Type 1 and Lantus

[shravan2k2]

I was diagnosed diabetes 3 years back, initially i was on tablet but that couldn't control m sugar levels and i started losing weight as well. Hence, i was put on lantus injection. I take 24 points in morning with one tablet of metformin and 18 point at night before dinner with no metformin at night. Metformin usually gets me irregular heartbeat if taken at night, so i take metformin only in morning. Bu the major thing is my post dinner blood sugar (after 2 hours) spikes a lot, if pre dinner levels are 150, it will shoot upto 300-320 after two hours. But morning fasting is fine at 100-110.
My doctor says its okay as lantus will slowly start affecting post dinner. Is this normal to have high post dinner blood sugar levels. Should i consult another doctor? should i be worried or should i continue as it is?

 

[catapillar]

Are you type 1 or type 2? Because a basal insulin and metformin sounds as if you are being treated as type 2. Most type 1s are on a basal bolus regime, so they bolus with fast acting insulin for carbs to avoid that post meal spike. Do you know what your HbA1c is?

 

[noblehead]

My doctor says its okay as lantus will slowly start affecting post dinner. Is this normal to have high post dinner blood sugar levels. Should i consult another doctor? should i be worried or should i continue as it is?

Lantus isn't used for that purpose, it's a basal insulin that keeps bg levels stable during period of fasting to match the release of glucose from the liver, you need to include another insulin like Novorapid/Apidra to take with your meals, this is what many refer to as a bolus dose/injection.

 

[shravan2k2]

Are you type 1 or type 2? Because a basal insulin and metformin sounds as if you are being treated as type 2. Most type 1s are on a basal bolus regime, so they bolus with fast acting insulin for carbs to avoid that post meal spike. Do you know what your HbA1c is?

I am type 1 and i have not checked Hb1ac recently.

Lantus isn't used for that purpose, it's a basal insulin that keeps bg levels stable during period of fasting to match the release of glucose from the liver, you need to include another insulin like Novorapid/Apidra to take with your meals, this is what many refer to as a bolus dose/injection.

Thanks for the reply. So that means i should consult another doctor

 

[shravan2k2]

but is it normal that post dinner blood sugar levels to go this high?

 

[catapillar]

So after dinner you are going up to 300-320 (16.5-18)?

Normal blood sugars (for a non diabetic) are not going to get a post meal spike much over 150 (8.5).

So no it's not normal. Even for a diabetic, with a basal bolus regime, most of us will be trying to avoid that level of spike (try to stay under 200/10) by giving a fast acting insulin as a bolus with or before food.

Are you seeing an endocrinologist? You should try to see a specialist to discuss whether a basal bolus regime would be suitable for you, and also to review your hba1c.

[sorry I can't think in mg/dL, so I had to put the mmol/L equivalent, which is what we use in the uk, with it]

 

[noblehead]

Thanks for the reply. So that means i should consult another doctor

If your current Dr continues to say that such high bg levels are OK then I'd certainly look for another Dr, as a type one you should be taking both basal and bolus insulins.