Type 1

[brross]

I am 62 years old Type 1 diabetic (male). I am taking 30 units in the morning and 10 units in the night before food. Additionally I am taking 60mg of Diamicron MR thrice daily. But my blood sugar level is fluctuating from 149 to 249 (fasting) Why?

[Stuboy]

I assume you are on MIXTARD if youre injecting twice daily?

If so, this is probably why you fluctuate so much. I used to be on mixtard and had great trouble stabalising my blood sugar, untill i went onto Basal and Bolus!

[brross]

What type of Insulin you are taking?

[Stuboy]

i am taking Lantus and Novorapid now. Used to be on Mixtard

How long have you had diabetes?

[brross]

may be around 10 years

[Cyborg]

Have you looked into an MDI treatment plan using a long acting insulin for your basal requirements and a fast acting insulin for you meal boluses?

[seacomp]

Have you looked into an MDI treatment plan using a long acting insulin for your basal requirements and a fast acting insulin for you meal boluses?

The analog insulins (Lantus, Levemir, Humalog, Novorapid) generally used for the basal/bolus approach may not be available in India and/or may be extremely expensive. It is possible, but not quite as easy, to use normal R and N insulins to the same effect.
You take an N insulin once or twice a day to cover the background glucose released by the liver, the basal. For most people this is usually about 25 units a day. You then take an injection of R insulin before each meal (bolus), the dose being dependent on the amount of carbs in the meal and your specific carb to insulin ratio.
This approach provides insulin to the body in a similar way to which it is produced by a non-diabetic. This, and the insulin pump, permit the lowest BG levels.

[Funnygrl]

Your blood sugars fluctuate so much because you are taking only 2 injections per day. This is proven to not allow for control in type 1 diabetes.

[spike]

I am 62 years old Type 1 diabetic (male). I am taking 30 units in the morning and 10 units in the night before food. Additionally I am taking 60mg of Diamicron MR thrice daily. But my blood sugar level is fluctuating from 149 to 249 (fasting) Why?

Bg level improve as one moves up "the ladder" in treatments.

First level: what u are doing
Second level: Multiple daily injections, including carb counting
Third Level: Pumping, which entails carb counting

Add to those, moderate exercise to increase your insulin utilization.

[spike]

oh, the Fourth Level isn't available yet: a failsafe artificial pancreas. :)

[BlueSky]

I am 62 years old Type 1 diabetic (male). I am taking 30 units in the morning and 10 units in the night before food. Additionally I am taking 60mg of Diamicron MR thrice daily. ...
If you are a Type 1 diabetic, why are you taking Diamicron? It is a sulfonylurea and only works if your pancreas still produces insulin .... :confused: If you are in fact a Type 2, you probably also need to focus on dealing with the insulin resistance.

[2bsugarfree]

Why is there problems in stabilising sugar level when on mixtard. From what I have read about mixtard (http://www.drugdelivery.ca/s3692-s-MIXTARD-INSULIN.aspx), it says that mixtard provides fast glucose lowering effect.
Maybe this works differently for others, that is it may be effective to lower glucose and keep it in control during the day.

[JediSkipdogg]

Why is there problems in stabilising sugar level when on mixtard. From what I have read about mixtard (http://www.drugdelivery.ca/s3692-s-MIXTARD-INSULIN.aspx), it says that mixtard provides fast glucose lowering effect.
Maybe this works differently for others, that is it may be effective to lower glucose and keep it in control during the day.

Mixtard is bad because you ARE NOT controlling the mix percentage. I'm not sure if they still make an NPH/R mix or not but say they do. If you have a 30/70 mix then that is 30% R and 70% NPH. You take that for your morning breakfast. Well, you must take it for the amount of NPH you need or you will run high in the 3-12 hours after you take it.

So, say you need 21 units of NPH to cover what you will rise in the late morning and afternoon. Well, that means you are taking 9 units of R. That means you MUST eat 9 units of R worth of food or else that R will drop your BG extremely low requiring you to eat more later making a correction. Also known as feeding the insulin.

So say you only eat 3 R worth of food that morning and you give 10 units of Mixtard. Now, you only have 7 units of NPH in the body which isn't enough so your BG is going to rise later in the morning and all afternoon a drastic amount (7 units vs. 21 units.) So how do you correct that? You can't give another shot of Mixtard as you'd then get another shot of NPH as well, which then means you will have overlapping NPH shots and be on a roller coaster all day as each one wears off.


Understand the bias against Mixtard? It's a great idea ONLY IF you eat the EXACT same number of carbs during the meals you take it AND you NEVER need to give a correction dosage. And how do you do a correction? Say you ate more for lunch than you thought, and at dinner you are 300 mg/dl....how do you bring that 300 mg/dl down without taking more NPH than you need? You can't, it's impossible, unless your doctor prescribes you a vial of R insulin as well, which I don't know any that do.

If one wants to only give one shot, at least use NPH and R in vials, mix them together in a syringe, and inject that way, making your own percentage mix each time you eat.

Any questions? Comments? Snide Remarks? If not, hold your peace and carry on.

[DeusXM]

Why is there problems in stabilising sugar level when on mixtard. From what I have read about mixtard, it says that mixtard provides fast glucose lowering effect.

There's your answer right there. 'Rapid blood glucose lowering' is not 'stable'. Mixtard isn't designed to exactly match your specific insulin requirements - it's a best guess and it's frequently wrong, either working too hard or working too little. MDI lets you match your insulin intake to your BG level - Mixtard doesn't, it makes you try to match your BG level to your insulin intake.