Q. Why is my brother-in-law's blood sugar level high after administering Insulin thrice a day?

Answered by
Dr. Zulfiqar Ahmed
and medically reviewed by Dr. Infanteena Marily
This is a premium question & answer published on Jul 11, 2021

Hi doctor,

My brother-in-law was injured and underwent surgery. After that, his diabetes is uncontrollable, and his level is 370 mg/dL. Even though Insulin is given three times at about 22, 22, and 16 units, and Lantus 16 units at night, the result is the same.

Current medication details:

Tablet Metformin.



Welcome to

Good day. Thank you for your query.

I suggest the following:

If his fasting sugar is over 150 mg/dL, I suggest increasing his Lantus (Insulin Glargine) every day for two units until fasting blood sugar comes down to less than 150 mg/dL. If it goes less than 90 mg/dL, then I suggest decreasing Lantus by two units.

Check blood sugar after two hours of eating lunch, breakfast, and dinner. If it is over 200 mg/dL, I suggest increasing the Insulin of that time to two units every day until it comes to less than 200 mg/dL.

Another important issue is to control diet and do exercise to control your sugar. Take bread, rice, juices, and other carbohydrates to the least. Eat more vegetables and fewer fruits, especially mango, bananas, and grapes.

Diabetes has many complications, so it is not just to bring down the numbers but to monitor and treat complications associated with diabetes.

Check his eyes for retinopathy and kidneys for Urine albumin to creatinine ratio. Check his feet.

Lifestyle modifications are the best diabetes treatment. Low carbohydrate diet and no added sugar. No sugary juices. No bread, rice, pasta, and potatoes. If he cannot stop, at least ask him to take as little as possible. More vegetables, salads, and fibers. Fruits only as a sweet dish. Do not take mango, grapes, and bananas. Apple not more than one piece. Strawberries and other berries are fine, along with peach, apricot, and small amounts of plums.

Intermittent fasting will also help to control his diabetes. Ask him to fast for 16 hours, like taking dinner at 7 PM and not eating anything after that. Next, to grab breakfast at 11 AM. During fasting, he can drink water and green tea without sugar. Extend his fasting to 24 hours then 36 hours as the body adopts. He should fast two times a week or as he feels comfortable, and it will control sugar.

He should drink more water. Sleep well and do exercise daily; at least walk for 30 to 40 minutes. The more he practices these things, the better will be his control. Check his sugar frequently. His fasting target should be 90 to130 mg/dL, and two hours after eating should be 150 to160 mg/dL. HbA1c (glycated hemoglobin) should be less than 7.

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