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From Toronto, Canada:

Is 10:00 P.M. the right time to be taking NPH? I know some pvernight lows and 10 gives me A.M. highs. Any suggestions?


There are many different ways to take insulin. The standard Regular and NPH twice a day routine would involve Regular (or lispro insulin [Humalog®]) and NPH before dinner. For some people the dinner NPH will be working too hard when it is peaking at 1-2 A.M., and then not lasting long enough through the night. People in this situation might try bedtime NPH, and a separate dose of dinner Regular or Humalog.

I would talk to your health care team about the right dose of insulin, but if one amount is too high, and the other is too low, then the middle might work well!


Additional comment from Dr. Songini:

To my experience and with very good clinical results, I advise almost all my IDDM patients, especially adolescents and young adults, to inject NPH insulin in the buttocks just before going to bed (and anyhow not later than midnight; if bedtime happens later than midnight, e.g., during the weekend, they are advised to inject a smaller dose of Regular insulin only around 3:00 A.M.). In case of hypos during the first part of the night, I generally prefer to reduce the supper dose of Regular instead of reducing the NPH, and this generally solves the problem without any increase in the fasting blood sugar. I increase the NPH insulin only in presence of persistent high fasting sugar levels.


Original posting 9 Jul 97
Additional comment added 22 Jul 97


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