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11/17/09
10:25 PM
"I keep having to increase the doseage of my Novalog 70/30 insulin. I have asked the doctor and all I get is you have diabetes. I inject 3x a day."
Asked By:
Frenchy
Category:
Insulin
Background Info Hide
I was diagnoised in 2008, I was put on a once a day injection by my regular physician and a pill. Since I have been seeing a diabetes doctor. He took me off all the meds previously taken and put me on Novalog 70/30. I was taking 4, 4, and 6 at first for breakfast, lunch and dinner. I now take 9, 13, 15 and my numbers flucuate a lot. I have asked the doctor if this is normal and all I get is you have diabetes. At first the insulin was working and my numbers fell between 90 and 140 with the rare reading above 200 and low of 60. But now they can be as high as 300 and low as 40. More high than low. I watch what I eat, I don't exercise but I am on my feet all day long doing lots of manual labor. The high readings are more in the evenings and late night. I test different times each day only one time unless the readings is of concern, or I feel like I am getting low.
Expert Answers (1)
11/29/09
11:33 PM
Diabetes is a progressive disease that changes over time, so an insulin dose that was working last year, may not be the right dose for you this year. That said, when you are unable to manage your diabetes and you are not able to achieve good blood sugar control you need to consider making a change. Novolog 70/30 is an insulin that is “easier” to use because it is a mixed insulin, however, sometimes you can not get adequate blood sugar control when you are taking a mixed insulin. In order to determine if your insulin is still appropriate for you, you may need to gather more data. In order to make an “educated” insulin change ideally you should collect blood sugar values first thing in the morning and then before and two hours after every meal. This may seem like a lot of blood sugar testing, but it will really help create a picture of your blood sugar fluctuations and will help identify which insulin dose needs to change. An option to achieve better blood sugar control is to use a basal insulin, like Lantus or Levemir along with a meal time insulin before each meal. By using this method, you can adjust the dose of insulin at each meal based on the carbohydrate content. This allows more flexibility in meal time schedule but does require more blood sugar testing and knowledge of carbohydrate counting. If this type of insulin regimen sounds interesting to you, discuss this with your clinician and ask for an appointment with a diabetes educator and/or dietitian who can work with you. Good luck!
Answered By:
Deborah Greenwood
Accreditations: MEd, CNS, BC-ADM, CDE
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