I’m a 42 year old black male with type 2 diabetes. I’m moderately active, but I do not have a strong exercise regimen. I’m currently using a 70/30 insulin premix. Is there a formula (i.e., a sliding scale) to calculate the units of insulin required to counteract a given blood glucose level when blood glucose is checked periodically?

Congratulations on taking a more active look at your diabetes management! Yes, there are ways to manage blood sugars for exercise, more food, less food, highs and other changes that life brings to blood sugar control. It would be my suggestion that you discuss the following with your physician and diabetes team:

Change your insulin regimen from 70/30 to a combination of insulins, such as Humalog and NPH, learning to adjust the Humalog (quick acting insulin) for food, activity and highs or lows and using the N at bedtime to bring your fasting blood sugar in at a level of 80-120 as well as N each morning (if needed) to balance your needs between meals.

Typically we begin by teaching carbohydrate counting and matching Humalog to the carbohydrate to be eaten, starting with 1 unit of Humalog for every 15 grams of carbohydrate. You can also add extra Humalog before the meal for higher blood sugars. We usually begin with 1unit Humalog for every 50 points over 120 if your are thin and 1 unit Humalog for every 30 points over 120 if you are overweight.

You didn’t mention if you are also taking a combination of diabetes oral agents along with the insulin. This is also a very popular approach to treating Type 2 diabetes today.

And most importantly, I hope you have the availability of working with a diabetes educator to learn all that I have mentioned. If not, you can call 1-800-TEAM UP 4 and ask for those living in your area.

KS
Additional comments from Dr. Quick:

Alternatively, Ultralente and Humalog, or an insulin pump might be considered instead of Humalog and NPH.

WWQ