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What Causes Dropping Of Sugar Levels After Taking Actrapid?
Question: Hi
I am a type 1 diabetic since 8 years(Last HBA1C - 6.5%). I take Actrapid and Basalog injections. Lately I have observed something strange in my blood sugar behaviour. I have my lunch at about 12:30 and take 12 units of actrapid before that. Two hours after my sugar levels are around 140-160. It drops to 90-110 after about an hour and then it keeps dropping at a rate of 50 mg/dl per hour till dinner. Even if I have a 2 slices of bread and tea without taking actrapid in the evening, my blood sugars don't shoot up very much. They just stay where they were(or may be increase by 20-30 units) for about an hour and a half and then again start dropping at the above mentioned rate..!!To the best of my knowledge, Bolus insulin does act for more than 3 hours. what could be the reason for my blood sugar dropping for hours after my bolus shot? Do I need to reduce my bed time Basalog dose? (I take 16 units basalog before going to bed).
Brief Answer:
Actrapid effect last for eight hours.
Detailed Answer:
Dear XXXX, this is Dr Phanindra dulipala.
I had gone through your query and understood your concerns.
Sir, Actrapid contains a type of insulin called soluble (or neutral) insulin. It is usually injected 15 to 30 minutes before a meal so that the increasing blood glucose levels after eating can be controlled. When it is injected under the skin it works rapidly, within 30 to 60 minutes, and its effects last for about eight hours. So, this is the reason your sugar levels are reducing continuously as the effect continues 8 more hours until dinner.
HbA1C value of 6.5% is good control. Monitoring of sugar levels is compulsory. If you feel too low of sugar levels then you need to change the dose of insulin under guidance of your treating doctor. Discuss this with your treating doctor.
Hope this guides you. If you have any further questions I will be happy to help. Wish you good health. Thank you.
Dr Phanindra Dulipala,
Consultant Diabetologist.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks for the reply doctor. If that is the case then it is not something unexpected I guess. I will probably adjust my evening snack so that I keep my blood sugars intact.
I had one more query. About 20 days back I has some pain and tingling sensation in my feet. I consulted a doctor and he prescribed Pregeb OD 75mg once a day at bed time and nerveup od on the morning. Within 3-4 days I got relief and now my feet are fine. My question is should I continue with these medications? If yes then for how long? Also, is this burning sensation in feet something serious? I mean I have kept my blood sugars under control for the entire time. Only my first two HbA1cs were greater than 7 (7.5 and 7.2). Other than that I have never had it less than 6.7. I check my blood sugar almost 5 times a day. Why did I get this feet problem then?
Brief Answer:
It is diabetic neuropathy
Detailed Answer:
Dear sir,
The symptoms of pain and tingling sensation in the feet is because of diabetic peripheral neuropathy. Diabetic neuropathies are a family of nerve disorders caused by diabetes People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness(loss of feeling) in the hands, arms, feet, and legs.
The above mentioned drugs help in relieving the pain. Control of sugar levels is one primary objective in order to prevent any further damages to nerves. Usually once started the medication for this, we continue lifelong. But you can discuss with the treating doctor regarding stopping for sometime and see. If relapse occurs, then you need to continue lifelong.
Hope this guides you. If you have any further questions I will be happy to help.
Thank you.
Wish you good health.
Dr Phanindra Dulipala,
Consultant Diabetologist.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
One last question. It is quite clear and understood that a diabetic needs to control his blood sugar. But I often see different blood sugar and HbA1C targets recommended by different doctors to different people. Some say post prandial sugars less than 200 are fine, some insist it should be less than 140. For HbA1C's some say that less than 8% is ok, some recommend 7%. I want to know, what should be my blood sugar and HbA1C target so that I can avoid complications later in life?
Brief Answer:
HbA1C < 7%; Post prandial blood sugar < 140mg/dl.
Detailed Answer:
Dear sir,
The HbA1c target and Blood glucose levels slightly vary depending on the various international diabetic associations.
For practical purposes,
The Diabetic patients should target HbA1C of 6.5%(for those who are at risk of hypoglycemia, target adjusted to < 7%).
Post prandial blood sugar level target should be < 140mg/dl.
Hope this guides you. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer. Thank you.
Wish you good health.
Dr Phanindra Dulipala,
Consultant Diabetologist.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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