3 doctors weighed in:

Hb1ac level is 12.7 . Take 1000mg metformin twice a day and a total of 120 units of lantus (insulin glargine) a day?

3 doctors weighed in
Dr. Quang Nguyen
Internal Medicine - Endocrinology
1 doctor agrees

In brief: Regimen change

You need to diversify the treatment regimen.
At the beginning, Lantus (insulin glargine) will help but as the disease progresses, meal time coverage is necessary. This is evident in your case. I recommend continuing with metformin but need to talk to your doctor about backing down Lantus (insulin glargine) and adding short acting insulins to cover foods. Other options instead or on top of short acting insulin: glp-1, sglt-2, ...

In brief: Regimen change

You need to diversify the treatment regimen.
At the beginning, Lantus (insulin glargine) will help but as the disease progresses, meal time coverage is necessary. This is evident in your case. I recommend continuing with metformin but need to talk to your doctor about backing down Lantus (insulin glargine) and adding short acting insulins to cover foods. Other options instead or on top of short acting insulin: glp-1, sglt-2, ...
Dr. Quang Nguyen
Dr. Quang Nguyen
Thank
Dr. Alan Feldman
Internal Medicine - Endocrinology

In brief: Uncontrolled

A hba1c of 12.7% says that you have uncontrolled diabetes.
You should be checking fingerstick sugars, and they are likely to be in the 300s. Taking Lantus (insulin glargine) Insulin alone will not work well. You likely need a combination of Lantus (insulin glargine) and short acting Insulin (taken before meals). Adding other oral agents such as pioglitazone, canagliflozin, bromocriptine may help. Switching to u500 Insulin as well.

In brief: Uncontrolled

A hba1c of 12.7% says that you have uncontrolled diabetes.
You should be checking fingerstick sugars, and they are likely to be in the 300s. Taking Lantus (insulin glargine) Insulin alone will not work well. You likely need a combination of Lantus (insulin glargine) and short acting Insulin (taken before meals). Adding other oral agents such as pioglitazone, canagliflozin, bromocriptine may help. Switching to u500 Insulin as well.
Dr. Alan Feldman
Dr. Alan Feldman
Thank
Get help from a real doctor now
Dr. Arnon Rubin
Board Certified,
21 years in practice
163K people helped
Continue
111,000 doctors available
Read more answers from doctors