H,
There are different approaches in controlling blood sugar depending on the levels taken. Basically, your mom is already covered for basal
insulin (
Lantus) and prandial (or during meals - breakfast and lunch). But from what you have said, that she had been having elevations at night time (for which she doesn't have an Actrapid dose in the evening), another dose of Actrapid can then be added to cover for the evening dose to prevent spikes.
Still, it is important to follow dietary restrictions to avoid sudden elevations of sugar levels.
Depending on the control, she can be shifted to tablets and especially if her
HBA1c becomes lower.
Insulins are relatively safe, and few disadvantages are noted like weight gain and hypoglycemia(low sugar levels beyond normal). Hypoglycemia on the other hand, can be a side effect of insulin if doses are disproportionately high, and are manifested as
cold clammy skin, tremors and palpitations, for which blood sugar levels should be checked.
I hope this help you in understanding what your mother needs, and I suggest frequent follow-ups with your Doctor for proper dose adjustment of the medications.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Daryl Derick B. Dizon, General & Family Physician