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I am a type 2 diabetic and I recently started taking Levemir…

I am a type...

I am a type 2 diabetic and I recently started taking Levemir I take 60 units a day it's been about 6 weeks. The doctor started me a 20 units and gradually work me up to 60 I am not eating any different as I know I should be but I'm not that being said The more Levemir I take the higher my blood sugar goes. This morning I checked my sugar I believe it was only after 5 hours but my blood sugar was 429. I'm only seeing my family doctor but the more I can't control this the more I'm concerned. I've read a lot that over 400 I should seek medical attention please advise.

Doctor's Assistant: What are your symptoms? Have you used any medication for this?

I've been taking metformin for probably 10 years I'm currently taking 500 mg twice a day. I take glimepiride, 2 mg twice a day Gabapentin for the neuropathy is twice a day 300 mg each. Metformin is 500 mg twice a day onglyza 5 mg once a day. Atorvastatin 20 mg once a day, Lisinopril 5 milligrams once a day then I take the box of Irene and that is 200 micrograms thoroughly call as 1 milligram twice a day

Doctor's Assistant: Have you used anything besides Lisinopril for this?

Box of Irene translated in correctly obviously that is supposed to say Levothyroxine.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I listed all of my medication above

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Answered in 10 minutes by:
3/17/2018
Dr. Sohaib
Dr. Sohaib, Doctor
Category: Medical
Satisfied Customers: 5,336
Experience: MBBS, FCPS Experienced in all Medical Specialities
Verified

Hello and thank you for the question.
I am Dr. Sohaib, a practicing Internal Medicine Consultant with over 13 years of experience and I will do my best to help you today.
Let me review your question for a minute and I will get back to you.

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I would like to ask few details regarding your symptoms/question to assist you more efficiently.

What is the general range of your blood sugars (fasting/pre-meals/post-meals)?

Do you have heart or kidney problem?

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Customer reply replied 1 month ago
The past year things started getting worse and the general range is between 170 and 190. currently I do not have any heart problems that I know of I was recently sick and they told me that my kidney function was a little below normal but that's all they said and my doctor didn't seem to be concerned about that

Thank you very much for the useful information.

The current drug regimen you are on is not able to control your blood sugars effectively, and this is very clear from the blood sugar numbers you have mentioned. Blood glucose level of 429 is also unacceptable.

At this point, I would increase the dose of metformin instead of further increasing the Levemir dose, as you are already taking a high dose and further increasing levemir at this point may not be very helpful.

The maximum dose of metformin is 2550 mg in 24 hours, and you are only on a small dose of 500mg twice daily. This should be increased further to 1000mg twice daily at first place. Then continuing with the diet and exercise, just monitor the blood sugars while you make this change.

If still blood sugars not adequately controlled, then you might benefit from basal + bolus insulin therapy.

Basal insulin (levemir) with bolus inulin injections (like novorapid, twice or thrice before the meals) is one of the best strategy to control erratic blood sugar readings.

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Also, if you feel that your GP is not able to control your sugars properly, you can always ask for an Endocrinologist referral, for taking decisions and fixing the treatment for diabetes, that suits best to your needs.

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In general, you fasting sugars should be less than 130, Pre-meals less than 160, and post meals less than 200 ---- once this is achieved, means your blood sugars are adequately controlled.

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Customer reply replied 1 month ago
thank you so much for the information I will definitely be making an appointment with an endocrinologist

Good luck and my sincere wishes for your good health.

Please do not forget to Click and Give 5 Star Rating (at the top of screen) to my service as this is the only way I get credit for my time and expertise on your question.
If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.
Kindest Regards.

Dr. Sohaib
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Customer reply replied 1 month ago
information is very helpful thank you
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