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From Laconia, New Hampshire, USA:

I am now 26 and have had type 1 since I was eight. I try hard to keep my diabetes under control. My HbA1c levels are under 7% but I can't seem to get my fasting sugars down. They are inconsistent, sometimes high, sometimes normal (80-120 mg/dl [4.4-6.7 mmol/L], and are currently around 200-275 mg/dl [11.1-15.3 mmol/L]. I am taking Ultralente at night and in the morning (15 at night, 18 in the am). I have tried increasing my morning dosage, but doesn't seem to affect my sugars. Can you please help?


The problem of persistent hyperglycemia before breakfast on Ultralente insulin is not an unusual problem. In roughly a third of patients on Ultralente, there is a need to give some additional insulin which peaks in the am, corresponding to the increased insulin resistance which comes with the early morning. There are several options. These include adding a dose of NPH at night before bed or switching away from Ultralente entirely. In short, there are solutions to your problem. I would recommend speaking with your physician caring for your diabetes for the best choice.


Additional comments from Stephanie Schwartz, diabetes nurse specialist:

You might also explore the possibility of an insulin pump. You can explore a lot about it by looking at Is pumping for you?.


Original posting 12 Oct 2000
Posted to Daily Care


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Last Updated: Tuesday April 06, 2010 15:09:14
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