Why are the blood sugar levels increasing despite taking insulin?

Q: My 68 years old mother is a diabetic for the last 24 years. She is taking insulin for the last five months. The insulin is Humalog mix 25 Kiwkpen - morning 12 and night 10. But with this her blood sugar level became low and the doctor reduced the insulin dosage to 10 in the morning and 8 at night. But now the blood sugar levels have started increasing. Please tell me what to do.

A:It is important to know what her blood glucose readings are and when does she exactly get low blood sugars. This can be done by doing self blood glucose monitoring with a glucometer at home before each meal and bedtime. The insulin she is using is combination of an intermediate acting (NPH insulin) and rapid acting insulin (lispro insulin) in 75:25 ratio. It is important that your mother takes her insulin at appropriate time just before breakfast and dinner and takes three consistent carbohydrate meals at consistent times every day. Missing meals or taking insulin at wrong times can also lead to low blood sugars.Once you have made sure that above instructions are being followed appropriately, then the dose of insulin can be adjusted based on home blood glucose readings.