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December 19, 2005

Insulin, Type 2

Question from Karachi, Pakistan:

I am currently taking Glucomet plus (2+0+1) with Glucobay 50 (1+0+0). I recently started taking 10 units of insulin at night. My fasting blood sugar was 164 mg/dl [9.1 mmol/L] and was the same two hours after eating barley porridge. Today, my fasting blood sugar was 184 mg/dl [10.2 mmol/L] and I think this is a bit high. How long do I wait until I need to adjust my insulin? How often should I check my blood sugars?

Answer:

You need to discuss with your physician as to what your treatment goals should be. I would agree with you that 184 mg/dl [10.2 mmol/L] is too high in the morning. I would usually use a number around 120 mg/dl [6.7 mmol/L] as your pre-breakfast goal. The insulin can then be increased in small increments until you reach the target. Yes, it will take some time. You need to find out from your physician how much to increase and how frequently to adjust. It is not unusual to try a dose for a week or so at a time before making further changes.

JTL