Diabetes Self-Management Blog

“I want to get off some of these drugs,” Ellen told me. “But my doctor says I need them. I’m on three for glucose, two for blood pressure, and one for depression. They’re costing me hundreds every month. What can I do?”

Ellen is a health-coaching client of mine, age 62 with Type 2 diabetes. She works as an executive secretary in an insurance company. It’s stressful. She’s usually there from 8 AM until 6 PM or later and comes home “too tired to exercise.” She mentioned that just “putting herself together” for work every day requires an hour of prep time. “You have to look good for these executives,” she says.

I asked about her drugs. She said she takes metformin (Glucophage and others), sitagliptin ( brand name Januvia), and pioglitazone (Actos) for diabetes, lisinopril (Privinil, Zestril) for blood pressure, simvastatin (Zocor) for cholesterol, and paroxetine (Paxil) for depression. Her A1C is now at 7.3%, down from a high of 9.9% a year ago, when she was on only two medicines.

“I think the drugs are depressing me,” she said. “The cost, the side effects… I have nausea most days, I have cough from the lisinopril. That doesn’t help at work. I don’t know what’s worse, the drugs or diabetes.”

What would you have said to Ellen? Although I strongly believe in reducing drug use, I told her what most experts say, that she can get off some, possibly all diabetes drugs, but it will take a lot of work. Asqual Getaneh, MD, a diabetes expert who writes for Everyday Health, says that doctors want to be “assured that an A1C will stay down” if a person goes off medicines. She says doctors usually won’t reduce medicines until A1C drops below 7.0%.

In the ADA publication Diabetes Forecast, pharmacist Craig Williams, PharmD, writes, “Unfortunately, the medications that are used to help manage blood glucose in people with diabetes do not fix… the diabetes itself. As a result, the medications generally cannot be stopped without losing the blood glucose control that they were providing.”

But Williams says not to give up. “Lifestyle changes can [reduce] the need for long-term medications, and sometimes enable people to stop taking them altogether… When we do stop therapies or reduce the dosages…, our goals for good control remain an A1C of less than 7.0% percent, a fasting morning blood glucose below 130 mg/dl, and random or post-prandial (after eating) blood glucose levels not above 180. If those targets can be maintained with lower doses or no drugs at all, then it is safe to change your regimen.”

Ellen’s A1C is still above 7.0%, so experts like Williams and Getaneh wouldn’t want her to change medicines now. But then, that’s what they all say. Medications are what our doctors do. That’s pretty much all they know. There are now at least eight categories of diabetes medicines, each with their own means of action and side effects.

One doctor who encourages reducing medications is Michael Dansinger, MD, a diabetes expert on WebMD. He encourages reducing or discontinuing medicines if it is safe to do so. In his view, the first drugs to stop would be insulin and sulfonylurea drugs, because they can cause hypoglycemia.

“Insulin dose reduction,” he says, “typically mirrors dietary carbohydrate reduction, and many patients are quickly using half as much insulin… Weight loss often brings additional reductions… The majority of my patients have not been able to discontinue insulin altogether, although nearly all of them have been able to significantly reduce their dose as well as their A1C levels.”

“But,” said Ellen, sounding frustrated, “I’m not on insulin or those sulfonyl-whatevers. How does this information help me?” Dr. Dansinger says that, after insulin and sulfonylureas “other drugs, such as pioglitizone (Actos) come off next. I typically wait until the A1C is 6.5% or less to propose stopping such drugs, and would not initiate or re-initiate any diabetes drugs (other than metformin) unless the A1C is above 7.0%.”

Ellen is on Actos, so that might be the first drug to try and stop. It’s one of the more expensive ones and carries increased risks of heart attack, according to a large study published in the journal Circulation.

So can Ellen get off drugs? Can she get her A1C down to 6.5%? Is it all about the carbohydrate? Obviously, she needs to move her body more and reduce stress. But how? Perhaps she can not work quite so hard for such long hours. “But if I do that,” she says, “I’m afraid they’ll let me go for someone younger.”

Or should she just stop the Actos or the Januvia and see what happens? Or drop some of the other meds? We’re still talking about it, but what would you advise? To be continued…

You can see more about my health-coaching practice at this Web page.

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Comments
  1. She is old and under an extreme amount of stress so it is a hard case.

