Insulin

I am a Type 2 Diabetic and on insulin. My blood sugars are all over the charts and we are trying hard to bring them down. I am taking 50/50 Humalog twice a day and Novolog twice a day. I have two questions: 1) What causes my blood sugar to rise from 88 at bedtime to 200 before breakfast? (Sometimes I wonder if I get up in my sleep and eat!) and 2) How much insulin can a person actually take? I am on almost 100pts a day now and wonder if this is really high or if it can go much higher. Thankyou.

[Anita Ramsetty, MD]

Hi,
There are few reasons why your blood sugar is hgiher in the morning, and you may need to do some careful investigation to find out which:
1)You ate something that is metabolized slowly(like pizza) late at night and doesn't REALLY show up in your blood stream  until a few hours later.
2)Your nighttime insulin is not at a high enough dose or is not lasting long enough, so it wears off before morning and your blood glucose then starts to rise--this is a very common reason. You may need to be changed to an insulin with a different ratio of long acting to short acting insulin(perhaps 70/30 will be better for you)
3)you are actually dropping low in the middle of the night and your body is bringing you up on its own to keep you safe--this is one you MUST investigate becase if you keep going low, your body gets used to it and eventually stops "alarming " quite as well.



Thereis actually no known highest dose allowed of insulin. I have had patients controlled on 24 units a day, and others taking almost 500 units a day. It really just depends on what you body needs, and the best medication to get the job done. We do try to keep the doses as low as possible to avoid hypoglycemia, and also weight gain associated with insulin. Talk to your doctor about using insulin along with oral sensitizers, Byetta or other combinations that may help decrease the amount of insulin you take. No guarantees, but sometimes they do work better in combination.

Take care.

[MissDixi]

Thankyou very much for your answers!