Suggest Dosage Of Insulin While Treating Diabetes

Posted on Wed, 22 Jul 2015

Question: i am 82 yrs. old.Suffering from diabetes since 1976.On insulin since july 2008.I had been taking novomix-30 with triexer l s-1.dose 14 and 8 with triexer l s-1 in the morning and evening respectively.complete blood testing done in march 2015.blood sugar...107(F),142(P).HBA1C....7.2%.Consulted another endocronologist.advised novomix dose 8and 4 in morning and evening respectively with glimsaveM2.Observed no steady results in fasting at morning.Present dose 10 and 8 morning and evening respectively with glimsaveM2.Morning it remains between150 and170.

Answered by Dr. Dr. Abhay A Mali (1 hour later)

Brief Answer:
Increase in night dose of insulin may help.

Detailed Answer:
Hi,

Thanks for your question.

After going through your question, I can understand your concern.

Considering your age of 82years and absence of other comorbid conditions like Hypertension or Heart disease or advanced kidney disease your blood sugar level target should be
Fasting 90 to 140
Postprandial 140 to 180
At bed time 150 to 180
HbA1c less than 7.5

Your blood sugar level was under target level with previous treatment regimen.

But current blood sugar levels of fasting 150 to 170 should be lowered as you have tolerated lower blood sugar level of fasting 107 and PP 142.

Now coming to your medicines -

Your previous Tab Triexer LS-1 contain Glimepiride 1mg + Metformin 500mg + Pioglitazone 7.5 mg.

Current Tab Glimisave M2 contains Glimepiride 2mg + Metformin 500mg.

For better control of blood sugar levels with current treatment regimen it is advisable to increase night dose of Novomix-30 gradually by 2 units every 3rd day till fasting blood sugar come under target range.

While doing this it is mandatory to monitor blood sugar levels by glucometer at bed time (preferably 2 hours after dinner and morning 3 am occasionally) and whenever there are symptoms of hypoglycemia (low blood sugar level).

Once fasting blood sugar levels under control we can target postprandial blood sugar level.

All these changes need to be done under supervision of your endocrinologist.

Hope I have answered your question.
I will be happy to answer your follow up questions if any.
Otherwise you can close the question and rate the answer.

Regards,
Dr. Abhay Mali.
Diabetologist.

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E