    Posted by calgarydiabetic |
  2. The advice and your experts comments all sound on target. Thank you for providing opportnity of the great unwashed to share our experiences. As one who has in many ways “been there - done that: - lon term type 2 diabetics, older in high stress working environment facing the stresses careflly described
    and short comings noted, high blood pressure, had stroke, forced out, had to REALLY fix diabetes and similar drug issues have following comments:

    1. Stress environment of daily adrenlin rushes a killer. I did not move fast enough or fix diabetes early to prevent stroke.
    2. unless you get diabetes better in control using diet geared to glucose control and calorie volumne
    down and extra hearty exercise, there will not be opportnity to pull drugs back. AFter getting diabetes better controlled, was then able to yank actos. At one stage it was the only drg really keeping blood glucose down, but once real problem of liver sugar release controlled by metformin than actos could be free booted. I went from 13.3 to 6.9 on a1c.
    3. metformin is a key drug you want to have in your list as it is currently the only drug that will kick the liver back from its type 2 diabetes make sugar all the time back to fasting. Night time doses at 10:00 and 12:00am midnight will shut down the liver sugar dawn effect escapade. Of all drugs I would keep this one.
    4. For a whole load of risk, swelling amd water retention in tissues - getting actos removed if you can is good. It is expensive as well and my kidneys and health are now way better for it.
    5. I am on accupril, diovan and toporil for heart meds. Blood pressure at work pre accupril only was 160 over 110 to 190 over 115 regularly. Now down to sub 120 over 80 and usually 117 over 78.
    High stress environment mentioned will make it impossible to extract these. use generics and buy cheapest.
    6. I would if at all possible try to get out of bad environment and factors to take load off heart and diabetes. I waited too long and had stroke.
    7. Exercise - walking throghout day and breaks can fill this in - just get lots regularly. 1 to 2 miles.
    8. All new trick drugs will be expensive and I am on metformin, starlix and insulin in am and night to shorten morning startup and get sugars down at night. Generics wherever possible.
    9. Diet, hearty exercise and metformin along with freqent glucose meter monitoring are KEY to getting monster on me caged.

    best wishes and good luck.

    Posted by jim snell |
  3. WOW I just found this site and have already signed up for the magazine. At $9.99, on unemployment that money means a lot. If I can find a way to reduce the cost of my meds and find out what supplements are good, safe and healthy,than $9.99, is a bargain.
    C—

    Posted by car |
  4. Dear David

    Giving the issue some more thought.

    If she can implement a very low carb diet then maybe the actos can be dropped. It is suspect for causing heart problems like avandia.

    The metformin my ophtalmologist thinks is the main reason why he has seen eye damage vanish from his practice with diabetics. He could be right so it may be good to keep that one.

    Paxil was a disaster for me very nasty side effects and no benefit whatsoever so I am not in love with that one.

    Ace inhibitors are known for causing cough. I switched to idapamide a diurectic. Cheap and very effective. Of course if going to the washroom at work is a problem them maybe not. Also it may raise triglycerides a bit so if that is already a big issue maybe not.

    Posted by calgarydiabetic |
  5. Okay, I’m done rolling on the floor laughing at calgarydiabetic who thinks 60 is old. And the woman works 10 hours a day!You should live so long and find out how young you are at 60 as long as you take care of yourself!

    Posted by Deb |
  6. Sorry if this is too tough, but I would’ve said something like this:
    “Ellen, that’s why exercise is a MUST for you! The excess sugar going through your blood, together with the high stress environment, is wearing you out. The only solution is exercise. Exercise will clear much of the excess sugar from your blood, and will reduce your stress levels.
    “With diabetics being at such an increased risk of heart attacks and strokes, you can’t survive in such a pressure-cooker environment, unless you have some outlet to lower your stress levels. Exercise is one such way, especially if you’re not taking time to relax and meditate.
    “I think if you started to exercise when you came home, you’d find that instead of sapping what little energy you have left, you would have more energy to face the evening - and the next day. Personally, I would like you to experiment: Try that six times over the next two weeks, and see what that does for you.
    “If the prospect of exercising after work is too daunting, then you need to use a half hour of your morning prep time to exercise.I think the executives would appreciate your coming in looking healthier and more energetic, even with less creams on your face.
    “You say you don’t have time? You’ll get back about half of your exercise time by needing less sleep, and the other half by being more productive at work and at home.
    “And with the added incentive of our being able to lower your medications in a few months, leaving more dollars in your pocket for your needs, I know you’ll be motivated to get your 5 half-hour walks in weekly.
    “Here’s a small log to write down your progress, and we’ll talk about how your exercise is coming along at the beginning of your next appointment!”

