Q: I have type 2 diabetes for more than 8 years. My haemoglobin A1c is fluctuating between 7.5 and 10.5. Recently my doctor put me on 20 cc of lantus and my sugar dropped below 60, so I cut the dose to 10 cc but still I have low sugar. Do I need to be on insulin? When will I get off insulin? I am still taking all the othe oral medications: Actos 30 mg and Glucophage 2000 mg.

A:When you say 20 cc and 10 cc of lantus, I presume you mean 20 units and 10 units respectively. If you are getting hypos even with 10 units, you clearly do need to reduce the dose, say to 6 or 8 units. However, I would also wonder like you if you really need such a small dose of insulin. I suggest you sit with your doctor and go over your daily regimen and home blood glucose record: can you increase exercise, cut down fat intake, adjust food timings, add acarbose to improve control? If the blood sugars and HbA1c still do not come down, then perhaps you do need the insulin.