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Suggest Treatment For Low Sugar Levels After Bypass Surgery
Question: My father has had a bypass surgery.His sugars before surgery were HBA1C 8.4 .
He has been advised mixtard 30/70 -34 units ,Trajenta an and carbophage in the morning
After which his pp after bfast is 230- 260
His fasting sugar after mixtard 30/70 -16 units and carbophage is 110-120
Please advise as after lunch his sugars are in limit.
Earlier after discharge from hospital we were using 50 units of actrapid in the morning. This caused low sugar levels in the afternoon.
So the doctor changed the actrapid to Mixtard 30/70 in the morning too.
The other medications he takes is
Clopilet,ecosprin,Pregablin, Metolar, Atovastatin
He has been advised mixtard 30/70 -34 units ,Trajenta an and carbophage in the morning
After which his pp after bfast is 230- 260
His fasting sugar after mixtard 30/70 -16 units and carbophage is 110-120
Please advise as after lunch his sugars are in limit.
Earlier after discharge from hospital we were using 50 units of actrapid in the morning. This caused low sugar levels in the afternoon.
So the doctor changed the actrapid to Mixtard 30/70 in the morning too.
The other medications he takes is
Clopilet,ecosprin,Pregablin, Metolar, Atovastatin
Brief Answer:
Monitor blood sugar levels regularly.
Detailed Answer:
Hi, I am Dr Mittal. I have read your query. I think I would be able to help you.
The data in the query is suggestive of the fact that while the fasting sugars are normal and well in control, the post prandial sugars are still relatively high.
It would be immature to change the insulin or sugar tablets based on just one reading. It's advisable to check blood sugar levels regularly at home. Also, it's equally important to know if the blood sugar levels get within normal limits before the next meal.
As of now, I would suggest continuing the same treatment and to watch his calorie intake. Also, you can ask him to start some exercise, if his cardiologist is fine with it and continue monitoring.
The reason why I would not suggest a very very tight control of blood sugar levels is because low blood sugar levels are more deleterious to him compared to high blood sugar levels. Hypoglycaemia can be dangerous.
I have tried to make it as simple as possible. I hope that the information helps you. Please feel free to contact us for more information.
Best of luck.
Dr Mittal.
Monitor blood sugar levels regularly.
Detailed Answer:
Hi, I am Dr Mittal. I have read your query. I think I would be able to help you.
The data in the query is suggestive of the fact that while the fasting sugars are normal and well in control, the post prandial sugars are still relatively high.
It would be immature to change the insulin or sugar tablets based on just one reading. It's advisable to check blood sugar levels regularly at home. Also, it's equally important to know if the blood sugar levels get within normal limits before the next meal.
As of now, I would suggest continuing the same treatment and to watch his calorie intake. Also, you can ask him to start some exercise, if his cardiologist is fine with it and continue monitoring.
The reason why I would not suggest a very very tight control of blood sugar levels is because low blood sugar levels are more deleterious to him compared to high blood sugar levels. Hypoglycaemia can be dangerous.
I have tried to make it as simple as possible. I hope that the information helps you. Please feel free to contact us for more information.
Best of luck.
Dr Mittal.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Can we increase the insulin dose to 38 in the morning. Before his surgery he was taking 42 units of insuman 25 / 75. .
Brief Answer:
don't increase based on one reading
Detailed Answer:
Hi
Good to hear from you again.
Ideally I would say, as before, that the dose should not be changed based on just one sugar reading. so you need to chart sugars more frequently before changing the dose.
Yet, I suggest you can increase it. But watch the sugars.
Best of luck.
Dr Mittal
don't increase based on one reading
Detailed Answer:
Hi
Good to hear from you again.
Ideally I would say, as before, that the dose should not be changed based on just one sugar reading. so you need to chart sugars more frequently before changing the dose.
Yet, I suggest you can increase it. But watch the sugars.
Best of luck.
Dr Mittal
Above answer was peer-reviewed by :
Dr. Shanthi.E
Does any dose take time to set as now i see that with 16 units of mixtard 30 the fasting sugars which were 110 + are now getting lower.to about 80 +.
Also what is the food intake required between breakfast and lunch if the sugar levels after breakfast are 112-150 with 36 units of Mixtard 30,Trajenta and carbophage to avoid hypoglycemia.
Should I make the dose back to 34 units in the morning and does Trajenta work throughout the day.
Also what is the food intake required between breakfast and lunch if the sugar levels after breakfast are 112-150 with 36 units of Mixtard 30,Trajenta and carbophage to avoid hypoglycemia.
Should I make the dose back to 34 units in the morning and does Trajenta work throughout the day.
Brief Answer:
specific requirements answered
Detailed Answer:
Hi. I am Dr Mittal. I am glad to hear from you. I will answer your specific questions.
First, the dose definitely takes time to set in. That's how I said last time that we will have to wait for the sugar monitoring before changing the dose.
110- 150 are a good range for sugars. I won't suggest eating just for the sake of sugars. However salads cam be taken if needed. You will need to chart pre lunch and pre dinner sugars as well.
Also, the tablets do have a long action. In view of the low sugars ,I would suggest lowering the insulin dose too. However, I would concentrate more on the bed time insulin when reducing. As you can imagine, the morning time insulin won't affect the sugars in morning as the night insulin. Fasting sugars are a function of night time insulin.
I have tried to make it as simple as possible. I hope that the information helps you. Please feel free to contact us for more information. Best of luck. Dr Mittal.
specific requirements answered
Detailed Answer:
Hi. I am Dr Mittal. I am glad to hear from you. I will answer your specific questions.
First, the dose definitely takes time to set in. That's how I said last time that we will have to wait for the sugar monitoring before changing the dose.
110- 150 are a good range for sugars. I won't suggest eating just for the sake of sugars. However salads cam be taken if needed. You will need to chart pre lunch and pre dinner sugars as well.
Also, the tablets do have a long action. In view of the low sugars ,I would suggest lowering the insulin dose too. However, I would concentrate more on the bed time insulin when reducing. As you can imagine, the morning time insulin won't affect the sugars in morning as the night insulin. Fasting sugars are a function of night time insulin.
I have tried to make it as simple as possible. I hope that the information helps you. Please feel free to contact us for more information. Best of luck. Dr Mittal.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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