May 16, 2002
Daily Care
Question from St Lazare, Quebec, Canada:
I have been on insulin for 21 years, and recently I have been having trouble with my sugars, and a friend (who is on insulin as well) tells me that I need to go on four injections a day. I am usually 58 mg/dl [3.2 mmol/L] in the morning, I proceed to take my 2 units of NovoRapid with my 44 units of NPH, and two hours later, I am low and need to eat again. One morning, I tried to not taking my NovoRapid one morning, and my blood sugar was 247 mg/dl [13.7 mmol/L]. This will go on for about four days and then all of a sudden after I eat my breakfast and take my 2 units of NovoRapid, I will be 160 mg/dl [8.9 mmol/L].
Answer:
It sounds like your insulin regimen is weighted towards too much NPH. Most intense insulin regimens require three to four shots per day and a ratio of long acting to short acting insulin around 1:1. I would check with your physician about adjusting your regimen so that you don’t have this problem.
JTL