Presentation and request for advice

Hello:

I have 51 and I am type-2 diabetic for 5 years.I have no family history.The story comes from October-2006 when I did a routine analysis in which values ​​of the order of 1,200 triglycerides, 11.50% HBA1c appeared ... the curious thing is that shortly before, in 2004 and 2005, it had suffered 2 colon interventions where nothing was nothingdetected in the pre and post operatories.It seems as if the pancreas had broken down as a result of the second operation.

When I visited the endocrine with such an illustrious analysis, I was prescribed to start with 20 units.of Lantus and a 1,600 calorie regime that took me from 86 to 76 kilos in 3 months (measure 1.76), and from the initial 20 units until 34 of Lantus to stabilize around 100 the fasting measurement.In later reviews they attached metformin (1-0-1, according to the doctor to favor the assimilation of insulin) and Atacand (1-0-0).

Earlier this year I started with some problems: the daily morning measurements were closer to 120 than the 100 objectives, a trend that was extended up to 130 or 140-even 150-160.In April I did a control and the analyzes were quite good (HBAIC 5.60%);Only triglycerides somewhat above -225-, surely due to my wine hobby that sometimes brushes excess.The endocrine "discharged me" and is now the family doctor who is in charge of control.

In June I stopped smoking and I have gained weight.I must be for the 85 or so.I have climbed Lantus to 40 units.and not low from 145-185 in the morning.In controls prior to meals during the rest of the day I move between 100-120.And in those of 2 h.After meals I am between 160-180.

The problem focuses on the morning of 145-185 and I don't know whether to continue increasing Lantus units or if 40 are already many.In theory, Lantus should increase until the measurement stabilizes in 100, but I fear that it would possibly reach 50 or 60 units and I do not know if these amounts are a barbarity or not.For the rest, the thing is overwhelming.

I would like to know if any of you have gone through a trance or similar.I know that it is best to go to the doctor but I like to go to the doctor as well as possible.

Salu2 and thank you very much.

Hello good.

Insulin, in principle, is neither much nor little.If you need 30, 40 are too many.If you need 50, 40 are too few.Everything is based on what each one requires.

Another thing is the distribution of insulin, which can be the application in only time or in several if quick insulin is used.In your case, being type 2 I do not know if you combine it with an oral antidiabetic or not.You tell us.

Health

Welcome to the forum.

From what I read, you have several pathologies: type 2 diabetes, hypertension, hypertriglyceridemia, some colorectal pathology (diverticulitis?but either anything crazy).

In addition to summarizing it, it is useful to see everything together because in the end you only treat the person, 5 unconnected pathologies are not treated.

I have not understood what reducing 10 kg of weight had to increase the dose of Lantus by 75%:-/
Normally it is the opposite, when body weight is reduced, insulin needs fall.
Perhaps you had insulin resistance (hence metformin) caused by colon problems and in general food absorption.

It is important to determine if you have absorption problems because otherwise you could see the possibility of including ultra -granted insulin in one of the meals or of some hypoglycemic pill (sulfoniruleas).
Another interesting possibility would also be the incredines: Link ... s/148.html >
Incredines have the plus of the body weight loss added to the drop in glycemia, which makes them ideal.
As long as your liver is in perfect condition ... :?: ?: ?:

The liver is responsible for metabolizing proteins and accumulating glycogen that sends it to the blood as the body demands.
Much of antidiabetic therapy is based on the control of this liver emission.

With all this roll I mean that there are other treatment possibilities, in addition to the increase in Lantus dose ...

My recommendation would be to divide the dose of Lantus into 2 punctures into 2 different areas ... The walls of the skin are not unlimited, they give for what they give, with high doses it is better to distribute the dose in 2 injections in 2 different points.

Hello again and thank you very much for answering:

[...] In your case, being type 2 I do not know if you combine it with an oral antidiabetic or not.You tell us.[...]

For what I read, you have several pathologies: type 2 diabetes, hypertension, hypertriglyceridemia, some colorectal pathology (diverticulitis?, stenosis? Tumors?) And a slight excess excess ofWeight (your BMI is 27 and peak, it is not ideal but nothing crazy either).I had colon perforation and had to intervene urgently.I have not always had the triglycerides, so the doctor has not considered hypertriglyceridemia.Nor have I strict hypertension: the doctor has believed timely as a preventive measure an attacand a day - the minimum dose as he told me - because I usually be at the limit of normal for the high part, especially theMinimum voltage.Excess weight is clear and undeniable.Basically it comes from the desire that produces to have abandoned tobacco and almost prefer not to deprive myself at the time of some whims ... everything will walk.

and that increasing 2 in 2 uds.of 32 units.of Lantus after a few weeks.And from then until the beginning of this year I had always arranged well with the 32 units of Mantinal Lantus, plus metformin every 12 hours.

Thank you very much for the link of the incretins.I will read it carefully and I will tell you if I have any questions.

My recommendation would be to divide the dose of Lantus into 2 punctures in 2 different areas ... The walls of the skin are not unlimited, they give for what they give, with high doses it is better to distribute the dose in 2 injections in 2Different points.In the abdomen and 20 units.in the thigh or arm, at the same time ;Or to click on two different places at different times , for example 20 units.In the morning at the abdomen and 20 units.At night on the arm or thigh.That is, if in addition to the care of the puncture area you also refer to dividing the doses throughout the day, even if it is Lantus.In some thread I have read that Lantus loses effect as the hours pass.

Well, if someone else has passed or knows a similar situation and is well interested, I would appreciate it very much.

Thank you very much and greeting to all.

Hi, E.covalera.
In my case, it is my daughter who has diabetes and is type 1, but do not worry, that in this forum there are people who will better understand your case and guide you.

Suddenly glycemia without apparent explanation, I think it is much more frequent than it seems.

Health

My recommendation would be to divide the dose of Lantus into 2 punctures in 2 different areas ... The walls of the skin are not unlimited, they give for what they give, with high doses it is better to distribute the dose in 2 injections in 2different points.

I don't know if you want to tell me to click on two different places, for example 20 units.In the abdomen and 20 units.in the thigh or arm, at the same time ;Or to click on two different places at different times , for example 20 units.In the morning at the abdomen and 20 units.At night on the arm or thigh.That is, if in addition to the care of the puncture area you also refer to dividing the doses throughout the day, even if it is Lantus.In some thread I have read that Lantus loses effect as the hours pass.

From 40 units you can consider the possibility of dividing the dose into 2 injections made at the same time.
Let's say that subcutaneous tissue is like a dam with a storage limit, from that dose you can study 2 punctures instead of 1, always at the same time.

On the other hand.
In recent times, the fashion of unfolding the Lantus has appeared in 2 daily cycles, that is, 1 puncture in the morning and another at night.
I don't just understand it.
If this issue was chosen, it would be better to go to Levemir, designed for this situation, although perhaps with less hypoglycemic power.