    Posted by Yisroel |
  7. We have gone downhill. My grandfather at 80 fell and chopped up a red pine with only his axe in about 2 weeks.

    Tonight I asked my wife: ” My beloved shall we go to the gym ? I can drive.” She answered: ” what are you trying to kill me.” she is only 62 and does not work outside the home. Light shopping at Costco killed her today.

    I am a mere 60 and feel dead. I went X-country skiing with his Lordship( a wheaten terrier for about 3/4 hour and that killed me.

    Something is rotten in the kingdom of America.

    Posted by Calgarydiabetic |
  8. Okay, I’m all for medicine reduction. I think it’s great if a person is truly committed to changing diet and lifestyle, and increasing exercise. But - and this is huge - that person must be honest with him or herself. Will those changes be sustained, or will they start to slip away, not unlike most New Year’s resolutions?? And will you start the medicine again the moment you see your new habits sliding? I am personally very committed to a healthy diet and regular exercise, but I won’t say that I never slip, never skip a workout. My bg values are generally quite good, but that occasional morning high always concerns me. And sometimes I can’t even identify what I did wrong to have that high value. I would love to reduce my drugs, but more than that, I want to see my good health continue.

    Posted by catgirl |
  9. This is a great topic and really should motivate all of us to keep working toward eating healthy and exercising instead of relying on medications.
    I am overweight and have recently lost 14 pounds. My blood sugar has gone down, too. Another thing I have done is stop drinking diet cokes, or anything with artificial sweetners. I can’t tell you what a difference that has made! I drink lots of water! The exercise professional I am working with convinced me to try this, and I can’t believe the difference!!! I take Metformin and Januvia and am striving to reduce some of these, or at least postpone adding additional med. I also take Cymbalta for depression, Benecar for blood pressure and Vitorin for Cholesteral and Topral for heart issues. No, I am not the picture of health, but I am really trying to reduce some of these meds. Yes, I am a young 61 years old. I have a wonderful doctor who monitors me closely and really listens to me. I feel blessed. Good Luck.

    Posted by Patsy |
  10. I will be 62 in a couple of months. I am not old. I still have the power to change my life.

    I have been on a roller coaster with diabetic drugs. I had previously been taking Metformin, insulin and Januvia. Januvia was wonderful at first. It helped me lose weight and the BG numbers looked good. But it caused some digestive side effects such as not being able to digest lettuce and I always had to be close to a restroom. After a year, though, it seemed to stop working. The BG numbers no longer stayed down. So the doctor switched me to Actos (still with Metformin and insulin). Actos had the opposite effect. I gained weight and couldn’t seem to stop it. I am a vegetarian (I eat eggs and dairy) so keeping calories down is not an issue. I stay away from simple carbs.

    I am single now, so I can go to the gym most nights after work and on weekends. I find that being in a place where others are working out encourages me to do the same. I employed a personal trainer to help me get started. In just two months, I decreased my body fat by 15 lbs and increased muscle mass by 9 lbs. That is only six pounds on the scale, but 24 pounds healthier. I feel and look much better. My blood glucose numbers have diminished significantly, which allows me to take less insulin.

    I am still on the Actos, but working out often. Exercise (weights and aerobic) is the only thing that helps me take the weight off. I hope to prove to my doctor that I can get off the Actos. My goal is to be on Metformin only with occasional insulin.

    Posted by linda |
  11. I was 200 lbs,type 2 diabetic for 10 years and starting to have kidney disease, eye problems and on 2 blood pressure medicines and zero energy. Stopped all carbs that turn to sugar including carrots beets, whole grains, potatoes, pasta. I eat all meat, eggs, cheese, leafy greens, green veggies, small amount of tomatoes and onions. I take my blood sugar after meals to see what raises and what does not.I also have a martini or glass of wine with dinner as it keeps your liver from producing sugar. It’s not always easy but like I told a fellow diabetic that asked me how I could give up bread how could you give up your eyes! For the last four years I have weighted 120lbs without ever counting calories and eating until I’m full, no medicines of any kind, a1c 5.4 and blood sugar under 100. Also my eyes and kidneys could not be healthier if I was a 20 yr old non diabetic. There’s no other way and you all know it deep inside. p s I have never exercised a day in my life, to lazy

