Is it really time for insulin?

[maggie1blue]

My 83 year old father is on glimperide 4 mg twice a day.  His A1C is 8.9, higher than usual, but taken after holidays and post holiday eating.  Very little acitivity since winter, bad lungs, joints, gout, heart, etc.  Doctor says he needs to change to Lantus insulin.  Should we see endocrinologist  for another opinion?  Couldn't we try other oral meds first and dietary changes?  Also triglycerides very high, 600s, for a while now.  Chronic renal disease, but stable,   Any ideas or recs.?  Is it better to go insulin route?  I am worried about hypoglycemia, as his mobility is limited.

[rosco888]

Am not sure what you mean by "dietary changes".  I have found that insulin-type meds promote hunger.  Be sure your father is not over-indulging at each meal.  Eating small amounts every 2 hours, even if inactive, gives the body a chance to metabolize food more efficiently and allows the insulin to do its job effectively.  (I was invited to the birthday celebration of an elderly man at a buffet restaurant.  He kept going back to the buffet line and returning with his plate piled high.  He confided that he had taken 2 doses of insulin so he could eat hardy.  He didn't fully understand--or care to understand--how to live healthily with diabetes.  Now he's on dialysis.)  

A diabetes education nurse can go into more detail about what foods combine well for diabetics.  Many hospitals and HMO's have diabetes centers at no cost, in response to the rising incidence of type 2 diabetes in the country.

In my opinion, the meds we take to stay alive (blood pressure, cholesterol, heart-related, etc.) contribute to higher-than-normal blood sugar readings.  Hence, the term "drug-induced diabetes".  

[WaveRider]

An A1c of 8.9% equates to a daily glucose average of 208.73 mg/dl, a little over twice the normal daily average. At 83 yo and with his current ailments Lantus may be required. A second opinion, especially from an endo, would not hurt.

If you decide to go with Lantus, his insulin glargine may come in cartridges [not vial], the medication will already be inside. He must only use the OptiPen One Insulin Delivery Device with the cartridges. Before he use the device for the first time, read the written directions that come with it. Ask his doctor, pharmacist, or nurse to show him/you the right way to use this device. Practice while the healthcare provider watches.