Justin Delgado is husband to Kacie Doyle-Delgado, diagnosed at age 11. After more than a decade together, he considers himself to be an expert carb counter and Dexcom inserter. He graduated with his Master of Science in Finance from the University of Utah in 2013 and has been working in commercial banking since then. He attended his first Friends for Life conference in 2015 and is looking forward to volunteering with the teens.
April 12, 2007
Insulin, Type 2
Question from Jakarta, Indonesia:
I have mild diabetes. My A1c is 5.5% and my two hours postprandial average is 168 mg/dl [9.3 mmol/L], but there is something that make me worry: my fasting blood sugar is rather out of control. Its average is 120 mg/dl [6.7 mmol/L] to 135 mg/dl [7.5 mmol/L] without exercise in the morning. If I exercise, it's usually 107 mg/dl [5.9 mmol/L] to 117 mg/dl [6.5 mmol/L], depending on how long I do this exercise or workout. I usually do this around 30 to 45 minutes. Is this common if I use a basal insulin analog like NovoMix 70/30 to make it in range or it will give me some adverse reaction besides hypoglycemia?
The high blood sugar in the morning is usually a function of long-acting basal insulin before breakfast. If your blood sugar rises high after breakfast, this is a result of not enough short-acting bolus insulin. Since the commercial mix has both basal and bolus insulin, it is important to determine which component needs to be altered. For this reason, I am less a fan of mixed insulins because you cannot individually titrate the insulins.