Metformin and Glargine combined

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JamietDE6

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Hi Folks, happy Friday to you all.
So the latest from my DSN is the consultant ( who i have never met) , wants to wean me off rapid and give Metformin a go combined with Lantus. Just wondering how that will work when sometimes my rapid does not work as expected? Levels this week range from 5-19 4 hours after meals?
 
What are you eating to get those high readings?
Are you keeping a food diary along with your pre and post meal reading?
Have you been on Lantus/Glargine all along or is that being introduced as NR is being removed? Apologies if you have covered that elsewhere on the forum.

Metformin works by helping your body to use the insulin it produces to overcome insulin resistance. Have you had a C-peptide test to see how much insulin you are producing yourself? I believe you had an inconclusive GAD antibody test didn't you?
 
I’d think it would make more sense to add Metformin to your basal/bolus regime. I know you had a negative GAD test but did they test the other Type 1 antibodies too?
 
rebrascora said:
What are you eating to get those high readings?
Are you keeping a food diary along with your pre and post meal reading?
Have you been on Lantus/Glargine all along or is that being introduced as NR is being removed? Apologies if you have covered that elsewhere on the forum.

Metformin works by helping your body to use the insulin it produces to overcome insulin resistance. Have you had a C-peptide test to see how much insulin you are producing yourself? I believe you had an inconclusive GAD antibody test didn't you?
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Hi
I am eating as i did pre onset and trying to bolus according to whatever that is approx 1 unit per 10 g carb plus if high i will throw in some extra workouts which always seems to bring it down. It was a no to c peptide until i am at least 6 months in according to DSN. I do often find my evening meal results in a high level which i assumed was because i was too frugal with bolus.
 
If they are hoping for you to manage without NovoRapid and just use Metformin and Lantus then you are probably going to need to modify your diet or suffer high levels. With them not knowing your Type, you are kind of stuck between a rock and a hard place. If you don't modify your diet, your levels will almost certainly rise and probably quite significantly and if you modify your diet, you may bring your levels down but they may take that as an indication you are Type 2 when you may not be. Personally I am happy I was misdiagnosed as Type 2 because there have been a lot of health benefits to me from going low carb and I would not have achieved it if I hadn't had the impetus of putting my diabetes into remission. I will be happy to eat this way for life now but I know it isn't for everyone.
 
I'm currently on Glargine (Semglee) & Metformin + Emapagliflozin.

I was originally on just Metformin but went on to basal/bolus following Covid. Once that was stable I was put back on Metformin & added Empagliflozin in addition to insulin. The effect of the oral meds meant I could gradually reduce both types of insulin to the point where I stopped the Novorapid in December.

But that was a gradual titration process & insulin doses were only reduced when waking & all pre-meal levels were sub-six. I would then reduce both by 10%. It's difficult to see the rationale for removing bolus when you still have levels in high double figures. But were not medically qualified in any way & don't know your full history. Rather than just accept it, I'd be asking for a detailed explanation of what the decision is being based on, & how they expect it to pan out.
 
Hi all
so latest visit to the DSN and the opinion is still leaning toward type 2 although when asked why I was told it was because levels were not wildly up and down ? I passed comment that they were still between 5 and 17 but this did not illicit any response. Plan is as of tomorrow introduce Metformin to a maximum of 4 doses a day over a 4 week period whilst at same time reducing bolus first at two units per meal and then once that is removed reduce basal. I am happy to give it a go of course but protested I would find this a lot easier to monitor with a monitor - still a flat no. I expect the bill for test strips is going to mount up….
 
JamietDE6 said:
Hi all
so latest visit to the DSN and the opinion is still leaning toward type 2 although when asked why I was told it was because levels were not wildly up and down ? I passed comment that they were still between 5 and 17 but this did not illicit any response. Plan is as of tomorrow introduce Metformin to a maximum of 4 doses a day over a 4 week period whilst at same time reducing bolus first at two units per meal and then once that is removed reduce basal. I am happy to give it a go of course but protested I would find this a lot easier to monitor with a monitor - still a flat no. I expect the bill for test strips is going to mount up….
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That is ridiculous, I suggest you contact the DUK helpline for advise. Surely if you are taking insulin you should be prescribed a monitor and strips regardless of what Type you are.
 
Sorry just to clarify I do have a finger prick monitor and strips on prescription. Would make this trial a lot easier though with a flash or CGM I would have thought. I have applied to abbot for the trial.
 
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