What are the two most important factors in your life right now?

Pharmacist George
By Pharmacist George Latest Reply 2014-01-12 09:49:41 -0600
Started 2012-02-19 23:23:03 -0600

Hello everyone,
I am thrilled to have joined your community and looking forward to helping you regain control of your health and your quality of life. I will be starting a series of inquiries to understand better your needs and help steer you in the right direction.
I will start by asking each of you to name the two most important factors in your life right now. Also What is the most nagging question or two you might have about your condition?

119 replies

Anonymous 2014-01-12 09:49:41 -0600 Report

i have so many worries - overweight - gallbladder removed, fatty liver - diagnosed mon jan 6 2014 - on metformin, high bp pills about to go start lipitor tomorrow (gotta get pills today) - have diareah a all the time - on water pills - i have to go to the bathroom make myself go - i am muddling my way thru what foods to eat - see dieticina jan 14 tues -at 4pm -
read too much on internet - found i should go on low carb low fat high protein
found out high protein can cause kidney failure —
blood pressure i am monitoring it like dr said 5 times a day different times - its all over the place from 174/100 to 114/95 —-
depressed —i started doing my ellipticla 10 min a day last 4 days - today i thought i'd try 3 seessions of 10 min — but if i not eating enuf i dont know how i will do it - i barely had 1000 calories i am terrified i will eat the wrong thing or too much of something and go into diabetic coma - ..
suggestions would be helpful - full of worries -figure its already too late for me to fix this situation i got myself into - (270lbs 5 ' 2" 53 yr old)

denipink 2013-06-22 10:43:24 -0500 Report

Thanks for answering our questions, George! Very appreciated :)

I have been taking Lithium for some 20 years for being Bipolar. I am also type 2 Diabetic.

I currently take 4 Lithium caps at night so i think that is 1,200 mgs. I am very worried about my Kidneys. They must be taxed to the nines because i have Psoriasis, too.

I want to go off the Lithium and i am told the withdrawal can be nasty. What do you know about the withdrawal? Is there something else i can take to make the withdrawal more tolerable?

I went off the Metformin because i read that it could cause damage to the Kidneys.

Doing my level best here, Denise

red flower lady
red flower lady 2012-02-27 22:18:31 -0600 Report

George, are you planning on answering questions on a regular basis or just hit or miss? Also, since this is a forum and we are posting public to your questions, I would expect your replies to be public as well. Am I correct in this. Thanks

jayabee52 2012-02-28 17:00:48 -0600 Report

that certainly makes sense Darlene! But see Dietcherry's reply on Feb 25 below.

red flower lady
red flower lady 2012-03-03 18:29:26 -0600 Report

Are you talking about her post where she post George's reply to her profile? If so, that doesn't answer all my questions. I see he hasn't posted anything since Feb 20th, I wonder why, is it because of some concerns about him making money off of us to get his books? Will he not help us even if we don't buy the books? I may have missed why he isn't answering our questions though.

jayabee52 2012-03-03 19:30:59 -0600 Report

If you haven't gotten an answer on your profile wall then he seems not to be answering our questions.

You could go to the bottom of any page and click on the "Feedback" link and ask there why George is not answering questions. You should get some kind of answer in 48 hrs from someone about your concerns.

red flower lady
red flower lady 2012-03-04 14:46:06 -0600 Report

Ok, so he is only answering on our profile, but do we ask the question to his profile then? I'm so confused with his participation here. He asked a question in a public post and then he was gone:~ so confused

jayabee52 2012-03-04 14:49:15 -0600 Report

That is my understanding. I've not asked a question of him so I am not looking for an answer from him.

Armourer 2012-02-27 00:37:28 -0600 Report

Welcome to the DC team! Need to lose weight. Since on insulin (humalog & lantus) I've gained 30-40 pounds in four years. The last six months my waist expanded 6 inches but no weight gain. For some reason have lumbar back pain in the muscles, but no pinched nerves or fractured back bones. I'm thinking the problem is caused by statins I took for 18 years, but been off for three months and still have the pain, can't brush teeth without pain causing my legs to lock.

red flower lady
red flower lady 2012-02-27 22:14:23 -0600 Report

Back pain can be caused by too much weight in the tummy area as well. Also can cause pain in the knees and feet from carrying it around. I know, just something else to add to the health list.

TsalagiLenape 2012-02-25 08:26:50 -0600 Report

Well many have replied but you havent…now what? Just curious to see what you are doing with this.

jayabee52 2012-02-26 09:05:22 -0600 Report

Temi somewhere else (i believe it was yesterday) I saw that George was answering on people's profile walls.

I would prefer an answer either on the discussion boards, or in an email where the activity feed does not sweep any answer away in the torrent of activity on most profiles.

Just a FYI Temi!

Graylin Bee
Graylin Bee 2012-02-24 19:57:43 -0600 Report

Important factors:
Continued improvement in my legs (regaining muscle and strength) after venous stassis, cellulites and MRSA disaster. Managing and maintaining diabetes while complications are minimal.
Nagging question:
Did the venous stassis, cellulites and MRSA cocktail contribute to the Diabetes or was it pre-existing and just get worse when the cocktail hit the fan?

