Time to add additional insulin?

[dhpeeple1]

I am taking Lantus, Glucotrol XL, and Glucophage. My sugars have not been in good control for the last 2 weeks or so. Thursday night I had a reading of 402. Upon drinking lots of water, I was able to get it down to 323. Called the Dr. the next day and he added an extra 500 mg Glucophage twice a day. My lowest reading so far was 156 yesterday. Today, after taking my Glucotrol and Glucophage and not eating, my lowest reading so far is 238. I am wondering if the time has come to see how much insulin I make and/or add bolus or additional Lantus. Is there a test for that covered by insurance? Right now I take 50 units of Lantus around 7 pm each day. Most mornings my readings are 180 or higher. Except for the last few weeks, my post work numbers are usually 95-110. My last A1C in January was 6.7. Any thoughts?

David

[Jan B]

David,

Your idea of taking more insulin may be right. It sounds like you need pre-meal (bolus) insulin. However, there are others in the group who may know better than I do. It sounds like you need more to me.

[morrisma]

May be time for insulin. You may be coming to the end of a honeymoon. When were you dx'd?
Mike

[dhpeeple1]

I was diagnosed June 1998.

[Emm]

I vote for bolus insulin :D Sounds like a good idea to me. It's never ever wise to leave the blood sugars so high.

Note that a lot of doctors like to avoid insulin, sometimes it's treated as a last resort - but it shouldn't be, it's just a tool, and the aim of the game is to keep those numbers in range.

[xMenace]

You need a week or two for the metformin to build up. Be patient.

Can you improve your diet?

[pdxdennisj]

My Lipid Doc, who deals with a lot of Diabetes, told me most folks fail on oral meds by about 5 years. I was Dx'ed in 88 and lasted until about 3 years ago. My pattern was similar to yours but not so sudden.

[BlueSky]

... Called the Dr. the next day and he added an extra 500 mg Glucophage twice a day. .... Right now I take 50 units of Lantus around 7 pm each day. ...
It could be that your doctor is reluctant to increase your insulin because it aggravates insulin resistance. It looks like you need more insulin. But anything you can do to improve your insulin sensitivity will help. You improve insulin sensitivity by getting more exercise, eating low-carb, and losing weight (if necessary). ;)