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How can i convince my dr?

  • Thread starter Thread starter Deleted member 208503
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Deleted member 208503

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I was doing very well last year.
On a premix insulin. Novolin 40/60. At 60 and 65 units a day.
I was meeting most of the set goals. I wasn't ravenous.
I ate regularly. I did not need to reuse tips as I have only 2 and the premix insulin was injected twice a day. I wasn't getting hypos.
And in our Dec. discussion my Dr said nothing needs fixed as in if it works why fix it. So we agreed nothing needs changed.
Then wam. That insulin was discontinued.
And he put me on glargune again. (Basaglar). And trurapi.
Then all the awful hunger began again so I requested ozempic.
But the point being --
How do I convince him to prescribe a premix? There are still some being made. I called some pharmacies to check.
( he wasn't the prescriber of the premix originally but that Dr was a walk in one who I would likely never talk to again as it depends on what Dr is working when u go).
 

Insulin glargine compared with premixed insulin for management of insulin-naïve type 2 diabetes patients uncontrolled on oral antidiabetic drugs: the open-label, randomized GALAPAGOS study

Demonstrate superiority of insulin glargine (±glulisine) strategy versus premixed insulin strategy for percentage of patients reaching HbA1c <7% (<53m…
www.sciencedirect.com
Seems the trial shows they are achieving similar results. Slightly better HbA1c with a premix and fewer hypo's with Glargine insulin.

ETA: If your doctor has seen this study, then it is unlikely that he will change your scrip. Ypu will need to show an allergic reaction or some major event that your current prescription is not fulfilling.
 
Has the dr refused to give you a different premixed insulin, or simply given you the ones you're on now? In other words does he know the issues you're having?
Has your hba1c or time in range got worse as a result of the insulin change, as that would be a good place to start.
 
I was on the premix when I first got him. He switched me knowing the issues.
I had time for 1 a1 c since the switch and it was better.
But I dont expect that to continue as they make me very hungry and I am already gaining my lost weight. Which will make he a1c higher? Regaining?
 
And yes he's refusing a premix
 
I'm not sure what I can do for this except maybe the a1c going up due to regain of weight due to it making me so hungry?
 
cdpm said:
I'm not sure what I can do for this except maybe the a1c going up due to regain of weight due to it making me so hungry?
Click to expand...
What that report does is say that if you want the doctor to change you back to premix, you may have a problem since it seems that glargine is an eqivalent, and probably cheaper than premix, so unless there is just cause or impediment, then your hopes of changing seem remote. You will have difficulty blaming your perceived high levels on the insulin itself.

I am not aware of HbA1c being weight related. It is a measure of high blood sugars, both height of spike and duration at the high level. It is an average of about 3 months of previous abuse from sugar. It is only related to insulin by the need for insulin to be present to actually use or store glucose. It is the insulin that is weight or volume related.
 
When you started the glargine when the premix stopped. did you reset the basal dose again? If you are using the premix settings, then the hunger is your body asking for more carbs. You need to set your carbs first then set your basal to match the carbs in the general sense then top it up with the fast acting insulin for each meal. I assume you are doing MDI, but the principle is similar for fixed dose too, but takes longer to fine tune the fast dose to match. But I believe you match the insulin to meet the carbs, not the other way round. I am surprised no ID users have come back on this with tips or advice.
 
When the dr switched me from the premix to glargine he said to take 25 units and said I could adjust. I'm not sure what he based this on when i told him I had taken toujeo (glargine) at 160 units a day still over 7 fasting when I got up.
And now I'm at 49 but in still not near a 7 fasting.
I have the book think like a pancreas. I haven't done the basal tests it talks about yet because anyone I ask just days increase a few units every few days or 1 person even said increase 1 unit a day. So i was just doing that. But I think now it's my fault because I complained to the dr that I was afraid the basal was going to make me gain my list weight back due to making me hungry so he said to try 49 units. so I shouldn't have said anything.
 
So idk if I'm allowed to adjust still or not now. He didn't directly say not to.
 
But I just don't understand.
Do my numbers look like I should be reducing my insulin!
And even if the newer insulins are equal or superior NOT every body responds the same.
Why am I not being allowed to be an insulin thst works for my body? My life? In more ways than one.
Am I missing something?
 
So I had to go off the glargine and trurapi. I was gaining so much weight and was so hungry.
Now I'm beginning to lose the weight I gained and am way more satisfied with my meals without the ravenous hunger.
 
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