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From Victoria, British Columbia, Canada:

I have had type 1 diabetes for over 10 years and recently have been struggling with my fasting sugars. I'm on a sliding scale, with Humalog before meals and NPH before bed. My sugars can go as high at 25.5 mmol/L [459 mg/dl] around 7 a.m. Often, at 3 to 4 a.m., it is anywhere between 2.8 and 7.0 [50.4 to 126 mg/dl] when I test it. I've tried a variety of combinations, no snack, with snack, NPH varying times (later, then earlier) and anywhere between 7 to 12 units of NPH with similar results. I exercise regularly, but always in the day time. I've also recently ceased taking the birth control pill. What do you suggest for me?


Although it is not always necessary, I prefer to use morning and evening NPH insulin with Humalog. The reason for this is that the Humalog goes away between meals and is not as long-lasting as regular insulin is. To that end, you may want to consider a morning NPH insulin dose at a smaller dose than your evening dose and increase your evening bedtime NPH to titrate to a fasting glucose in the target range. Please discuss these changes with your physician before making any changes on your own.


Original posting 14 Mar 2005
Posted to Hyperglycemia and DKA and Insulin


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Last Updated: Tuesday April 06, 2010 15:10:00
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