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I totally agree with above; if T1DM, lantus plus mixtard (no longer available in UK) is an odd regime, but lantus on own does not seem a step forward. Trying to attain reasonable control on Lantus alone in T1DM will mean either you are high after meals or on a bigger dose that you go low before...

Great heat warming story. Gareth Williams and Mimi Chen published about dogs spotting hypos in the BMJ about 10-15 years ago, but I do not think it was ever taken further. Also a series of dogs who spotted owners bladder cancer! Amazing. best wsihes

Metformin is famous for diarrhoea; I had never heard of constipation before; any drug can cause any side effect, so I have learnt something new (I would never be patronising). Half folk on metformin find their gastrointestinal side effects resolve on switching to the modified release, which...

Interesting comments above re low glucose levels in T2DM; totally concur with the comments about insulin. But sulphonylurea tablets such as gliclazide, glipizide, glibenclamide, glimepiride and tolbutamide can also make the glucose levels go too low. In the UKPDS study, sulphonylureas were just...

It would seem that you are motivated and trying hard to control things, so very despiriting that not getting the desired effect. The comment about the pancreas getting older and doing its own thing is not particularly helpful; yes, as T2DM progresses, the pancreas is less able to make insulin...

Pity that the Metabet (long acting metformin) upset her. Agree could be re-assessed for help at home. Home care from social services will help with food preparation, washing and dressing in our area; supervision of medication is variable. Will not help with tidying and cleaning Regarding BDA and...

Older folk might need a more straightforward diet; the Nutrition Advisory Group for Elderly (NAGE) of the British Dietetic Association (BDA) do (or did) big print, clear picture appropriate diet guides for older folk and one used to be able to download from internet.

Totally agree with above re food; I am not paid by Wiltshire farm foods, but they have an extensive catalogue with food marked as suitable for diabetic folk etc. One orders a week's supply and they deliver. I think they cover the whole of the UK. Choice of diabetes tablets is interesting; one...

Reactive hypoglycaemia is shown by a long (3 hour) GTT with samples every 30 mins - ouch. WHy most folk get it is not clear, but surgical proceedures on stomach for peptic ulcers were a common cause 50 years ago (before my time). I think it is a case of eating a diet without excess refined CHO...

yes - difficult. Ketones of 1 after 72 hour fast are probably just about normal. The GTT result leading to a diagnosis of diabetes is in correct in you. Firstly, a one off high glucose level does not mean diabetes; it needs confirmatory evidence such as another raised level, diabetes symptoms...

I would totally agree with above. Things are not always clear cut, and I have been surprised by folk who have had a lot of thier pancreas removed and do not have diabetes, and diabetes is a risk factor for pancreatitis. How do you feel in yourself? What is your weight doing? Any diarrhoea...

If your legs are getting weak with the risk of falling, then you need to see someone about it, and be able to tell them duration of symptoms, glucose levels, duration diabetes and medication history. It is not part of having diabetes and there are several possible causes. I have great respect...

Fiddly, but insulin mistakes like this are quite common. Generally, one should not stop the long acting, so I would give the Lantus as normal. I have little to add to the novorapid advice above - have enough CHO to cover the novorapid and make sure glucose level OK before bed and check (I'd...

Sorry to hear this; the thread above is interesting and helpful. Firstly, I would just check that there is not anything else contributing to neuropathy such as low vitamin B12, low vitamin D, underactive thyroid, monoclonal gammopathy (check a serum electrophoresis), calcium and LFTs (sorry -...

Thanks - you are very kind. Yes, if happy with lantus, do not change. Never thought of vials being more compact; but pens are more accurate at lower doses. Yes - stick to your guns, best wishes Simon

The studies suggest, as others have said, that the Lantus does not quite last the full 24 hours and 5% of folk need to take Lantus BD. Agree that Lantus can sting, it is slightly acidic to keep it soluble in the cartridge. If my patients were having bother with Lantus, I would switch to...