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November 6, 2002


Question from Niskayuna, New York, USA:

My three year old daughter, diagnosed with diabetes last month and currently taking NPH in the morning and at bedtime, as been low around 11:00 am for the last three days. Today she was 57 mg/dl [3.1 mmol/L] at 11:00 am so we treated with juice and at 11:45 am she was still only 68 mg/dl [3.8 mmol/L]. The doctor says the NPH should not be peaking at this time, so what would cause the low sugar? After 15 carbohydrates of juice, why would her level go up so slightly?


I have seen the NPH effect at lunch so wonder if she isn’t seeing activity earlier. It looks like a morning snack is needed or a lower dose of NPH.


[Editor’s comment: If she was recently diagnosed and having low blood sugar levels, she is probably entering a honeymoon and needs smaller doses of insulin. You should discuss this with your daughter’s diabetes team.