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December 11, 2001

Daily Care

Question from Mexico City, Mexico:

I am a 38 year old male with secondary diabetes from chronic pancreatitis, treated with NPH and Regular in the morning and NPH in the evening, and I sometimes have hypoglycemic episodes about at 2 pm. May I reduce my morning NPH?


I would recommend you not make any changes until you discuss them with your physician. On the basis of your description, it does sound like the am NPH insulin is the one to change.


[Editor’s comment: Your hypoglycemia at 2 pm on occasion could be due to inadequate food intake at lunch, extra exercise, and several other factors. You also do not tell us what your blood sugars are at lunch so it is very difficult whether the NPH or Regular may need adjusting. In addition, you probably shouldn’t change anything unless you are seeing a consistent pattern. However, I agree with Dr Lane in that you need to visit with your diabetes team to sort out what’s happening and change your treatment plan to deal with it if necessary.