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February 10, 2006

Daily Care, Insulin

Question from Bradenton, Florida, USA:

I have been using Humalog insulin with Humulin NPH for several years by now. I have always had higher readings after breakfast and late afternoon/early evening hours. When I increased the Humalog with the meals, it did not really help. I tried to split up the Humulin NPH dosage into three injections instead of two. I increased my morning NPH unit and I gave the first dose early morning around 6 a.m., the second dose around 12 p.m. and the bedtime NPH remained the same as it was before. My readings are perfect since I have tried this, but my doctor doesn't want me to do this. Do you have any real concerns why I should not go on with my experiment?


When I look at your first statement about higher sugars after breakfast and before dinner, I see two different fixes. One would be to increase Humalog with breakfast. Second, the pre-supper blood sugar could be fixed with noon NPH. Be careful about adding additional insulin in areas you don’t need it as it may cause you to gain additional weight and also cause more risk of hypoglycemia. Three doses of NPH have been used rather frequently. It is not necessarily dangerous. It is really helpful for the time in the evening after your Humalog wears off. I would be sure to check two-hour post-meal blood sugars to see if your Humalog is dosed appropriately.