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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What To Do If Sliding Sugar Scale Shows Highly Fluctuating Insulin Levels Before And After Food?

My doctor gave me a sliding sugar scale to use for type II diabetes. I test before I eat. I haven t taken any insulin today because I m not high according to the scale. I had a granny smith apple for breakfast, along with a protein bar. checked. Count was 81. No insulin needed at 10:30 am. I ate a cheese stick. Lunch time (12:30 pm) I ate a large lettuce salad with 3 eggs for protein as well as 15 small cut-up carrots, 10 radishes, 5 clumps of cauliflower and 2 slides of lean ham. Again no insulin. I ate another cheese stick at 2:00 pm. 3:50 pm my count is 58. I sweat terribly when that happens. I ate a snickers candy bar because I needed something ASAP - now it is 98. I took it 2 mins later because I wanted to make sure it was ok --- it is now 90. I hate this up/down stuff. I don t seem to be able to regular this very well. My doctor just tells me I need to eat more protein. When I do, it seems to lead to very high results. Where is the best place to get help, as my local HyVee chapter charges me $25.00 when I meet with their diabetic consultant. My insurance company just wants me to go to a group and I d really like individual help with my situation. ?? I take lantus at night (my doctor said to not take more than the combined amount of humalog pen I take during the day.) But at night sometimes my count is high (210 last night) and if I haven t taken any humalog penduring the day, then what do I take at night? I feel like I need help.
Wed, 26 Feb 2014
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Diabetologist 's  Response
Hi, welcome to our site. I am Dr Saumya Mittal.

Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query

Please do understand that every person needs a different dose of insulin. The dose on insulin has to be individualized. Till that dose is reached you may have trouble.

I need to know more details from you about your therapy. What are the types of insulin you take, at what times and what is the average dose you need?
And what is the syringe you use?

I would also suggest you test your HbA1C.

Personally I would reduce the dose of insulin in a patient I was treating, simply because hypoglycemia are more dangerous than high sugars. I think maybe your sugar is too tightly controlled. And so you go into reduced sugars as soon as you eat a bit less or exercise a bit more.

I would suggest reducing the dose of long acting insulin gradually and see how it goes from there.

Suggest you upload the sugar chart, along with the corresponding insulin taken so that a better advice can be given.

I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck.

I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you.

Please do understand that some details could be extracted from a detailed history and examination.

Looking forward to your return query with the details asked so that I can help you further.
(If the answer has helped you, please indicate this)
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What To Do If Sliding Sugar Scale Shows Highly Fluctuating Insulin Levels Before And After Food?

Hi, welcome to our site. I am Dr Saumya Mittal. Read your query. That is a very significant question and i appreciate your problem. I will try my best to answer your query Please do understand that every person needs a different dose of insulin. The dose on insulin has to be individualized. Till that dose is reached you may have trouble. I need to know more details from you about your therapy. What are the types of insulin you take, at what times and what is the average dose you need? And what is the syringe you use? I would also suggest you test your HbA1C. Personally I would reduce the dose of insulin in a patient I was treating, simply because hypoglycemia are more dangerous than high sugars. I think maybe your sugar is too tightly controlled. And so you go into reduced sugars as soon as you eat a bit less or exercise a bit more. I would suggest reducing the dose of long acting insulin gradually and see how it goes from there. Suggest you upload the sugar chart, along with the corresponding insulin taken so that a better advice can be given. I hope this helps you. Inform the reports mentioned above so i can be of help further. Best of luck. I have given you the answer to the maximum considering the information provided. The results of the tests could further enhance my answer to you. Please do understand that some details could be extracted from a detailed history and examination. Looking forward to your return query with the details asked so that I can help you further. (If the answer has helped you, please indicate this)