I used to be on Victoza 2.8mg once a day and Metformin 500 mg twice a day, my doctor switched me to Lantus 10 mg once a day and Novalin R as needed. My blood sugar is staying between 250 and 300 and my doctor is on vacation. My question is can I take the Metformin 500 mg with the Lantus to try to see if I can bring my blood sugar down

What you need to do is do the sliding scale insulin with the Novalin R.

I have used the Novalin R on the sliding scale and my sugar is still not coming down. My doctor just put me on this medication yesterday and my sugar is staying high even with the Novalin R

How often are you checking your sugar? Are you watching your diet?

Also, are you Type I or Type II?

I am checking my sugar around 6 times a day if not more, I just had surgery April 15th for pancreas cancer and I am not eating a whole lot just yet. I believe I am a type II, after my surgery I was not having sugar issues so I was off all diabetic medicine until I went to the ER on Wednesday night with a blood sugar of 527, On Thursday my doctor put me on the Lantus and Novalin R but my sugar will not go down. I just checked my sugar and it was 317. I just want to know if it is safe to take Metformin with Lantus, I do not want to make another trip to the ER.

No, they are not safe to take together. Taking them together could bottom out your blood glucose to the point of having to go directly to the hospital.

Okay, Thank you so much. I will try more Novalin R to see if that helps. I am just scared of not doing enough and getting sick but I don't want to do too much and get sick at the same time. I don't really know about this Lantus but I took the Metfornim with Victoza so that is why I was asking. I tried to hit the helpful tab but it would not let me but you have been very helpful. Thank you again.

Since this is relatively new to you, do you understand how to use the sliding scale?

I'm willing to help you if you are confused. This can all get overwhelming in the beginning.

I was told to give 3 units if it goes over 200, 5 units if it goes over 250, 8 units if over 300, and 10 units if over 400

I took 10 units of Lantus at 10 P.M. cst, I checked my sugar at 11 and it was 324 so I took 8 units of Novalin R, I just checked my sugar a few min ago and it was still 317

Hold on a minute. I'm going to see if I can actually find the Novalin R sliding scale for you so that you will have something to visualize rather than having to remember. Be right back.

Okay, thank you

Unfortunately I cannot copy and paste it, but this is a PDF. I hope you can read it.

ftp://www.stjoebreese.com/stjbreese/docs/ebms/Sliding%20Scale%20-%20Insulin.pdf

Now, we check sugars at my facility, with sugars like yours, every 2-4 hours. Novalin R is not going to be immediate acting. It has gone down from 324 to 317 in a couple of hours, so it's working.

The R in Novalin R stands for Regular. Meaning it is a Regular insulin, not a long acting insulin. While Lantis is a long acting insulin.

I was able to view it and save it to my computer. Thank you so much for all your help. I will check my sugar again in about 20 min and if it is still going down I will not do anything. Thank you again

Let me know in 20 minutes. I'll still be here for a little bit before I have to go to bed.

I understand you aren't eating too much, but what are you eating? Your diet can certainly affect what is going on here. Also, as far as the cancer, I'm sorry about that, I am a cancer survivor also, your body may still be in shock and when a body is unhealthy it usually produces too much glucose. You have to monitor your diet VERY closely.

Are you on a ADA diet?

I am not on any diet, this all started when my wife and I were celebrating our wedding anniversary Wednesday and I over did it with the sweets. Sense than I have not been able to keep my sugar down at all, I went to the hospital with a 527 sugar level Wednesday night. I have been staying away from anything that will bring my sugar up for the most part. What is a ADA diet?

My sugar is 424 and I have not had anything but water and black coffee sense 9 p.m. we ate fish for dinner with french fries, I have not had anything for breakfast or lunch today. I did have a glass of cranberry juice with dinner. I don't know what to do. Should I take 10 units of R?

ADA is American Diabetes Association diet.

With sugars like yours you REALLY need to follow a very strict diet.

Sweets are an absolute No No. And should have been since you started the Metformin and the Victoza. I have to say that your doctor is sorely lacking if he/she has not counseled you on your diet.

Here is a link that should help you.

What Can I Eat - American Diabetes Association (http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/)

I will give you an example. Wheat bread instead of white. Sweet potatoes instead of regular potatoes. No candy, no alcohol, diet sodas if you must drink sodas. No cakes, cookies or pies.

Watch your carbs. The increase blood glucose dramatically, and that kind of spike is hard to get under control.

Many of our patients are required to go through a lengthy dietary counseling session along with their spouses.

I'm sorry, but I find it very disheartening that your doctor prescribed these meds without discussing diet and exercise with you.