low glucose level

[puri6798]

my glucose levels flucuate from lows of 24, 26, and 37 to highs of 284,358,and 388 i am having difficulty trying to determine if its about the insulin prescribed or diet. my current insulin intake is twice a day at 40cc each. the level flucuation could be about the dosage or simply what i eat or don't eat. please advise. more info supplied were necessary

[Emm]

Welcome to Diabetes Forums, Puri - I hope we can help you but first we'll need some more information.

What type of diabetes do you have?
which insulins are you taking?
Are you on set doses or do you match your insulin to your food?
Do you exercise?
What's your diet like?
How often do you test your blood sugar?

[UpNorth]

MDI or pumping is the way to go... By the sound of it, you're on a mixed insulin and that's some peaky ****! With MDI your bloodsugar can become more stable because you inject insulin when you need to inject insulin and in the amount needed. And it's also possible to easily fix a high reading... And i guess you mean 40 units and not 40cc:eek:

[puri6798]

type 1 70/30 humulin set doses, test six times per day, 1800 calorie intake, not much exercise

[Emm]

As Upnorth said - you will have heaps better control with MDI. Your testing is good. Are you able to test more sometimes, when you suspect you could end up low / high?

Is there any routine to your lows and highs or do they surprise you?

1800 calories... but do you watch your carbs? Are you aware of what goes into your meals? Do you know how much carb you need to match that mix insulin?

I hope you can talk to someone about going onto MDI - I'm sure you'll be a happier person once you get into that!

[UpNorth]

Premixed insulin:ahhhhh: :banghead: No wonder you're going up and down more than the elevators in Empire state building:s: You'd be better off with 2 separate insulins and more injections everyday... I know it might be tough to take maybe 5-6 injections. I'm taking 5-6 everyday. But the freedom it gives, and the stability it can provide... It's so worth having those injections! I've never been on a mixed insulin, though my doctor wanted to put me on it when i was diagosed... I choose MDI instead... Had heard a lot about mixed insulin before :s:

[Gary_W]

my glucose levels flucuate from lows of 24, 26, and 37 to highs of 284,358,and 388 i am having difficulty trying to determine if its about the insulin prescribed or diet. my current insulin intake is twice a day at 40cc each. the level flucuation could be about the dosage or simply what i eat or don't eat. please advise. more info supplied were necessary

All of the above.

When you use insulin, it needs to match your body's needs and the food that you eat. Just whacking in the same dose every day and then varying what you do or eat is not going to work. Well, it isn't working; you can see that from your levels.

Some people do OK on two shots a day, though the vast majority keep much better on multiple daily injections (MDI). Whether you choose to stick with two or move over to MDI, ditching the pre-mixed stuff is a great start. If you do exactly the same things every day (eat the same, move the same amount) you might get away with pre mix. You clearly don't.

Once you get onto a more sensible basal insulin (most folks here use either Lantus or Levemir for this), you can work with your doctor to set your basal rate. If your doctor does not know what this means, find one who does. If you wish to stick with 2 injections per day, Lantus and Levemir aren't appropriate as they cannot be mixed in a syringe with rapid acting insulin (so I gather, never tried it...). Others here on two per day can clarify what would be appropriate to mix with. I haven't done the mixing in a syringe thing 'in anger' since I was first diagnosed, and then I only did it for a few months before moving over to a pen.

Once your basal rate is set, you can learn how to count carbohydrates and then match these carbohydrates with an appropriate amount of rapid insulin (Apidra, NovoRapid, Humalog are the 3 most rapid that I know of). Once you've got this pegged, life will seem a whole lot better :)

Gary