I am 34 years male and I am diabetic last 11 years. I am taking glimepiride 2 mg voglibose 0.2 mg metformin 500 mg in morning and night and also vildagliptin 100 mg in only morning. From 17 july I am taking 16 unit huminsulin nph in night .after taking insulin I am observing that fasting sugar increase up to 233 avoiding first two days. First two days sugar reduce to 108 but after two days sugar has been rise. What is the reason? Have I insulin resistance.

Dr. Prabhakar Laxman JatharEndocrinologist50yrs exp

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Mr. lybrate-user, thanks for the query. I have seen the details given. It is a bit of a surprise to know that after taking insulin fasting glucose has gone up. The reasons could be that the night food intake may have been more than usual or insulin dosage may not have been adequate. It is necessary to look at total dietary intake (from morning till night), extent of physical activity along with all the medications. After going through all these if there is a need then may we may have to look at either increasing insulin dosage or change the type of insulin that is being taken or add a preprandial rapid acting insulin too. So please come back with following information: current fasting, pp glucose, hba1c%, lipid profile, dietary details, extent of daily exercise. Then I will be able to give specific guidance. However, only if you come in a private conversation that can be done as in this communication we are supposed to give ony general guidelines, no drugs can be prescribed or recommended. Thanks.  

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