Type 2 Erratic Sugars After Novorapid

[Rav]

Hello all, i wonder if anyone can comment on the following, recently my GP took me off gliclazide (40mgs) as he told me i should compensate this with Lantus, within few days of stopping my sugars became erratic, so now he has asked me to experiment with novo-rapid with my lantus, i have now been on Novorapid for 4wks and my levels are allo over the place, i find the novorapid works quite well within an hour of taking it then i get terrible spikes that don't come down. I have noticed weight gain around the waist so I'm reluctant to keep pumping in more insulin be it lantus of novorapid.

The GP now wants me to try trulicity, i have been on exanatide in the past that was not well tolerated.

Any views, perhaps i am taking the novorapid incorrectly i.e. not counting carbs in the right way.
Many thanks

 

[GrantGam]

How are you counting your carbs and do you have an Insulin to carb ratio calculated?

Many T2's are insulin resistant and for that reason may need substantial amounts of both basal and bolus insulin to keep their numbers in range.

 

[slip]

What was the reason for stopping gliclazide?

So you go on to insulin and have odd glucose levels so the doc says take even more, different, insulin.........result, even more odd glucose levels.......?!

There's a myriad of things that could be causing erratic glucose levels - quick acting insulin timing, carb ratios, correction ratios, what you're eating, your liver, pancreas, your basal might not be right, you exercise regime.......

Start with a basal test, search on here there'll be a link or someone else may provide a link to the site that discusses how to do a proper basal test.

Best of luck.

 

[novorapidboi26]

It sounds as though you have been taken off the oral meds and put on insulin with no tutoring on how to dose said insulin...

I am just making assumptions here due to lack of information....

When you first went on the Lantus...did you test and adjust it accordingly....?

 

[Rav]

It sounds as though you have been taken off the oral meds and put on insulin with no tutoring on how to dose said insulin...

I am just making assumptions here due to lack of information....

When you first went on the Lantus...did you test and adjust it accordingly....?

Well my GP describes gliclazide as a dirty drug what ever that means, though I'm aware that it promotes the pancreas burning itself out, having said that I've been on it for 10yrs and its been fine. I was told literally that i have a play with novorpaid (yes those exact words) and see what happens, i ve asked for a referral so lets see.

Whilst on the gliclazide 40mgs and 40 units of Lantus p/day i was getting post meal highs, but overall the HBA1c has always hovered at about 6.4-7%, since messing about with meds its shot upto 8.1%. As mentioned i am not overweight BMI of 27 and really dont want to pump insulin unless i can help it. I real target is to stop post pran spikes and i guess this can only be done with correct dosage

The last chat with the GP was that I should perhaps try Trulicity, so perhaps another option.

Many thanks

 

[novorapidboi26]

Being type 2 with some of your own insulin production means no pump unfortunately....or fortunately......whatever way you see it....

as a type one the only way to know if a dose is working, specifically the basal [Lantus] is to test it....

So has it been tested.....?

Post postprandial spikes suggest a need for a bolus too......but trying to adjust that is pointless without knowing for sure if the Lantus is correct...

So, the GP offering up all these options seems a bit hasty.....if there is a chance the insulin you are on hasn't been used correctly..

 

[Rav]

Yes i would agree the background needs to sorted 1st, i was told by my clinic that the best way to gauge lantus dose is to use fasting levels as the benchmark, i.e. getting as close to normal fasting range as possible which i actually was on 40units and depending on what i ate the night before, now its a constant 8/9, somethings changes !!