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What's going on?

I just started on Lantus and Humalog and my blood sugars seem to keep going up, I take 30 U at night Lantus and I take Humalog 10 before meals if my bs is 180 or higher, does this sound right, I was diagnosed a Type 2 about 6 years ago, but the Glipizide and Metformin I was taking has been stopped, but my fasting bs has been 270 or higher any suggestions I know control my diet I get that, I also weigh 239 my Dr's say to loose weight, and I am going to try.
3 Responses
144586 tn?1284666164
Well - yopu have to lose weight. That is a must. 10 units of Humalog before meals is high but  isn't exceptionally high.  What is your glucose reading two hours later? What kind of meal are you eating?
231441 tn?1333892766

you might want to ask your dr about going back on metformin.  It is an insulin sensitisesr and can safety and effectively be used with insulin.

The proper dose of lantus is the one that controls your blood sugar.  IF your blood sugar fasting is 270 then you need to increase your lantus dose.  Ideally your fasting glucose will be in the 80 - 100 range).

Your dr allowing you to have a blood sugar of 180 before taking medications is also keeping you consistently high.   Typically people with diabetes will have a correction factor to bring blood sugars down to target.  As an example, a person may know that 1 unit of Humalog will bring down their blood sugars by 10 points.  So if that person was 180 and wanted to be 100, then he would do a correction of 8 units.  Further, the amount of insulin at meals is matched to the amount of carbs eaten.  For example 10 g of carb need 1 unit of insulin (everyone is different in this).  So if you will eat 50g of carb at the meal, then you would take 5 units of insulin.    The target is that the before meal blood sugar (say 100) is already returned to be 3 - 4 hours post eating and the peak due to eating is not more than about 40 points (iideally).

You are going to need to do basal testing to work out how much basal insulin you need.  You will also need to bolus testing to work out your carb: insulin ratio.  You can find information on this testing online.  Also recommend the books:  Using Insulin (John Walsh) and "Think Like a Pancreas'.

Please do work out how to have good control.  Such high blood sugars put you at risk of complications sooner than later.  If your Dr thinks that 180 is ok (double  normal fasting), then he/she is not very aggressive with manageing diabetes.

low carb diet (low carb, moderate protein, enough fat you are satisfied), daily exercise and weight loss will all help your efforts.  Hope my response will be helpful.

144586 tn?1284666164
Super_Sally has given you great advice. You really need to get in touch with a good nurse practicioner who is a diabetic specialist to explain things to you. You shouldn't just give ten units because that is the protocol. It depends on what your readings are before eating and what your meal is.  Some diabetics take their readings at night, and then add just enough fast-acting insulin to bring levels to slightly above normal. Then they base their nightly Lantus dose on what is just enough to bring their morning levels to just above normal.
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231441 tn?1333892766
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