My Journey With Insulin, 18 Months Later

I never thought insulin would be part of my diabetes journey. Why? Because I seemed to have been able to deal with diabetes without it. 18 months ago, I was informed it was time to add insulin to my care plan. I was resistant, devastated, and scared. It's not the needles I mind; it was the thought that I could mess up the insulin dose.

I had this vision that figuring out insulin dosing was difficult. The difficulty, as it turns out, was not about the dosing; it was still about diabetes itself and the lack of control we have over how it fluctuates, even with insulin.

Insulin dosing seemed easy

My endocrinologist started me on Lantus at bedtime. I couldn't believe how easy it was! A preloaded pen? Seriously? He started me on 10 units. It seemed like a lot to me, but I was also resistant to starting it in the first place. What do I mean by starting? I was instructed to raise the amount of insulin based on my morning blood glucose. Over time, I was up to 21 units and 30 pounds heavier!

Dealing with fluctuating weight

In 2005 when I was diagnosed with type 2 diabetes, I was 230 pounds. By 2006, I had lost 70 pounds. I felt good. I walked for exercise and watched what I ate. As diabetes progressed, I maintained my weight but needed extra help to keep my blood glucose in check. I tried different oral medications over the years. Some I tolerated well, others not so much. Some, simply put, didn't work.

Fast forward to 2020. I was working from home almost entirely at a computer and barely walked. I managed to continue eating well but did indulge in some less-healthy foods. But when I got more physical activity and focused on nutrition, the small amount of weight I put on during that time came off quickly until insulin.

Weight gain is a common side effect

The 30 pounds came on fast and furious. I wanted to lose weight and return to where I started before insulin. It did not matter what I ate, how little I ate, or how much I walked; the weight would not come off. It would not even come down a pound! Weight gain is a potential side effect of insulin. I was getting more distressed about it. My clothes didn't fit, and I felt bad about myself. This was affecting my mental health.

Care not meeting my expectations

When I consulted with my family doctor, I got a speech like, "Join a gym and get your husband to go with you." I repeatedly told him that gym memberships were a waste of my money because, in the past, I did not use my gym membership. I wondered when it became my responsibility to tell my husband he should go to the gym. I was not happy with that advice. He did not listen to me. My cardiologist essential gave me the same speech.

My endocrinologist listened to my needs

Next, my endocrinologist listened when I told him the weight gain significantly affected my mental health. We decided to add Jardiance to my treatment plan. That could be risky because I had a history of yeast infections. We agreed to try it with the provision that if the yeast infections flared up, we would try something else. My endocrinologist was willing to support me in getting a solution to my weight gain.

Hypoglycemia concerns after changing my treatment plan

Almost immediately after starting the Jardiance, the hypoglycemia hit. My Libre sensor went off almost every night, several times a night. I double-checked with a finger poke, and it was correct. I should not have to rescue my blood sugars.

My blood sugar readings hinted that the current Jardiance and insulin dosages were not working together. Since I had the education to increase the insulin based on finger pokes, I decided to try slowly lowering the insulin. Before changing my dosages, I checked with my endocrinologist to ensure this would be safe. He expressed concern over dropping the insulin and firmly informed me not to go just by the sensor. I lowered my insulin 1 unit at a time when I kept going hypo. I slowly lowered the insulin, checking my Libre sensor and performing finger pokes to monitor my blood sugar.

Moving closer to my goals

Currently, I am down 9 pounds in 8 weeks. I'm taking Jardiance with no signs of yeast infections. My provider listened and worked with me to change my treatment plan. I have maintained my insulin at 18 units. My mental health is much better now, and I feel empowered to move forward to lose some weight. I am at peace with having to use insulin. I'm on my way to my goal weight!