Dad having diabetes past from 20 years

[govi84]

My dad is having diabetes past from 20 years and we are giving Insulin (human mixtard) to him
dosage:- 35 units in morning and 28 units in the night
but still his blood glucose levels are showing 380-400.
few days back he has undergone actrapid insulin I.V at that time it shown glucose levels as 150,but  after 40 mins he immediately got sweating all over his body, so we have given some biscuits assuming that his glucose levels falls below normal levels.

we checked the glucose levels on the same night using gluco meter and it was showing exactly 380 (before meals)

he is under below medication
------------------------------------------
Pioz-15 before food (morning)
35 units of Insulin (human mixtard) before break fast
28 units of insulin (human mixtard) after meals

His blood pressure is under control.
medicines using for BP are as follows
-----------------------------------------------------
Amlong-A (morning)
Revas-H (night)

Note:- He is having slight Albumin discharge in his urine but no signs of infection.
He lost his vision due to diabetic retinopathy 2 years back.

My question is, why blood glucose levels are not coming down even after giving above said medicines and he is maintaning good diet also.


Please someone answer my question
Thanks in advance.

[govi84]

Thanks for your valuable suggestion :)

[govi84]

Thanks a lot for your valuable advice.

[Super_sally888]

Hello,

please discuss with his dr.  Such high blood sugar levels are extremely dangerous to his health.  He could develop a condition called diabetic ketoacidosis, which can be fatal.

His blood sugars need to be reduced with proper dose of insulin.  

However, please note that if his body is used to his blood sugar being so high it is important to reduce his sugars over a period of weeks.  Ie. initially targetting to keep blood sugars below 300 at all times.  Then reducing this to keep below 200 at all times and finally easing down to keep his blood sugar below 180 at all times and preferentially in the range of 80 - 140.  But this should only be done if you can avoid him having lows.

Mixed insulin may not be the best approach given how your father's blood sugars are so high. Please ask his doctor about a basal bolus approahc.  This is where 2 types of insuylins are used: a slow acting (Basal) that is given once or twice a day, and a fast acting that is given before eating and also is used to bring blood sugar down if he is high.

What do you mean by proper diet.  You will need ot follow a lower carb diet with your father.    The amount of carbs he eats at each meal needs to be very controlled.  This will allow the dose of insulin to be titrated.

You need to work with a diabetes educator to help get this under control.  You also need to work closely with his doctor.

I can recommend a book called "Using Insulin" by John Walsh which would help you understand the basics of using insulin and then help in management of your father's diabetes.  however, this would not replace working closely with his Dr and a diabetes management team.

Very high blood sugars can also be caused by infection.  So he needs to be checked to also make sure there are no other conditions contributing to this very high blood sugar.

[WaveRider]

"My question is, why blood glucose levels are not coming down even after giving above said medicines and he is maintaning good diet also."

This is nearly impossible to determine without reviewing his medical records and history, something we cannot do. The questions to you are:
1. Are you testing his blood sugar levels just prior to giving him insulin?
2. And, then 2-3 hours after a meal to see if the foods he ate are elevating his levels? And, the proper dose of insulin is being administered?
3. Are you assuming his dose or following doctors directions?
4. Have you discussed this with his Endocrinologist?
5. And what is "maintaning good diet also."? Hopefully it means no foods made with flour [breads and crackers], no starchy foods such as white rice and potatoes, no diary products [milk, yogurt], no foods high in carbohydrates, and no sugary foods and no sugary liquids.

As you can you can see there is too much speculation to arrive at a proper answer. Hopefully his Endo can provide the answers you're looking for. If not find another one that can. Good luck -