My lovely five year old daughter was diagnosed with diabetes about a year and a half ago. Our family has been adapting ourselves to this new “approach of life”, and she has done very well from the beginning with intensive therapy which was our choice. We are using Humalog with one NPH shot in the morning. Anyway, to have a better sleep, what is a good blood glucose at midnight and in the middle of the night? She is 180 mg/dl [10 mmol/L] and 150 mg/dl [8.3 mmol/L] in the middle of the night overnight — is that good? We are not giving her insulin at night. Is that a good approach?

If I understand completely, your five year old an “intensive insulin regimen” of NPH insulin each morning and then I presume Humalog with each meaI which I presume is based on carbohydrate counting. However, your note suggests that she gets her NPH and Humalog only once daily, in the morning. Is that really the case?

I am not too concerned with a midnight glucose of 180 mg/dl [10 mmol/L] and a middle of the night (2:00-3:00 am) of 150 mg/dl [8.3 mmol/L], but it would be more informative if we knew her typical glucose values before bed, her value upon awakening, her meal times relative to these values, insulin dosages, and her hemoglobin A1c. If she really is only getting morning insulin (which is rare but not impossible), I sure hope her HbA1c is on target, reflecting a good honeymoon. Inadequate insulin coverage may lead to early cessation of the honeymoon.

DS