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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Diabetes. On Glimipiride, Metformine. Started Taking Basalog Long Acting Insulin. No Improvement. Proper Medicament?

Sir, I am 44 & having diabetes since 10 years. i am taking Glimipiride 2mg, Metformine 1000mg, Vildagliptin 50mg
all are both time. Before 10 days i started basalog long acting insulin glargin with 20 unit/day. After 4 days i increased it to 30 unit/day. then i took 40 mg/day for 2 days. Now I am taking 50 unit/day. today my fasting is 200 & PP is 211. What should i do. Please help me to manage my orals and insuline. which drug should i take and in which quantity.
Thu, 16 May 2013
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General & Family Physician 's  Response
Hello,
Have you incresed the dose of injection GLARGINE yourself or it has been advised by your doctor?
There are different class of anti diabetics which can be used judiciously in different combinations.
You must consult a diabetologist for proper adjustment of your oral anti diabetics with injection GLARGINE or stopping your oral medicines and putting you on injectable insulin only.
However a try for more oral anti diabetics can be done by increasing the dose of GLIMMIPRIDE TO 4 mg twice daily and adding a alpha glucosidase inhibitor like VOGLIBOSE .3 mg twice a day.
If you are unable to control your sugar levels with maximum dose of oral anti diabetics,then it would be better for you to switch over to injection insulin round the clock
There is no need to increase the dose of inj.glargine now as you are already taking a high dose of it.
Please discuss with the diabetologist and readjust your medications.
Remember that you have to control your blood sugarvlevels meticulously to avoid any future complications.
Thanks
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Have Diabetes. On Glimipiride, Metformine. Started Taking Basalog Long Acting Insulin. No Improvement. Proper Medicament?

Hello, Have you incresed the dose of injection GLARGINE yourself or it has been advised by your doctor? There are different class of anti diabetics which can be used judiciously in different combinations. You must consult a diabetologist for proper adjustment of your oral anti diabetics with injection GLARGINE or stopping your oral medicines and putting you on injectable insulin only. However a try for more oral anti diabetics can be done by increasing the dose of GLIMMIPRIDE TO 4 mg twice daily and adding a alpha glucosidase inhibitor like VOGLIBOSE .3 mg twice a day. If you are unable to control your sugar levels with maximum dose of oral anti diabetics,then it would be better for you to switch over to injection insulin round the clock There is no need to increase the dose of inj.glargine now as you are already taking a high dose of it. Please discuss with the diabetologist and readjust your medications. Remember that you have to control your blood sugarvlevels meticulously to avoid any future complications. Thanks