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Suggest Treatment For Fluctuating Blood Sugar Levels

Posted on Sat, 13 Sep 2014

Question: I am 74 and diabetic Type 2. I am reacting to several diabetic medicines like metformin and its combinations - so for the last three months i am on Insulin XXXXXXX mix 30 pen fill - my sugar levels are fluctuating some time morning sugar fasting is 160 and post lunch it 150 ? what is your advice- I am taking 16 units two times each

Answered by Dr. Anshul Varshney (27 minutes later)

Brief Answer:
Detail Follows.

Detailed Answer:
Dear Friend.
Welcome to HCM. I am Dr Anshul Varshney.
I undertand your concern.
See if you have reactions to oral hypoglycemic agents best is to be on insulin.
Your blood sugars as you have described are fairly under control.
Novamix is given as 2/3 rd of the total dose required in morning and 1/3 rd in night.
You are taking equal doses twice a day.
In total you are taking 32 units.
I recommend you to take 22 units in morning and 14 units in night that is total of 36 units.
Prepare a pre meal blood sugar chart for around 15 days and get back to me.
Also if you have not got following investigations get them done:
1. Kidney function test.
2. Urine for microalbumin.
3. ECG
4. HbA1c
5. Lipid profile.
If you have any further query please feel comfortable to ask me.
Stay Healthy

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (2 days later)

Dear Doctor
Hope you have noted my morning fasting readings are high (170) and post lunch is 150. If I take 14 units in the night and 22 units in the morning My morning reading will go up- (I hope you are suggesting me to take 22 in the night and 14 in the morning). or you can suggest better insulin

I had these test done
1 Kidney function test. Normal
2. Urine for microalbumin. - Normal
3. ECG normal as seen by Cardiologist
4. HbA1c this reads 8.9 ( this seems high ) four weeks back
5. Lipid profile. all parameters with in the range

I have Vitamin D below 17 for which I am taking some supplements
I request you to please advice me
XXXXXX

Answered by Dr. Anshul Varshney (1 hour later)

Brief Answer:
Detail Follows.

Detailed Answer:
Dear Friend.
No I am asking you to take 22 units in morning and 14 units in night.
It's actually that this insulin acts as immediate acting and as well as intermidiate or long acting. So start with this and revert me after 15 days of charting.
Good luck

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar