February 18, 2008
Daily Care, Insulin Analogs
Question from Beaufort, South Carolina, USA:
My current A1c is 6.4. My fastings are averaging 120 mg/dl [6.7 mmol/L] to 135 mg/dl [7.5 mmol/L]. My doctor suggested I add a small dose of Lantus at night to bring down my fasting blood sugars. I currently take Starlix for my postprandial highs. Do you think insulin is something I need at this time considering my A1c is not very high?
Answer:
It is always an issue as to how aggressive you should be. In patients with type 2 diabetes, where it is possible to normalize the fasting glucose, I think it should be done. If fasting glucose levels are consistently over 140 mg/dl [7.8 mmol/L], there is reason to have an additional agent on board to treat the high fasting values. If you are on Starlix only, the other thought is that there are other agents that would also be effective against the fasting glucose, including metformin. The choice of agents would be up to you and your physician to work out.
JTL
