DIABETES - ADULT TYPE II COMMUNITY
Worse with insulin?

Worse with insulin?

3 months ago my 84 year old father was switched from 4 mg glimperide to lantus 30 units, then 40 units. A1c was 8.9 before change. Now it is 11.5 and he has lost appetite and 10 pounds. This week we started 8 units of insulin before meals. Bs still 200s to 300s all the time. He does have chronic renal failure which has been stable. My question is why go through all this hassle, which is not easy for his age if it's making bs worse?  Couldn't he go back to pills and add on another med?? Like byetta or something. Also I read that crf causes insulin resistance.  Any ideas??  His bs has been 350- 500 before adding fast insulin.  
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231441_tn?1333896366
Hi,

with bs of 350-500 before adding insulin, the oral meds were definitely not working.

Insulin is only his choice by this stage.  However, sounds like he needs a lot more adjustment of his insulin.  Perhaps you can attend some education classes so you can help him.  Maybe you should also be attending his drs appointments with him to ask questions and make sure all possible is being done.

His level of blood sugars are very detrimental to his health.  At his age it is critical to get things in better control and regain his appetite before.

Best wishes to you and your father.
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141598_tn?1338139820
To add to Sally's comment on his insulin adjustment, his Endocrinologist, not his PCP, should be aware that upping his Lantus dosage has not helped. You may wish to discuss premixed insulin, which is a combination of specific proportions of intermediate/long-acting and short acting insulin in one bottle or insulin pen. Btw, Lantus [not to be confused with Apridra] is a long acting insulin not short [fast].
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