2012-02-24 14:34:05 -0600 Report

The only thing that I'm truly worried about is that I've been on Metformin ever since I was diagnosed with type 2 diabetes 17 years ago. Now can being on this particular medicine for this length of time, do any type of damage to other eternal organs? (I also take 20mgs of Zorcor for high cholesterol, & 100mgs twice weekly of Diflucan for a chronic yeast infection.)

jayabee52 2012-02-24 20:18:34 -0600 Report

for some (like me) Met seems to weaken our kidney functions. I had to go on dialysis for 10 months starting in Nov 2006. Now my kidneys are failing again and I may need dialysis again, probably for the remainder of my earthly life.

Set apart
Set apart 2012-02-23 20:42:03 -0600 Report

My first important factor is to stay on track as far as my focus in taking care of my D through my choices, such as must make healthy choices, must exercise, must take meds, must limit carbs, etc. my second most important factor is to enjoy my life through my spirituality, family, and friends! And let's not forget DC and the impact it has made on me!

MoeGig 2012-02-22 20:27:04 -0600 Report

Well, now the most important factor is to be able to enjoy retirement without complications; and second, to minimize the cost of control (a corollary to the 1st goal). To accomplish this, low carb diet, exercise, and continual monitoring, A1c in the 6';s, etc. Fear of failure is the primary motivator…because you know the resulting scenario for failure…expense, problems, complications, pain, surgeries, etc…need I say more?

pkwillhoite 2012-02-22 16:48:25 -0600 Report

Welcome Pharmacist George, I have been on here for a while but have been really busy with going to a training and I took a month to learn how to do peoples taxes. My 2 most important factors are just to be able to deal with the highs and the lows and find a job to get the meds i need and be able to go t the dr. Right now I dont really have a nagging question because I am not taking meds or testing at the moment. I have no health coverage and no money to pay for the supplies I need. Thank you for listening to my complaints. I hope I will be able to be back more often now that I am almost done…

Jan8 2012-02-21 17:41:58 -0600 Report

welcome Pharmacist George, in answer to your question I think I just want to feel better and then i would like to be able to get out of this house for longer than 20 minutes.What are the 2 most nagging questions you have? I have pretty much given up on my conditions because I have little I am able to control. Now the one thing I bekieve in is the pharmacist and medication because if it were not for them ,I wouldnt be here. Sure the doc can order the meds but you are the ones who are really helping our lives by giving us what we need. Thank You for being who you are.

locarbarbie 2012-02-21 16:50:10 -0600 Report

Welcome Pharmacist George! I have 3 important factors…1st is maintaining a healthy diet and low A1c to keep complications from occuring, 2nd is keeping my head above water financially ( to avoid stress) and 3rd is knocking my insulin resistance to the curb and losing the weight.

My nagging questions are: Is metformin really necessary for me? I have never personally seen any difference one way or the other either with bs levels, A1c, or whether it has made any difference with the insulin resistance and weight. My last A1c was 5.8 and that was when I had NOT been taking met. I started again because my DR convinced me it would help with insulin resistance. I feel the risks outweigh the benefits. I am frustrated because it seems as though taking a med is always a Drs first line of defense.

Pharmacist George
Pharmacist George 2012-04-29 15:32:32 -0500 Report

Hi “Locarbbarbie”
You have raised very important issues that most people with diabetes struggle with and I’ll help you sort them out. First off let me congratulate you on your A1C level of 5.8% because this is ideal and actually below the recommended desired level of between 6 to below 7%. Metformin is what lowered your A1c to this level plus any lifestyle changes you may have already implemented and need to keep up with.

Your A1C may not go any lower and will stabilize even if you keep taking medications but chances are that Metformin is what keeps it there. It’s a good sign that your A1C is at 5.8% because this may mean that your body has become more sensitive to insulin due to Metformin and physical activity (I am not sure if you’re physically active or not but I am assuming so). Generally when someone is experiencing moderate to severe insulin resistance their A1C may remain elevated at 7 to 8% despite medications and some lifestyle effort.

Since I don’t have many specifics about your health state, your doctor may keep you on Metformin because you on it for several reasons pertaining to your condition and current lifestyle factors. If you have made strides in lifestyle changes, lost some weight and have been making balanced food and physical activity choices then that’s awesome and highly encourage you to keep on doing them because they must be a part of every human’s lifestyle and not just people with diabetes.

Always remember that the end outcome to making favorable lifestyle choices is not only weight loss but the ultimate benefit from such a great lifestyle is disease prevention and improvement of quality of life. In other words, if you been making good food choices and have been walking then after a while you stop losing weight. Don’t be discouraged but keep on making those good choices and that does not mean that your body stopped benefiting from the choices you’ve been making.

Weight loss is nothing but one of the benefits of good lifestyle choices and your main goal is not only weight loss but to learn how to build those new habits and keep them with for life in order to avoid and manage diseases.

Metformin is a great drug and a corner stone treatment for Type 2 diabetes that has a tolerable side effects profile, is very affordable, has long term benefits on A1c and weight. Ask your doctor why you are still on it and ask him/her to consider lowering your dose since you have such a great A1C.

In a week or so I will release an article on the causes of Insulin Resistance and a simple approach to reverse it or improve it. So check out and read my current articles in “Living with Diabetes” where you’ll find articles addressing several diabetes related issues and where you can have access to my new article about Insulin Resistance. Take care.

flipmom 2012-02-21 14:44:47 -0600 Report

just wanted to say hello and welcome… 2 most important factors for me are my faith and my best friend… my faith gives me inner stength and my best friend because he gives me all the support i needed…

Pharmacist George
Pharmacist George 2012-03-27 13:34:45 -0500 Report

Thanks for the welcome "flipmom" and the two factors you mentioned are awesome and very important. Don't undermine the power of prayer and trustworthy support person or group are inevitable for our emotional and physical wellbeing and healing.

