Un controlled my sugar readings

by k.laxmi
(hyderabad, india)





Question: I am 38 years old and developed type 1 diabetes at age 21. I previously used plain and zinc insulin, then Mixtard 30/70 and Mixtard 50. Until last week I was taking Mixtard 50, 22 units in the morning and 7 units at night. During the last 10 days my glucose became uncontrolled, so another doctor changed me to NovoMix 30, 28 units in the morning and 8 units at night. Today my fasting glucose was 180 mg/dL, it was 175 mg/dL 2.5 hours after breakfast, and 256 mg/dL before dinner. Why are my readings uncontrolled, and what should I do?




Quick Answer



Your fasting glucose of 180 mg/dL and pre-dinner glucose of 256 mg/dL are above the usual targets for many adults with diabetes. Because you have type 1 diabetes and recently changed insulin, contact your diabetes clinician promptly for a structured dose-and-timing review. Do not increase, skip or replace insulin on your own.


If the 256 mg/dL reading is current, check blood or urine ketones according to your sick-day plan, especially if you feel unwell. Continue insulin unless your clinician gives different instructions.




Why Can Glucose Rise After an Insulin Change?


Type 1 diabetes does not become uncontrolled because your body becomes “used to” insulin. Insulin remains essential, but the amount, timing and type needed can change. Common reasons for a sudden rise include:



  • The new premixed insulin dose or timing does not match your meals and overnight needs.

  • A missed, delayed or incompletely delivered injection.

  • Incorrect pen technique, failure to prime, a blocked needle, leakage, or repeatedly injecting into a lumpy area.

  • Insulin exposed to excessive heat, freezing or direct sunlight, or insulin used beyond its in-use period.

  • Illness, infection, pain, emotional stress, poor sleep, menstrual or other hormonal changes, or steroid medicines.

  • More carbohydrate than the insulin mixture can cover, changed meal timing, or reduced activity.


NovoMix 30 is not a one-hour-only insulin. It contains 30% rapid-acting insulin aspart and 70% protamine-crystallized, intermediate-acting insulin aspart. Mixtard 30/70 is also a premixed insulin containing short- and intermediate-acting components. Premixed regimens can be convenient, but fixed ratios may not match each meal and the overnight period equally well.



How High Are These Readings?


For many nonpregnant adults with diabetes, commonly used targets are 80–130 mg/dL before meals and below 180 mg/dL about 1–2 hours after the start of a meal. Your personal targets may differ. The 175 mg/dL result was taken 2.5 hours after breakfast and cannot be interpreted without knowing the meal, injection time and glucose trend, but the fasting 180 and pre-dinner 256 readings show that the current plan needs review.



What to Do Now



  1. Contact your diabetes clinician today or as soon as possible. Provide several days of readings, exact insulin times and doses, meal times, carbohydrate amounts, activity, symptoms and any missed doses.

  2. Check ketones when glucose is high according to your personal sick-day plan, particularly with glucose above 200–250 mg/dL, illness, nausea, vomiting or missed insulin.

  3. Use only a prescribed correction plan. Do not add extra insulin based on general internet advice, because overlapping doses can cause delayed severe hypoglycemia.

  4. Inspect technique and insulin quality. Use a new needle, prime the pen, rotate sites and avoid hard or lumpy areas. If using a cloudy premix, follow its resuspension instructions exactly. Check storage, opening date and appearance.

  5. Stay hydrated with sugar-free fluids unless you have a medical fluid restriction. Do not use exercise to force glucose down when ketones are present or you feel ill.


Most adults with type 1 diabetes are treated with a basal insulin plus separate mealtime insulin, or an insulin pump, because these approaches allow more flexible adjustment. Ask an endocrinologist whether premixed insulin remains suitable for you; do not make that change independently. Our insulin treatment guide explains the main regimen types and safety principles.




When to Get Urgent Help


Seek urgent medical advice if high glucose is not falling after following your written insulin plan, or if blood ketones are 1.6–3.0 mmol/L. Go to an emergency department or call local emergency services for blood ketones above 3.0 mmol/L, urine ketones 2+ or more, repeated vomiting, abdominal pain, deep or rapid breathing, fruity-smelling breath, severe dehydration, marked drowsiness, confusion, or inability to keep fluids down.




Diet, Exercise and Supplements


Balanced carbohydrate planning and regular activity can support insulin treatment, but a very-low-carbohydrate diet is not a substitute for insulin and may increase ketosis risk in type 1 diabetes. Bitter melon and cinnamon have not been proven to correct an inadequate insulin regimen. Do not add glucose-lowering supplements during an insulin adjustment without discussing them with your clinician, because product strength and interactions are unpredictable.



Related Questions




Related Resources




Medical References




Answered by: Dr. Albana Greca Sejdini, MD, MMedSc

Medically reviewed by: Dr. Ruden Cakoni, MD, Endocrinologist

Last reviewed: July 2026


Medical disclaimer: Educational only—not personal medical advice. Diagnosis and treatment should come from a qualified clinician who knows the patient’s medical history.



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