About a month ago, my doctor put me on 15 units of Lantus at bedtime, and after two weeks, there were no results so I called the doctor twice, and he has now raised me to 24 units, but still no results. In fact, I think my blood sugar has actually gone up. I test three times a day, and in the month I have been on insulin, I have had only five readings under 200 mg/dl [11.1 mmol/L]. The diabetes nurse at the clinic suggested I throw the bottle of insulin our and start another one which I did last night, but still no change. My diet has not changed, and my exercise has doubled at least. Is this a unusual situation? Can you give me any clues regarding this situation?

It’s hard to answer your question without knowing what other medications you might be taking for diabetes, your blood sugar levels fasting and pre/post meals and bedtime and whether or not you have type 2 diabetes (which I am guessing you do). From the little I do know, I suspect a long-acting background (basal rate) insulin such as Lantus may not be all you need to control your sugar. You may also need to take fast acting (bolus) insulin before meals to control postprandial high blood sugars (the rise in blood sugar from each meal).

It is a good idea for you to sit down with the diabetes educator and go over exactly what you are eating and when, and to review your blood sugars before and after meals. It was a good idea to throw out the bottle of Lantus to see if maybe it was the culprit, but I suspect the real culprit is that you need more medicine to control your diabetes. Your diabetes educator and an endocrinologist can help you bring your sugars down, but it may take a little bit of time and some hard work.

JS