Hops 2012-02-21 14:25:05 -0600 Report

I am using BD Low Dose Insulin Syringes that take up to 30 units of insulin. My Lantus insulin dosage I prepare 5.5 units of insulin on these syringes for full units. Are there and half unit measurement insulin syringes I can use and not mistakenly draw up too much or too little insulin in the process?

Pharmacist George
Pharmacist George 2012-03-27 13:29:32 -0500 Report

Hi “Hopps”,
The 30 unit insulin syringe is actually the smallest syringe you can get and there are no half marks on insulin syringes. You just have to aim between the 5 and 6 unit marks. Since we’re talking about dosing insulin let me give you a couple of injection tips. First clean the tip of the insulin vial with an alcohol swab and let the alcohol dry thoroughly before you use it. Do not use alcohol on your skin because you may get a false reading.

Then draw 5.5 units of air in the syringe and inject the air into the center of the insulin vial. Then flip the insulin vial upside down and then draw out the insulin into the syringe up to the 7 or 8 unit mark and keep the syringe tip inside the vial and don’t take it out yet.

As you’re withdrawing insulin into the syringe air bubbles will be forming inside the syringe. Now since you have 7 or 8 units of insulin in the vial you start pushing syringe back in very slowly to reach to the 5.5 unit mark and as you’re doing so then with your other hand you want to flicker the syringe with your finger to get rid of the air bubbles. If you get to the 5.5 unit mark and there still are bubbles then you can repeat the procedure again by withdrawing the insulin back to the 7 or 8 unit mark and work your way back to the 5.5 units following the same procedure.

Once you have reached the right dose then you withdraw the insulin syringe tip from the vial and you form a pinch of fat with your free hand 2 inches above your navel and inject the insulin straight into that pinch of fat. The best place to inject insulin is directly into your stomach fat because it has the highest absorption rate.

Then dispose of the syringes, lancing tips or any blood borne syringe tips into Sharps Containers that you buy from the pharmacy or into closed glass or plastic cans or in closed empty prescription vials then contact the Sharps company or a medical waste treatment site (contact your city utilities or a local hospital to get such contacts) to schedule a pick up. This will help protect workers from pricking themselves with contaminated blood born objects.

Hope this was helpful. Take care.

pixsidust 2012-02-21 11:03:38 -0600 Report

From a Phar­maci­st point of view. My concerns are preserving the health of my organs. I know meds like Metformin have been known to damage kidneys. What are the best drugs to use and the best ways to preserve the health of our other organs?

Pharmacist George
Pharmacist George 2012-03-23 19:05:50 -0500 Report

Hi “Pixidust”
This is not true about Metformin it does not cause Kidney damage but to the opposite it is a cornerstone treatment for Type 2 Diabetes and in some cases Type 1 and has several benefits beyond blood sugar lowering. It has a very manageable side effects profile and a very low incidence of hypoglycemia (a dangerous quick drop in blood sugar) and actually has one positive side effect which is weight loss. If your doctor chooses to put you on it then I would definitely not hesitate if I were you. It sensitizes your body to respond to the insulin that your body produces and reduces your liver’s production of sugar.
Also some of the benefits of Metformin is that it’s one of the aggressive drugs to reduce your A1c by up to 2%. Also Metformin can drop your bad Cholesterol LDL by up to 8% and even may cause a rise of your good Cholesterol HDL by a couple points.
You can preserve your internal organ by making favorable lifestyle Choices, become physically active, make balanced food and activity choices and lose weight gradually (if you have excess weight).

Some blood pressure drugs have been clinically shown to also preserve your kidneys such as the class of ACE Inhibitors and ARBs. Also the class of blood pressure lowering drugs Beta Blockers have been also shown to protect your heart. Your prescriber will make the decision to prescribe the appropriate drug for you.
All of the factors I brought up here with regard to all diabetes medications oral and injectable, weight loss and lifestyle choices are all available in great simplicity in Lifestyle Makeover for Diabetics and Pre Diabetics.

jigsaw 2012-03-24 08:15:42 -0500 Report

Thanks George! I have been on Met for a few years. I manage my bg tightly and have for about 18 years. My kidneys are doing fine as confirmed by numerous tests over the years by numerous doctors. I suppose that it could be confusing for some to realize that high bg, and high bp are more commonly the culprit of kidney failure as opposed to Metformin. I have discussed the use of Met with 3 endocrinologists, and two primary care physicians as well as my pharmacist. They all are of the same opinion that you have. I feel it is of utmost importance for those that need to be on medications to know with reasonable accuracy and info , what their choices are. I have yet to hear of any blind studies that have shown Met to cause kidney damage. I mention this for those considering the use of Met.

Pharmacist George
Pharmacist George 2012-03-24 14:54:02 -0500 Report

Hi “Jigsaw”
I totally agree with you and concur once more with opinions of the various professionals you consulted with and here’s my final response to the Metformin matter.

