June 24, 2003
Family Planning
Question from Seattle, Washington, USA:
My 23 year old daughter, who has has had type 1 diabetes since the age of four, is newly pregnant. Her last hemoglobin A1c was 8.9%, and; she is using Lantus plus Humalog to cover carbs. She is currently visiting her in-laws in Morocco for a month, and since becoming pregnant, her blood sugars have been dropping very low during the night. She has reduced her Lantus, but she is still having lows in the middle of the night. She is eating supper late (10pm) ala Morocco-style, so should have plenty of protein on board at bedtime. What should she do?
Answer:
Since your daughter is eating late, the Humalog may be lasting into the early hours. Therefore, she may try using less Humalog for her evening meal or have a light snack just before bedtime. In theory, the Lantus should not have a peak effect, but if she is injecting Lantus later in the day or in the evening, then it may be having a stronger initial response. One consideration would be to inject Lantus in the morning.
OWJ
