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Can I Increase The Dosage Of Novolog For Elevated Blood Sugar Levels?

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Posted on Thu, 26 Feb 2015
Question: My general doctor prescribed methylprednisolone for a cough. I am diabetic and
My blood sugar spiked to 326. Should i increase my Novolog 70/30
doctor
Answered by Dr. Shehzad Topiwala (19 minutes later)
Brief Answer:
Diabetes

Detailed Answer:
When I see someone like you in my practice, I encourage them to increase the dose of Novolog 70/30 by as many units that are needed to bring glucoses closer to 150. But I caution them to be careful about getting low glucose reactions.
This requires frequent self monitoring in the form of regular capillary blood glucose checks using fingerstick samples and a glucometer.
This is important because Novolog 70/30 has fixed amounts of two different kinds of insulin and so increasing the overall dose delivers higher amounts of both insulins. This is not always desirable.
For example when your blood glucose is 326, plain Novolog is preferred at this moment in time as it acts quickly and can rapidly bring down glucoses.
I suggest you contact your endocrinologist to learn how to best address this elevated glucose level.
I have trained my patients in managing high glucoses using Novolog with a specific 'scale'.
Such scales cannot are difficult to apply to Novolog 70/30 for reasons explained above.
I counsel my patients to got o the emergency room if glucoses persistently stay above 250 despite several insulin doses, especially if they have symptoms like nausea, vomiting, chest pain or shortness of breath, or if they have a meter that tests positive for ketones in a fingerstick blood sample.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (11 minutes later)
I currently take 39 units in the am and pm. What should I increase to?
doctor
Answered by Dr. Shehzad Topiwala (4 minutes later)
Brief Answer:
Follow up

Detailed Answer:
It is not the objective of this forum to give precise guidance on medicines and their doses.
That being said, as I have mentioned in my response above that when I see a patient in your situation in my practice, I advise them to bump up the doses by several units till glucoses down towards 150. If that results in significant variations in blood glucose levels owing to the shortcomings of 70/30 Novolog in this situation, then I offer them a Novolog scale which instructs them exactly how many units to take for a given range of blood glucoses.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

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

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Can I Increase The Dosage Of Novolog For Elevated Blood Sugar Levels?

Brief Answer: Diabetes Detailed Answer: When I see someone like you in my practice, I encourage them to increase the dose of Novolog 70/30 by as many units that are needed to bring glucoses closer to 150. But I caution them to be careful about getting low glucose reactions. This requires frequent self monitoring in the form of regular capillary blood glucose checks using fingerstick samples and a glucometer. This is important because Novolog 70/30 has fixed amounts of two different kinds of insulin and so increasing the overall dose delivers higher amounts of both insulins. This is not always desirable. For example when your blood glucose is 326, plain Novolog is preferred at this moment in time as it acts quickly and can rapidly bring down glucoses. I suggest you contact your endocrinologist to learn how to best address this elevated glucose level. I have trained my patients in managing high glucoses using Novolog with a specific 'scale'. Such scales cannot are difficult to apply to Novolog 70/30 for reasons explained above. I counsel my patients to got o the emergency room if glucoses persistently stay above 250 despite several insulin doses, especially if they have symptoms like nausea, vomiting, chest pain or shortness of breath, or if they have a meter that tests positive for ketones in a fingerstick blood sample.