[forex]

Well,I took my father to endo. doc. (we actually had two appointments).He ran all the tests and put him on long lasting insulin.(Lantus)
His BG was very high,it wasn't going down no matter what we did,range was 180-200,A1C was in 8-9 range.
Even though he is a type 2,doctor said that he is very unusual for type 2 since he had no weight problems,weight is only 173lbs.
He started taking insulin 4-5 days ago,but we don't see substantial change,BG has gone down to 126 and 146,but is pretty high overall.
I was just wondering if anyone had the same experience with Lantus.How long will it take to bring down the BG under control with Lantus?Doctor said to keep taking medicines as well. (Amaryl and Actose)
My other question is about eye treatment.Can anyone recommend anything?I've heard about laser treatment but have yet to do more research on this.He doesn't have insurance and is on self-pay so we are trying to keep the costs down but will do absolutely necessary things.
Another problem is treating diabetes damage,he's got some foot numbness,are there any medicines or shots that can be taken to improve condition of legs?(Doc. said that nothing can be done,I can't believe this)
Overall,I didn't find his endo. doctor very helpful,he doesn't give us whole lot of information,maybe because there is nothing that can be done.He told us to come back in about a month and if BG didn't go down with long lasting insulin,he would recommend fast acting insulin.I thought he would give us some tips as far as diet,exercise,eye,leg and kidney treatment.
I would appreciate all the feedback from you guys,thanks in advance.

[Scrabblechick]

Hmmm. Sounds like he might need some Metformin. He might be very insulin-resistant. I'd also ask for the GAD test to see if he might be a 1.5, not a T2. (Isn't that the test that determines 1.5?) Met takes 4 weeks to 3 months to reach maximum effectiveness, so you might not see results right away.

My dad never had a weight problem either. He was 6'0 and usually weighed about 180-190. He had never been obese.

[Hammer]

How much Lantus is he taking every day? You might want to increase the Lantus by 2 units every three days if you don't see the numbers dropping. You need to be careful though since he's also taking the other meds....you don't want his BG levels to go low.

When you are first precribed Lantus, they start you on a very low dose....usually around 8 units. After taking 8 units for three days, if the numbers don't drop, then you would increase the Lantus by 2 units to 10 units and use 10 units for three days to see what happens.

They started me on 8 units and I didn't get the results I wanted till I got to 74 units. I'm not taking Amaryl or Actos, but I do take Byetta injections. Amaryl will stimulate the pancreas to produce more insulin, so taking it and injecting Lantus means you need to carefully watch his BG levels.

Since he's a type 2, that means that his body is resistant to the insulin he produces. The Actos helps break down that insulin resistance, so combining all three might take a little while before you get the dosages right. You're adding insulin (the Lantus), you're making the pancreas produce more insulin (the Amaryl) and you're breaking down the body's resistance to the insulin (the Actos), so you've got three things working from three different angles trying to control his BG, so careful monitoring is needed till you get everything right.

Also, his eyesight will change as he gets his numbers back to normal, so you might want to see how that plays out. The same thing with his feet....lowering his BG levels will affect his feet, so maybe wait a bit till you see how he feels after normalizing his BG levels.

[forex]

thanks guys,that's helpful.
Doctor started off with 25 units of Lantus. How many times a day should we check his BG? Also, what do you think are the best numbers to maintain for him? Like I said, he used to be in 180-200 range,we are trying to bring it down to 120 and not more than 150-160 after eating,how do these numbers look?
Also,wouldn't it make sense to take fast acting insulin rather than increasing Lantus to 75 units?
Doc. said that he doesn't need metformin,we thought he would put him on metformin,but tests showed that his body is not making enough insulin.
So here is another question, he is taking 4 mg of Amaryl,2 times a day and half a pill of Actose, which is like 7.5 mg. Should we increase Actose dosage?
I am kind of scared of increasing insulin dosage since 25 units are a lot to start off with.

[GeorgeGuinn]

Originally Posted by forex

Doctor started off with 25 units of Lantus. How many times a day should we check his BG?


Also, what do you think are the best numbers to maintain for him? Like I said, he used to be in 180-200 range,we are trying to bring it down to 120 and not more than 150-160 after eating,how do these numbers look?


Also,wouldn't it make sense to take fast acting insulin rather than increasing Lantus to 75 units?


Doc. said that he doesn't need metformin,we thought he would put him on metformin,but tests showed that his body is not making enough insulin.

So here is another question, he is taking 4 mg of Amaryl,2 times a day and half a pill of Actose, which is like 7.5 mg. Should we increase Actose dosage?


I am kind of scared of increasing insulin dosage since 25 units are a lot to start off with.

You want to check it in the morning and then before meals and 2 hours after meals. You want the 2 hour reading to be 140 or less.

My Dr. Has me trying to get to 100 as my morning fasting number. I was shocked since I haven't seen 100 in over 10 years. But I am getting close down to 120 from a morning BG reading of 240 6 weeks ago.

The Lantus is to provide a steady stream of insulin during the day. The fast acting is to counter the highs caused by eating. I started at 10 units per day and increased the Lantus 2 units per day until I got to 70 units. When that hadn't done anything to help my BG readings I went back to the Dr. and had to add the fast acting insulin.

This article explains the different type 2 diabetes drugs and what each does.

Type 2 Diabetes Medications - a knol by Caring.com Eldercare Experts

The Metaformin "It helps your parent's body use insulin better, and it helps the liver make less sugar and lowers the amount of sugar his body absorbs from food. " My Dr. left me on Metaformin for now (actually Janumet)

The Amaryl stimulates the production of insulin my Dr took me off it.

I wouldn't change the dosage of the Actos with out your Dr. approval. But you will want to increase the Lantus dosage if the morning BG don't go down. You may want to do like I did work with the Lantus for a week then if the numbers aren't going down go back to the Dr. You and your father have to take charge and push the Dr. They are way too laid back for my taste.

A great book that was recommended to me on the forum is

Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin

I got it from my local Library but after reading it I am ordering it to have my own copy.

Amazon.com: Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin: Gary Scheiner, Barry Goldstein: Books

Hope this helps.

[mortis505]

25 units isnt really that large of a dose. Talk it over with your Dr but Hammer gave you some really good advice. Give it a try and see if it starts to lower those numbers. You may even want to consider splitting the dose to a.m. and p.m. on a 50/50 ratio.

If he isnt producing much insulin I would ask for a GAD antibody test. See if those little buggers are present. If not, then he may be experiencing Beta Caell Burnout.