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Q:

I am taking 30 units of 25-75 Humalog in the am, 20 at lunch and 20 before dinner and 25 units of Levimir before I go to bed, but I still can't lower my A1c.

Patty Bonsignore

A:

It may just be that you need more insulin, but without looking at detailed food and blood glucose records, it is hard to say. As you and your practitioner try to determine the cause for your high A1C, it is important to check your blood glucose before meals and at bedtime. Keep track of the results by writing them down in a log book. Look at the numbers and ask yourself the following questions: When are my blood glucose levels high? When are they low? Is there a pattern to the numbers? Are the highs and lows related to food or activity? Are the numbers erratic -- up and down without any clear pattern? Take these questions, along with your findings to your next medical appointment . If you have not seen a dietitian recently, reviewing your dietary habits with a nutritionist can be helpful. Increasing your physical activity can also help to lower your blood glucose levels. The current recommendation for physical activity, is to do some type of aerobic activity for 30 minutes, 5 out of 7 days a week.

December 21, 2012 at 12:53 am