    Posted by lily |
  12. Five yrs ago my dad fell & broke his hip. He had
    one terrible year of in/out the hospital/rehab. I was diagnosed w/diabetes from the extra stress.
    I have tried and recorded results of many kinds of medicines. I have aged 10 yrs in 5 yrs. I am allergic to the sulfite in the medicines. I was on 3 meds and could hardly walk. The Drs. took away 2 and I feel better. The one(Humalog) still bothers me. My stress level is high at home. I
    have a know-it-all husband who thinks I can just
    stop taking all medicine and go on with life. I
    now have cateracts that need to be removed. I am
    my best advocate. I am allergic to many medicines. I used to walk 2 miles every day before diabetes. There is no way I could do that
    now. Any suggestions?

    Posted by Amazing |
  13. VERY INTERESTING ARTICLE.
    IN MY 40 YEARS FIGHTING DIABETES AND THE LIES FROM BIG PHARMA ,THE TRUTH BASED ON EXPERIENCE IS THAT EVRY CASE IS A UNIQUE CASE AND IF WE CAN KEEP THE PATIENT BETWEEN 130 AND LESS THAN 180 WITH GOOD NUTRITION….WATER…CINNAMON (IF THEY DO NOT SHOW PROPENSITY TO GLUCEMIA)….THEY WILL BE ABLE TO MANAGE THEIR PROBLEM.
    WE HAVE ALSO EXPERIMENTED WITH GOOD VITAMINS AND THEY HAVE KEPT AT BAY THE SPIKES OF GLUCOSE IN THEIR BLOOD.
    THANKS .
    Dr DAVID SASSOON

    Posted by DR DAVID SASSOON |
  14. Changing drugs may be best for Ellen, especially since she complains of excessive coughing and fatigue. Both of those symptoms are probably caused by lisinopril,an ACE (angeiotension inhibibor)which is known to cause fatigue and also coughing in as many as one out of four people who take it. A better anti-hypertension drug is Diovan, an “Arb”, an angiotension II Receptor blocker. It causes coughing in much fewer of those who take it. I’ve taken it for years after having to get off of ACE drugs. My doc told me it was soon go genaric and thus could by less expensive than what she is taking

    Once she stops coughing her fatigue levels may also lessen so might be able to increase her exercise levels.

    Also, I bet she needs to lessen her carbohydrate intake and throw out all recipes which contain too many carbs. I swear by low glycemic foods myself and have even put up a website on the subject. I’m not sure about your policy on posting website addresses and my coughing advice alone can benefit her so don’t want to take a change of this not being posted but she can google my name and “low glycemic recipes” and probably it will come up.

    Posted by Maury Breecher |
  15. David:

    you got comment - lots. That hes really got the folks up off the derrier to respond.

    Any help??

    Posted by jim snell |
  16. Dr David,
    My Doctor made me stop all of my vitamins and
    cinnamon. I can try to stop diet cokes. I drink
    water and tea, too. Have any of your patience been sensitive to sulfites (attacks my muscles)? Sulfa gives me 24 hrs of charlie horses & 24 hours to get my strength back in my legs. I have been allergic to these for 32 years. Sulfites
    are in bread,pasta,wine,toothpaste and much more.
    There are brands that I can have…organic wine &
    wheat bread & pasta. I have sinus issues 6-8 mos
    of the year…I’m allergic to cats,christmas trees and more. I don’t know where to go to get
    the help I need. Should I go to an all natural
    doctor for suggestions? I’d like to live as long
    as my parents (late 80s). I have a long bucket
    list to finish.

    Posted by Amazing |
  17. I know exactly how Ellen feels about all those damn drugs. I was told a few years ago that I had Type II Diabetes I am still trying to take it all in. I did try on my own to stop a few of the meds that I have to take and it didn’t turn out the way I had hoped. My cholesterol went from 157 to 333 in just a couple of months off the meds. I was very upset because I have lost about 23 lbs. and 4 inches off my belly area and I have changed a lot of how and what I eat but apparently it is not good enough so my Dr. told me to get back on my meds. I take Metformin and Januvia which I don’t mined to much but then its medicine for cholesterol and blood pressure (something mostly to do about the kidneys) then I have to take all kinds of vitamins a multi-vitamin is not good enough. I have got a counter full mostly of those and I ain’t even 60 yet. I think the whole world has become dependant on drugs—-I mean you have to take this drug for this thing than this drug for the side affects it produces then other crap just in case. And then we are told try not to stress out. I hope all goes ok with Ellen and her quest for making things a little less stressful and cheaper.

