I'm really worried about my mom. She's been on Human Mixtard insulin with 20 units in the morning and 15 at night, but she's been having these really scary hypoglycemic episodes. Recently, her kidney issues were also pointed out by a distant doctor. At a nearby hospital, they suggested switching her to Ryzodeg and changing her dose to 10 units. But ever since that change, her blood sugar has skyrocketed to 480 at night before insulin and dinner, and her fasting level is at 280. I'm really anxious about these high levels. What can I do to help get her sugar levels under control? Any advice would be really appreciated.

Dr Dr Khaleel Ur Rahim

General Practitioner

• MBBS
• 1+ Yrs

Consult Now

Ryzodeg and Human Mixtard are both insulin therapies, but they have different properties:

Ryzodeg

1. Fast-acting and long-acting insulin analogue: Ryzodeg contains insulin degludec and insulin aspart.
2. Faster onset and longer duration: Ryzodeg starts working within 30 minutes and lasts for up to 24 hours.
3. More flexible dosing: Ryzodeg can be administered at any time of day, regardless of meals.

Human Mixtard

1. Intermediate-acting human insulin: Human Mixtard contains human insulin suspension.
2. Slower onset and shorter duration: Human Mixtard starts working within 1-2 hours and lasts for up to 12 hours.
3. More rigid dosing schedule: Human Mixtard typically requires a more structured dosing schedule, tied to meals.

Considering your mother's:

1. Concurrent hypoglycemia: Ryzodeg's faster onset and longer duration may help reduce hypoglycemic episodes.
2. Kidney failure: Ryzodeg may be a better option, as it has a lower risk of accumulation and toxicity in patients with renal impairment.

However, the recent blood sugar readings (480 at night and 280 fasting) indicate that the current Ryzodeg dosage (10-0-10 units) may not be effective.

Recommendations

1. Consult her doctor: Discuss the recent blood sugar readings and adjust the Ryzodeg dosage accordingly.
2. Monitor blood sugar levels: Regularly track her blood sugar levels to ensure the new dosage is effective.
3. Consider additional therapies: If blood sugar levels remain uncontrolled, her doctor may recommend additional therapies, such as oral medications or other insulin types.

Answered 04/07/2025