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I Am A Type 1 Diabetic Patient. Taking Insulin. Is It Safe To Start Istamet?

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Posted on Mon, 3 Sep 2012
Question: hi doctor, i am a diabetic patient since 1982 and taking insulin 30/70 humaninsulin 100 i.u, i was diagnosed as type 1 diabetic. my current dose of insulin is at break fast 40 units,mataday 1000mg and pioglar 15mg. after noon 10 units. night 6 units. i discussed with my doctor to shift my doses to 2 time insulin. he advised to start istamet 50/1000mg in after noon and stop afternoon insulin. my question is as i m type 1 patient is it ok for me to start istamet. as the myth is only insulin is good for type 1. usually i got hypo. in the morning around 4 am. or around 6 p.m. is it ok to take that much medicines and insulin together, i feel that can create more hypo. to me in the eve. thanks
doctor
Answered by Dr. Mayank Bhargava (55 minutes later)
Hi,

Thanks for posting your query.

If you are getting hypoglycemia in the morning hours at 4 am and 6pm then you may have somogyi phenomenon.

In such cases, patient has hypoglycemia at early morning and because of body mechanism, blood sugar in fasting condition is very high and doctors generally increase the dose of insulin. This will further deteriorate the condition. Treament requires sequential reduction in the dose of insulin.

Istament 50/1000 contains sitagliptin and this is DPP -IV inhibitor and by its mechanism, it will inhibits insulin metabolism thus insulin works for more hours.

If you are getting hypoglycemia at evening time, then dose of insulin/ other medication must be reduced.

Are you over weight?

Have you family history of diabetes?

Generally in type I diabetes,oral hypoglycemic agents donot work. You should consult with yor treating physician/ endocrinologist whether you have Type I diabetes or Maturity onset diabetes in young.

You should go for regular blood sugar check up: before breakfast, 2 hours after breakfast, before dinner and 2 hours after dinner.

Put your query if you have.

Best regards,

Dr. Mayank Bhargava
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Mayank Bhargava (1 hour later)
i am 5'9" and weight is 73 kg, my family backround history is no one is diabetic yet. i had done gad test as well, and diagnosed type 1 diabetic. my main query was if i start taking insulin human insulin 30/70 , 100 i.u, 40 units in the morning plus 1 gm. metaday and pioglar 15mg. in the noon istamet 50/1000 and in the night 6 units insulin.
is pioglar and sitagliptin workable or any side effect taking morning and afternoon the adviced medicine by my doctor.
doctor
Answered by Dr. Mayank Bhargava (1 hour later)
Hi,
Considering your all data's, your diabetes appears to be type I DM.
You should go for metaday and pioglar as both of these medication improves insulin sensitivity.
Take care,
Dr. Mayank Bhargava
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Mayank Bhargava

Internal Medicine Specialist

Practicing since :2003

Answered : 1658 Questions

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I Am A Type 1 Diabetic Patient. Taking Insulin. Is It Safe To Start Istamet?

Hi,

Thanks for posting your query.

If you are getting hypoglycemia in the morning hours at 4 am and 6pm then you may have somogyi phenomenon.

In such cases, patient has hypoglycemia at early morning and because of body mechanism, blood sugar in fasting condition is very high and doctors generally increase the dose of insulin. This will further deteriorate the condition. Treament requires sequential reduction in the dose of insulin.

Istament 50/1000 contains sitagliptin and this is DPP -IV inhibitor and by its mechanism, it will inhibits insulin metabolism thus insulin works for more hours.

If you are getting hypoglycemia at evening time, then dose of insulin/ other medication must be reduced.

Are you over weight?

Have you family history of diabetes?

Generally in type I diabetes,oral hypoglycemic agents donot work. You should consult with yor treating physician/ endocrinologist whether you have Type I diabetes or Maturity onset diabetes in young.

You should go for regular blood sugar check up: before breakfast, 2 hours after breakfast, before dinner and 2 hours after dinner.

Put your query if you have.

Best regards,

Dr. Mayank Bhargava