    Posted by Karen |
  18. I feel Ellen’s frustration. She is not old and certainly should not have to feel so just because she has diabetes. First thing she should do is begin some lifestyle changes such as cutting carbs, adding daily exercise and finding time for relaxation. If she will make these changes and stick with them I think she will find her need for some of her meds decrease. But to get rid of the meds she needs to make the other changes first. I believe she can do it if she really wants to. good luck Ellen.

    Posted by CINDY |
  19. I too have Diabetes type 2. I also have glaucoma, high blood pressure and high cholesterol. So I am taking some of the same meds as Ellen. I too would like to loose some of this weight and get off alot of these meds. I look like a pharmacy when I take them. I am approaching 65 and have just adopted three children under 11, so my stress level is right up there. I will be interested to see the diagnosis for her dropping her meds. I stay around 6.5 on my A1C but no one has ever said I could drop any of my meds.

    Posted by Brenda Aldridge |
  20. I would get off of Actos.I gained 8 pounds in one week on it. I know many people are afraid of shots and needles but I feel insulin is a lot safer and healthier. I have been on it for 18 years. My AC1 is 6.3. She must find ways to lower her stress, get up and walk away from your desk at least once every 2 hours. Just a short walk. Drink lots of water. If she does not find ways to lower her stress and lower her blood sugars she is asking for many health issues. Try something nice just for you once a day. you deserve it.
    You can/must do it .

    Posted by Vie |
  21. I am 68 and have had Type 2 for 11 years. Keeping glucose down in the early years was not too much of a problem, but for the last 3 years, my readings have been higher. I began with metformin as my only diabetes med, but over time have had to increase it to one per meal,add glyburide - one per meal. I take Metoprolol, Lipitor, Benicar, Amlodipine, Furosemide, and Potassium because of heart issues, blood pressure and cholesterol. In April of this year, my A1c reached 9. I determined that I would not have to take insulin. I went on a strict vegan diet as promoted by Dr. Neal Barnard in his books. I also went to Curves three days a week. I lost 8 pounds and brought my A1c down to 7.3 in six months. I will be retiring soon. My goal is to get off some of those meds by that time. My internist has let me cut down on the glyburide, two instead of 3 per day. By continuing a vegan lifestyle, I hope to be able to eliminate the glyburide altogether. Ellen, try a vegan lifestyle for 21 days and see for yourself how much more energy you can have.

    Posted by Juanita |
  22. I just celebrated 77. I was diagnosed 8 years ago and it scared me to death. I read everything I could find about diabetes and kept a food diary with blood tests to go along with it. I lost 50 lbs. and started exercising regularly. I begged my Dr. not to start me on medication for my diabetes and she agreed to hold off if I could get my A1c down and keep my blood sugar levels down. I haven’t had to start medication for blood sugar but do take it for cholesterol and hypertension. If I start to get sloppy with my eating habits, I am reminded about the scary things that can happen with uncontrolled diabetes and it scares me back into my good habits again. It seems to me that people need to read and learn as much as possible about the condition they have and then be brave enough to implement whatever requirements are necessary to keep themselves healthy.
    Jean F/Jan.21

    Posted by Jean F. |
  23. I am a type 2 diabetic & have been for over 10 yrs. i was on metformin until 5 months ago when my doctor suggested that I discontinue taking it and keeping a daily fasting blood sugar record. I developed severe diarrhea, nausea and vomiting and did not know what was causing my problems. I had a gallbladder ultradsound, colonoscopy and many blood tests before my doctor took me off metformin. My symptons disappeared almost immediately and have not returned so I am currently not on any diabetic medicine.
    My blood sugar fasting is in the range between 96 and 114, I eat many more vegetables than I did before this regimen which provides me with good fiber. I think fiber is one of the keys to better health for diabetics. I am 85 yrs old, i am on Lisinopril and a diuretic for blood pressure control. My blood pressure ranges between 132 and 138 most of the time. I may have to go back to a diabetic medicine but for now I am going to try to avoid it.

    Posted by Lois Peteson |
  24. Thanks everyone for these good suggestions and heartfelt stories. I printed them out and shared them with my client. (She doesn’t do Internet away from work.) I’ll let you know how it goes. Hopefully, she can put more priority on moving her body than looking good for work, but I gather there’s a lot of pressure. The diet and drug advice is very helpful.

