Dad's sugar levels not under control despite insulin; suggestions?

[Medinmark]

Greetings!

My dad is suffering from diabetes (T2) for more than past two decades. He has been on insulin for past 8-10 years now. He is 63 years of age.

Issue - My biggest concern at this time is that the 'blood sugar levels' are not under control; 'sugar level report' has been close to 250/300 at fasting and varies between 300/350 at PP/random; he also experiences painful cramps many times at night.

Background - He has been taking treatment from PGI Chandigarh; apart from occasional hiccups, he has pretty much kept everything in control; is extremely disciplined and particular with diet habits and exercise schedules; is very active and mobile (touch-wood); He is getting regular treatment from PGI (Endo, Nephro & Eyes)

Current medication:
Mixtard 50:50 (26 BBF & 20 BDN)
Dytor (40 - 8am & 20 - 3pm)
S.numlo 5mg at 8am
Sustamet 50mg at 8pm
Ecosprin AV (75+10) at 10pm
Shalcal CT (BBL & BBD)
Nodosis 500 (TDS)
Urimax 400mg OD

My dad was on insulin 30:70 but was suggested with 50:50. Unfortunately, that has not helped either. I would like to know if we should switch to 'plain insulin'. If yes, was should be the dosage to start with? I can share his latest 'blood sugar level' reports on the forum also. Please let me know what inputs are required; Any help, suggestions, highly appreciated.

Thanks & Regards,
Saurabh Aggarwal

[diabetes86]

Super_Sally  said it

[Super_sally888]

Hello,

To get better control your father should be on a basal bolus insulin regime.  This means that he takes a long acting insulin once or twice a day and a fast acting insulin before meals.  he also needs to learn to count carbs accurately so his insulin can be matched to his diet.  A low carb diet will also give more stable blood sugars than high carb.

His currenbt regime of mixed insulin is notoriously difficult for giving stable managment.  His dose of insulin is way too low if his blood sugars are in the 200 - 300 range consistently.

I recommend the following books all of which should be available in your country, or from Amazon:-

THink Like A Pancreas
Using Insulin - John Walsh
Diabetes Solutions - Dr. Richard Bernstein.

[WaveRider]

What I didn't see mentioned in your post are test results on the pancreas and thyroid.
● Pancreas functionality testing results
● IAA [Insulin anti-bodies test - measure from two sources]
● C-Peptide [insulin produced by the pancreas]
● IM-IVTT [insulin-modified intravenous glucose tolerance test] test beta cell function, cells that make insulin
● GAD test [Glutamic acid decarboxylase - helps determine between T2 and LADA [Latent Autoimmune Disease in Adults] - misdiagnosed as t2 but really borderline t1 [type 1.5]
● Thyroid test [may disrupt insulin production]

The cramping may be signs of onset of diabetic neuropathy.

Also not mentioned is his diet. Does it consist of dairy products, white foods such as white rice, potatoes, things made with white flour? All these will elevate blood sugar levels.

Cannot comment on his medications as they are country specific to India, nor can we suggest type of insulin as we are not privy to your father's medical records or history. Good luck -