Lantus? - Diabetes Message Board

SanAnton · 05-15-2002, 03:44 PM

Hi, haven't posted in a while because it took me this long to get my husband back to the clinic. Today the P.A. put him on 10 units of injectable insulin-Lantus each night before bed time. He kept him on his glucophage and avandia, but discontinued his use of amaryl. He had lost 15 more pounds and is down to 140. (He was 195 last year at this time.) PA did not do the C-Peptide test as someone advised. I wasn't there to advocate. I'm just wondering if anyone has any advice, comments regarding Lantus. You can see my past discription of his health by scrolling down and reading the post I made last month. Thanks everyone!

jacksonhgts · 05-15-2002, 07:05 PM

If your husband's weight loss continues you might want to measure ketones for a while. He may be type 1 or type 2 but not producing very much insulin on his own. I'm type 2, but I lost 37 lbs without even trying when I was first diagnosed. If you have elevated blood glucose and keytones in your urine, then you are insulin starved, and may be borderline ketoacidosis (which if you go over the line can kill you). What happens is that your body can't utilize the glocose in your blood stream, because of lack of insulin (which leaves your BG high), and burns fat for energy to keep you alive, which produces the keytones. And all the while your BG is high your are contributing to the onset of diabetic complications, like peripheral neuropathy, kidney failure, retinopathy, and cardiovascular disease. Unfortunately, it may be a little expensive to find out what the problem is right now, but in the long run it will me a worthwhile investment. If your are referring to Physicians Assistant, by P.A. you might want to bite the bullet and visit an endocrinologist, for an expert opinion. I'm sure your P.A. means well, but may not be well versed enough on diabetes.

SamQKitty · 05-15-2002, 08:53 PM

Just a quick addendum to what JacksonHgts has already said re P.A. - You mentioned taking your husband to a clinic...is this like a walk-in health clinic? Or any kind of general health clinic? I believe it is absolutely IMPERATIVE for anyone with diabetes to be seen by an endocrinologist or diabetologist. This is an extremely complicated illness, and most general practioners or internists who do not SPECIALIZE in diabetes care do not have great expertise. A P.A. who is also a diabetes educator or who works with an endocrinologist might be okay, but definitely not a general P.A.

I agree that your husband's condition sounds rather serious, and a C-peptide test should definitely be done, as well as possibly putting him on a regular insulin regimen (in other words, not just using a bit of insulin to supplement all the oral medications, which don't seem to be working)

Has he had an HbA1C test done? This is also called a glycosolated hemoglobin, and it measures how well the blood sugar has been controlled over the past 8-12 weeks.

Does your husband have a glucometer, and how often does he check his blood sugars? What have his numbers been?

Not to scare you, but the sooner his blood sugars are under control, the sooner he will stop losing weight and start feeling better. And, as JacksonHgts pointed out, if he's in ketoacidosis, he could be very close to a life-threatening situation.

Write back and let us know how you're both doing.

SanAnton · 05-15-2002, 11:00 PM

This all makes me so worried my stomach is burning. It is not about biting the bullet. There just isn't any money in our lives. I'm feeling okay about being totally honest here as I feel pretty anonymos. We couldn't even pay the clinic the full amount today, and yes this is just a general P.A. at a walk in clinic. This has worried me from the begining too. His vision is so blurry and we haven't been able to scrape up enough for him to go to an optometrist. We have been qualifying for free meds but the process takes 6 wks and we did not get the Lantus script filled today because we do not have the $150. I have 3 small children. I'm worried that I could lose my husband and my children could lose their father and it could all boil down to lack of money. I'm so frustrated. I'm actually a well educated strong individual and do not view myself as helpless, however, I don't know how to advocate or work toward something else happening. I once had a child in ICU who almost died with severe acidosis. The internist talked to me about ketones and ketoacidosis. After 12 days in the hosp. he was okay and they sent him home with no diagnosis. They did do perineal dyalysis on him to correct the acidosis. He was 18 mths old. When he was 4 I ended up with another 18 mth old child in ICU with the same symtoms. The doc said they believed something genetic was going on but couldn't determine what it was. My children are very healthy and number 3 is 2 1/2 and has never been truely sick. Anyway, could there be ANY connection here? Just seeing you type acidosis sends chills down my back!

SanAnton · 05-15-2002, 11:09 PM

I forgot to answer a few questions.

Yes, they have done the HbA1C test all 3 times he has been in the clinic since last September. Today the receipt says they did a CMP and the hemoglobin glycated test.

Yes he has a glucometer, he seems to use it every 3 days or so. At first he did it about 4 times a day, but now he does not see a reason to do it as often. I just checked, it looks like he has stopped writing down the numbers in the journal. The few times I have been standing by when he checked his bs, it has been in the lower 200's, although i have seen it in the 300's.