    A couple of people mentioned “feeling dead.” We had a good discussion of fatigue a couple of months ago that might be worth rereading. Please also have your testosterone levels checked if you haven’t — that’s exactly how people with very low T levels describe it, “feeling dead.”

    Posted by David Spero RN |
  25. One of the things not mentioned is her weight,if she is overweight that is an area that would improve her glucose level. One of the comments I read was she was “old”

    Posted by Jerry |
  26. I’ve had Type2 diabetes for 15 years. I take metformin and glyberide. I started doing Weight Watchers a year and a half ago and lost 32 pounds. My A1C went down to 6.8. Also, at that time I found experientially that the metform dosage I was (1000 mg)on was too high and so I reduced it by half without ill effects. Note that I work out 3 or more times a week, and I know that helps a lot — especially in the stress department.

    Posted by Sandy C |
  27. I think Cindy had a good entry. When I overeat carbs (especially ice cream in summer) my readings go up. Take off any extra weight.(I lost 30#). I’m lazier now at age 78 and should get more exercise - spend less time with computer and TV. Change- easier said than done. Essential!

    Posted by Jay |
  28. I would suggest doing some of the same things I have done. Make breakfast your biggest meal. Eat Three eggbeaters, 3 pieces of Turkey bacon, and special pancakes(I will tell you how to make them) and sugar free syrup. For lunch eat 7 oz. meat and a small salad with oil and vinegar and some cheese on the salad. Maybe 1/4 apple. For diner eat 7 oz of meat 1/2 c of Brocholli, small salad like lunch. At lunch, Dinner and bedtime drink 10gm of protein supplement. Reduction of carbs is the key to reducing blood sugar, I have found. Have urine checked every three months for protein.

    I have dropped my A1c from 7 to 6 with this process. It is tough. You will loose weight. I walk 30 minutes every day possible. My weight dropped from 185 to 155 today. My blood pressure is 120/80, colesterol is 180.

    Pancakes are special mix. Use 2 cups of Soy flour, 2 cups of whole wheat flour, 2 cups of flax seed flour, 1 cup of wheat bran, 1 cup of oat flour. Mix well and use this as a source for pan cakes.

    To make pancakes use three 1.5 cups of the mix. 1.5 cups of eggbeaters, 3 tables spoons of vegetable oil, and water to mix to make it use able consistency. I usually add 1 - 2 cups of water to the mix. I cook this into cakes about 4 inches. I cook all the mix and freeze them. I use 3 pancakes each breakfast. Drink plenty of water with all meals.

    I drink very little milk. Don’t eat bread, Limit fruit(eat small portions through the day).

    You can eat raw vegetables like carrots, cauliflour, brocholli, lettuce, cucumbers, tomatoes, salsa, etc.

    Check blood sugar four times per day, rising, before lunch, before dinner, bedtime.

    It is hard but you can do it.

    Posted by Bill McCorquodale |
  29. I am also 62 and since being diagnosed with Type 2 a few years ago I am off of my diabetes medication and I’m only on one colesterol medication in addition to an anti-depression and thyroid medication. My A1c is always less than 6.0 and my testing numbers are in the 90’s when fasting and in the 70’s & 80’s before dinner. I have lost 15% of my body weight, changed my diet, and try to exercise as much as I can with a high stess job. I was on Actos twice a day, and higher strength colesterol and anti-depression medicaions.

    Posted by Patricia James |
  30. I am a type 2 Diabetic. I take Byetta, glipizide, Metforman, and Levimer plus, Diovan, simvastatin, sertraline, levothyroxine, warfarin, digoxin and detrol. I was on lisinopril and I too had a constant cough. It was worse at night and I couldn’t sleep. I had allergy testing and had no allergies. I finally looked up the drug on the internet to find out that coughing is a side affect of lisinopril. My doctor changed me to Diovan and coughing has stopped. I have lost a considerable amount of weight, and my glipizide has been dropped to 5mg once a day and also dropped one of two blood pressure medications. My goal is to lose 20 more pounds and get off some of my medications. Byetta is very expensive and when my husband retires my perscriptions will cost me a lot more. I also joined a gym 3 years ago and working with weights has really helped my diabetes numbers to go down. My A1c is 6.3 now.
    Weight training helps the body to absorb insulin better per my endocrinologist.

