Resolved question:
I'm a nurse and I have a mentally challenged diabetic patient (28) year old. I inject him insulin bid. No violin 70/30' 30 units AM, 25 units PM. This morning he was at fasting 109 mg/dL. This afternoon, he was at 308 mg/dL. He had 2 spoonfuls of rice and chicken for lunch at 12:00. I saw him at 3 PM AND HE WAS AT 308. Yesterday was not much better. What do you think of this.
Submitted:
4 Days
Category:
Endocrinologist
Hello.
Thank you for your query at DoctorSpring.com.
I appreciate your concern. Your patient is having post-prandial hyperglycemia.
He will need an additional short acting Insulin like Actrapid or Lispro at lunch time. It can be injected either 10 to 15 minutes prior to or up to immediately after the meal. This should normalise the rise you see after lunch.
I hope this was helpful. Feel free to ask queries.
Regards.
THANK YOU. One more question. This is a medicare patient and we can no longer give three visits per day. What could we do different?
Hello. Thank you for the follow up.
You can add a Oral drug like Acarbose or Voglibose with Lunch and Dinner to control the postmeal glucose!
Hope this is helpful,
Regards.