Should I still be on Lantus

I have been T2 for 13 years and through that time have been on Metformin. Last year I was put on insulin (Lantus) after having an HbA1c 98 mmol/mol and ended up on 30 units at night time. Results have been great with HbA1c of 40 in September and now 37 this month. My doctor is concerned that I am too low now and wants to take me off the insulin and put me back on Metformin, I am not happy with this as I feel great. I hated Metformin. He will leave it to me, I am now on 26units in the past 2 weeks and believe I am on the right track. BG average at present is 6.6 on BG meter. HELP, what should i do

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Get a new doctor!
(Just joking around a little bit. If he will leave it up to you, he might be a decent doctor.)

If your A1C is 37 in IFCC/SI units, that is close to the normal range for non-diabetics.

As long as you are not experiencing dangerous lows and your BG can be handled as it is, keep working on it how you are doing. Make adjustments and check your BG regularly and keep doing all those good things.

As long as you don’t have frequent BG crashes that you can’t fix by yourself, and as long as you can feel the low BG so that you can fix it, having an A1C of 98 is much more dangerous long-term than an A1C of 37.

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I do not understand the numbers . Can some translate for us. Thank you. Nancy50

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This is the best translation site I have seen. You just enter one number and it gives you all the equivalents.

Hey Nancy50
37 mmol is equvalant to 5.5%.
97 mmol is the equivalant of 11.0 %

What is your weight like? Insulin is a fat storing hormone and T2 can have insulin resistance and high insulin levels to start with.

If your weight is high, I would look at low carb <50g a day and see if you can reduce the insulin more. If you weight/belly fat is OK, I would stay on the insulin, or low carb as well.

Hi Mikeke,

I’m also a T2, and us T2’s have what is often considered a “progressive” illness. That is, after many years of having T2, we no longer produce as much insulin as a non-diabetic: although ALL of our insulin-producing cells may not be gone, our bodies are so insulin-resistant that some of the cells experience a form of “burn-out”.

Metformin didn’t exist back when I was first diagnosed, and within 4 years I ended up on insulin, and have now been on an insulin pump for over 18 years. Best thing that ever happened to me. Before insulin, my numbers were truly awful; after being put on insulin (shots), my numbers were better, but still not great (A1c’s were typically between 7.8 and 9.0). Since the pump, I’m averaging A1c’s of 5.8 to 6.1, with no serious lows.

If insulin works for you, and you’re willing to do the work (counting carbs, etc.), go for it. Especially if you’re not “old”…the longer you have D, and the higher your numbers range over the years, the more damage can occur. Not to say you’ll absolutely never have a high number on insulin, but it’s much easier to correct if you do, so you’re not high for that long - like all day or overnight. And, us T2’s can qualify for pumps, so you may eventually want to go that route.

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Metformin was invented in the 1950’s. I have been using it sine 1992. Switch to XR,helped a lot. When A1C hit 8 I was put on Lantus. Upgraded to Tresiba. I also take trulicity. Endo said this is what is keeping me off of short term insulin. I have no long term issues. Have you thought about trying Tresiba? Or other. Nancy50

Thanks, Nancy50, Tresiba is not available in New Zealand where I live. Great country but meds are slow in coming to market

Hi been diabetic since around 2000. Self Diagnoses!! My daughter diag. Type 1 march 10 1992 at3pm that day. It’s a family thing. After just pills, metformin and amaryl My best Doctor put me on Lantus and metformin. Since then A1C has been well under 7. Lantus is the best thing ever happened to me. I gave up alcohol and developed a sweet thing No problem usually.
I’ll be switching to Tresiba shortly as ins. doesn’t pay for Lantus. Insulin is 6 AM. I take metformin as follows A little hi AM take Metformin before I eat so it gets to blood stream first. Low in AM I take Met. after eating, gives digestion a head start.
80% of the time Porter and I head out for some walkies. 2.5 miles at least. Cold and rain are the factors limiting exercise.
If the Doctor ever suggests being off insulin Not my doctor any more.
I have back pack food and Grape soda (my favorite soda??). I go to my supplies 40% of my walks. Exercise is the key to being a happy Diabetic. My daughter a an orthopedic PA also hikes constantly is also doing great. Hope this helps

Thanks, George, I have switched to a new doctor. My Diabetes Nurse Practioner confirmed to the doctor that I was in full control and so have left to me, I only have had 3 lows in the last 12 months on Lantus. Generally, after exercise and I am very sensitive to Hypos coming on anyway, always feel when BG is below 4.5ish.
I am altering my Lantus units based on my reading 2 hours after the last meal, so could be as little as 24U or as many as 32U. Its working well and feeling great

Even though you aren’t getting too many hypos and have a good A1c. which kind of makes my post irrelevant. That may not be a good idea. You would normally have a fairly constant basal dose. Post meal highs is normally corrected with a fast acting bolus. I think your natural insulin production is covering the spread and keeping you out of trouble for now.

The relationship between A1C and eAG is described by the formula
28.7 X A1C – 46.7 = eAG