With regard to any technical data about medications I get my information from professional pharmacy resources such as Facts and Comparison , Lexi-Comp Drug Information and the drug’s manufacturer recommendations. As a health professional I have the ultimate responsibility to provide accurate information to people.

When the doctor decides to put a patient on a certain medication he or she weighs the benefits verses consequences and they customize medication prescribing to each patient after a thorough examination. These quick posts are not intended for detailed discussions about various medications or to analyze all the side effects and drug interaction profiles.

It is my ultimate responsibility as a pharmacist and health professional to provide general recommendations and steer people in the right direction based on reliable facts and help people avoid myths especially when I know very little about the details of each one’s condition.

Here are at least 3 resources anyone is welcome to check regarding Metformin not causing Kidney damage:
1) From Wikipedia: http://en.wikipedia.org/wiki/metformin

2) From Emed TV: http://diabetes.emedtv.com/metformin/metformin-warnings-and-precautions.html

3) From Everyday Health:

I stand by my response I posted earlier regarding this inquiry.

jigsaw 2012-03-24 18:27:18 -0500 Report

These links should definitely clarify some misconstrued details concerning Met. Obviously 48,000,000 prescriptions in the U.S. during the year of 2010 alone, is a powerful statement in itself !
Thanks for the excellent links and your validation concerning the usage of Met.

granniesophie 2012-03-24 06:46:08 -0500 Report

I don't believe this about Metformin and I don't think others will either. I have been directly told by my doctor that it DOES cause kidney damamge and once my kidney function goes down a little more, if indeed it does, I will be taken off it to preserve function, and I know of someone who isn't on it because of damage to the kidneys. While Metformin can do a host of good things and it is the "gold standard" for diabetes meds, I don't agree with everything you say, since I personally have had very little of the benefits that you say will happen in your reply.
I certainly would not personally tell anyone not to go on it, but I do have great reservations about it, and I challenge you to prove your statements, since it has been proven that long term use of Metformin does indeed cause kidney damage, and I would like to see where you are getting your information that disproves all the Doctor's research on this.
Certainly lifestyle choices also have a great deal to do with diabetes control and how organs react, but for those of us on meds as well, we want to know exactly what a med is doing to our organs, and the research is out there that is disproving what you are saying, along with medical people saying this as well.

shnell25 2012-02-21 09:47:12 -0600 Report

Hello Pharmacist George. Welcome to the DC community. I am fairly new myself, but I am enjoying the community and have learned a lot.

Two important factors for me are: maintaining my diabetes with a healthy diet and exercies and also to continue monitoring and lowering my BG levels and ultimately my A1C level.

Pharmacist George
Pharmacist George 2012-03-23 18:24:51 -0500 Report

Hi “Schnell 25” those are worthy goals and I would like to highly emphasize that when you you’re your medications as prescribed, monitor your blood sugar, make favorable lifestyle choices by raising your physical activity throughout each day, make balanced food and snack choices then everything start going the right way including your fasting blood sugar and A1c. I congratulate you for realizing that it is important to bring down your A1c level.
A major landmark trial has confirmed that dropping your A1c by 1% reduces your risk of complications such as neuropathy to the feet, eye problems and the incidence of blindness and kidney damage by a whopping 35%. It is very critical to aim at bringing gradually your A1c down to below 7% in order to avoid those complications I just mentioned. It seems most people who posted replies to my inquiries want know more about “Diet and exercise”. Consequently, I will be addressing those issues in my posts and articles. Progress and action starts with positive intensions which you have. Great for you and stay tune.

TsalagiLenape 2012-02-20 22:58:12 -0600 Report

Hello George. Welcome to DC. I see there is some confusion over your arrival and etc. So my two points is: To eat healthier and to lose weight. My annoyance comes from doctors who dont "team up" to help their patients. As well as get the answers their patients seek. Or refer them to someone who can. Then again too there are those of us on fixed or reduced incomes. We have a choice between having food or test strips for example guess what we are picking? Food.
Thus far to date, I am the leading force behind my control of health and quality of life. Tis my choice to learn use and grow from what I have done thus far. I applaud anyone willing to help along the way. Yet be realistic that some of us cant afford simple daily needs like test strips. I agree with Young1s about controlling D with diet and exercise.

Pharmacist George
Pharmacist George 2012-03-19 17:31:31 -0500 Report

Hi “T.”
Well I understand your frustration with Doctors but believe me they are not totally to blame because they have very little time to spend with patients due to the fact that our healthcare system is swamped with people who have chronic preventable conditions . They barely have the time to diagnose your disease conditions and check on your progress. Pharmacies and pharmacist are in the same boat too. During our practice when an average pharmacy is filling 400 to 500 prescriptions per day then we hardly have less than one minute to spend counseling our patients. The majority of patients have multiple chronic conditions and are on multiple medication regimens and need to spend more time with a health professional to help them make sense out of their conditions and medications.
As for the medication expense believe me that I totally understand where you’re coming from because I deal with this issue day in and day out. I try what I can to help people out with the various means at my disposal to make medications affordable to them. Believe me a lot of times I paid people’s prescription cost out of my own pocket when I know that they can’t afford it and that they would have to otherwise go home without their medications. I’ve posted an opinion about this matter of medication and strip affordability that I would review.
I love the statement you made “Thus far to date, I am the leading force behind my control of health and quality of life.” This is the single most critical and important element to your long term wellbeing. I have also shared some posts with regard to making favorable lifestyle choices in terms of raising your physical activity and making more balanced food, snack and beverages choices and raising your fiber intake. So check them out. Also, make sure you read my upcoming articles because I address a variety of these issues.
So keep those intentions and your drive to improve your health because that should be all humans’ first endeavor. Good for you.

