Can you double your meds?

[aisha1977]

Hello. I've been a type 2 diabetic for about a year and a half now. My numbers have been under control until lately. Almost two weeks ago I suspected that I was pregnant due to a missed period, higher numbers, and fatigue. Well, a couple days ago it was confirmed by an emergency doctor. My doctor just so happen to be out of town and won't be back for another week or so. My numbers are running like 200-350 all day. I supposed to take 30units of Lantus at bedtime and 3 doses of Novolog Pen during the day. Well, for the past few days I've been doubling the Lantus taking 60units at night. And instead of the average "7units" per meal of Novolog, I've been giving myself an average of 15units per meal 3times a day. I notice my numbers are going down but not to my satisfaction. They are averaging about 150-300 now. FINALLY, my question is, if your numbers get high, can you give yourself a really high dosage of insulin to bring that down or is it dangerous to do so and a doctor should be seen? When I give myself those high dosages of meds I get really nervous because before I got pregnant it wasn't necessary. Now that my numbers are really high and my doctor is out of town, I figure that my doctor would up my dosage to satisfy my body and bring the sugars down. Please!!!!! help!!!! Am I doing the right thing or should I stop before I find myself in a coma???

[Harold]

The type 1 's and 2's on MDI vary their insulin dosage depending on their levels and meals. I am not a doctor or on insulin so giving you a how much would be foolish on my part. Your doctor should have had you instructed on this. Surprised no one had answered you yet then I noticed where you posted this. You need better exposure so will move your post to the general Diabetes forum. You should get an answer that will give you some of a guide line to go by quicker there.

[Subby]

The information seems a bit at odds, maybe that's why no one is replying.

Obviously I can't be sure, but from your post your sound like you may in fact be type 1. You say you are type 2 and have put it in your profile. ("I am a: type 2") Could you absolutely confirm that? You could ask at your doctors (if your doctor is away, your clinical notes will say).

Until we know for sure we can't make very meaningful comments :)

The one comment one thing I can make is that generally, you have to really know what you are doing when it comes to significantly modifying insulin doses. The very fact you are not sure if it is safe or will just land you in a coma, suggests you should not take it further, and instead wait to discuss what's going on with your doctor.

You might choose to learn more about how insulin works and how the dangers work, in which case you could then revisit the question of changing your own dose and how much it is safe to do it.

[davef]

FINALLY, my question is, if your numbers get high, can you give yourself a really high dosage of insulin to bring that down or is it dangerous to do so and a doctor should be seen? When I give myself those high dosages of meds I get really nervous because before I got pregnant it wasn't necessary. Now that my numbers are really high and my doctor is out of town, I figure that my doctor would up my dosage to satisfy my body and bring the sugars down. Please!!!!! help!!!! Am I doing the right thing or should I stop before I find myself in a coma???

I'm not using insulin, but my advice would be when dealing with insulin where an incorrect dose could send you too low is that you should seek medical advice. I would think that doubling your dose without specific medical advice is not a wise thing to do - I reckon you know this as you have mentioned the risks (highlighted above). So see a doctor.

[fgummett]

I guess it is not that uncommon for someone with Gestational Diabetes to be controlled with Insulin for the duration of the pregnancy, and increasingly these days we are seeing the benefit of Type 2 being controlled with insulin.

You are right to want to bring the BS numbers under better control, especially during your pregnancy.

With that said we do need more information.

How often are you testing and when? Are the 150-300 readings at fasting or postprandial?

As above, many of us on MDI or insulin pumps do make adjustments independently of our Doctors but that is only after agreement with out Doctors - who have been satisfied that we understand enough to make those adjustments safely... which chiefly requires frequent testing. :)

[TomB]

Doubling up on insulin is a lot of insulin over a short period of time. Hope you're testing very, very frequently because hypoglycemia is highly possible. Hope you know the signs of going hypo as well. Even though your numbers have recently jumped up, you might want to reconsider and increase your insulin at about 10% per week. Getting in to a pre-natal care doctor or nurse would be a real good thing, too.
Congratultions with bringing another Blessed soul into the world. Best to you,
Tom

[barko]

Well.... being a guy I can't answer the pregnancy part (other than I have 7 kids and have finally figured out the cause) -lol

But....I would encourage you to get consultation as soon as you can and to match your insulin dose with your carb intake - what is your carb ratio? For best results your insulin intake should be matched with actual carb intake ;-)

[pdxdennisj]

When my doctor is out of town he always leaves an alternate contact doctor for just such emergencies. I cant imagine taking someones advice from the internet in your situation.

[Crash220]

First,, if you are not seeing an endocrinologist, make an appt to see one. I have been battling type 2 for 15 or so years. 2008 has been a horrible string of events, pedestrian jumping in front of my work truck, shoulder and toe sugery, and last week i had an MTA bus put my van into a pole, which has contributed to my loss of bg control. My primary care doc referred me to the endo I am seeing now, and he is working on a regime which is helping a ton. He has cut out Diabeta and Prandin, and reduced the total amount of insulin, just rearranged my schedule. The biggest change is I vary my Apidra dose depending on my carb intake. (just a few units here and there but it does make a difference) He gave me a carb booklet, (avail anywhere) and looking at my bg graphs I can see the improvement. I have been seeing my primary care doc for a very long time, but obviously I have gotten to a point where a specialist was needed.

Tom