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Suggest Treatment For Type 2 Diabetes

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Posted on Tue, 14 Feb 2017
Question: My husband was recently admitted to the hospital with DKA. He was not aware that he was diabetic at the time. His diagnosis at discharge was uncontrolled Type 2 Diabetes. He is taking 12 u Lantus twice a day and 2 u humalog at meals. His numbers are now much closer to 100, however he is experiencing a lot of lows, especially in the mornings. He is also experience extreme vision problems. He was told he had cataracts at his last vision screening, and he has always been somewhat near-sighted, but now he is having a really hard time seeing up close, and his distance vision has improved. He has an appointment with his doctor next week.
They last told him to wait to see his eye doctor. So, my concern is the lows, like 64, or even 57, in the mornings, and his vision problems.

doctor
Answered by Dr. Mirjeta Guni (30 minutes later)
Brief Answer:
About blood glucose control:

Detailed Answer:
Hello and thank you for asking!

I have gone carefully through your query and understand your concern regarding to your husband's health!

I think there should be a misunderstanding regarding the dose of Lantus. As it effect lasts 24 hour, usually we do not divide it twice a day, only when the daily dose is to high (more than 40 UI).

The fact that he has hypoglycemia or low blood sugar, means that the insulin dose is too high and should be lowered.

I would recommend only one injection of the Lantus during 24 hours. If he does hypo's with such low insulin doses, your treating physcian will recommend to substitute it with oral antidiabetic tablets.

The visual problems are common in a patient that has been for a large period of time with high blood glucose levels, the eye is accommodated with higher osmolarity caused by high blood glucose and precepts the normal glucose levels as abnormal. It will take a couple of weeks to get improved.

Hope i have answered your query.
Best wishes,
Dr.Mirjeta
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2414 Questions

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Suggest Treatment For Type 2 Diabetes

Brief Answer: About blood glucose control: Detailed Answer: Hello and thank you for asking! I have gone carefully through your query and understand your concern regarding to your husband's health! I think there should be a misunderstanding regarding the dose of Lantus. As it effect lasts 24 hour, usually we do not divide it twice a day, only when the daily dose is to high (more than 40 UI). The fact that he has hypoglycemia or low blood sugar, means that the insulin dose is too high and should be lowered. I would recommend only one injection of the Lantus during 24 hours. If he does hypo's with such low insulin doses, your treating physcian will recommend to substitute it with oral antidiabetic tablets. The visual problems are common in a patient that has been for a large period of time with high blood glucose levels, the eye is accommodated with higher osmolarity caused by high blood glucose and precepts the normal glucose levels as abnormal. It will take a couple of weeks to get improved. Hope i have answered your query. Best wishes, Dr.Mirjeta