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Question:

From Sweden:

Can too much insulin trigger the production of glucose? I used to take 8 U Humalog at lunchtime and two hours later my readings often were in the 12-15 mmol/l range. I tried 10 units, 12 units and even 14 units which didn't make any difference. Once I mistakingly took 6 units and all afternoon my readings were perfect! Today I take 6 units and only if I eat less than usual do I see values above 10 mmol/l.

Answer:

If too much insulin causes hypoglycemia, then the liver releases glucose first from stored liver glycogen (glycogenolysis) and after a while as de novo synthesis from substrates such as gluconeogenic amino acids (gluconeogenesis). This can often happen after eating with lispro insulin [Humalog®] (as you describe) due to the faster peak absorption rate from injection sites compared with Regular insulin. If you consider this, you can then easily understand the high values you register 2 hours after eating and why a reduced dose does keep good values over the afternoon. I'm wondering whether the shorter waning time of lispro compared to Regular could be implied in any upsurge of blood sugar late afternoon if not mixed with NPH.

MS

Original posting 1 Apr 1998
Posted to Hypoglycemia

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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