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Would 14 Units Of Glargine Insulin Lead To Hypoglycaemia?
Brief Answer:
Possibly yes
Detailed Answer:
Glargine is a basal insulin. What this means is that it is designed to control fasting glucose readings and those before each meal.
It is not used specifically for the purpose of improving post-meal sugars. However if the pre breakfast ie fasting glucoses are at goal, it is likely that other pre-meal readings will also be fine.
If this is not the case then it indicates the need to discuss the diabetes control with an endocrinologist who will come up with ideas to address the post meal glucose elevations.
8.5 for an elderly person after breakfast is not bad at all. So if I saw some one like the individual you are referring to in my practice I would be concerned about the risk of hypoglycemia.
I woud review the fasting and before-meal readings to see if Lantus is a consideration
Possibly yes
Detailed Answer:
Glargine is a basal insulin. What this means is that it is designed to control fasting glucose readings and those before each meal.
It is not used specifically for the purpose of improving post-meal sugars. However if the pre breakfast ie fasting glucoses are at goal, it is likely that other pre-meal readings will also be fine.
If this is not the case then it indicates the need to discuss the diabetes control with an endocrinologist who will come up with ideas to address the post meal glucose elevations.
8.5 for an elderly person after breakfast is not bad at all. So if I saw some one like the individual you are referring to in my practice I would be concerned about the risk of hypoglycemia.
I woud review the fasting and before-meal readings to see if Lantus is a consideration
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Insulin was administered at 0730.
Instructions are to give 10 units if fasting BGL is under 4mmol, or 14 units if fasting BGL is over 4. They are on Glargine but take tablets for other health conditions, which I can't remember.
Anyway, I'm concerned because yesterday and the day prior, fasting BGL was 3mmol/l. Today, however, no fasting BGL was obtained ... only BGL 'after' breakfast which was 8.5mmol/l.
Consequently, they were given 14 units approximately 30 minutes post-breakfast (bowl of rolled oats, milk, stevia a natural sugar substitute, and mango).
I’m concerned they would be hypoglycaemic later today or tomorrow morning. Feeling worried.
Instructions are to give 10 units if fasting BGL is under 4mmol, or 14 units if fasting BGL is over 4. They are on Glargine but take tablets for other health conditions, which I can't remember.
Anyway, I'm concerned because yesterday and the day prior, fasting BGL was 3mmol/l. Today, however, no fasting BGL was obtained ... only BGL 'after' breakfast which was 8.5mmol/l.
Consequently, they were given 14 units approximately 30 minutes post-breakfast (bowl of rolled oats, milk, stevia a natural sugar substitute, and mango).
I’m concerned they would be hypoglycaemic later today or tomorrow morning. Feeling worried.
Brief Answer:
Follow up
Detailed Answer:
I see.
Those glucose targets appear a bit too tight for an elderly person.
However these goals are typically individualized by the endocrinologist and the patient jointly after taking into consideration many factors.
When I see someone like the person you are describing, I immediately lower the dose of glargine and even consider discontinuing it because there is clear hypoglycemia occurring.
Now that the dose has been already administered, it is prudent to watch out for the possibility of hypoglycemia for the next day or so because glargine last about 24 hours and even longer if there are kidney problems.
So the most judicious step is to be vigilant and check glucoses with the monitor frequently, and eat food if hypoglycemia occurs.
Contact the healthcare provider who has prescribed this treatment at the soonest to see what changes are necessary to minimize the hypoglycemic episodes without compromising the degree of control.
Follow up
Detailed Answer:
I see.
Those glucose targets appear a bit too tight for an elderly person.
However these goals are typically individualized by the endocrinologist and the patient jointly after taking into consideration many factors.
When I see someone like the person you are describing, I immediately lower the dose of glargine and even consider discontinuing it because there is clear hypoglycemia occurring.
Now that the dose has been already administered, it is prudent to watch out for the possibility of hypoglycemia for the next day or so because glargine last about 24 hours and even longer if there are kidney problems.
So the most judicious step is to be vigilant and check glucoses with the monitor frequently, and eat food if hypoglycemia occurs.
Contact the healthcare provider who has prescribed this treatment at the soonest to see what changes are necessary to minimize the hypoglycemic episodes without compromising the degree of control.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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