Young1s 2012-02-20 21:48:05 -0600 Report

Diabetes related? Being able to check my BG's as often as I want to, without my insurance company dictating how many strips THEY think is necessary per day. And, being able to finally control my D with just diet and exercise.

Pharmacist George
Pharmacist George 2012-03-17 17:07:01 -0500 Report

Hi There, I agree with regard to insurances they dictate to doctors, pharmacits and patients what and how much they'll cover. But if you're not using insulin check your blood sugar at least once per day on a fasting state and preferrably two hours after lunch. If you're using insulin then check your sugar before every injection. Think of your medications as lifesavers but making favorable lifestyle choices with regard to balanced food and activity choices are at the heart of diabetes control. If you have Type 2 diabetes and without any organ failure or complications then you could aim at reversing it. Read my posts to all members and articles then apply what works for you because I address the various factors of diabetes control and reversal. Take action.

Tess K.
Tess K. 2012-02-20 21:18:03 -0600 Report

The two most important factors right now for me is the high stress level of only one person in the household working (part time at that, me) which results in lack of funds for everything and my improper eating habits (could use some help to get motivated). I am sure there is more but I don't want to bend your ear too much right now.

Pharmacist George
Pharmacist George 2012-03-09 17:09:57 -0600 Report

Hi “Tess”
These are very real concerns but do you think that living with this high stress level will worsen or improve your current situation? It will of course worsen your health, your diabetes and will place a tremendous pressure on your budget as well because you may have to spend more on your conditions that may undoubtly get worse due to stress and the unfavorable choices you are making.

In the face of adverse situations in your life you only have 2 options: 1) Take it out on your health by feeling down, smoking more (if you smoke), consuming more “comfort food” and higher quantities of nutrient deficient choices of packaged food, snacks and beverages that are loaded with sugar, fat and salt (that costs more than making simple meals and snacks from scratch at home), and becoming less physically active. Or 2) making favorable lifestyle choices that are good for your health and your diabetes that cost less money and which put you in a much better shape to overcome that major stress factor in your life and defeat it.

With the first option your current disease conditions will get worse and you will suffer complications and acquire more diseases. Consequently, you may not be able to work and earn the additional income needed. However, with the second option you will regain control of your conditions, prevent deadly complications and you will have better chances at finding work and supporting your spouse or partner in improving the financial state of your family.

So I strongly urge you to make the obvious right choice that will benefit both you and your family. In my posts and articles I address all of your concerns in a variety of angles that will benefit you and everyone else. Check the other sites besides Diabetic Connect where I place posts like Obesity connect, COPD Connect and Heart Connect. Take care.

nzingha 2012-02-20 13:52:21 -0600 Report

the 2 most important factors…? do they need to be diabetis related?

Pharmacist George
Pharmacist George 2012-03-09 15:12:33 -0600 Report

No any 2 most important factors in your life

nzingha 2012-03-10 10:17:52 -0600 Report

hi there.. almost forgot that i had done this post but thnks for responding.. 2 concerns..
1- cushings disease/syndrome.. can it develop as a result of the body's resistance to the use of insulin?
2- if the body is rejecting insulin…both from what u produce and the one being injected, what is the next move becaiuse there is no cure for diabetes and if its not injected insulin and metformin, what else.. does one become a cow/goat or just roll over and die..sooner than later ??? lol!

Pharmacist George
Pharmacist George 2012-03-17 15:53:04 -0500 Report

Hi “Nzhingha”,
No don’t roll over… because you have many other options and I’ll share a couple helpful tips. In response to your first question, insulin resistance does not cause Cushing’s Syndrome nor does injected insulin. As for the insulin resistance inquiry, the good news is that with injectable insulin there is no limit to the dose that can be used to control your blood sugar. In other words even in the presence of insulin resistance your doctor can increase your insulin dose to whatever dose needed to reduce fasting blood sugar to the desired level which is below 110 mg/dl.
There are several ways to dose insulin and although I will not address how to dose insulin because dosing insulin is individualized by your prescriber but I will give you an idea how the insulin dose can be increased in case of resistance. So let’s say your doctor started your insulin regimen based on your body weight and figured out your current dose based on 0.5 units per Kilogram (Kg) of body weight then he or she may raise it to 1 unit per Kg or 1.5 units per Kg or more in order to get to the desired blood sugar level.
However, having said that it is critical for you know that with higher insulin doses the potential for side effects increases drastically namely hypoglycemia or low blood sugar attacks especially with short and intermediate acting insulin like Humalog, Novolog and NPH . I’ve addressed all these issues thoroughly in Action Step 2 of Lifestyle Makeover for Diabetics and Pre Diabetics.
Actually if you have Type 2 Diabetes you may be able to actually reverse it if several factors are addressed such as physical activity, weight loss, the quantity and quality of the choices of food, snacks, and beverages. Moreover your meal and snack structure and distribution throughout the day are also critical to stabilizing your blood sugar.
If you are in a stage where disease reversal is not an option then managing and regaining control of your blood sugar, diabetes and health is always an option regardless of which stage you’re in. I have addressed the topic of defeating diabetes in various ways in a series of articles that all of you will be getting soon.

