April 27, 2003
Daily Care
Question from Murrieta, California, USA:
My son, diagnosed with diabetes nearly two years ago, is on NPH and Regular without a sliding scale. He wakes up with good blood sugars (80-120 mg/dl [4.4-6.7 mmol/L], then peaks at snack to about 400-450 mg/dl [22.2-25 mmol/L], and by lunch, he goes back down to the mid 100s mg/dl [11.1 mmol/L]. The doctor thinks this is excellent control because his A1cs are good, and at meals his blood sugar is fine, but he is spiking like this every day, and I know he cannot feel good. Whenever my son gets high at a meal the doctor simply raises the NPH. This could not be right. What should I do?
Answer:
I would suggest changing his insulin in consultation with your son’s physician to one that is less likely to contribute to his spikes. I have had good success in this age group using Lantus (insulin glargine) as the long-acting insulin and Humalog or NovoLog for meals and highs. You may wish to speak with your son’s physician regarding making a change.
MSB