    Posted by Lorraine Schoedler |
  31. OK.. now for a short comment: get on insulin, read a lot and decide what works best for you.
    And get lots of test strips — you’ll need them until you get it right. Hint: everything you read isn’t correct.

    Opps almost forgot the important part: get rid of all those diabetes drugs. From my experience, really really bad news!

    Insulin is not the “last resort”. It is a safer and better way IF used properly.

    Posted by John_C |
  32. The sad truth is you have to exercise and you have to stop eating carbs.

    If Ellen keeps doing what she’s doing, she’ll keep getting what she’s getting.

    You can’t eat carbs. You can’t! Carbs are the enemy! I stopped eating carbs and have lost 56 pounds so far and A1c has gone from 10.0+ to 5.2. Don’t buy into the carbs are good for you lie because they’re not. Get your carbs from veggies because they’re FULL of carbs!

    Why is Ellen working 10 hours a day? Is she finding the cure for cancer? Probably not. Ellen needs to put her health first (like that will happen!!)and not put in those long hours every day. Does Ellen honestly believe that the company she works for actually CARES about her?? That’s funny!

    If meds are too expensive go to walmart.com and print out their 10 dollar for 90 day supply list. Take it to the doctors and tell him the same thing I told mine… if it’s not on this list… do not prescribe it for me. If he doesn’t comply for you, fire the doctor and get another. They’re a dime a dozen. Doctors work for you… if they don’t… fire them! Simple. Yes I’ve done it plenty of times and could care less what they think.

    This is what I’ve done for myself. I stopped being a big crybaby and realized that I will die if I don’t take complete charge of me! I’ve taken charge of me and am doing 100 times better. I advise Ellen to do the same. It’s hard but an A1c of 5.2 is well worth it!

    Posted by Tia |
  33. I take metformin, tricor, lipitor, baby asprin, and glimepride and I have started to incorporate veggi’s in my food I have an A1C is probably high well i know it’s high and I have very high colesterol I would probably see if their were any of the meds in generic form and i would do what i could to try and eat proper and get plenty of rest on the weekend while not working, watch what I ate daily for a week, I recently bought Glycozene and their are herbal vitamins out their that helps with lowering diabetes results like chromium Picolinate over the counter and priced pretty reasonable, B vitamins help D vitamins and K12 vitamin I do my research as I’m alway looking to stop being a diabetic, I’m not perfect and I don’t always follow my doctors orders, But what may work for some may not work for others, Try to meditate relax unstress your self Listen to soft music while getting ready for bed to change things in life is a good thing change is better then no change I try not to stress myself out My doc told me one day because i smoke and all my readings are out of wack he told me he wasn’t giving me past the age of 51 I’m 50 now I weigh around 218 @ 5′7″ so I’m not really over blowen in weight I could stand to lose some until I get to 180 is my goal I guess all in all Keep it simple one day at a time Living in the here and now isn’t easy by all means and everyone is struggling now days do what you have to do for you first How much help can a person be if their not taking care of themselves, if I don’t take care of me first I can’t be of help to someone else I know I have no control over people places and thing But I can make choices, I’m not a doctor I’m just another diabetic type 2 I suppose if weather permitting I’d say walking is good hahaha I should practice what I preach I wish you all the luck and do what you can for you Please keep it simple.

    Posted by Jon M |
  34. Many good comments but one issue that gets missed all the time is the amount of aging and the amount of disfunction of the endoctrine system.

    Point is simple and has to do with the body buffering system of glucose by liver/kidneys and how
    well it fills in without shooting in too much glucose between meals and as gut runs out during day and at night doing dawn effect. If that part works reasonably well; many comments about diets, all low glycemic, all veg are doeable. Otherwise!

    For me, I am cutting back liver at night with metformin doses at 10:00 pm and 12:00am and during day, I meter extensively - now cgm and keep glucose tablets in hand to jump in front of liver and keep BG from going sub 100. If I do not do this during humolog and/or strlix present, BG will whip to 54 no sweat. Night used to be sugar add of 238 by am and during day liver would ram to 311 on glucose add on BG low at 50. Prior to this a1c was 13.3 and now 6.9.

    With that in hand, diet works, I need some carbs and must be controlled and I am finally losing weight on 1200-1500 diet I was on for last 3 years.

    I do not see all meds gone nor a simple diet solution even though I now extensively exercise which is absolutely necessary.

