High pp readings after taking Levemir flexpen Inj

[zak51]

my wife is diabetic last 15 years, had heart surgery 10years back.
started insulin 50days now.
presently on Levemir flexpen twice daily before meal on dose 30units each 12hours.
her fasting readings have dropped to average 125 but pp still at around 250 both after breakfast and dinner.
oral medicine includes diamicron 60 BB and Onglyza 5mg after meal.
What could be the reason of pp levels being still so hgh although 30units of levemir taken.
Could y suggest reasonable remedy.

by zak51 March 3 2014

[zak51]

thanks Sally, my doctor has now suggested Novarapid before lunch/ I would come back with results.

[Super_sally888]

You wife needs both the long acting insulin (Levemir) to be taken twice a day, and she will also need a fast acting insulin (such as novalog, Humalog or aphidra) to be taken just before eating so that it can 'cover' the food she eats (and with dose adjusted based on how much carbs and protein she eats).

She should go back to her doctor complaining of the high PP blood sugars and be prescribed this additional insulin (and hopefully also sent to diabetes educator so she can best learn how to use it).

[diabetes86]

Carbs provide a surge of  BG so a surge of insulin is needed to regulate the BG, that is the function of rapid insulin.   Levemir is a Basal insulin provides a long term (24 hour) insulin supply.  Levemir is NOT meant to counter BG rise due to food.  eating food will raise BG for 2, 3 or 4 hours levemir lasts 24 hours a rapid insulin lasts about 4 hours so it matches the BG result from food.

[zak51]

thanks for the advise but will Novalog needs to be taken after meals additionally to Levemir.
i can understand that carbs raise BG levels after meals, but does that mean that the 24 hour effect of Levemir does not work?

from: zak51

[diabetes86]

Levemir is a background insulin NOT intended to counter eating carbohydrates.  for meal insulin she will need a rapid insulin like Apidra or novalog.  counting carbs and taking a rapid insulin based on HER particular insulin/carb ratio will work better at lowering her after meal numbers.

Also  eating carbohydrates... ALL carbs raise BG.  what does she eat?  I eat under 25gr of carbs per meal.