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From St. Louis, Missouri, USA:

I was diagnosed IDD in mid 1996. Am a 55 year old male with no family history in diabetes. For two years my endocrinologist had me on Novolin 70/30 and kept increasing the dosage to 15 units in A.M. and 25 in P.M. My glycohemoglobin tests which he ran each quarter were showing a reading of 10.0 to 11.0 and he switched me to variable regular insulin three times a day mixed with Ultralente A.M. and P.M. Am currently taking 19 units A.M. and P.M. mixed with 5-10 units Ultralente depending on blood glucose readings. My readings range from 65 to low 200's.

Question: Do I need to monitor each time when the amount of Regular varies so little? I always monitor at least once a day but have lately just been taking the Ultralente mixed with 7 units of Regular.


When you are taking multiple insulins working at different times, there is no one time of the day that you can test that will give you all the information you need to know to adjust your insulin to optimize blood sugar control.

If you are adjusting your insulin according to the blood sugar at the time of the injection (sliding scale method), you will not be able to decide how much insulin to give without testing.

If, on the other hand, you are not trying to adjust your insulin on a day to day basis based on blood sugars at the time, but rather are looking for patterns over several days at different times of the day to adjust an insulin in the future (an insulin to be given before the blood sugar goes higher or lower than you want consistently at a certain time of the day) to try and improve the blood sugar at this time, you may not have to test several times a day every day if you find you are fairly consistent from day to day.

If you are only testing once or twice a day, I suggest that you try to test at different times of the day on different days to see if your needs are changing.

Note, if you get sick, or are spilling ketones, you must test several times a day to evaluate if you need extra insulin right away.


Original posting 14 Dec 96


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