I am regularly consulting with Imperial College Diabetic Center about my type 2. Recently ICLDC research Cneter put one sensor under my skin for 3 days. After 3 days they removed the sensor. From that sensor they took print out of my bodies glucose up-down graph. I am attaching that graph here. If any comments comes from you which might help me to maintain my blood glucose level well. Thanks.
Vildagliptin 50mg 2 times daily
Metformin 500mg at night
1. Graph (The Graph time is AM to PM)
2. Pathology Test Report
Did you record what you were eating during the three days because those are quite high readings? What did your doctors advise?
If the graph is typical of your usual BG, your A1c should be higher than 6.3. Are you testing regularly with a meter?
It seems that you need a higher dose of meds, a different combination of meds or insulin to get BGs more level.
Do you know if the graph time is AM to PM, or PM to AM?
The graph shows that you have sometimes huge spikes after meals (7/15 and 7/18). Your body tries hard to get the glucose level down over night. But still this progresses slowly and only one day (7/18) shows a normal fasting level - although a very healthy person would still be lower.
If you look at the day 7/16 this really shows your problem: your glucose levels are too high. A healthy person would be within the two limit lines all the time.
You have to talk to your medical team about these options:
-possibly the use of basal insulin (1 shot of Lantus or 2 shots of Levemir or NPH)
-if it is impossible to lower the after meal spikes then you should also consider a bolus insulin for the meals
All that step by step and in close consultation with your medical team.
As others have mentioned, without knowledge of what you are eating and your activity, the sensor data tells you little except your blood sugar excursions are too high.
I will give you “my” opinion of your medication.
Only taking 500mg is way too little to be effective, you should be taking at least 1500mg, perhaps more.
Second. Why have you been given Vildagliptin? It is like the latest greatest designer drug (in the same class as sitagliptin) it is not even approved in the US.
I think a safe and conservative approach is always warranted. Personally, I refuse to be a science experiment. Low carb diet, exercise, and metformin (the oldest, safest and perhaps the most effective drug for most type 2s) can be quite effective, but you have to take enough metformin.
ps. Take any advice you get on the internet with a grain of salt, especially from people with goofy faces and always consult with your doctor.
Thanks for your straight forward discussion. It will help me to consult with doctor.
As the graph showing sharply up after meals. And your advice on it. I will discuss with doctor closely. Thank you very much.
Good Morning Gerry,
After your reply i understood my eating should be recorded, which i did not. But now I recalled from memory and noted down whatever I had during the sensor time. I will show it to the doctor.
Did you see my Pathology test result which I attached later on. My doctor is on vacation. But I already started having one more 500mg Metformin after meal.