Sugar Matters
November 18, 2014
What to expect from those older insulins

This past week I saw a patient in clinic, a young man with Type 1 diabetes. Because of cost issues, he was not able to continue using the insulins his doctor had initially prescribed and he had to switch to the older insulin, called NPH. He was having difficulty with both high and low blood sugars at different times of day and was especially worried when he went to bed at night.{{more}} For this man, NPH insulin was truly not enough of a medication to really take care of his blood sugars. It was frankly asking too much from that one medication, because NPH insulin acts in one particular way, and it is not very flexible for taking care of mealtimes, when sugars tend to rise very quickly. What I recommended for this gentleman was to add a second medication called Regular insulin to his regimen, and this would help bring everything under better control.

This specific medication issue is not what I want to highlight here for you, but instead the fact that many times the one medication you are taking will not do EVERYTHING in terms of controlling your blood sugars. Here is what I recommend when you start taking medications for diabetes:

1) Talk to your doctor or nurse about what to expect from this medication, in terms of how long the effect lasts, if your sugars might drop without warning, if there are side effects to watch out for when you start etc. Knowing what to expect can change your entire experience with a medication and totally effect how successful it is for you.

2) Plan on checking those sugars regularly, as much as possible.There is NO way to know if the medication is working without looking at those blood sugar numbers. Yes, you might feel differently, but as they say, the proof is in the pudding, in this case the numbers.

3) Plan on continuing to watch your diet and exercise. All diabetes medication regimens will work better when you also watch what you eat and try to stay physically active.

4) If there are shortcomings to the medication, like in the case of this young man’s insulin, then talk to your doctor about ways to fix this issue. It may mean another medication; it may mean changing your meal pattern around or both. Don’t hesitate if you think you may have to take more medication. Remember this is your health we are talking about and extra effort is worth it.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227