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Resistent Hyperglycaemia

Dear All,
Needs some expert advice form medical colleagues.
I am having a a 76 years old female.
Type 2 diabetic for 20 years
Weight 105 kg, have got bad knee and hip arthritis, so weight loss possible is not an easy option.
HbA1c 11
Medication.  Metformin SR 2 gram OD
Amaryl 2mg OD
Sitagliptin 50mg BD
Lantus 80 units OD
Novorapid 40 unitis TDS Her fasting blood suger is around 16-20 ans post prandilas are 20-30 all the time.
Unfortunately Victosa and Dapagliflozin is not available where she lives.
Any advice please?
2 Responses
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231441 tn?1333892766
Her doctor will need to Increase insulin dose until suitable blood sugar control is achieved.    Very high doses of insulin may be required if the patient is very insulin resistant.

Strongly recommend that the patient adopts a very low carb, moderate protein and high (healthy fats) diet.  This will lower her insulin requirements to cover food.

Despite difficulty of weight loss, this should be attempted with moderate calorie restriction (this is easier on a low carb diet, as the high fat makes it quite satisfying, and using low carb veges for their filling effect.  Weight loss will help reduce insulin resistance.

If she is on a statin drug, consider option of taking it out.  Statin drugs are not well proven for women, and may contribute to the insulin resistance.  Weight loss and very low carb diet may result in independent improvements in lipid profile.
Helpful - 0
4851940 tn?1515694593
Your 76 year old female needs to be seen by her doctor to review the medication that she is on for her diabetes.

My husband took Victosa for a while and it did not suit or help bring his sugar levels down to an acceptable level.

Make sure that the diet is not high sugars, fats or high carbohydrates.
You can see more information with regard to healthy meal options on the web.  Cutting out biscuits, cakes, processed foods and white bread can help.  

The doctor may suggest some of the diabetic tablets to take as well as insulin.

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231441 tn?1333892766
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