Q. What is an alternative to Lantus in controlling blood sugar level?

Answered by
Dr. Mahmoud Ahmed Abelrahman Abouibrahim
and medically reviewed by iCliniq medical review team.
Published on Aug 16, 2018 and last reviewed on: Oct 09, 2018

Hello doctor,

I have moderate NPDR and I am diabetic for the last 15 years. I am 189 cm tall and weigh 89 kg. I was taking fast acting insulin Humalog 25 and tablet Tragenta Duo 1000 1-0-1 for the past 2 years.

After I found NPDR, I shifted to Lantus as the doctor said NPDR can cause sudden variation in blood sugar level. I was using Lantus for 10 years in the past and during that time I had no problem.

I am taking 25 IU in the morning. However, my body is not responding to insulin. While doing exercise, 12 IU will be enough for me. Sugar level went down below 90 in the afternoon. If exercise is not done, controlling the sugar level becomes a major problem due to insulin resistance.

How can I control sugar level through other medicine? My current HbA1c level is 9.1.

Dr. Mahmoud Ahmed Abelrahman Abouibrahim

General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

NPDR (nonproliferative diabetic retinopathy) is one of the common complications of diabetes. We cannot prevent it completely, but we can delay it for years. Our target is to delay the proliferative phase by controlling the blood sugar level.

Regarding your medications, they are good but deficient as Lantus (insulin glargine injection) is not advisable to be given alone. Humalog 25 is required before main meals. Trajenta Duo (Linagliptin) 1000 can be replaced with Metformin 1000 once after lunch.

The target HbA1c is below 7 in order to be strictly controlled. You are taking a low dose of insulin. So, we cannot consider it insulin resistance. Also, lifestyle modifications can help a lot.

My advice :

  1. Humalog 25 10 units before main meals, Lantus 25 units at a fixed time every day, Metformin 1000 once after lunch. Consult your specialist doctor, discuss with him or her and take medications with their consent.
  2. Walking 30 minutes every day.
  3. Strict diabetic diet.
  4. Regular follow up and fundoscopy are required.

For more information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician


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