September 21, 2005
Daily Care, Insulin
Question from Wilmington, Massachusetts, USA:
I am a type 1 diabetic trying to get a tighter control on my diabetes. I try to take my insulin doses based on the amount of carbohydrates I am eating. Sometimes, even in that case, my blood sugar two hours later may still be high, above 200 mg/dl [11.1 mmol/L]. If, at the time I am testing my blood sugar and it is over 200 mg/dl [11.1 mmol/L], should I take a shot to correct my blood sugar or should I wait until my next insulin injection and add in the correction then? I take injections before each meal and before bed. I don’t want to give myself shots constantly if my blood sugar is too high, but I don’t want to cause damage by having it remain high until my next insulin injection. What is the recommended course?
Answer:
What you are suggesting is part of a plan to intensively control blood sugars. We do this with our pump patients. However, it can be a bit tricky. If you take your blood sugar two hours after eating, you still have some rapid-acting insulin on board (presuming you take Humalog or NovoLog). We would also have you calculate the amount of insulin to take for a high blood sugar based on a calculation. Please see your physician to discuss this more completely. This type of intensive therapy does carry some increased risk of hypoglycemia.
JTL
