CKD and insulin dependent diabetes

[malaka]

I had something verified by my endocronologist yesterday.  I'm a type 2 diabetic but need insulin to control my blood sugar as the meds I was taking for CKD made my metformin pills ineffective.  In recent months, I'd noticed more hypoglycemia and had myself adjusted downwards my insulin doses.  I saw the diabetes doc yesterday and told him what I'd been doing.  He asked what my creatinine levels had been and did on of those medical "hmmms".

Well, come to find out that insulin is excreted through the kidneys  so as your clearance declines, the insulin stays in you and keeps working. So you need less.  Lesson:  make sure the doc who is taking care of your diabetes knows your kidney function.  Hypoglycemia is no fun at all.  I'm making sure he's on the cc list henceforth.

[dawn24]

I was actually wondering about this . . . I also wonder if you're doing dialysis on a cycler at night what happens if you have sugar low?  DBF's lows usually hit between 3-5am

[Dannyboy]

Same thing here (had to reduce Insulin as GFR falls to prevent hypo).   Haven't heard of that explanation, but it makes sense.
--Dan