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May 13, 2005

Hypoglycemia, Insulin Analogs

Question from Warwick, Rhode Island, USA:

My son was diagnosed with type 1 diabetes one month ago. For the past two weeks numbers have been good, 80 to 180 mg/dl [4.4 to 10.0 mmol/L]. He takes two units of NPH in the morning, half a unit of Humalog at dinner, and half a unit of NPH at bedtime. He is very active and plays outside a lot. I check him often and he is often low, 66 to 69 mg/dl [3.7 to 3.8 mmol/L]. Would he be okay without the dinner Humalog since he is often low following after dinner exercise? My son's doctor has said to skip the Humalog on baseball nights.

Answer:

This is quite typical for early diabetes. The “honeymoon,” as we have called it, is a period when he is making insulin. We do lower doses and sometimes can go for a while with some of the insulin skipped. Follow your doctors lead here. It seems reasonable to me.

LD