Should I still be on Lantus

Hi
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.

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

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.

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