had an appt today for a diabetes review (with a really nice doctor). My a1c was the same as december at 8.3% and i had lost 3kg and (apparently) grown 2cm. We talked about where the problems are, wanting to reduce my weight and bgs more, and what i've tried before etc. The summary is he was keen for me to try a t2 non-insulin medicine in combination with my insulin to see if it does anyting to improve my bgs or my weight. This was a new suggestion to me and i hadnt really realised it was an option before other than metformin. The options suggested were forxiga, victoza or januvia. I have tried januvia and byetta (similar to januvia) before, amongst other medicines, and havent managed to achieve / maintain good control with them, but never tried it combined with insulin. Maybe it will help weight or bgs, maybe it wont, but it seemed worth a try in case it does help. I'm on 0.6 for a week from today, then going to 1.2 from then on, if side effects are ok.
The other change is to stop the tresiba and go back to lantus. I've said to previous drs that i dont see much if any benefit in tresiba over other basals, and the negative of not being able to adjust dose to account for more or less active days or illness etc is annoying. Basically it costs double the normal basals without particularly offering any benefits other than not running out before 24hrs, and offers a big negative. My a1c hasnt reduced using it. Previously i've always been told to stick with it though and not switch back. I'll be switching to lantus when i've finished the remaining cartridges of tresiba in my fridge, so in a month or two.
As a precaution to start i'm reducing my basal from 30/day to 20/day, and keeping the same 1:10/1:15/1:15 ratios. I'll be increasing / decreasing the basal as necessary once settled on the victoza once i see if anything happens to blood sugars. I'm also going to see a dietician to see if it helps with the weight loss. Was a bit reluctant as not sure it will be any use but i'm just going to see her once, if its a waste of time then i dont need to see her again, if it happens to be useful then great. Worth a go anyway.