in a hospital based ADA accredited Diabetes Care Center . I also have type 2 diabetes. I hope that you will be able to find an endcrinologist who will be able to help you achieve good control sooner, rather than later. Most PCP's think they are capable of treating type 2 diabetes, but in my experience, they tend to undertreat and take much longer than necessary get good results. Make sure you go to a Board Certified endo.
Good luck with your education session on Friday. I would love to hear from you to see how you are doing.
Last edit by Myxel67 on Jan 26, '07
: Reason: typo