Eh, it happens. I had a patient a few weeks ago who was ecstatic that his triglycerides were DOWN to the 700's. "My sugars must be getting better too!" 7.3% is not the end of the world. :)
I know, but it's not helping with getting the weight off or getting A1c < 6.0.
The daily 20/2000 is maxed, so it's time to look at alternatives/additions. Byetta would probably be a good choice it it wasn't for being self-employed; cost is a big factor.
A1c < 6.0 is rough. Getting most patients to 7 without hypoglycemic incidents is bad enough.
Byetta is pretty pricey, I will admit that. I've seen really good results with it, if you can handle the nausea/vomiting. Januvia is not an unreasonable option. I'm not sure on your thoughts on the safety of Actos.
The endocrinologist was nice enough to finally be straight with me about the Byetta after a year or so of use. Many adjustments with timing etc. to no avail. "Well it's SUPPOSED TO MAKE YOU SICK!" Um, that is not the primary desired effect in the literature. I put the Byetta option on the "never again" shelf along with the Avandia.
Januvia has been very, very good for me. Pricey (my plan pays half), but good results. I take it along with metformin and glipizide. A1C's around 5, and dramatic weight loss. And no nausea like with Byetta.
Was that an "instant" test or a regular blood work lab test? I ask because several weeks ago I had both done within minutes of each other. The regular wait a few days for results test was .5% higher than the instant test drawn less than 20 minutes earlier. Don't even get me started on the wild variances I see with the regular blood glucose meter. I've seen differences of 40 points on those over the span of two minutes. The longer I deal with this the less believable I am finding the methods behind the treatment.
This is how i do it: 1. 500mg Avandamet 2 times daily. 2. Eat every 3 hours - 6 x daily - 2,200/6 = @ 350 calories per meal. 3. Eat mostly from low GI foods. I've learned to love black beans. 4. 30 minutes cardio. 5. walk 10 minutes before dinner, 10 minutes after.
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I'm strongly thinking the glucovance is losing effectiveness. Needless to say, I was NOT HAPPY when I picked up the results from my fax machine.
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What doses are you currently on, if I may ask?
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The daily 20/2000 is maxed, so it's time to look at alternatives/additions. Byetta would probably be a good choice it it wasn't for being self-employed; cost is a big factor.
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Byetta is pretty pricey, I will admit that. I've seen really good results with it, if you can handle the nausea/vomiting. Januvia is not an unreasonable option. I'm not sure on your thoughts on the safety of Actos.
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5.9
This is how i do it:
1. 500mg Avandamet 2 times daily.
2. Eat every 3 hours - 6 x daily - 2,200/6 = @ 350 calories per meal.
3. Eat mostly from low GI foods. I've learned to love black beans.
4. 30 minutes cardio.
5. walk 10 minutes before dinner, 10 minutes after.