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Type 2 Diabetic with CKD
My grandmother, 75 yrs of age, is a diabetic for past 15-20 years, taking metformin (2g daily) plus insulin (40+35). Where I am from we don't usually give a basal bolus regimen, just 70/30 in morning and evening. She also has history of IHD one year back.

Recently, her renal function tests revealed a creatinine of 2.0 (178micromole/L). Her GFR according to MDRD equation is less than 30. This clearly means metformin should be stopped.

However, when I stopped her metformin, she developed high blood glucose (9.7 fasting), so now I am not sure what to do? Are oral agents really needed with insulin for glucose control? And if not, how many units am I to increase her morning/evening insulin dose on each adjustment? How frequently to monitor? I myself am a doctor, so I know to always get the patient checked before any modification in treatment, but I just thought to also obtain the view of any experienced doctor over the internet as well. Any help would he appreciated.
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19383564 tn?1477513584
Hi Pleomorphism,

Welcome to the Type 2 Diabetes forum on MedHelp and thanks for posting! I'm the community manager here at MedHelp.

Our communities are now patient-to-patient communities. We no longer offer expert doctor advice. Our community members can provide advice from their own experience with Metformin, but we always recommend checking with a physician before making changes to any drug regimen.

Thanks!
Kendra
MHCommunityManager
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231441 tn?1333896366
Hi,
the most important thing that you can do to help your grandmother's kidney function is to keep blood sugars as close to normal as possible.

This will involve taking her medications (insulin / metformin) and eating lower carb meals, along with close monitoring of blood sugar levels.

please discuss with her dr whether it is appropriate to modify her medications, as this is not something we can comment on from this online community.

Wishing you and your grandmother good health.
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