Advice ?

[Spireite72]

Took my BGL before Dinner 3.9 only 5 minutes before food so had dinner and checked 15 minutes after 4.2 ( 1, 500 Metformin) 2 hrs after dinner 3.8. No NovoRapid now and only 4 units of lantus last night. 8.25 now going to re test in about 10 minutes had 2 glucose tablets and a small apple.

 

[Spireite72]

Back up to 4.4 now

 

[Kaylz]

In my opinion I'd get onto your team as soon as possible, I've been keeping an eye on your readings in the what did you eat thread and even though you are only on basal they are far too low, I wouldn't be happy at all sitting under 5 for most of the day, to me I think you need to further reduce your lantus or eat a bit more carb xx

 

[Spireite72]

In my opinion I'd get onto your team as soon as possible, I've been keeping an eye on your readings in the what did you eat thread and even though you are only on basal they are far too low, I wouldn't be happy at all sitting under 5 for most of the day, to me I think you need to further reduce your lantus or eat a bit more carb xx

I’ll phone my DSN Tuesday surgery is closed until then. I can reduce my lantus again tonight I’m only on 4 units right now I’ll be down to no lantus at all soon. I add carbs where I can and my BGL still goes down not up most of the time. It’s ok is in the mornings after I’ve reduced my lantus but drops in the next few days. Not sure if my metformin isn’t helping through the day I take one with each meal. Could this be to much? I’ve lost lots of weight trying to be more active( as much as I can at the minute). My insulin resistance seems very low. If my insulin production has improved significantly can the metfomin push my BGL to hypo levels.

 

[Kaylz]

I'm only on 1 unit of my basal at the moment, I cant help with the metformin theory as I have no knowledge or experience of it, increased activity will change how much insulin is needed etc, so does change in weather amongst a lot of other things, as far as I know metformin doesn't cause hypo's although I think I've seen folk say it has, don't quote me on that though, I'm not sure how many type 2's here are on insulin but I'm hoping @Ljc might see this and may be of more help than me as cant think who else is 😳 xx

 

[Spireite72]

I'm only on 1 unit of my basal at the moment, I cant help with the metformin theory as I have no knowledge or experience of it, increased activity will change how much insulin is needed etc, so does change in weather amongst a lot of other things, as far as I know metformin doesn't cause hypo's although I think I've seen folk say it has, don't quote me on that though, I'm not sure how many type 2's here are on insulin but I'm hoping @Ljc might see this and may be of more help than me as cant think who else is 😳 xx

Thank you

 

[TheClockworkDodo]

I also believe Metformin doesn't cause hypos (hopefully a type 2 will come along who can tell you for sure) but I know that small doses of Lantus can be very unstable, causing spikes and plummets - I was on 4 units of it and I had to change basal because it was causing me to have so many random hypos. So I'd definitely lower the Lantus a bit for now, but in the longer term I'd ask your diabetes team to review your meds, as you may need to change to a more stable basal insulin or drop the insulin altogether if you're now producing more of your own.

 

[Spireite72]

Yes that’s what I though you don’t get hypos with metformin. Just keep reducing my lantus for now even if it means I have to stop taking it. See if that helps.

 

[trophywench]

Please wait several days after reducing it to 3u before even considering reducing it further - unlikely to see an awful lot of difference on day 1 but should see it on day 2 - day 3 will confirm whatever the reduction has done.

(When changing from either Lantus or Levemir to an insulin pump - we are all told not to expect instant results 'as it takes a full 3 days for the L to be out of the system')

 

[Spireite72]

Please wait several days after reducing it to 3u before even considering reducing it further - unlikely to see an awful lot of difference on day 1 but should see it on day 2 - day 3 will confirm whatever the reduction has done.

(When changing from either Lantus or Levemir to an insulin pump - we are all told not to expect instant results 'as it takes a full 3 days for the L to be out of the system')

okay thank you I’ll try this for a week and see if it improves.

 

[Spireite72]

@Spireite72, I was just looking at 'What did you eat yesterday?` and can see the low carb diet is coming along nicely. Well done, your hard work is being rewarded with much tighter numbers. I think you are ready to hang up the Lantus for a few days. 4 units of Lantus is a very small dose, equivalent to a 6th of a unit per hour.
Make an appointment with your DSN to discuss your further reduction of medications.

Going to call her bank holiday so not in until Tuesday.

 

[everydayupsanddowns]

My understanding is that Met makes you use insulin more effectively (presumably your own as well as the Lantus you are taking). Weight loss will make you more insulin sensitive too.

If you are regularly dropping below 4 and spending most of the day in the 4s, like @Kaylz says I would drop down to 2u or stop Lantus entirely.

Readings below 4 should be treated with 15g of fast carbs and recheck after 15 mins. So 2-3 Jelly Babies, a handful of Skittles or 3 glucose tablets.

Hope you can relax and your BGs keep above 4 over the BH weekend. 🙂

 

[Spireite72]

My understanding is that Met makes you use insulin more effectively (presumably your own as well as the Lantus you are taking). Weight loss will make you more insulin sensitive too.

If you are regularly dropping below 4 and spending most of the day in the 4s, like @Kaylz says I would drop down to 2u or stop Lantus entirely.

Readings below 4 should be treated with 15g of fast carbs and recheck after 15 mins. So 2-3 Jelly Babies, a handful of Skittles or 3 glucose tablets.

Hope you can relax and your BGs keep above 4 over the BH weekend. 🙂

Took 2 units last night try that for a few days until I can speak to my DSN 4.6 this morning see how it goes.

 

[Bubbsie]

Yes that’s what I though you don’t get hypos with metformin. Just keep reducing my lantus for now even if it means I have to stop taking it. See if that helps.

There is a general consensus that T2 diabetics using Metformin cannot have a hypo...to a large degree that is right in my experience...however technically anyone can have a hypo diabetic or not...Metformin is unlikely to cause a hypo in the way other medications would such as Victoza (low risk) or Glicazide ( higher risk)..

 

[Martin9]

I also believe Metformin doesn't cause hypos (hopefully a type 2 will come along who can tell you for sure) but I know that small doses of Lantus can be very unstable, causing spikes and plummets - I was on 4 units of it and I had to change basal because it was causing me to have so many random hypos. So I'd definitely lower the Lantus a bit for now, but in the longer term I'd ask your diabetes team to review your meds, as you may need to change to a more stable basal insulin or drop the insulin altogether if you're now producing more of your own.

Metformin on its own doesn't cause hypos, but if used in conjunction with insulin it will exacerbate the effects of insulin so can help lead to hypos as far as I understand ...

 

[Spireite72]

28th woke up to a 4.6 had breakfast. Made a hash chopped up new potatoes tomato red onion left over jerk sausage fried in a little olive oil and a fried egg on top. 2 hours later 5.5, getting there

 

[trophywench]

Brill !