I am 46 years old, and I have had type 1 diabetes for 43 years. Up until this year, I have had no side effects from the diabetes except for problems with keeping my blood sugar level. I take NPH and Regular in the morning, and often experience low blood sugar in the middle of the night, after the insulin has worn off, and then high blood sugar in the morning if I do not awaken in time to eat a snack. have also tried Lantus, which did not solve the problem. Sometimes I experience episodes of low blood sugar for a period of two to three days at a time, and even candy will not make it come up.This often happens when I am in the sun.

I am not able to visit an endocrinologist in my area for another two weeks. How can I level my blood sugars (without experiencing the continuous low blood sugars) and still keep it in the recommended ranges?

It is important that you understand this service is not appropriate for recommending treatment. It is most helpful as an informational service. The first thing I would do is call your endocrinologist’s office and speak with someone there so that the changes that can be made to your regimen would be in concert with the care given through your provide

I fear you are at high risk for developing a severe reaction. Your long duration of diabetes also puts you at risk for hypoglycemia unawareness. The long duration until low sugars are treated is also consistent with severe episodes that are already ongoing. When this occurs, the efforts should be directed at avoiding hypoglycemia through changes in the insulin regimen, snacks, frequent monitoring, and changes in activity. I would look very carefully at when the NPH is given so as to prevent lows. Lantus (insulin glargine) has already been tried but other modifications of NPH schedule may be helpful.

JTL