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What Causes Elevated Blood Sugar Levels At Bedtime?
Question: My mom has been a diabetic for 20+ years. Recently her hab1c levels have been too high at 10.8. So her Dr has put her on actrapid (12 units)before breakfast and lunch and lantus (20 units) before breakfast and has asked her monitor her sugar levels 4 times a day for a month. He says her sugar levels are not in control coz of her vitiligo. Other than that all her thyroid tests have come out normal. Myp question is now inspire of insulin her bedtime sugar levels r quite high near 300 consistently. Other than that her before breakfast and lunch levels r in control- less than 200.
Does she need so much of insulin or her sugar levels can bw controlled thru tablets (coz she is more comfortable with tablets).
Why is her sugar levels still high at bedtime?
Wht r the side effects of taking so much of insulin.
Is there a possibility of low sugar episode?
Does she need so much of insulin or her sugar levels can bw controlled thru tablets (coz she is more comfortable with tablets).
Why is her sugar levels still high at bedtime?
Wht r the side effects of taking so much of insulin.
Is there a possibility of low sugar episode?
Brief Answer:
Explained
Detailed Answer:
Hi,
I am Dr Mittal.
I have read your message.
I think I can help you.
You need to understand what the doctor is doing to understand the answer to the query.
The sugars are high. It was not on control with the tablets she was on. So the doctor had to initiate insulin. On insulin, her day time sugars are normal. Only her nighttime sugars are high. But you may have noted that the doctor has not started Actrapid at night. This is because while insulin is the best medicine for diabetes, it has the potential for causing hypoglycaemia or reduced sugars. This is most likely during the night. The actrapid dose will need to be adjusted at a later date to get the night sugars within range.
Now to answer your questions.
1. No, I don't think it would be possible to control sugars on tablets especially when the sugars are still out of control despite that much insulin.
2. Yes , insulin has side effects especially hypoglycaemia. That's why her sugars are being monitored 4 times a day. Once her needed dose is settled, the sugar monitoring can be reduced.
3. Her insulin dose is being individualized. this needs time so as to avoid hypoglycaemia. So her night sugars are temporarily high and can be controlled with subsequent dose change.
I suggest that you monitor her diet also. Sugar levels are a balance between diet intake and insulin taken.
I have tried to make it as simple as possible. Please feel free to contact us for further information. Best of luck, Dr Mittal.
Explained
Detailed Answer:
Hi,
I am Dr Mittal.
I have read your message.
I think I can help you.
You need to understand what the doctor is doing to understand the answer to the query.
The sugars are high. It was not on control with the tablets she was on. So the doctor had to initiate insulin. On insulin, her day time sugars are normal. Only her nighttime sugars are high. But you may have noted that the doctor has not started Actrapid at night. This is because while insulin is the best medicine for diabetes, it has the potential for causing hypoglycaemia or reduced sugars. This is most likely during the night. The actrapid dose will need to be adjusted at a later date to get the night sugars within range.
Now to answer your questions.
1. No, I don't think it would be possible to control sugars on tablets especially when the sugars are still out of control despite that much insulin.
2. Yes , insulin has side effects especially hypoglycaemia. That's why her sugars are being monitored 4 times a day. Once her needed dose is settled, the sugar monitoring can be reduced.
3. Her insulin dose is being individualized. this needs time so as to avoid hypoglycaemia. So her night sugars are temporarily high and can be controlled with subsequent dose change.
I suggest that you monitor her diet also. Sugar levels are a balance between diet intake and insulin taken.
I have tried to make it as simple as possible. Please feel free to contact us for further information. Best of luck, Dr Mittal.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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