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Asking For Father, Male 65, township lahore
my father is a known diabetic for 30 years along with hypertension for 15years. For diabetes he is taking short acting insulin twice a day before meal and long acting levemir at night H.S along with that he has been taking been taking oral hypoglycemic one in the mornin and the other at noon. Now from the past 2 months he has been complaining for low blood sugar post dinner. after 2 hours the sugar level goes below 80 and even after takinh dextrose water it won't come up. He is also varying the insulin units but the problem still persists. i have asked him to get his HbA1c checked. that is usually within controlled range of 6.5 to 6.7 . but the hypoglycemia is worrying please guide regarding that. he get 22units of short acting and 20units of levemir.
what is the age of patient any family history of diabetes ? what is weight of patient which oral hypoglycemic is he using and for hypertension which medication he is taking for hypertension
his insulin dosage might needs to be revised.just note down his fasting and post parandial blood sugar readings for one week.than make an appointment with diabetologist for dose and medicine adjustment..
reduce dose of short acting insulin at night to 20 unit and long acting to 18 unit,also monitor blood glucose 2 hrs after meal,check his diet also
Hello.. He needs to reduce the dose of long acting insulin at night.. Because this kind of Hypoglycemia can trigger serious complications. And yes HbA1c needs to be repeated.. alongwith monitoring of fasting and random sugars
aoa.plz reduce the dose of insulin before meals by 2 units consecutively.also reduce oral hypoglycemic.give him tab.once aday.and which tab is he taking?
Member
he has reduced his short acting insulin dosage from 26 to 20. but the results are same. he takes dapa 10mg in the morning and galvus 50 in the noon. i told him to skip dapa but when he did his sugar is deranges is the whole day after that.
4 years ago
Kindly reduce the dose of levemir to 10 units at night.Keep an eye on his condition and check his sugar level 2 hrs after dinner.
It appears to be hypoglycemia due to increased insulin levels. The dose of insulin needs to be readjusted, specifically the night doses before dinner. Kindly make a chart of blood sugar levels for a week and get an appointment with your diabetes physician to readjust insulin dose... Meanwhile carry sweet stuff all the time with you in case signs of hypoglycemia appear
Member
he has been recording his blood sugar levels for the past 2months. they keep on fluctuating. if he decreases the dosage more than 2 units per day the fasting sugar goes up.he has already reduced actraped from 26 unit to 20.
4 years ago
Kindly dont adjust dose on your own, rather get a followup with your diabetologist who recommended these dosages
4 years ago
monitor the glucose level daily and note it
consult with an endocrinologist
Maintain proper sugar charting for 2-3 days.
Consult endocrinologist with that chart so actual issue and specific time when sugar is low can be addressed.
Which medicine he takes may need it's dose adjustment.
Meanwhile ensure that after insulin and hypoglycemic agent he takes proper meal not skip it or take less than usual meal. Monitor RBS and give insulin before meal and repeat RBS 2 hrs after meal or before bedtime, if it's low give a sweet/tofee etc or some fruit.
Member
that's exactly what he does. he eats his dinner at 9pm and then before he goes to sleep he checks post dinner at 11 which usually is low nowadays. he eats something afterwards but then again there is not much increase.
4 years ago
Which medicine is he currently taking?? and at which dose??
Reduce insulin unit by 2 units every dose. But reach out to your physician to adjust doses according to his personalised requirements.
4 years ago
Member
and if he reduces his insulin units more than this his fasting sugar goes up. is there any significance of decreasing the units of levemir? because it starts it's action after 6 to 7hours
4 years ago
go on for HbA1c then report here
dose of levemir needs to be adjusted ....
for the adjustment of dosage consult ur diabetologist
Aa
Please book an online appointment with me for further consultation.
ws Dr Naveed
Please reduce Levemir to 10 units and let me know blood sugars after 2 hours after meal
book appoinment for online consultation
problem can be due to either complications regarding diabetes like renal impairment or other issues should also be sorted out
u need to have certain investigations and modification of treatment.
u should get early appointment.
i am consultant physician and diabetologist can help u in this matter.
book your online consultation and appointment.
Readjust insulin based upon your body at and reduce morning oral hypoglycemia drug
Member
yes we have a positive family history of diabetes. he is diabetic since 30years. he taking dapa 10mg and galvus oral anti diabetics and short acting actrapid and levemir long acting insulin at night. for hypertension he taking renetic blokium sorvasc loplat and a statin too.
4 years ago
MBBS | Bahawalpur | Book Appointment
brother his whole diebetic plan including insulin and oral hypoglycemic needs to be revised i think you need a simpler plan
4 years ago