The most important factor for you to know is to not expect and not to rely solely on medications alone to bring your blood sugar under control and reduce insulin resistance. Losing weight by increasing physical activity and raising fiber intake are major factors to sensitize your body to insulin even more so than Metformin. I’ve addressed the issue of insulin sensitivity with regard to physical activity and raising fiber intake in previous posts so check them out.

nzingha 2012-03-19 04:23:18 -0500 Report

thnks for ur response. i am managing the diabetes well.. the docs have confirmed that.. its the 2nd part of the question that continues to baffle me. i am still waiting to see the endo and it seems to be taking forever.. anyway i have set up a google alert on cortisol excess and cushings.. so i am reading up a lot..maybe too much in the meantime.
it is clear that i do need the insulin.. tho sometimes i am able to take reduced dosages/units depending on the readings… when i overdo it..meaning when i do take too much less than the prescribed dosage, and depending on what i eat. .. my sugar will spike.. but for the most part i try not to take less than 2 units of the prescribed dosage.. and i do excercise…thnks again for ur advise

Caroltoo 2012-03-19 16:38:39 -0500 Report

Glad to hear you are doing well with your diabetes, Nzingha. Now just to get to the endo and figure out the cushings part of the puzzle!

Just Joyce
Just Joyce 2012-02-20 11:54:48 -0600 Report

Hi George, what is nagging me is that with the economy the way it is today and many people needing diabetic testing equipment can't afford it especially those on fixed incomes or with no health insurance. Meters are far cheaper than testing strips. Has the National Pharmacist Association taken a stand to get drug companies to lower the cost of testing strips or provide them at a lower cost to those ill equipped to pay full price?

Some of us have to test often throughout the day and depending on your meter, 100 strips is over $100.00 making one strip well over $1.00 per strip. This cuts into your income and if it is fixed some people are making choices with their health that no one should have to make.

jayabee52 2012-02-21 11:57:32 -0600 Report

Joyce, drug companies do not control the price of strips, the companies which manufacture the meters and strips do. They're the ones who need to be challenged about costs.

Also it is the insurance cos. who restrict the number of test strips we are allowed to use because they want to lower their costs of care for People with Diabetes (PWDs)

The drug manufacturing companies have their own issues for which we all need to be on them regarding the high costs of meds.

That is how I understand it from a "layman's" perspective.

Just Joyce
Just Joyce 2012-02-21 12:05:16 -0600 Report

I agree, however, they do play a roll. Some won't give a card for meds at a lower cost. I have had drug companies offer me a prescription card for meds I don't take.

I have been following the articles on the shortage of a cancer treatment drug. One vial is normally $12.00 that has now gone up to $1000.00 a vial. People suffering as it is with the high cost of everything.

I had health insurance and would not let the doctor give me a rx for strips because at least I can control how many I may or may not need. Cost more but at least I can control something regarding me. Thanks for the input.

jayabee52 2012-02-21 13:08:15 -0600 Report

I was not aware of the situation regrding the CA treatment. Yes the cost of everything is way too high. I feel it too.

Pharmacist George
Pharmacist George 2012-02-20 14:08:51 -0600 Report

Hi Joyce, by joining DC my intention is to fulfill my personal and professional mission which is to help people avoid the dangers of disease complications and enjoy the best quality of life. I wrote 5 books to help my patients during my pharamacy practice address all the underlying factors and regain total control of their health. I just wanted to clarify my intentions that I am on a mission to help you regardless of any financial incentives.

Now with regard to your question many pharmacy chains and mass discount pharmacy chains provide their own meter and strip brands at 60 or 70% off the the other brands bring the cost of 100 strips to $25 or $30. Plus almost all will have a list of the most frequently used 300 or 400 drugs for $4 or $5 per month including diabetes, blood pressure, cholesterol and just about any other conditions. Shop around and find out what's local to you.

Just Joyce
Just Joyce 2012-02-21 11:41:47 -0600 Report

I have several meters, I am asking because there are members who are in need of meters and can't afford them. Many chains don't make it known that they have their own meters or test strips. In fact the last time I bought a meter I later learned of the store brand as they were not displayed with the meters but with the test strips. I think when people ask, the pharmacist should also as how much the person is willing to spend. Some people have limited funds and don't know that a store brand meter is comparable to well know brands.

As for the cost of drugs. Most people are aware of this unfortunately doctors will still prescribe the higher cost drugs to patients they know can't afford them. My concern is for those who are on fixed incomes, the unemployed and those with no medical coverage.

dietcherry 2012-02-20 11:21:42 -0600 Report

Hello and welcome George! We are a rabid bunch when it comes to protecting the integrity of our beloved DC!! I may have been on your case too if Id been around the last couple of days ;)

The 2 most important (health) factors in my life right now are:

1. Maintaining stable blood sugar levels
2. Avoiding long-term complications of T1 (so far, so good!)

Three nagging questions: My Endo thinks I may have developed insulin resistance after 32 years of T1. He started me on Metformin (500mg once a day) and cut my former insulin dose to half (36 units now down from 70). How does an individual know if Met is working for them, could they need a larger dose to make a difference, and will it have any effect on a T1 who isnt otherwise insulin resistant?

