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Is my wife taking the correct insulin dose?

Q: My 29 years old diabetic (type 1) wife was taking Elli Lilly insulin (Huminsulin R, Huminsulin N, and Huminsulin 50/50) for the last 8 years. Her blood sugar levels were not normal then, so the doctor changed the dosage level many times but all in vain. Now five months back her insulin was changed again and now she is taking Novorapid (5 units before breakfast, 10 units before lunch, 9 units before dinner) and Lantus (14 units before bedtime). Her blood sugar levels are – fasting 126 mg/dl to 87 mg/dl, breakfast PP – 140 mg/dl, lunch PP – 112 mg/dl, dinner PP – 156 mg/dl. Are these levels correct? Can she continue to take this dose? Or is there any need to change the dosage?

A:This query is regarding the targets of blood glucose level while treating diabetes mellitus (DM): As per American Diabetes Association following are the targets: FBG / Premeal - 90-130 mg/dl PP / After meals - <180 mg/dl HbA1Cc <7% (This tells about composite last three months control) BP <130/80 mmHg LDL-C <100mg/dl. With the current regimen your wife is doing fine, therefore continue the same. Keep getting HbA1Cc once in three months as well.

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