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Nov. 17, 2016

dave

Many prescribers are seeing the benefits of using an SGLT-2 inhibitor with insulin in their patients, and in this month’s edition we have an article on the benefits of using these together. From a personal professional experience, I have first hand knowledge of how that works as you can see below:

Just recently a close family member had their labs done and came back with a 435 mg/dl glucose reading, and a subsequent A1c revealed a 13.1 level. The patient had been using hormone pellets and although her testosterone was at 245, this was within the normal range for the therapy. I believed this was the reason for the high glucose levels, but they could not be removed. I immediately called the prescriber to ask them to start her on metformin 500mg bid and 20 units of glargine. We titrated the glargine up to 40 units daily and got the glucose levels down to around 170mg/dl. We had a C-peptide test done and the levels were nondetectable. Five days later, we started the patient on Farxiga 10mg and a low carb diet. Four months later, the patient is on 5 units of glargine, the Farxiga, and A1c is now 7.1. The pellets have been reinserted, and there has been no weight gain.

Dave Joffe

Editor-in-chief