dietcherry 2012-02-25 12:31:06 -0600 Report

George I took it upon myself to re-post your response to my inquiry here. Although I appreciate you posting it initially directly on my profile, it will be lost to the newsfeed forever and I thought you made some critical points within for many members to learn from for years to come!


it’s great both important factors fall within the context of having great health. This should be every human’s endeavor. Good for you.
Now with regard to your questions there are many reasons such as excess weight, physical Inactivity or the lack of enough amounts of fiber why anyone with Type 1 or Type 2 may become resistant to insulin. In this situation it was a great move by your doctor to prescribe Metformin because it’s a corner stone treatment. The way Metformin works is that it sensitizes your muscles, body fat and liver to become more sensitive to insulin and consequently reduce blood sugar.
Among all of the various categories of oral diabetes drugs for Type 2 diabetes only Metformin can be prescribed to people with Type 1 to sensitize their body to insulin. With regard to dosing Metformin your Dr may start you on a 500mg per day for a week then work the dose up gradually over 2 to 3 weeks to get to the maximum effective dose of 2000mg per day or 1000 mg twice daily. This will help minimize the nuisance abdominal side effects such as bloating, nausea, diarrhea or flatulence. Take Metformin with food.
You will see the maximum benefits of Metformin in terms of lowering fasting blood sugar in 3 to 4 weeks. So you should be monitoring blood sugar before every insulin injection and you’ll be able to tell how well Metformin is working.
Another integral factor to sensitize your body to insulin which is free and has no side effects is Physical Activity. Another crucial factor is raising fiber intake. The presence of fiber in your meals and snack is a great insulin sensitizer.
Stay tune for my articles and posts to learn about the importance of physical activity, practical tips to a physically active lifestyle and the importance of fiber and balanced well structured meals. I hope this answers your question.

4 days ago · Comment · Unlike
You and 4 othersCaroltoo Tess K. Young1s jayabee52 like this.
Thank you for all of this George! I am quite slim and exercise regularly, so Im thinking it may be an issue of fiber in my diet! Well that and possibly some hormonal issues. I will begin eating more fiber and see what gives. Thanks again George!!

jigsaw 2012-02-25 13:00:02 -0600 Report

Extremely helpful info here! By the way, increasing my fiber intake has helped me in a few ways including bg control. My diet always included many vegetables and fruits, and I thought my fiber intake was adequate. My gastroenterologist disagreed and recommended increasing my fiber intake. Well, thats what I did with my diet. I also added flaxseed, its cheap, natural, healthy and it works.

dietcherry 2012-02-25 14:37:59 -0600 Report

I eat alot of vegetables but Im going to assume its still not enough. I really cant eat any more food a day than what Im already eating so I will need a supplement; I was thinking the S-F Metamucil…

jigsaw 2012-02-25 18:39:52 -0600 Report

The S-F version of Metamucil uses maltodextrin as a sweetner. Maltodextrin in excess and over long periods of time can cause your bowels to become lazy. The question is, what is considered excessive? The next thing that comes to mind is, the main purpose of Metamucil. It is intended to help eliminate constipation. I'm not sure what the effect might be in combination with Metformin if your having the opposite problem. So these are a few points that you may want to consider.
Have you ever used flaxseed? If you haven't, check it out. You can mix it in a variety of foods, and it will increase your fiber intake for sure. Personally, I like the taste. I am not talking about flaxseed oil, so don't get confused. Only the actual seeds. You can buy a box of flaxseed at Walmart for about a $ 1.50. It's loaded with fiber, and very low in carbs. I definitely have insulin resistance, and the flaxseed appears to help control my bg to some extent. It also has numerous other health benefits. Unless you have an unusual reaction like an allergy, I don't believe it can hurt you any more than a stalk of celery. Some additional benefits included per two tablespoons:

1) 4g dietary fiber,130mg antioxidant lignans
2) 3g ALA Omega-3
3) Protien and anti oxidants
4) boost to the immune system
5) boost in energy
6) a natural food with nothing artificial

dietcherry 2012-02-25 21:44:47 -0600 Report

Points considered Jigs! lol I dont know that I can use flaxseed safely; it apparently acts like estrogen in the body, similar to soy, and I am estrogen-dominant and suffer female problems becasue of it. I will need to discuss it with my Dr. first. I may still try the Metamucil but will be wary of it. If anyone reading this has any other ideas, please let me know!

jigsaw 2012-02-26 06:54:31 -0600 Report

I've never heard anything specifically in regards to how much Maltodextrin is considered excessive. I suspect that one would have to consume enormous amounts beyond what the average person would normally ingest. I believe the risk implied would come from using numerous products with maltodextrin in the ingredients. The other side of the coin, I've been using Metamucil for over a year, and my wife has also. No neg effects to either one of us.
I have a question for you! If flaxseed has the ability to act like estrogen, am I at risk for growing a pair of breasts ??? )-;
You brought up an interesting point, so I started looking into the estrogen effects of lignans and also soy products especially since my wife consumes both in moderation. Here's a link I came accross:

dietcherry 2012-02-26 09:29:20 -0600 Report

hahahaha I guess youre in a better position to answer that question! ;)

Ive researched flaxseed in the past because of its many benefits and found that women who have conditions caused by, or related to, excess estrogen, including breast cancer, endometriosis, uterine fibroids, PMS, PMDD, should carefully consider ingesting phyto-estrogens.
As usual, experts dont agree on the safe usage, effects, and any complications of such, so I choose not to use them on a regular basis.