    Sometimes. one needs to stand back a little and realize there may be more complexity in sitation that is not obvious on a few details originally spoken.

    Posted by jim snell |
  35. I’ve been a borderline diabetic since 97 when I had gestational diabetes. I’m 5′4 and 110 lbs, always been skinny. Imagine my surprise at being diagnosed with diabetes. My a1c is always around 6. The interesting part of my story was that I started taking meds about 4 years ago. First avandia, then added januvia and metformin and my a1c never changed, at all. All those meds and no improvement and I gained about 10 lbs. At first I took them all very religiously, and was very conscientious to use “diet” foods and drinks, I counted carbs, checked my glucose, etc. I guess I got sick of taking meds because I kept forgetting to take one or the other. Eventually, I took a little medication holiday and much to my surprise, my a1c dropped slightly. I might add that I cut down on artificial sweeteners at the same time. So now, without meds, I’m running in the high 5’s. My doc said ok, we’ll see how it goes… it seems to be going just fine. It’s been over a year and I’m still stable.

    I find it very interesting that all those meds did nothing for me and when I stopped taking them there was a slight improvement. I must point out that I stopped using aspartame at the same time. Makes me wonder if the aspartame was causing insulin resistance somehow. I used to put it in coffee (3-4) daily and a daily diet coke. Now, I only have the occasional diet coke and use non-diet hazelnut coffeemate stuff (love that stuff).

    I certainly don’t advocate for stopping meds, especially when your a1c is up there, but I do think artificial sweeteners play a role in insulin resistance. I am eager to see some research results regarding artificial sweeteners, particularly aspartame. But that’s another topic.

    Most people here seem to have more severe DM than me. The key to success in my opinion, is exercise. It’s hard to get started, but once you get into it, you’ll like it. It makes you feel good, gives you energy, makes you stronger, burns those calories and makes your body a more effective machine. Exercise is the #1 treatment for DM, especially type 2. You might not be able to stop all the meds, but if you work hard, you WILL benefit.

    Best of luck to everyone here. Don’t give up, don’t get discouraged, just get out there and produce some endorphins! And you might cut down on the artificial sweeteners. Research is coming and it just might be making matters worse…

    Posted by Sunny |
  36. What I do not see mentioned is how Ellen eats - fast food, sack lunch… My diabetes (even though I weigh 230) can be managed with no drugs. I just have to lay off sugar and most carbs. BUT, I crave the things I should not eat. Because of a broken femur that does not want to heal, I am pretty much inactive. By that, I mean that I do not exercise above the “have to”. I do house work, cook and go shopping and to church.
    I realize that one person’s diabetes is not the same as another’s. I just wonder if there are not some things Ellen can do besides the drugs. Education is a must. I have learned about combinations of foods, serving sizes and when not to eat certain things - a small slice of pie following a meal of sensible foods rather than pie as an inbetween meal snack.
    Of course there are times I go off the deep end and eat something I shouldn’t - then I have to take 1/4 of a 2.5 mg Glyburide.

    Posted by Janet Dobbs |
  37. Its very heartening to read about people who have been able to drop medication. i have been taking januvia for a year and my hba1c is 6.5 from 9. i exercise very regularly and watch the carbs. Weigh 122 pounds and am 5 ft 2. maybe could lose a few pounds more. am contemplating dropping the januvia. worried a bit about doing that.

    Posted by supriya yadav |
  38. Supriya, I would advise not rushing into stopping the Januvia. Work towards that goal. Use some of the suggestions people have posted about low carbs, reducing stress, and especially moving more.

    Posted by David Spero RN |
  39. Supriya:

    I believe David is quite correct and my sense is you do not want to drop your diabetic meds till Doctor/body indicates not really needed.

    Extra unusual lows on same diet and exercise routinr would indicate in this layman’s mind that one is improving control. As always, I leave it to the professionals to rule on this one.

    Best wishes.

    Posted by jim snell |
  40. Why do carbs have to be the enemy?

    The cells need fixing. Why is no effort on the drug companies made to fix the cells?

    Why do they get “broken” to cause diabetes in the first place?

    All I hear is meds, no carbs, exercise like a fiend, and none of it heals the diabetes so it is gone.

    Very depressing.

    Posted by Susannah |
  41. Read the China Study. Very interesting info with lots of research to back it up. All carbs are not evil. We can be in control of some aspects of fighting this disease.

    Posted by Dawn |

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