July 29, 2001
Daily Care
Question from New Delhi, India:
I am 21 years old, have had type 1 diabetes since I was 12, and my sugar level has not been normal in spite of keeping a strict control on my diet. Whenever I get my sugar level checked, mostly its between 220-280 mg/dl [12.2-15.6 mmol/L]. I am taking insulin injections twice a day, morning and evening. For the last three to four months, my sugar level shot up to 400 mg/dl [22.2 mmol/L], and now it has been stable at about 300 mg/dl 16.7 [mmol/L] for the last few weeks. My doctor has increased my insulin also but it’s also not working. I must mention here that I am working and have a very hectic lifestyle. My job demands most of the day. In spite of taking all kinds of precautions, why is the level not coming down? What should be my insulin dosage in these circumstances? What can be the result of this condition?
Answer:
Every person has their own level of sensitivity to insulin. Therefore, it is not possible to tell you what your insulin dose should be. I will say that twice a day insulin sounds insufficient for your need. I would recommend more intense therapy. If you do not have the ability to pursue this with your current physician, I would inquire about someone with experience in diabetes. It also sounds like you may need to spend some time with a diabetes educator, if one is available. They can help you to address non-pharmacologic issues impacting your diabetes. These include schedule, diet, monitoring, among others.
JTL
