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How Should The Elevated Sugar Level Be Controlled If Insulin, NovoRapid, And Lantus Are Not Sufficient Enough?

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Posted on Wed, 26 Sep 2018
Question: Hi Doctor,
I have attached my mother test reports.She is on insulin: 25 units novorapid 3 times a day and at night 25 unit for lantus.Still, her sugar does not seem to be under control. Also her CBC report revealed mild lucocytosis. Please suggest further course of action. I am reachable at 0000.
doctor
Answered by Dr. Minal Mohit (14 hours later)
Brief Answer:
No report attached. Just the XXXXXXX is there.

Detailed Answer:

Hello,

I could not find any report attached. just XXXXXXX XXXXXXX is there. kindly send the reports also self monitoring blood glucose values.

Waiting for your response.

Regards,
Dr. Minal Mohit, Endocrinologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Minal Mohit (5 hours later)
I have attached the report.

1 Day Readings:
morning fasting : 210
Afternoon before meal : 180
Afternoon after meal: 201
evening before meal: 170
evening after meal: 198

doctor
Answered by Dr. Minal Mohit (25 hours later)
Brief Answer:

Adjust insulin and add OHA.

Detailed Answer:

Hi!

Now as per the reports, her HbA1c is poorly controlled. so the choice would be to increase Lantus at bed time.

Rest continue same plan. Also add a Tab Istamet twice a day, before breakfast and before dinner.

Recheck her sugars after 2 days and let me know.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Minal Mohit, Endocrinologist
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Minal Mohit (2 hours later)
Thanks Doctor for your reply. I will surely follow this up. Also any concerns regarding her CBC report as her TLC is bit out of range.
doctor
Answered by Dr. Minal Mohit (30 hours later)
Brief Answer:

No, hyperglycemia per set cause mild leucocytosis.

Detailed Answer:

Hi again,

For now let us follow sugars. Once things are settled we will repeat CBC.

Hope I have answered your query.

Regards,
Dr. Minal Mohit, Endocrinologist


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

Endocrinologist

Practicing since :1998

Answered : 836 Questions

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How Should The Elevated Sugar Level Be Controlled If Insulin, NovoRapid, And Lantus Are Not Sufficient Enough?

Brief Answer: No report attached. Just the XXXXXXX is there. Detailed Answer: Hello, I could not find any report attached. just XXXXXXX XXXXXXX is there. kindly send the reports also self monitoring blood glucose values. Waiting for your response. Regards, Dr. Minal Mohit, Endocrinologist