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The Question
03/20/10 07:22 AM

"What would cause an elevated BS level of 250-495 that will not be brought down by insulin (Lantis) 30 units or Metformin 2000mg seperate or togather?"
Asked By: jayk49  
Category: Newly Diagnosed

Background Info Hide
I am a white Male 50 with an average fasting BS of 250-275 2hr after eating I’m around 380-400 my highest recorded was 495. My A1C was 14. I have restricted my diet to a very low GI. at 30 units of lantis I felt very weak and shaky not able to stand long. Whats "normal" lantis dose for a 260lbs man?

Expert Answers (1)

03/23/10 07:01 AM

Thank you for your question. I'm glad you are giving your attention to improving your blood sugar control. With fastings of 250-275 you are in need of more Lantus. There isn't really a "normal" amount of insulin - it is the amount needed to bring your blood sugar into target. The Fasting target is about 100. Lantus can be increased 2-5 units every 3 days until your fasting is where it needs to be. Discuss this with your primary care provider before making changes. Since your A1C was 14 your body is used to very high blood sugars so sometimes you will get what I call a "false alarm" - your blood sugar will be in normal range, but because it is so much lower than your body is used to - you will get symptoms of low blood sugar. Just do some deep breathing, drink some water and reck in 15-20 minutes to make sure it is not going lower. Your body will soon realize what normal is again. If you treat normal blood sugars by eating to feel better, your body does not reset to the normal range. With your after meal blood sugars going so high, I would advise talking to your provider about adding rapid acting insulin at meal time. Lantus is just a basal insulin to help fasting and between meal blood sugar control. I would suggest you see a certified diabetes educator to help you with your meal plan and activity plan so you can lose some weight which will also help to improve your blood sugar control. It is never to late to make changes and improve your blood sugar control. It is the high blood sugars that cause complications - preventable complications. Don't give up - it is a process to find the correct amount of insulin balanced with your meal plan and activity level.
Answered By: Beth McKinzie
Accreditations: RN, BSN, CDE
Sources Show

Community Answers (1)

03/26/10 11:13 AM

There is no "normal" dose. I am a type I and weigh 240 pounds. I found that the Lantus did not last 24 hours for me and I was always waking up with high blood sugars. I ended up splitting the dose and taking 22 units at 10 AM and 22 units at 10 PM. That works wonderful for me. I know people who are on as much as 140 units per day or more. You may need to think about asking your doc about a rapid acting insulin and running a "GAD Test" to find out if you're Type I or II. If you're Type I, Metformin or other oral diabetic drugs aren't going to do a thing. Also, the more carbs you eat (doesn't matter if it's low GI), the higher your blood sugars will run. If you eat large meals, that will also make your blood sugars run high even if you cover them properly with the insulin. The body will take longer to digest large meals, and although you may be okay a couple of hours after the meal, 5 hours later, you could be high. I eat about 60 carbs per meal that I cover with rapid acting (Novolog) and 15 carbs before bed that I do not cover. It took nearly 4 months to figure the proper dosing so that I don't run high or too low, but it's all down to carbs. Find a diabetes educator if you don't have one. They can really help you find the answers and get you started on a path to good control.
Answered By: pdewey1969
FLAG
SourcesShow



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