April 30, 2008
Hyperglycemia and DKA, Insulin Analogs
Question from La Manche, France:
I have recently moved to France and have not seen a specialist as yet. I am waiting for appointment with an English speaking doctor at the moment. My sugars are running a little high at the moment, I take Humalog three times a day but, after dinner, sometimes I will be running extremely high. Although I adjust my dosage well most of the time, I was wondering if I could take another dose to help bring my level down. It can be running as high as 20 mmol/L [360 mg/dl] before bed.
Answer:
With the blood sugars running high after your dinner in the evening, the next appropriate adjustment would be to increase your rapid-acting insulin upward at the meal. The problem you have is that you need a physician to supervise your adjustment with this dosing. I hope your wait is not too long to see a physician. It is safer to increase the dose before dinner than to take an additional dose of short-acting insulin at bedtime. The problem with short-acting insulin at bedtime is that your sugars may run low and since you would be asleep, you would not know it.
JTL
