Insulin Is Much Easier to Take Than in the Past

Like so many people with type 2 diabetes, Daniel Wimer didn't watch his blood sugar—even though as an RN, he had seen firsthand the serious damage caused by toxic blood sugar levels. He started using insulin more than 20 years ago, but stopped taking it until a few years ago. After a few health scares of his own, Wimer, now age 68 and living in Tampa, has his blood sugar and weight under control thanks to a combination of Byetta and insulin. Wimer shares his health struggles on his blog and in motivational talks as a member of the National Speaker Association of Central Florida.

I began taking insulin in 1988. I had type 2 diabetes and was going to nursing school and was just too busy to take care of myself. I wasn't controlling my diet or taking my pills like I should—one of the problems in the medical field is that doctors and nurses are notorious for not taking good care of their own health.

As a nurse I was even making home visits to people who had had their feet and legs amputated due to diabetes. However, I never thought it would happen to me. It was sheer hubris, I know, but I thought that as a medical person I really didn't need to follow the rules.

I knew that extreme thirst and frequent urination are signs of high blood sugar. Still, the symptoms can creep up on you. Before you realize it, you have already done damage to your body. I had a tremendous thirst—I would drink a 64-ounce thermos full of water and still be thirsty. I had to literally drop what I was doing at times to go to the bathroom.

Oral medications weren't working

I tried to manage my blood sugar with oral medication, but couldn't. So I decided to go on insulin. It was frustrating because I gained a lot of weight when I started taking it. At one point, I was 300 pounds. One of the side effects of insulin is that you get hungry. You are hungry and you eat; then you get too fat and have too much insulin. It's a cycle.

After a few years, I started doing better. But I got tired of insulin and quit taking it. Then, about four years ago, my wife, who is also a nurse, put her foot down. She said I had to do something different. I went to an endocrinologist who put me on Lantus, which is a once-daily insulin shot, and Byetta (exenatide), a drug I take twice a day that helps control blood sugar and curb my appetite.

When I first started taking Byetta, I was really sick. The first month I was so nauseated I could eat hardly anything. Then the second month, I doubled the dose, but could handle it a little better. By the third month it was okay and now it doesn't bother me. I have noticed, though, that I have to eat at least something about 30 minutes before I take it or I don't have any appetite all day. I wont eat much of anything that day.

Insulin is also much easier to take now than it was in the late 1980s. You can give the shots in your arms, stomach, or other areas, and the needles are so much smaller.

The shots, though, we're never really a problem for me. The biggest issue I had was with the old portable, handheld glucose monitors. You had to give yourself a pretty good cut with the lancet to get enough blood to use the monitor. After a while, you would run out of places on your fingers and you had to stop using it until they had time to heal.

The newer lancets are much easier because they are smaller, and you need less blood for the glucose monitors. It makes a big difference—it is so much easier to be compliant now.

I had two heart attacks

If I could give anyone advice, it would be to take your medications. Over the past 22 years, I have had three strokes, two heart attacks, and seven stents. All of those have come from the debilitating affects of diabetes.

Back when I was first diagnosed, doctors knew diabetes was bad, but not like they do today. They know now that the disease affects so many parts of your body. And we know that aggressively controlling your diet and exercise and maintaining your medications can halt or radically slow down the side effects.

Strictly following my regimen over the past four or five years has reversed some of the damage. My glomerular filtration rate (a measure of kidney function) used to be 44, which was low for my age. When I wasn't taking my medication, it went down to 32, which is near dialysis levels. Now its back up to 42.

Once I got used to the diet and began a regular routine, I didn't have many problems. The ones who have the problems are teens, who don't want to follow the rules, and old farts like me, who also don't want to follow the rules!

The biggest problem I have now is low blood sugar, which sometimes happens when people take insulin. Its bad news when it's high, but the effects are more gradual. When you have low blood sugar, you can go into a coma very quickly. I know when its coming on because I get nervous and irritable. I just have to make sure Im always prepared for it.

It has been interesting being on both sides of the line, as a patient and a nurse. I try to tell people what I have learned. I make sure my feet are clean and dry. And if I travel, I carry Neosporin around with me to treat any cuts and open sores. (Diabetes can reduce the body's ability to heal properly, and the feet are especially vulnerable.)

Aggressively controlling your diet and using insulin regularly is the best way to contain diabetes. Exercise is one of the best ways to maintain good blood sugar balance too.

And, most importantly, you have to be aware of the signs—especially if you have a family history of diabetes, which gives you a higher probability of getting it. If you have tremendous thirst and urgent urination, there is already damage to your pancreas.

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