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Question:

From Connecticut, USA:

My daughter is two and a half years old. She was diagnosed at age 15 months. She is currently on a 2 injection regimen, pre-breakfast R to scale plus 11.5 units of NPH and pre-dinner R to scale. She is experiencing overnight hypoglycemia even on the nights that we skip her dinner R. We tried lowering her morning NPH but then her lunch and dinner readings are too high. Do you have any suggestions?

Answer:

It is unusual to take Regular alone in the evening without any intermediate or longer acting insulin. You might want to discuss with your physician lowering the AM NPH and adding a second dose of NPH in the evening. If the blood sugars go high before lunch, you might need more Regular in the morning which may carry into the afternoon. If she is still going low during the night, you might want to try lispro insulin [Humalog® brand] instead of Regular in the evening.

You might also want to cut back on your sliding scale for a while and just try to give insulin to prevent highs or lows based on the previous day's readings, rather than trying to compensate for a high or low at the time of the injection until you have established an insulin dose that works on the average the best. Regular can last for 10 - 16 hours, so if you increase or decrease your dose to compensate for a high or low blood sugar at the moment, you may have more or less insulin working hours later when you do not want it.

If you are unable to obtain satisfactory blood sugar control on a twice daily Regular and NPH regimen, you might want to try a more intensive regimen.

TGL

Original posting 15 Mar 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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