I am taking human mixtard 30/70 for the last 20 years. Currently I take 25 units x 2 times (morning and night) and one metformin 500 mg in the night. I am 71 years old, do not have any known complications. Sugar levels are 170/250. Should I increase insulin intake? Or should I have any additional drug >? Can I change to basalog insulin - george puthiyamadathil.

Santhosh C AbrahamEndocrinologist17yrs exp

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Your fasting blood sugar should be ideally below 120 and postprandial below 160. Atleast fbs should be below 130 and postprandial between 140-180. Currently you need more insulin. If you increase the mixtard you could have a risk of hypo. Basalog is insulin glargine which is long acting and you can have boluses of lispro before each meal. This is better than a fixed dose combination. Basalog alone will not be able to check your blood sugars within appropriate targets. Also you can increase your metformin up to 2000 mg as long as your kidney is ok. Hope it helps.  

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Dr. Prabhakar Laxman JatharEndocrinologist50yrs exp

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Mr. lybrate-user, thanks for the query. I have seen the details mentioned. You have given the glucose level as 170 /250 mg, do you mean to say fasting is 170 mg & pp is 250 mg? Is that so? What is the hba1c%? It is important to know that, because it gives a long term view of glucose control. To give any advise I need to know hba1c%, exact fbg & pp levels, serum creatinine, urea, dietary pattern & extent of daily exercise. One can definitely change from 30/70 insulin to glargine, but dosage needs to be adjusted. To calculate that all the other information is required. We may have to look at possibility of adding an additional oral drug too. Hence, please come back with necessary details. Preferably in a private conversation. I hope things are clear. Thanks. 

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