The more I think about it, the more Ive convinced myself that my fiber intake is woefully lacking; is there any kind of test to measure fiber level? Thats probably a stupid question but I need to put it out there.

After what George said, I feel it could be the missing link in my diet and Im eager to find out if it can solve the riddle of my alleged insulin sensitivity. In fact, Im shocked my Endo didnt mention it!

Pharmacist George
Pharmacist George 2012-03-09 15:10:59 -0600 Report

Hi “DietCherry”
With regard to your inquiry about Fiber Choice, it is sweetened with “Sorbitol” (a sugar alcohol) along with a tiny amount of “Dextrose” (a form of sugar) that won’t impact your blood sugar levels. Sugar alcohols are sweetening agents used in commercial products for their sweet taste instead of artificial sweeteners or plain sugar. Some of the problems with sugar alcohols is that they may cause bloating and diarrhea. Also half of the calories from the sugar alcohol content is absorbed into your blood and can impact your blood sugar depending on the amount included. Whereas artificial sweeteners are absolutely safe according to the ADA and all health organizations and are recommended for the general population and people with diabetes.
If you are wanting to use Fiber Choice, Psyllium Husk containing products or other OTC fiber products for regularity then I do recommend them for this use. However, I don’t recommend using these products to raise fiber content in your diet. The best way to raise your fiber is from dietary sources. There are ample food sources in the market that are loaded with fiber.

Aim at raising your daily fiber intake up to 30 or 35 grams and I’ll show you how you can reach this amount with just a couple choices: 1) Fiber One bars by General Mills or Fiber Plus bars by Kellogg’s have each 9 grams of fiber, they are delicious and a great way to start your morning. 2) “Double Fiber” by Oroweat or by Nature’s Own brands contains 5 to 6 grams of fiber per slice. You can create a delicious lunch sandwich with a couple slices of these breads smeared with mustard, include lean ham or any other choice of lean deli meet or poultry, a slice of cheese then loaded it up with lettuce and tomato slices. This sandwich will yield about 12 grams of fiber.
Then for dinner if you eat a salad, a different choice of protein than lunch and a bowl of any form of beans or peas then this is going to get you at least another 11 to 13 grams of fiber or more. Including a couple fruit snacks in between meals daily will supply you between 3 to 5 grams of fiber per choice of fruits such as bananas, apples (with peel) or oranges (keep some of the white rind).
PS: Flaxseed is a great source of fiber and Omega 3 and you can include it as part of your daily meal or snack choices. Women with the conditions you mentioned can consume flaxseed as part of a balanced meal structure.
So there you have it just a couple of choices in the structure sample I provide you will supply well over 30 grams of fibers, will sensitize your body for insulin, will promote blood sugar balance and prevents highs and lows, will keep you full and keeps hunger away and will provide your body with a plethora of nutrients from a variety of sources of vegetables, protein and comples carbs. Take care.

jigsaw 2012-02-26 09:57:41 -0600 Report

Right now I'm looking in the mirror ( shirtless ) to make sure I haven't eaten to much flaxseed. (-: I'm happy to say, nothing unusual going on!
I assume that u are aware that Metamucil is primarily psyllium fiber/husk ?
I have a suspicion that diet may be part of the missing link for you also. My dietician broke through my skepticism with diet improvements concerning fiber, and they helped.

dietcherry 2012-02-26 10:26:27 -0600 Report

lol No I didnt know! In fact I guess I dont know jack about fiber!!!!

Im happy to hear everything is business as usual with you! ;)

jigsaw 2012-02-26 10:46:19 -0600 Report

You know, one of the things I enjoy about you is how you question many things. I'm sure this is part of why you have so much info to offer!!!

dietcherry 2012-02-26 11:08:59 -0600 Report

Awww shucks Jigs :)
Ive learned so very much from my DC family and I just want to return the favor. And who knows, we may make an important health discovery in discussing our experiences! We are all a part of something pretty big here IMO!!

jigsaw 2012-02-26 20:04:06 -0600 Report

I think you're absolutely correct! With enough determination, focus and direction, I think we could crack some additional barriers wide open. This could have positive effects not only for diabetics, but also for all those affected by the long range of consquences that it causes.

Caroltoo 2012-02-25 20:55:47 -0600 Report

What irony! A preparation that is used to prevent constipation which, when used in excess, causes it. I think I'd prefer something like psyllum fiber/husk which is basically inert, but helps the intestines keep on moving (pun very much intended).

Caroltoo 2012-02-26 15:24:28 -0600 Report

I haven't. I've had so many intestinal issues because of gluten, that I haven't want to upset the system any more than it has been, since I don't need it for bowel function. My husband does use it and it seems to be relatively inert except for the expected response. I would think the fiber would help with both insulin sensitivity and lowering BGs. I eat lots of fiberous foods already, so just haven't wanted to add anything else until I am more sure that I'm past the active effects of the G-I and my recent gallbladder distress.

granniesophie 2012-02-25 15:40:55 -0600 Report

I tried increasing my fiber by adding Fiber Choice chewable tablets and drinking more water as directed. After about 5 days of the minimum amount (2 tablets) I found out that this was not a really bright idea. I was in intense pain and doubled over for several hours until it finally let up. I have not taken any since, and don't think it was the right thing for me, adding fiber! Think very carefully about adding fiber in this way.

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