First day off insulin

I’m a new T2. I was diagnosed on New Years Eve. In the ER my glucose was over 600mg/dL, my vision was totally screwed up, I was breathing ketone vapors and ■■■■■■■ sugars. I had to titrate insulin up to 32 units before my fasting glucose was below 120mg/dL.

But then I jumped on a program of radical changes in diet and exercise. I’m losing weight. I had to start dialing my insulin down. Now, just under 50 days later, I’m off insulin. This is my first day managing diabetes without insulin.

I’m super happy about it. This is what I wanted and have been working so hard for, but I have to admit it feels scary. Insulin injections saved my life. But the future feels uncertain.


@Mike2.718281828 congrats. You are managing your situation and that is fantastic. Glad that your hard work is paying off. I wouldn’t worry about the future, just worry about the here and now. Working like you are currently means that you will probably need insulin in your future, but not for some period of time. Enjoy it. When insulin is required again, you will be prepared and can manage that as well. Life is what we make of it.


Thank you for the kind words. Going off insulin felt conceptually like I was exiting the blood sugar control process. Several weeks in, that couldn’t be further from the truth. In fact, no insulin in the mix means one less parameter to manage. I don’t have to struggle to keep my glucose up anymore. I don’t have to tote around bags of nuts and protein bars. This is all easier without insulin.

I went to Cuba for a while after quitting insulin. I’ve just returned. I had a big internal conversation about if I was going to bring insulin or not. I decided I needed to be confident in my new skills and leave the unfinished insulin pen at home. Things went great. It was a huge confidence booster to know I could manage just as easy on the road.

I’ve also - with the direction of a clinical pharmacist - halved my metformin dose now.

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A big wrench got thrown in my gears today. I went to pick up my Freestyle Libre from CVS and was told Blue Cross Blue Shield was no longer covering my CGM. Evil bastards. So I guess being T2 and off insulin means GCMs are no longer medically necessary. What these assholes don’t understand is that,

(1) I’m hypoglycemia unaware. I feel just fine when my blood sugar is low.

(2) I experience nighttime hypoglycemia. Worse, since I track my sleep now with a smartwatch, I know that my heart rate jumps up to like 140 and I toss around when my glucose goes low in the night. My sleep tracker thinks I’m awake for a moment but I’m not.

It may be that, now that I’m off insulin and my metformin dose is down, I’m out of the hypoglycemic woods. But my last low glucose event was on March 2nd. We don’t know if I’m out of the woods yet.

Yeah, probably when you went off insulin, you dropped out of their category that pays for the Libre. You will probably have to document your hypoglycemia un-awareness and have your physician fight for it. Were you also using a MiaoMiao or something like that to turn your Libre into a CGM? Otherwise, you might want to fight for a Dexcom which is truly a CGM.