Even with multiple diabetes medicines, blood sugar can remain high for several reasons. The most common causes are incorrect insulin dose, missed or delayed injections, unhealthy diet, lack of exercise, stress, infection, weight gain, or poor insulin absorption from repeated injections at the same site. Sometimes the body becomes more resistant to insulin over time, especially in long-standing diabetes. Eating excess carbohydrates, irregular meal timings, or taking insulin too far from meals can also keep fasting and post-meal sugar levels high. Certain medicines, such as steroids, may also increase blood sugar. Your wife?s fasting and post-meal readings between 245 and 265 mg/dL suggest that her diabetes is not adequately controlled, and her treatment plan may need adjustment. She should consult her doctor soon for a detailed review of insulin timing, injection technique, diet, kidney function, HbA1c level, and possible dose changes. Do not increase insulin doses without medical advice, as this may cause dangerous episodes of low blood sugar.

Human Mixtard 40 IU/mL and Human Mixtard 50 IU/mL are both premixed insulin preparations used to control blood sugar in people with diabetes. The main difference between them is the proportion of short-acting insulin and intermediate-acting insulin. Human Mixtard 40 contains more intermediate-acting insulin (60%), which works slowly and helps keep blood sugar stable between meals and overnight. Because of this, it is often helpful for controlling fasting or background blood sugar levels. Human Mixtard 50 contains a higher amount of short-acting insulin (50%), which works faster and is more effective in controlling blood sugar rises after meals. This can be useful for people whose blood sugar levels rise sharply after eating. Neither is universally better than the other. The choice depends on the patient?s eating pattern, blood sugar levels, lifestyle, and how their body responds to insulin. Some people may need better control of fasting sugar, while others need stronger control after meals. A doctor will select the most suitable type after reviewing blood sugar readings and adjust it based on the response over time.