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From Fayetteville, Arkansas, USA:

I am a 27-year old Type 1 diabetic diagnosed 10 years ago. I'm afraid until recently that my blood sugar was not under tight control, but last year with the help of exercise and a stricter diet I was able to maintain blood sugars consistently in the 70-150 range.

My problem is this: last year I had several episodes of extremely low blood sugars in the mornings (sometimes but not always following exercise), two of which necessitated trips to the ER. This was not only traumatic for me and my wife, but also hurt our insurance standing. Since then, I've become almost paranoid about going to bed without eating, even though my last nighttime snack is meant to be 2 hours before bedtime. Many times I eat something just to avoid hypoglycemia, and then I wake up with high blood sugar -- typically 200 or 250+. I know this can't be good for me, but I don't want to wake up in the hospital again. What can I do?

I see an endocrinologist when I can, but because of the aforementioned insurance problems it's become difficult to finance. Please bear this in mind when answering.


Controlling blood glucose does carry the risk of hypos. One needs to find a level of control that doesn't cause hypos in the morning.

I don't know your schedule, but maybe Humalog at supper and NPH at bedtime might help. The fact the Humalog ends its activity in the night and the NPH doesn't start right away leaves a little "gap" that others have documented. I often wonder if it isn't really a safety net.

You need to document glucoses in the night and early morning.


Original posting 20 Apr 1999
Posted to Hypoglycemia


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Last Updated: Tuesday April 06, 2010 15:09:02
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