Stopping insulin intake, suddenly or overtime

[faheemakbar18]

hello experts

M father is 57year old and is diabetic for around 12years
he was taking metformin hcl 500mg till december last year when he was sick and doctor told to get it tested again
morning fasting was around 170mg/dl and 2h postmeal 260
doctor prescribed mixtard 30 penfill 28unit morning 20 unit night before meal
metformin 850mg after breakfast and dinner not at lunch

last fasting reading around month ago was 100mg-dl

now he wanna stop the insulin and check if he require insulin or its ok without insulin....can he leave suddenly or dropping it by units

2ndly..he now get ill early with cough and fever. what to do about it

and he has pain in legs and feet sometimes.. should he take methycobal tablets as he been diabetic for 12 years or so and it cause neuropathy, if he should then how much dose

[jemma116]

The doctor will recommend how often the diabetic patient should do a self-monitoring of blood glucose.

Self monitoring is a good idea when feeling the symptoms of hypoglycaemia (sugar level too low). The symptoms of hypoglycaemia include dizziness, shaking, sweating, chills and confusion.

Or feeling the symptoms of hyperglycaemia (sugar levels too high).  The symptoms of hyperglycaemia are sleepiness, blurry vision, frequent urination and excessive thirst.

I know when my sugar levels are too low when I start to feel hunger accompanied by nausea.  

Urine testing strips are still used to check for too much glucose.  But the level of the glucose needs to be above 11 before it shows anything on the strip, and of course it does not give you any information of how high or low the level of glucose is in the body.  It also depends on the persons kidney function.

[caregiver222]

Taking multiple blood sticks several times a day, before meals and two hours afrterwards is reasonable and appropriate as a method of establishing diabetic control. This does NOT have to be done every single day or even on several consecutive days. But multiple blood tests during a day should be performed periodically. When awakening, before each meal, two hours after the meal, and before going to bed. Consult your R.N. diabetic specialist for recommendations on how often and when this should be done. In the United States many R.N./diabetic specialists have a computer and when you visit the meter downloads the time, hour and date of the blood glucose measurements into her database. Ideally, if you record this information after a "sandard meal" it will hold for a similar meal. Prodiding your diabetic nurse/R.N. with this information assists them greatly. With the modern tests and nusing different fingers the discomfort is minimal. That being said, taking blood sticks without recording the nature of the meal insofar as calories and protein, etc. deprives the physician from information necessary to control the problem. With the advent of the modern glucometer measuring blood sugar urine has become an obsolete method of controling glucose.

[jemma116]

Tell your father not to decrease or adjust his diabetes medication without supervision and advice from his doctor.

If he is feeling unwell and is finding it difficult to still control his sugar levels, he MUST tell his doctor.  There are different types of medications for diabetes and the one he is on now may not be  right for him.  The dosage also needs to be adjusted to get it just right.  

I would not recommend doing blood prick tests before and after meals umpteen times a day - no doubt he will feel like a pincushion.  This is not necessary.  Your father's doctor will tell him how often and when to do a blood sugar test with the blood sugar monitor.

My husband was put on Victoza which was administered through an epipen.  This did not suit him and he is now on normal insulin injections, but the dose is changed depending on the HbA1C test.  This blood test that the doctor (or nurse) takes, gives an average sugar level reading over a period of 9-12 weeks.  

A prick test will only tell you the blood sugar level at the time of doing the test.  It is a good indicator whether or not you are controlling your sugar levels adequately, but does not give the bigger picture.

With regard to the pains that your father is having in his legs and his feet, he should also talk to his doctor about this.  And yes, it is highly probable that he has diabetic neuropathy.  I am sorry, but I do not agree with one of the above posters that diabetes does not give you neuropathic pain due to nerve damage.  I was not a diabetic and my sugar levels were always fine, yet I had neuropathic pain.  A specialist confirmed that I did have peripheral nerve damage and to control my diabetes (I was not a diabetic).  

Once the nerves are damaged, unfortunately, there is no cure.  Yes, keeping sugar levels under control will help for the condition not to get worse.  For this type of problem the doctor usually prescribes an antidepressant (in the UK) called Amitriptyline.  This does not stop the pain altogether, but does help. Your father should always check with his doctor with regard to taking any over the counter medicines.

Sorry, but again avoiding sugar is old thinking.  A person who has diabetes can eat anything, but this has to be in moderation.  Sugar comes in different forms - fruit contains fructose which is a type of sugar for example.

Going on the web to learn about portion sizes, healthy eating and exercise, and the types of foods to eat only on occasions will help you.

Regarding your father feeling ill now with a cough and fever, this will have nothing to do with diabetes.  It is possible that he has a bacterial or viral  infection.  Steam inhalations will help.  

Tell your father to also keep an eye on his urine.  If it is cloudy, dark or smells very strongly he may have a urine infection and that too could make him have a fever.  The doctor will be able to examine him for any respiratory infections and any urine infections and prescribe the appropriate medication is necessary.  Tell your father to drink lots of fluids, herbal teas, water.

The other thing to remember is that people with diabetes have great difficulty to control their blood sugar levels and also blood pressure may be higher when they are ill.

Best wishes.

[caregiver222]

I think you really have to get together with a good nurse R.N., or nurse practicioner who specializes in diabetes and will take time with you. Metformin is generally increased to 1000 mg doses before going to insulin, for example. The R.N., together with a dietician, will come up with a comination of meds, diet and protocol that will be best for you. A good one will see you once a week for several weeks until everything settles down. You have to keep good track of meals and do intensive testing every so often. Not "once a month". Intensive testing means in the morning before eating. Two hours after eating. Before every meal and two hours after the meal and before going to bed. It is difficult to understand what is going on from books. I like the John Walsh book, but it is too complicated fror many people, who need "one-on-one" supervision., As for the "prefilled pens", they are more expensive, can cause more discomfort, and make it difficult to adjust meds for special ocasions. I think they are the perfect solution to which no known problem existed.

[Super_sally888]

No, he cannot stop insulin.  Further you should get a home blood glucose monitoring kit so that his blood sugars can be checked at home and adjustments made, if necessary.

I think both you and your father need to read up on diabetes, it's causes and it's treatment.   Can he get to attend a diabetes education class.  This at least would be a step in the right direction.

I can recommend a book called 'using insulin' by John Walsh, as a starting point as well.  Your father is still young.  It is very important that you control his diabetes well to avoid complications.

Low carb diet, exercise and weight management are all important.  Diabetes cannot be managed just with a pill or an injection - it is a lifestyle and requires comprehensive management.   He must avoid sugar.

[diabetes86]

Diabetes does not cause neuropathy , neuropathy is from BG out of control 170...260 those numbers will cause neuropathy.  as for dropping insulin one reason to reduce insulin is if his numbers are too low (under 70)  since insulin lowers BG and his numbers are 100 if he stopped insulin his BG would rise, and quite a bit I think.  

BG over 140 is what causes complications ie neuropathyboth in his feet/legs and in his eyes, hart Kidny...  his numbers are good with insulin why stop?

I am NOT an MD I am on insulin and well controlled