My father's fasting blood sugar levels fluctuate even after taking medicines. Why?

Question

Hi doctor,

My dad is having diabetes for 27 years. Now he is 67 years old. His condition was properly managed with the help of the doctor. He is taking Metformin 500 two times a day with food management. After retirement, this treatment has not helped him. He is taking Insulin 70/30 10 units two times a day and Lantus insulin 16 units for the past one month and it helped him a lot. His FBS has got reduced from 300 mg/dL to 160 mg/dL. But now again his glucose level has got raised to its highest state yesterday morning. It was 297 mg/dL. His urinary incontinence got increased. He feels hungry and aggressive all the time. I feel difficult to manage him. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through the details given. It is necessary to upgrade his current treatment. There is a need to increase his insulin dosage. Initially, you can increase the dosage of Lantus insulin to 20 units at night and check his fasting glucose level. If the level is more than 140 mg/dL, then you can increase another two units. If the postprandial blood sugar is higher than 180 mg/dL, then increase insulin 70/30 by two to four units. This should be done once in three to four days. FBG (fasting blood sugar) and PP (postprandial glucose) as well as predinner glucose, should be checked regularly. If the glucose level remains high, then a lot of glucose is excreted through the urine and there is an increase in urination. The patient tends to drink more water, passes urine more often, and also feels more hungry. Once the glucose gets controlled, then all the other symptoms comes under control.