I am type 1 diabetic for 15 years, on novo mixtard 30/70 twice a day until last month. For last two years, my hba1c is disturbed. Recently after making a regular note of the my blood glucose levels throughout the day, for two months now, my doctor switched me to novomix 30/70. Even after that, the blood glucose levels, specially after lunch, arnd 7 pm, were elevated. Please note that I took insulin at breakfast and dinner time. Then I started taking it three times a day, before each meal. Now the blood glucose levels are better after lunch, but very sporadic in the morning over the last one week. I am also having problems in controlling hypoglycemic episodes. I have had many instances, when, fot example, if my fasting blood glucose level came out to be 60, and I took 5-10 gms of glucose, it shot upto 250. I am shocked because the ada advises 15 gms of glucose in an hypoglyic event. I have observed this in general, that whatever I eat (i eat mainly low glcyemic foods), my body's glucose senstivity is so high, that my blood glucose levels shoot up enormously. I am also suffering from hypothroidism for three years now. Recently, my urine microalbuminuria levels came out to be 180 microgram/mg of creatinine (two readings, spaced out over a month). In addition to insulin, I am also taking thyronorm 75 mg soon after I wake up, glycomet 500mg before each meal, voglibose 0.2 mg after breakfst and lunch, nervz-b after brkfst, telmisartan 20 mg after breakfast and storvas 10 mg at night. Please suggest what can I do to have a tighter blood glucise control, advise if I need to make dietary changes, chanes in insulin type or any other medications.
Ask Free Question
The problem may lie in any of the three i) the dose and type of insulin is not properly tuned or working and it is not cared by your consultant. Ii) your diet is not properly planned and some how not matching your need or iii) your lab is giving wrong reports. For first two you can discuss your diabetologist he is suppose to give you a logical answer acceptable to a knowledgeable person like you. You are quite an educated person and aware of your disease. Your awareness about diabetes is quite commendable, I felt. So I believe none can give you any bullshit. If you feel it is not satisfactory you have right to change your consultant. Look sir, 5-10 g of glucose can never shoot you blood glucose from 60 to 250 mg%. They are giving wrong report. Your microalbumin / creatinine ratio is alarmingly high. It is indicating towards diabetic nephropathy. There must be some lack somewhere - either in medicine side or from your side that you have not compiled properly with advises. I am afraid you need a second opinion from a reputed institution's diabetic care unit.
Take help from the best doctors
Ask a free question
Get FREE multiple opinions from Doctors