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January 13, 2004


Question from New Delhi, India:

I live in India. It's winter time out here. The temperatures remain under 15 deg. C. Since the last three days, my post breakfast sugar levels have been soaring as high as 250 mg/dl [13.9 mmol/L] when they usually remain between 140-170 mg/dl. In fact, when this happened first, I had to take an exceptionally high dose of Humalog to bring down the sugar level. My usual dose is 40 units before breakfast and 20 units before dinner of Huminsulin 30/70 from U-100 pen cartidges. Also there are no apparent signs of coughing or any illness in me. What has gone wrong?


A temperature under 15C is not low enough to affect your postbreakfast sugar level. I’d think instead that where you inject your prebreakfast insulin dose might have affected its rate of absorption – that is poorly reproducible with premixed insulins such as Huminsulin 30/70 – and hence an unpredictable postabsorption sugar level may happen. Otherwise, if this is not the case, try to change with a new vial of Huminsulin 30/70 and see whether it works.