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Views on levels

R

Rav

Member
Messages
11
Type of diabetes
Treatment type
Insulin
hi all, I finally signed up to this community after many months of reading many interesting threads.

I am a 41 yr old t2 diabetic diagnosed about 12 yrs ago that has recently moved onto Lantus @ 24uts per day. I have a few questions and would appreciate your views

- since starting the lantus about 3 mts ago i have seen good fasting and pre prandial, ie between 4. 2 and 5 respectively, however my post prandial levels mainly after lunch can be 9 but normally under 10
- my last hba was 6.8

My gp is of the view that the hba reading is what matters, however I am reading many articles suggesting that post prandial levels are generally ignored by many medics that seem to focus on the 3 month average and that level in the 8s and 9s can also be lead to long term complications

'My gp suggests that 6.8 is a safe level and that too quicker a reduction can also cause issues with organs, nb, the threat of a hypo with aggressive medicating does not bother me as I sufficiently educated to foresee symptoms and subsequent treatment in such eventuality, my aim is to get to 6 to 6.5 with lifestyle, medication etc

What's the general view.

Ps, I also take 160mgs gliclazide and 200mgs of metformin

many thanks

Rav
 
Hi. Your blood sugar level during the day reaching 10 isn't too bad, but obviously could be better. The HBa1C of 6.8 could also be better. If you want to improve things you need to convince your GP to move you to a Basal/Bolus regime i.e. add a rapid insulin such as NovoRapid to the Lantus. This would need two pens and an extra injection before any important meals. I was lucky that my DN offered me this shortly after just giving me the long-acting insulin; I said I wasn't happy with the meal peaks. I was on once-a-day long acting and my DN preferred adding the Rapid rather than splitting the long-acting; surprised me but the end-result is better. I'm not sure I agree with the GPs comments about moving the HBa1C too fast? I moved down a lot and am still alive. BTW I asked my DN to stop the Gliclazide which she was happy to do. It has little effect when on insulin. So, I think you've got some persuading to do.
 
Yes your right, it's seems to be a persuasion game, I have been discharged from the care of the DN as hba is below 7, the gp seems to think 6.8 is acceptable, personally I would like to get it lower. The dn is not prepared to offer a fast acting or pre mix regime and had stated increasing lantus will not help (that I know) so I am stumped. I also understand that taking fast acting application can be dependent on what you eat and is not necessary before each meal depending on what is is of course. I suspect I'd only need it for lunch to stop the peaks

Cheers
 
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