2 years ago

147

http://www.DoctorsToTrust.com
@doctorstotrust3552
presents episode 1165 | Dr Penny Figtree
Low Carb Down Under podcast

Safely reduce insulin for T2D:
-is your blood sugar controlled? A1C?
-if very well controlled, may be concerned about hypoglycemia
-if badly controlled, can be less anxious
-if on short-acting insulin: since now on keto, just stop it
-on long-acting insulin [once daily], just cut in half
-mixed insulin is more complex
-if poorly controlled blood sugars,
just half the mixed insulin
-if well controlled, switch to
once-daily long-acting insulin

Patient needs to measure blood sugar before and 2 hours after
each meal--inform the doctor if there is a spike
-aim for 10 mmol/L [180 mg/dL]
-if next day level is below 10; can drop insulin down
-have daily contact with doctor

Case 1: 65 yr male on 20 units long-acting, once daily insulin...
-pretty well controlled blood sugar [3 to 14 mmol/L] after
eating porridge for breakfast; is hypoglycemic in afternoon!
Doctor: let's STOP all insulin; and no more porridge
THAT WAS IT
Case 2: 55 yr male T2D on 140 units long-acting daily insulin...
-on insulin 10 years, more over time
-A1C 6.8%; glucose 5-8
Cut Insulin In Half--next day: OK
so: cut completely...no problem
"that was 2 years ago!"
TG down from 5.4 to 1.1

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