Type 1 and gliptins

[Julia]

Hello,
Sorry I haven't posted for a while but have been lurking 🙂

I had an interesting appointment with my consultant today. He reckons I might have an exaggerated glucagon response and he mentioned gliptins.

In my first post here last year, I said I was struggling to get an HbA1c under 8. Well I'm still struggling! Most recent 8.5, best in last year 8.1. My DSN and consultant agree it's not for lack of trying! I know my lifestyle doesn't help - working long, crazy and unpredictable hours as well as doing long distance running and cycling.
Anyway, my BG will soar with stress (often up to 14-15mmol/l) and I get a really marked rise immediately after exercise. The thing my consultant was really interested in was, last week I did a basal test missing evening meal and BGs were perfect and stable 🙂 . Next day had completely carb free evening meal (no salad dressing or anything!) and BGs rose to 13.6mmol/l within 4 hours. I know that carb free meals send me high, so I avoid them as I have no idea how much to bolus.

Anyway he mentioned gliptins. I know it's normally a type 2 treatment and can only find one small pilot study for its use in type 1s.

If anyone has any comments or experiences (side-effects etc?) in type 1 or 2, I would love to hear them.

Thank you!
Julia

 

[Northerner]

Hi Julia, it's a new one on me, but good to hear that they are pushing the boundaries in search of better control for you 🙂 My levels rise after exercise but then I become a lot more sensitive to insulin later in the day. If I go for a run in the morning, with the same insulin dose, then my levels will be on the high side by lunchtime. If I don't run, then they will be on the low side! And if I eat a biscuit after finishing the run, with no extra insulin, my levels will be just right!

 

[trophywench]

There is something you perhaps could try that anecdotally works for some people. And that is - COUNT your protein and jab for it. Usually suggested amounts 50% for protein and 10% for fats.

ie if you take 1u to 10g carbs, you would take 0.5u of insulin for 10g protein or 0.1u for 10g fat

Obviously - be mega cautious. And test, test test !

 

[Julia]

Thank you Trophywench and Northerner for your replies.

I actually mentioned bolusing for protein to the consultant and he didn't really comment, but I think I'm going to give it as go as you suggest Trophywench. Thank you. Now I have no idea how much protein is in a pork chop and things 🙄 .... but I am glad I have the "carbs&cals&protein&fat" book. I'm sure if they did a study comparing the mental arithmetic of diabetics and non-diabetics we'd come out on top!

I'm afraid, Northener, your technique of small amount of carb at end of exercise doesn't work for me (I tried it a couple of times after you mentioned it before). Shame. Bolusing 1-2iu immediately at the end of exercise seems to be working better (most of the time!).

As for the gliptins, unless there lots of people on here who say they had lots of the side-effects or they didn't help at all, I think I would be keen to give them a go.