Insulin Time

Well, I was first diagnosed with Type 2 diabetes at 32 years old, so about eight years ago.  I'd had gestational diabetes when I was pregnant in 2000, which was controlled by a very strict diet of 30g carbs for meals and 15g for snacks, and a morning dose of insulin at 7am every single stinking day.  When diagnosed as a T2 I was on Metformin and Amyril and drove my A1c right down to 5.4 at my best.  However, over the last handful of years I've been slipping.  In part, I've been lazy, not testing, not being as strict in my diet, not walking or exercising every day, but also my diabetes has progressed.  I take my meds every day, just as they are meant to be taken.  I'm not sedentary, though I'm not highly active.  And I've managed to continue my very slow but sure weight loss to the point where I'm at 170lbs from an all time high eight years ago of about 230lbs, and I'm still gradually working my way down.  I want to be 160lbs for the summer and a size 12, instead of the size 14 I am right now.  I'm getting there.
But my A1c is getting somewhere, too....mainly in the 9-11 range.  I take 100mg Januvia, 2000mg metformin, and 5mg of glipizide every day, between morning and evening doses.  I even take the occasional extra 2.5mg of glipizide, or extra 1000mg of metformin....mainly during my PMS week when my fluctuating hormones drive my numbers up a solid 50 points or more.  Le sigh.
So basically, I'm out of control, medicine is no longer keeping anything even close to where it should be, and I've been avoiding my doctor most of this year and last.  Which does nothing, of course, but allow me to live a fantasy and damage my body, but sometimes denial is just the game we play with ourselves.
I'm not completely out of denial yet, but I have a doctor's appointment tomorrow morning at 8:30am and I am doing what I can to mentally prepare myself to be starting insulin.  I expect that the Januvia and glipizide will go bye-bye and hopefully the metformin, too.  I'm ready, I think, to stop acting like I've failed, somehow, and accept that even walking six miles, eating right, and taking my meds, isn't going to stop the march or this disease.  I think that it might even be a relief, in the end.  I know I'll certainly FEEL better when things are where they should be.
So I've googled, read up, and asked a dozen questions to somebody I know who is a Type 1, to learn about insulin.  I want to try the pen instead of injections.  I did injections when I was pregnant and there were mornings when I sat there with that tiny little needle poised above my thigh and the ONLY reason I managed to stick that dart in was for the child in my womb.  I HATE NEEDLES.  Oh, the irony, eh?  Well, the pen sounds a lot easier.....more like using the lancet in my glucometer, which though I hate it, I do manage to do several times a day now.  My T1 source explained how a sliding scale works, and that makes so much sense and seems to much easier than taking some extended release pill, and then testing, testing, testing, and walking, jumping jacks, elliptical, etc, trying to fight the inevitable rise of glucose in my blood.
I do have questions....but I don't know who I might know  who's a Type 2 on insulin.  If you read this -- let me know!  lolz

When you're on insulin and are going to be drinking alcohol, how do you plan for that?  Do you take less insulin  knowing that the alcohol is going to eventually drop your glucose number?  Or do you do things like your normally would and just watch your numbers and eat something if you need to?

What about birthday parties or other special events when you want a damned piece of cake or some ice cream?  Or PMS when chocolate is an absolute MUST and you're just constantly in a state of munchies?  If you find your numbers are higher than they should be, do you take an extra dose of insulin?  That is, if you've got fast acting insulin?

Right now my morning numbers are high, but slightly lower than my bedtime numbers, so nothings going up at night.  In the past I've had to have a bedtime snack to prevent going too low overnight.  Does this mean I'll likely need some long acting or middle whatever insulin?

Le sigh.  I'm sure there are other questions I don't even know enough to be thinking of yet.

The hardest part of this really is getting over this mental hurdle of guilt, that whole 'you did this to yourself' thing.  Even though my fitness and nutritional habits kick started this journey, it was a journey that my genes planned for me.  Diabetes is genetic.  Thin people can develop Type 2, and there are many obese people that NEVER have any problems with blood glucose.  Type 2 Diabetes has been with us for many years....it didn't just develop during the "obesity epidemic".  My doctor told me at one of my visits last year, when my A1c was a horrifying number and I told her I'd been being bad, she told me that I couldn't have been that bad, not if I was taking my meds, not and be living a normal lifestyle, keeping active, working on losing weight and succeeding....she told me that there's more at work than anything I'm doing.  I take that to mean that my beta cells are giving up the ghost and shutting down, sending me toward LADA/Type 1.5 realm,. or something along those lines.....can you develop a tolerance to these meds I've been taking?  I don't know, but I don't think there are many other choices of meds out there.

Anyway.....I'm crazy nervous for this visit tomorrow.  It's all well and good to say that I've accepted the inevitable, but it's a whole different story to actually face facts and go through with things.  As they say, denial ain't just a river in Egypt.  So if you're reading this and have any words of experience to offer, by all means do so!  I already know the medical science part of most of it, though, so thanks anyway there.

Okay....off to be productive again!